Personalized medicine, catalyst for Dominican health

In Latin America and the Caribbean, health systems go through common situations such as the aging of the population, challenges in medical infrastructure, fragmentation of health care, resource limitations or the prevalence of non-communicable diseases, among others.

The pandemic has exposed these deficiencies and, at the same time, has shown that there are opportunities to overcome these challenges, thanks to the convergence of medical knowledge and technology, elements that contribute to building sustainable health systems, personalizing the service for the benefit of the society.

The health crisis generated by covid-19 has redirected the efforts to transform the health ecosystem, towards one that is much more digital and personalized, but also more inclusive and participatory. Governments, health authorities, the medical community, the pharmaceutical industry, patient organizations, academia and other actors that come together in the system are called upon to work towards innovation, based on knowledge, technology and all available resources. , with the aim of improving conditions for everyone in general.

The research report “Personalized Medicine in Latin America: Universalizing the promise of innovation”, prepared by The Economist Intelligence Unit (EIU), recommends the construction of an initial frame of reference that includes issues of governance, awareness and attitudes, infrastructure and financial administration, where patients, the medical community and health authorities understand the possibilities and challenges of personalized medicine, for the benefit of patients and society.

According to the EIU research, to adopt personalized medicine, countries like the Dominican Republic should have value-based care models, digitalization of health (including electronic medical records), incorporation of real-world evidence in regulatory processes and Technology Assessment Sanitary (ETS). Medical advances, technology, genomics and data science come together in this new approach to medicine, which in addition to the potential to improve clinical outcomes for patients, allows health ecosystems to make decisions based on data, making more efficient use of the resources.

In the country, Law 87-01 has brought with it a health subsystem that is responsible for providing services; and that of social security, which is responsible for ensuring access to said benefits. This structure exhibits relatively broad levels of coverage, which provides a basis for ensuring that patients in the country have health coverage.

Likewise, the efforts to improve primary care as a gateway to the health system seek, on the one hand, to promote the development of a system based on prevention, which strengthens early diagnosis, even more, in those rare and chronic cases, which arrive in a late stage or maturity to the High Cost Medicines and Medical Assistance Program. On the other hand, it aspires to consolidate the effectiveness of the system, based on objectives that do not overload its operation, but rather speed it up.

Strong and resilient health systems are those in which there is a clear commitment to early investment in health through preventive medicine. This because? Because there are greater health benefits at a lower cost. In addition, the improvement of health systems aimed at optimizing results, focused on the needs of patients and the long-term sustainability of systems, are strategies that are more efficient in the medium and long term.

To achieve this goal, the use of technology by medical professionals is essential. This implies analyzing and interpreting the data that health systems have to make intelligent decisions that favor public policies on comprehensive health.

In the same way, to ensure objective and verifiable criteria, there is the Evaluation of Health Technologies with which the technical, social, economic, ethical and legal consequences derived from the use of technology are examined. Health technologies are medicines, devices, surgical medical procedures used in medical care, as well as the organizational systems with which this health care is provided.

For example, pricing mechanisms in health care could be made based on decisions that consider sustainability, the efficiency of the system and, above all, the best health service for the patient; however, the evaluation of health technologies in Latin America, in many cases is implemented based on price with a view to reducing the budgetary impact, however, it should have a data-based decision-making approach, with innovative mechanisms for access to the new therapies and medical interventions and that optimizes investment in health.

The Dominican health system has the opportunity to achieve the comprehensiveness of health services and also face this challenge by moving from a curative approach to a preventive and data-based one. The country has the capacity and the will of the public and private sectors and civil society to transform its healthcare paradigm. Now is the time to co-create the country’s health future with vision and accelerate progress toward a sustainable and resilient system.