Opportunities and Barriers for the Implementation of the Personalized Medicine in Lithuania

OBJECTIVES: The study aimed to evaluate opportunities and barriers to implementing personalized medicine in Lithuania.

METHODS: A qualitative semi-structured interview approach was employed, utilizing key informant interviews with the main groups of stakeholders. The guide was developed through desk research, including a grey literature review, focusing on three main topics concerning the implementation of personalized medicine (PM) in Lithuania: 1) actual situation, 2) leadership and responsibility, and 3) barriers and opportunities. The principal interview groups were identified according to 2023 stakeholders’ involvement in the open-format PM development initiative group: representatives of providers, the pharmaceutical industry, regulatory institutions, patient organizations, and academics. The evidence-based framework for studying the Non-adoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability of Health and Care Technologies (NASSS) (Greenhalgh & Abimbola, 2019) was applied to analyze responses to the main questions.

RESULTS: The NASSS framework was employed to identify areas of high complexity and identify potential opportunities to reduce complexity. The domains of technology, value proposition, and wider systems had the highest level of complexity among all seven. The technology domain has shown specialists’ hesitation in adopting innovative practices due to routine work challenges. The value proposition domain has shown that legislators/regulatory institutions lack interest in investment value, whereas patient groups show boundless enthusiasm, but feel excluded from the decision-making process. The wider system domain highlights the complexity arising from a lack of autonomy, flexibility, and self-regulation within the system, specifically concerning specialists and healthcare facilities.

CONCLUSIONS: The study underscores the necessity of a comprehensive approach to PM in Lithuania, emphasizing a need for a supportive regulatory and organizational environment. Minimizing complexity will be pivotal for the successful implementation of PM in the country.