Precision medicine needs to be appropriate and affordable

We thank Ms Grace Chua Siew Hwee for her letter, “Will more personalised healthcare plans cost patients more?” (July 17), and share her concerns.

Like all major technological breakthroughs, precision medicine promises to deliver a lot of good to humankind, but it also inadvertently presents downsides.

For example, precision medicine can facilitate early diagnosis, target clinical interventions to prevent disease or its progression, and optimise medication to minimise severe drug reactions. These are potentially cost-effective treatments that improve health outcomes. 

However, it can also be abused. For example, insurance coverage could be denied based on the results of genetic screening, and couples could test for genetic traits of a foetus before deciding whether to keep it. That is why the Ministry of Health imposes a moratorium on the insurance industry against the use of genetic test results in health insurance coverage.

In between these clearly positive and negative applications are many applications with pros and cons, or benefits that we can realise, provided we address key concerns.

As Minister Ong Ye Kung said during the Precision Public Health Asia 2023 Conference on July 13, “…most of the applications envisaged, including treatments like gene editing, are experimental in nature and may only work on a selected few. Treatments can also be expensive, costing up to millions of dollars per treatment, that may not be financially sustainable for any healthcare system in the world”.

Hence for us to benefit fully from precision medicine, much work needs to be done – in clinical development, ascertainment of cost and medical effectiveness, healthcare financing policies, legislation, and determining what is encouraged, allowed and proscribed.

Lim Siok Peng
Press Secretary to the Minister for Health