Navigating Precision Medicine Within European Law: Ethical Considerations and Legal Challenges


Published: Oct 1, 2024
Keywords:
precision medicine European legal frameworks ethical considerations healthcare policies
Eleni Vlachothanasi
Abstract

Precision medicine, characterized by personalized treatment strategies based on extensive patient-specific data, has gained prominence in recent years. This paradigm shift from the traditional one-size-fits-all approach aims to optimize healthcare outcomes by integrating genomic, clinical, and lifestyle information. While precision medicine's transformative impact in fields like oncology and pharmacogenomics is evident, regulatory frameworks, including GDPR, Clinical trials regulation, IVD regulation, and the recently effective Health Technology Assessment Regulation (HTAR) from January 2025, are scrutinized for their contributions and identified gaps. Despite significant progress, challenges persist, including issues related to informed consent, companion diagnostics, direct-to-consumer genetic tests, intellectual property rights, and diverse healthcare policies across the EU. The lack of global harmonization adds complexity to regulatory environments. The conclusions stress the dynamic nature of precision medicine, proposing proactive measures such as the establishment of multidisciplinary committees within the EU to adapt swiftly to emerging advancements and ensure seamless integration into healthcare systems. This symbiotic relationship between precision medicine and European law reflects a commitment to creating an environment where cutting-edge medical technologies can thrive, contributing to a healthier and more resilient population through ongoing efforts to refine legal frameworks.

