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Review
. 2021 Feb;6(2):e004415.
doi: 10.1136/bmjgh-2020-004415.

Availability and funding of clinical genomic sequencing globally

Affiliations
Review

Availability and funding of clinical genomic sequencing globally

Kathryn A Phillips et al. BMJ Glob Health. 2021 Feb.

Abstract

The emergence of next-generation genomic sequencing (NGS) tests for use in clinical care has generated widespread interest around the globe, but little is known about the availability and funding of these tests worldwide. We examined NGS availability across world regions and countries, with a particular focus on availability of three key NGS tests-Whole-Exome Sequencing or Whole-Genome Sequencing for diagnosis of suspected genetic diseases such as intellectual disability disorders or rare diseases, non-invasive prenatal testing for common genetic abnormalities in fetuses and tumor sequencing for therapy selection and monitoring of cancer treatment. We found that these NGS tests are available or becoming available in every major region of the world. This includes both high-income countries with robust genomic programmes such as the USA and the UK, and growing availability in countries with upper-middle-income economies. We used exploratory case studies across three diverse health care systems (publicly funded/national (UK), publicly funded/provincial (Canada) and mixed private/public system (USA)) to illustrate the funding challenges and approaches used to address those challenges that might be adopted by other countries. We conclude by assessing what type of data and initiatives will be needed to better track and understand the use of NGS around the world as such testing continues to expand.

Keywords: health policy; health services research.

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Conflict of interest statement

Competing interests: KAP receives consulting income from Illumina. Disclosures have been reviewed by the University of California San Francisco. MPD receives consulting income from Illumina. DAM, JB and SW have received travel expense reimbursement from Illumina to attend meetings.

Figures

Figure 1
Figure 1
Study framework: focus on T3 translation, implementation, and case studies of funding. NIPT, non-invasive prenatal testing; SGD; suspected genetic diseases, TS, tumour sequencing, WES; whole-exome sequencing; WGS, whole-genome sequencing.

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