Paving the road to personalized medicine: recommendations on regulatory, intellectual property and reimbursement challenges.

Personalized medicine (PM) aims to harness a wave of 'omics' discoveries to facilitate research and discovery of targeted diagnostics and therapies and increase the efficiency of healthcare systems by predicting and treating individual predispositions to diseases or conditions. Despite significant investment, limited progress has been made bringing PM to market. We describe the major perceived regulatory, intellectual property, and reimbursement challenges to the development, translation, adoption, and implementation of PM products into clinical care. We conducted a scoping review to identify (i) primary challenges for the development and implementation of PM identified in the academic literature; (ii) solutions proposed in the academic literature to address these challenges; and (iii) gaps that exist in that literature. We identified regulatory barriers to PM development and recommendations in 344 academic papers. Regulatory uncertainty was a cross-cutting theme that appeared in conjunction with other themes including: reimbursement; clinical trial regulation; regulation of co-development; unclear evidentiary requirements; insufficient incentives for research and development; incompatible information systems; and different regulation of different diagnostics. To fully realize the benefits of PM for healthcare systems and patients, regulatory, intellectual property, and reimbursement challenges need to be addressed in lock step with scientific advances.

Stem cell research ethics: consensus statement on emerging issues.

This article is a consensus statement by an international interdisciplinary group of academic experts and Canadian policy-makers on emerging ethical, legal and social issues in human embryonic stem cells (hESC) research in Canada. The process of researching consensus included consultations with key stakeholders in hESC research (regulations, stem cell researchers, and research ethics experts), preparation and distribution of background papers, and an international workshop held in Montreal in February 2007 to discuss the papers and debate recommendations. The recommendations provided in the consensus statement focus on issues of immediate relevance to Canadian policy-makers, including informed consent to hESC research, the use of fresh embryos in research, management of conflicts of interest, and the relevance of public opinion research to policy-making.

Application of modern biotechnology to food and agriculture: food systems perspective.

The purpose of this article is to provide nutrition educators with an introduction to a range of considerations and forces that are driving the application of modern biotechnology in the food and fiber sector based on a food systems perspective. In doing so, the following issues are critically assessed: (1) the global debate on how to regulate genetically engineered (GE) foods and crops, (2) cultural differences in public perceptions of GE foods, and (3) evaluation of selected GE traits against the principles of social, economic, and ecological sustainability, including the potential of modern agricultural biotechnology to enhance global food security. Where appropriate, we also review other agricultural technologies and the broader political, social, and economic contexts in which these technologies have been introduced. Finally, we offer recommendations for how multiple stakeholder groups, including policy makers, biotechnology advocates, and nutrition educators, can move toward a more informed dialogue and debate on this issue.