Approach to Concept of Personalised Health Diagnostics and Precision Treatment for Better Outcomes

Miss Cheryl Chan Wei Ling asked the Minister for Health (a) with regard to preventive healthcare, how is the Ministry approaching the concept of personalised health diagnostics and precision treatment for better outcomes; and (b) what implication will this have on existing policy guidelines and insurance coverage.

Precision Health technology is advancing rapidly, and has the potential to transform how we manage our health and improve healthcare. This includes identifying groups who are at higher risk of disease or its progression, to allow for early screening and preventive action. To harness its benefits and mitigate risks and downsides, there are three things that MOH is doing.

First, continue to develop our capabilities in this area. The Precision Health Research, Singapore (PRECISE) programme is a key research initiative, to develop breakthrough and cost-effective clinical applications of companion diagnostics for precise health prevention and treatment. For example, it is studying whether familial hypercholesterolemia, an inherited condition that results in very high cholesterol levels, can be identified and treated early.

Second, to ensure that the activities surrounding Precision Health is guided by ethics and a code of conduct. In anticipation of the increasing use of genetic testing, MOH had developed in 2018 the 'Code of Practice on the Standards for the Provision of Clinical Genetic/Genomic Testing Services and Clinical Laboratory Genetic/Genomic Testing Services'. The Code of Practice will be translated into standards and requirements under the new Clinical Genetics and Genomics Services Regulations under the Healthcare Services Act in 2023.

Third, continue to ensure inclusivity in our healthcare support and safety net. With genetic testing, it has become possible to deny individuals’ insurance coverage due to their higher propensity to contract certain diseases. Precision in diagnosis and treatment does not necessarily have to lead to precision in insurance coverage, which can be socially undesirable. MOH and the Life Insurance Association (LIA) has therefore introduced the 'Moratorium on Genetic Testing and Insurance' in 2021. Under the moratorium, genetic test results from biomedical research will not be used in insurance underwriting. Life insurers are also generally not allowed to use predictive genetic test results in assessing or deciding the outcome of insurance applications.

MOH will continue to review the international developments in Precision Health, and to conduct our own research and studies, to inform our health policy guidelines and improve healthcare outcomes.