A National strategy for precision medicine
The development of precision medicine has been ongoing since the 1990s. From treatments for a few patients, we are today faced with the widespread introduction of precision medicine in new parts of healthcare. It is about a possible system change with the aim of offering patients significant health benefits. Such a development is taking place internationally and Sweden was early on but now risks falling behind. Important parts are in place, but the overall structure required for the whole of Sweden to have equal access to precision medicine is missing. We consider the following three parts to be decisive for equal and cost-effective implementation of precision medicine in Swedish healthcare.
1. A National strategy for precision medicine
An overall national strategy for precision medicine is needed, with a shared vision/ambition for the development and implementation of precision medicine in Sweden over the next ten years. The strategy can also result in agreements with concrete commitments for central actors, including the state, the healthcare regions, SKR, universities, SciLifeLab, GMS and patient representatives. Prevention and screening should have high priority, patient involvement, self-monitoring of patients at home, research but also new financing and payment models. Based on the strategy, regional roadmaps can be developed. Since precision medicine is a way of working that is intended to influence new parts of healthcare, the strategy should be linked to (or jointly written with) other policy documents such as the cancer strategy, the Life Science strategy, the strategy for rare health conditions and the pharmaceutical strategy.
2. National management structure: Give GMS a broadened and deepened mission and establish precision medicine centers in all healthcare regions
Establishing a new overall working method in one of the world´s most decentralized healthcare systems requires some kind of management structure. Our proposal is to make use of existing structures and that GMS, which is currently a consortium administered via Region Skåne, gets a broadened and expanded mission needed for the national implementation of precision medicine over the next ten years. An expanded GMS should have responsibility for the national strategy, be a forum for information sharing, for discussion between central stakeholders and coordination of international collaborations. As the area is undergoing rapid development, an annual knowledge conference on precision medicine is needed and the content needs to be made available to relevant healthcare professionals. For equal implementation, a precision medicine center is also needed per healthcare region and cooperation between these.
3. National infrastructure for health data, ownership and management
The government has a goal of a national digital infrastructure for healthcare where the government takes greater responsibility. Several important initiatives have been initiated: A national coordinator for digital infrastructure in healthcare has been appointed. An investigator must enable a national digital infrastructure for health data. A former investigator sheds light on health data registers and possibilities for follow-up, while another investigation works with health data as a national interest and interoperability. But decisions will be required in 2024 regarding GMS infrastructure which is used by healthcare for whole genome screening or broad gene panels, based on SciLifeLab's various platforms. Thanks to GMS, Swedish healthcare has been early on with sequencing. However, GMS is a consortium between different stakeholders without long-term funding.
Please observe that the report is in Swedish!