Bangkok, Thailand: In the past, every patient suffering from the same disease would have to go through the same screening, diagnosis and treatment process based on the one-size-fits-all approach. However, recent medical advancements have presented innovations and technology that played crucial roles in transforming the healthcare landscape; thus expanding treatment options and elevating the quality of lives for patients. One medical advancement that had implemented significant changes is the groundbreaking innovation of personalised healthcare.

Today, we will take a closer look at the importance of personalised healthcare and how beneficial it could be for Thailand to fully adopt and implement this approach in the future.

Personalised healthcare is an approach that utilizes the development of genomic data to better understand and identify differences that exist within each disease. It is essentially a patient-centric and data-driven approach that leverages fundamental health background and medical history of each patient for genomic analysis. Whereby, the results indicate that despite having the same disease and displaying similar symptoms, the root cause of each patient’s illness may differ. Therefore, applying a tailored treatment plan that is specific for individuals is imperative because all patients have unique genetic profile, environmental conditioning, and lifestyle. Thus, when considering all these factors, medical professionals can better evaluate each patient’s risk to each disease, provide a more accurate and prompter diagnosis, as well as select the most appropriate treatment plan that caters specifically for each patient.

With regards to the importance of personalised healthcare, the APAC Personalised Health Index is a first-of-its-kind, policy tool that measures the readiness of 11 health systems within the Asia Pacific region, including Thailand. The Index aims to enable personalised healthcare as the standard practice and improve equity in access to everyone. It also equips policymakers with data that can guide and inform the direction and prioritisation of efforts to improve the readiness of health systems, both within the public and private sectors in the future.

According to the Index findings, Thailand currently belongs in the “Focus Area Country” group along with Malaysia, China and India. The countries in this group are in the beginning stages of implementing personalised healthcare. The Personalised Health Index measures performances across four categories called 'Vital Signs', which include (1) Policy Context, (2) Health Information, (3) Personalised Technologies, and (4) Health Services. Thailand ranked 7th overall from 11 countries within the APAC region. When measured against each specific Vital Sign, Thailand placed 7th in Policy Context, 5th in Health Information, 6th in Health Services and last in terms of Personalised Technologies.

1. Policy Context – This vital sign intends to promote the effort to increase government expenditure in order to facilitate access to insightful data and treatment options for medical professionals and researchers. Additionally, the measure also aims to reduce social gap that has a direct impact on the patients’ access to treatment, which in turn will enhance equity of access to personalised healthcare. 

2. Health Information – This vital sign indicates the level of national health strategy implementation concerning Electronic Health Records (EHRs), health data and statistics collection such as national cancer registries and comprehensive access to data for research.

3. Health Services – This vital sign considers the delivery of services that will drive personalised healthcare within the public health system. This includes R&D expenditure, access to medical facilities, telemedicine, registry quality, and evidence-based guidelines for personalised healthcare.

4. Personalised Technologies – This vital sign measures the utilization of wearable gadgets, applications, platforms and Artificial Intelligence (AI) technology in health services, and the reimbursement structures that will drive personalised healthcare based on the needs of stakeholders. This is a potential focus area for Thailand, as the country needs to strengthen this area to drive further advancements in the application of personalised healthcare. 

In addition to the readiness across all 4 Vital Signs, a deeper look into the data shows that Thailand, along with Taiwan, ranked first when it comes to Personalised Health Strategy. However, Thailand still has a long way to go when it comes to the policy context, especially in Social Mobility, where Thailand ranks 8th and the country’s public health is reliant on societal factors, such as living conditions, occupation and nutrition. In terms of Health Services, especially concerning R&D expenditure on personalised healthcare, Thailand ranks 9th. Therefore, the Index findings are good indicators to help point out Thailand’s strengths and weaknesses, as well as provide guidelines that can help improve the accessibility of personalised healthcare and subsequently increase Thailand’s readiness and performance.

Personalised Healthcare will greatly benefit the Thai society in the future. A perfect epitome is cancer, a leading cause of death for the Thai population for several consecutive years. From a former cancer patient’s perspective, Sirintip Kudtiyakarn, President of the Thai Cancer Society (TCS) revealed the benefits of personalised healthcare, as stated “Cancer is a complex disease, as it is not only difficult to treat but comes with many potential complications. Therefore, patients receiving similar treatment options may not respond in the same way. On the other hand, personalised healthcare can help medical professionals in tailoring treatment decision to fit each patient’s medical profile and health background. This can subsequently reduce treatment time and cost, as well as minimise side effects from medication. Thus, enabling patients to lead the most fulfilling life possible.”

In Thailand, even though most cancer patients seek medical help in the advanced stages, owing to medical advancements, comprehensive genomic profiling can detect mutations in hundreds of genes associated with cancers, including lung cancer and breast cancer. This method helps each patients receive the most targeted treatment option to maximise the treatment outcome and achieve a high quality of life during the patient journey, as well as increase overall survival rate.

Asst. Prof. Aumkhae Sookprasert, MD., Medical Oncologist, Department of Medicine, Khonkaen University, explained some of the challenges in implementing personalised healthcare and generating tangible outcomes from this approach, as quoted, “Limitation of comprehensive genomic profiling in Thailand is that some genes, but not all, can be tested simultaneously. Access to targeted therapy, likewise, is restricted to some extent, albeit an increase in variety and efficacy with fewer side effects. Therefore, multi-stakeholder partnerships, from public and private sectors, are instrumental in driving the advancement and the equity of access to comprehensive molecular testing. In fact, comprehensive molecular testing should be made a strategic national priority. Additionally, R&D in cancer treatment should gain more support, as cancer is consider a health threat to Thai population. More importantly, it is crucial to advocate for the reimbursement of anti-cancer medicines in the Thai National List of Essential Medicines (NLEM) for greater accessibility for Thai patients under all schemes.”

Comprehensive genomic profiling is not yet a mandatory practice in the Thai public health system, despite being the first step towards personalised healthcare. Hence, it appears that Thailand still has a long way to go to improve its preparedness and accessibility to personalised healthcare. This transformation will no doubt increase the efficiency of the Thai public health system and drive medical advancements, which in turn will promote better health and sustain a quality of life.