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The second decade of the twenty-first century has witnessed a surging interest in personalized medicine with the concomitant promise to enable more precise diagnosis and treatment of disease and illness, based upon an individual’s unique genetic makeup. In this book, my goal is to contribute to a growing body of literature on personalized medicine by tracing and analyzing how this field has blossomed in Asia. In so doing, I aim to illustrate how various social and economic forces shape the co-production of science and social order in global contexts. This book shows that there are inextricable transnational linkages between developing and developed countries and also provides a theoretically guided and empirically grounded understanding of the formation and usage of particular racial and ethnic human taxonomies in local, national and transnational settings. The Open Access version of this book, available at http://www.taylorfrancis.com/doi/view/10.4324/9781315537177 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.
Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement of PPM is a challenge in traditional clinical, reimbursement, and regulatory landscapes because it is costly to develop and introduces a wide range of scientific, clinical, ethical, and socioeconomic issues. PPM raises a multitude of economic issues, including how information on accurate diagnosis and treatment success will be disseminated and who will bear the cost; changes to physician training to incorporate genetics, probability and statistics, and economic considerations; questions about whether the benefits of PPM will be confined to developed countries or will diffuse to emerging economies with less developed health care systems; the effects of patient heterogeneity on cost-effectiveness analysis; and opportunities for PPM’s growth beyond treatment of acute illness, such as prevention and reversal of chronic conditions. This volume explores the intersection of the scientific, clinical, and economic factors affecting the development of PPM, including its effects on the drug pipeline, on reimbursement of PPM diagnostics and treatments, and on funding of the requisite underlying research; and it examines recent empirical applications of PPM.
High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan's National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage--including the FISH diagnostic test and trastuzumab for early-stage breast cancer--strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
"The book Novel Perspectives in Economics of Personalized Medicine and Healthcare Systems represents a valuable interdisciplinary contribution created to fill an existing gap in the field of health economics and healthcare systems. The book brings the latest insights from the growing field of health economics and healthcare systems. It deals with various economic, technological, sociological, ethical, legal and philosophical implications and questions arising from the development and implementation of personalized medicine. It is unprecedented in combining practical guidelines for the use of economic tools and techniques with an analysis of the current process of decision-making in the health service sector. The book also provides several insights into the factors that determine human health, the socioeconomic aspects of population aging and the social implications of the evolving burden of disease. Some contributions are highly innovative and cover extremely relevant branches of medicine such as oncology, neurology and endocrinology. In addition, in a brave, yet professional and sovereign manner, the book covers the issue of biological predictors of health outcomes; though they are currently mainly used as global analytical methods, they are yet to be applied or have only recently been applied in clinical medicine. Further, it provides an example from traditional Korean medicine, a proven and valuable tool for personalized medical healthcare. This edition is unique in the sense that 30 chapters were written by 41 authors, all of them experts in their respective fields of research. The authors hail from Croatia, Hungary, South Korea and the United States. The volume is intended to serve as valuable teaching material for university students, as well as a reference book for research scholars, policymakers, business executives, health managers, physicians and freelance readers"--
This book gathers scientific contributions on comprehensive approaches to personalized medicine. In a systematic and clear manner, it provides extensive information on the methodological, technological, and clinical aspects of high-throughput analytics, nanotechnology approaches, microbiota/human interactions, in-vitro fertilization and preimplantation, and various diseases like cancer.Moreover, the book analyzes the social and legal aspects of social security systems, healthcare systems and EU law – e.g. the role of solidarity, regulatory possibilities and obstacles, justice and equality, privacy/disclosure of data, and the right to know – from an interdisciplinary perspective. Lastly, it explores the economical and ethical context in the fields of business models, intellectual property issues, the patient/physician relationship, and price discrimination.