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References
König IR, Fuchs O, Hansen G, von Mutius E, Kopp M V. What is precision medicine? European Respiratory Journal. 2017 Oct 19;50(4):1700391.
Wang ZG, Zhang L, Zhao WJ. Definition and application of precision medicine. Chinese Journal of Traumatology. 2016 Oct;19(5):249-50.
Carrasco-Ramiro F, Peiró-Pastor R, Aguado B. Human genomics projects and precision medicine. Gene Ther. 2017 Sep 14;24(9):551-61.
Sarhangi N, Hajjari S, Heydari SF, Ganjizadeh M, Rouhollah F, Hasanzad M. Breast cancer in the era of precision medicine. Mol Biol Rep. 2022 Oct 22;49(10):10023-37.
Adams SA, Petersen C. Precision medicine: opportunities, possibilities, and challenges for patients and providers. Journal of the American Medical Informatics Association. 2016 Jul 1;23(4):787-90.
Stenzinger A, Edsjö A, Ploeger C, Friedman M, Fröhling S, Wirta V, et al. Trailblazing precision medicine in Europe: A joint view by Genomic Medicine Sweden and the Centers for Personalized Medicine, ZPM, in Germany. Semin Cancer Biol. 2022 Sep;84:242-54.
Levit LA, Kim ES, McAneny BL, Nadauld LD, Levit K, Schenkel C, et al. Implementing Precision Medicine in Community-Based Oncology Programs: Three Models. J Oncol Pract. 2019 Jun;15(6):325-9.
Low S, Zembutsu H, Nakamura Y. Breast cancer: The translation of big genomic data to cancer precision medicine. Cancer Sci. 2018 Mar 30;109(3):497-506.
Grosse SD, Kalman L, Khoury MJ. Evaluation of the Validity and Utility of Genetic Testing for Rare Diseases. In 2010. p. 115-31.
Wang CW, Preclaro IAC, Lin WH, Chung WH. An Updated Review of Genetic Associations With Severe Adverse Drug Reactions: Translation and Implementation of Pharmacogenomic Testing in Clinical Practice. Front Pharmacol. 2022 Apr 25;13.
Aronson JK, Ferner RE. Biomarkers-A General Review. Curr Protoc Pharmacol. 2017 Mar 17;76(1).
Hsueh CT, Liu D, Wang H. Novel biomarkers for diagnosis, prognosis, targeted therapy and clinical trials. Biomark Res. 2013 Dec 16;1(1):1.
Table of Pharmacogenomic Biomarkers in Drug Labeling [Internet]. [cited 2024 Jan 28]. Available at: https://www.fda.gov/drugs/science-and-research-drugs/table-pharmacogenomic-biomarkers-drug-labeling
Sethu SG, Nair RS, Sadath L. Big Data in Precision Medicine and its Legal Implications. In: 2020 IEEE 15th International Conference on Industrial and Information Systems (ICIIS). IEEE; 2020. p. 350-6.
Blasimme A, Fadda M, Schneider M, Vayena E. Data Sharing For Precision Medicine: Policy Lessons And Future Directions. Health Aff. 2018 May;37(5):702-9.
Beccia F, Hoxhaj I, Castagna C, Strohäker T, Cadeddu C, Ricciardi W, et al. An overview of Personalized Medicine landscape and policies in the European Union. Eur J Public Health. 2022 Nov 29;32(6):844-51.
Dove ES. The EU General Data Protection Regulation: Implications for International Scientific Research in the Digital Era. Journal of Law, Medicine & Ethics. 2018 Jan 1;46(4):1013-30.
Thapa C, Camtepe S. Precision health data: Requirements, challenges and existing techniques for data security and privacy. Comput Biol Med. 2021 Feb;129:104130.
Alvarez MJR, Griessler E, Starkbaum J. Ethical, Legal and Social Aspects of Precision Medicine. In: Precision Medicine in Clinical Practice. Singapore: Springer Nature Singapore; 2022. p. 179-96.
Singh KK. Biotechnology and Intellectual Property Rights. New Delhi: Springer India; 2015.
Scheibner J, Ienca M, Kechagia S, Troncoso-Pastoriza JR, Raisaro JL, Hubaux JP, et al. Data protection and ethics requirements for multisite research with health data: a comparative examination of legislative governance frameworks and the role of data protection technologies†. J Law Biosci. 2020 Jul 25;7(1).
Negrouk A, Horgan D, Gorini A, Cutica I, Leyens L, Schee genannt Halfmann S, et al. Clinical Trials, Data Protection and Patient Empowerment in the Era of the New EU Regulations. Public Health Genomics. 2015;18(6):386-95.
Regulation on Health Technology Assessment [Internet]. [cited 2024 Jan 29]. Available at: https://health.ec.europa.eu/health-technology-assessment/regulation-health-technology-assessment_en
Stenzinger A, Moltzen EK, Winkler E, Molnar‐Gabor F, Malek N, Costescu A, et al. Implementation of precision medicine in healthcare—A European perspective. J Intern Med. 2023 Oct 26;294(4):437-54.
Knowles L, Luth W, Bubela T. Paving the road to personalized medicine: recommendations on regulatory, intellectual property and reimbursement challenges. J Law Biosci. 2017 Dec 1;4(3):453-506.
Koleva-Kolarova R, Buchanan J, Vellekoop H, Huygens S, Versteegh M, Mölken MR van, et al. Financing and Reimbursement Models for Personalised Medicine: A Systematic Review to Identify Current Models and Future Options. Appl Health Econ Health Policy. 2022 Jul 4;20(4):501-24.
Govaerts L, Simoens S, Van Dyck W, Huys I. Shedding Light on Reimbursement Policies of Companion Diagnostics in European Countries. Value in Health. 2020 May;23(5):606-15.
Fears R, Brand H, Frackowiak R, Pastoret PP, Souhami R, Thompson B. Data protection regulation and the promotion of health research: getting the balance right. QJM. 2014 Jan 1;107(1):3-5.
Bin P, Conti A, Capasso E, Fedeli P, Policino F, Casella C, et al. Genetic testing: ethical aspects. Open Medicine. 2018 Jul 2;13(1):247-52.
Niemiec E, Kalokairinou L, Howard HC. Current ethical and legal issues in health-related direct-to-consumer genetic testing. Per Med. 2017 Sep;14(5):433-45.
Faulkner E, Holtorf AP, Walton S, Liu CY, Lin H, Biltaj E, et al. Being Precise About Precision Medicine: What Should Value Frameworks Incorporate to Address Precision Medicine? A Report of the Personalized Precision Medicine Special Interest Group. Value in Health. 2020 May;23(5):529-39.
Horgan D, Bernini C, Thomas PPM, Morre SA. Cooperating on Data: The Missing Element in Bringing Real Innovation to Europe’s Healthcare Systems. Public Health Genomics. 2019;22(3-4):77-101.