Disparities in the Implementation of Precision Medicine Technologies

In many health systems, there are disparities in who can access and use existing precision medicine technologies. These disparities can result from a reduced ability to access health care because of costs, availability, geography, and awareness. They are also exacerbated by systemic racism in health care, which excludes and makes health care inaccessible to racialized people and Indigenous Peoples. Moreover, some populations have historically not been included in health research or the databases used to develop precision medicine technologies. As a result, the precision medicine tests developed using these databases are not necessarily applicable to or interpretable for those who are racialized or otherwise underrepresented in health research.

Health care decision-makers will need to ensure equitable development of and access to precision medicine technologies and mitigate the potential for precision medicine technologies to replicate or exacerbate existing health inequalities. Different health care systems are developing targeted approaches that could be important to watch,
such as:

• Investing in population-representative databases: To address bias and inequities within precision medicine technologies, health systems are investing in the collection and building of representative genomic databases. For example, within Canada, Genome British Columbia is funding the Silent Genomes Project, which aims to address the lack of First Nations, Inuit, and Métis genomic representation in cancer genetics databases for children.
• Reducing barriers to access: Pan-Canadian collaboratives such as PRecision Oncology For Young PeopLE (PROFYLE) by the Terry Fox Research Institute aim to make the technology that provides molecular profiling of tumours available to children and youth regardless of where they live.

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