"In the erudite essay that opens this forum, Prasenjit Duara turns to both indigenous thinkers and the premodern past for tools with which to think about Asia in a global age. Contemporary modalities of regional exchange – ‘weakly bounded, network-oriented, pluralistic, multitemporal’ – chime with earlier patterns of cultural circulation without state domination, giving rise to a prophetic vision of ‘Asia Redux’. This attempt to capture the contours of a (re)-emergent region was calculated to provide. And what a debate it kicks off. Wang Hui resolutely reframe imagining Asia as a political project on a world-historical canvas. Tansen Sen greatly complicates the map of intra-Asian commercial exchange in earlier times; Amitav Acharya outlines five competing conceptions of Asia in the domain of international relations alone.; Barbara Watson Andaya teases out the paradoxical way in which regional religions make clashing claims about Asian unity; and Rudolf Mrazek asks, what of the Asia that bleeds? what of exploitation and its spawn, the inglorious ‘built-ends’ of the global economy? The reward for those who read this collection straight through is a thrillingly cacophonous conversation about how to grasp Asia in our time.” —Karen E. Wigen, Stanford University “Will a re-emergent Asia extend the violent rivalries and inequalities of Western-dominated empires, nations and capital? Or can Asia somehow draw on a relatively more peaceful past of maritime trade, interlinked religions and circulations beyond states to think and make a very different sort of region and world? Prasenjit Duara and his interlocutors define this vital debate on Asia’s future through illuminating reflections on its recent and deep past. A touchstone for anyone concerned with a future shape of an inter-connected Asia newly possessed of wealth and power” —Engseng Ho, Duke University
Will genome-based precision medicine fix the problem of race/ethnicity-based medicine? To answer this question, Sun and Ong propose the concept of racialization of precision medicine, defined as the social processes by which racial/ethnic categories are incorporated (or not) into the development, interpretation, and implementation of precision medicine research and practice. Drawing on interview data with physicians and scientists in the field of cancer care, this book addresses the following questions: Who are the racializers in precision medicine, how and why do they do it? Under what conditions do clinicians personalize medical treatments in the context of cancer therapies? The chapters elucidate different ways in which racialization occurs and reveal that there exists an inherent contradiction in the usage of race/ethnicity as precision medicine moves from bench to bedside. The relative resources theory is proposed to explain that whether race/ethnicity-based medicine will be replaced by genomic medicine depends on the resources available at the individual and systemic levels. Furthermore, this book expands on how racialization happens not only in pharmacogenomic drug efficacy studies, but also in drug toxicity studies and cost-effectiveness studies. An important resource for clinicians, researchers, public health policymakers, health economists, and journalists on how to deracialize precision medicine.
This book develops the concept of Asian Medical Industries as a novel perspective on traditional Asian medicines. Complementing and updating existing work in this field, the book provides a critical and comparative analytic framework for understanding Chinese Medicine, Ayurveda, Sowa Rigpa, and Japanese Kampo in the 21st century. No longer subaltern health resources or conservative systems of traditional knowledge, these medicines have become an integral part of modern Asia as innovative, lucrative industries. Ten original case studies employ insights from anthropology, history, geography, pharmaceutical sciences, botany, and economics to trace the transformation of Asian medical traditions into rapidly growing and dynamic pharmaceutical industries. Collectively, these contributions identify this as a major phenomenon impacting Asian and global healthcare, economics, cultural politics, and environments. The book suggests that we can learn more about Asian medicines today by approaching them as industries rather than as cultural or epistemic systems. Asian Medical Industries is a highly original resource for students and scholars across a range of academic fields such as anthropology, history, and Asian studies, as well as medical practitioners, health sector actors, and policymakers.
"Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence."--Publisher's website.
Advances in the technology used in personalized medicine and increased applications for clinical use have created a need for this expansion and revision of Kewal K. Jain’s Textbook of Personalized Medicine. As the first definitive work on this topic, this book reviews the fundamentals and development of personalized medicine and subsequent adoptions of the concepts by the biopharmaceutical industry and the medical profession. It also discusses examples of applications in key therapeutic areas, as well as ethical and regulatory issues, providing a concise and comprehensive source of reference for those involved in healthcare management, planning and politics. Algorithms are included as a guide to those involved in the management of important diseases where decision-making is involved due to the multiple choices available. Textbook of Personalized Medicine, Second Edition will serve as a convenient source of information for physicians, scientists, decision makers in the biopharmaceutical and healthcare industries and interested members of the public.