Obama’s precision medicine initiative: an update

Despite significant challenges, President Obama’s ambitious initiative to lay the scientific foundation for precision medicine remains on track, say federal officials and outside experts.

Yet, the long-term effort to accelerate research aimed at helping clinicians tailor medical treatments to  individual patients must have funding to continue. Obama is asking Congress for $309 million to fund the Precision Medicine Initiative (PMI) in fiscal year 2017, up about $100 million from the previous year.

PritchardSome experts assert that PMI’s bipartisan support and enrollment of the first volunteers into its 1-million-person research cohort will also put pressure on Capitol Hill to keep the initiative going.

PMI is “a strong effort, a great commitment from the [Obama] administration, and I believe it will continue on ... regardless of the outcome of the elections,” Daryl Pritchard, PhD, vice president of science policy for the Personalized Medicine Coalition in Washington, D.C. told Managed Healthcare Executive earlier this fall. “... It’s not a controversial program.” The coalition's 225-plus members include Aetna and numerous academic health centers, community hospital systems and information management firms.

A complex initiative

The program, first announced by Obama during his 2015 State of the Union Address, has many moving parts. Funding for fiscal year 2016 provided $130 million to the National Institutes of Health (NIH) to create a 1-million-person research cohort (the PMI Cohort Program); $70 million to the National Cancer Institute (NCI) to ramp up efforts to identify genomic drivers in cancer; $10 million to the FDA to acquire more expertise and develop databases to support the regulatory framework for precision-medicine advances; and $5 million to the Office of the National Coordinator for Health Information Technology to develop interoperability standards and ensure privacy.

Anyone in the U.S. who is willing to share their medical information, take a health survey, get a baseline medical exam and provide a blood sample can volunteer to serve as part of the research cohort.

In February 2016, during a summit to discuss next steps, John Holdren, director of the White House Office of Science and Technology Policy, described PMI as "an all-hands-on-deck operation."

“Precision medicine holds incredible promise for the future of healthcare,” Holdren says. The initiative has brought the “relevant federal agencies to a new level of activity and collaboration in pursuit of that promise, and it’s drawing as well on the essential contributions of groups outside of government-providers, technologists, researchers, privacy and security experts, physicians, and, of course, patients.”

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