Decoding India’s DNA - Will Precision Medicine Become a Game-Changer?

The GenomeIndia Project: A Foundation for Personalized Medicine

India’s GenomeIndia Project is a landmark initiative aimed at sequencing the genomes of 10,000 individuals to create a comprehensive genetic database. This effort is crucial for public health planning, tackling genetic disorders, and strengthening India’s biotech ecosystem. However, a bigger question remains— Can this initiative accelerate the growth of precision medicine in India? With a thriving pharma sector, increasing biotech investments, and a global shift toward targeted therapies, the potential is enormous. Yet, the challenge is to translate genetic insights into scalable, commercially viable, and accessible healthcare solutions.

The Global Market: A Booming Industry

Precision medicine is gaining momentum worldwide. The global personalized medicine market was valued at USD 529.28 billion in 2023 and is projected to grow at a CAGR of 8.20% from 2024 to 2030, reaching USD 1,315.43 billion by 2034. India accounted for 2.3% of this market in 2023, indicating significant room for growth.

In 2024, the oncology segment contributed the largest market share (41.96%), with personalized nutrition and wellness accounting for 48.40% of total revenues. While the U.S. dominates the market, China is emerging as the fastest-growing player in the Asia-Pacific region.

India’s Precision Medicine Market: Growth and Key Drivers

The Indian precision medicine market is expected to grow at a CAGR of 16% and cross $5 billion by 2030. The sector currently contributes 36% of India’s bioeconomy, alongside cancer immunotherapy, gene editing, and biologics.

Key growth drivers include:

Technological Advancements – AI-driven diagnostics, genomics, and bioinformatics are accelerating precision medicine adoption.
Expanding Genetic Databases – Large-scale sequencing projects like GenomeIndia provide crucial data for drug development.
Rising Chronic Disease Burden – With increasing cases of cancer, diabetes, and cardiovascular diseases (CVDs), the demand for precision treatments is growing.
Government Support – Policy initiatives, investment in genetic research, and regulatory reforms are expanding opportunities.
Growing Applications – Personalized medicine is gaining traction in oncology, neurology, psychiatry, pulmonology, and rare genetic disorders.

Apollo’s Strategic Shift: Beyond Oncology to Cardiovascular Research

While oncology dominates the global precision medicine market, Apollo Hospital’s recent initiatives highlight a strategic shift toward cardiovascular diseases (CVD). The Centre for Digital Health and Precision Medicine (CDHPM), launched in collaboration with a global research institution, aims to advance research in CVD, acute and emergency medicine, and multi-morbidity. This focus aligns with India's existing healthcare infrastructure, where cardiology is well-established compared to precision oncology.

A crucial question arises: Although oncology is the dominant precision medicine segment worldwide, does India’s strong CVD infrastructure make cardiovascular research a more strategic priority?

If Apollo’s model succeeds, could it pave the way for more hospitals and research institutions to integrate precision medicine into cardiology, critical care, and preventive health strategies?

The Insurance Dilemma: Coverage for Genetic Testing

One of the key challenges for precision medicine in India is insurance coverage for genetic testing. While whole genome sequencing costs range from ₹1-2 lakh, targeted genetic tests, such as those offered by DNA Labs India (₹25,000), are available for detecting cancer-related mutations.

Globally, precision medicine treatments cost nearly $300,000 in North America in 2022, but prices are expected to drop below $260,000 by 2027. While genetic testing is a valuable tool for early detection and intervention, most private health insurance policies in India do not cover these tests.

The Evolving Landscape of Insurance and Genetic Testing

2018 – The Delhi High Court ruling (M/s. United India Insurance Company Limited v. Jai Prakash Tayal) deemed the blanket exclusion of genetic disorders from health insurance unconstitutional. The court stated that genetic predisposition cannot be used as a basis to deny insurance coverage.
2019-2020 – The IRDAI (Insurance Regulatory and Development Authority of India) mandated insurers to remove generic exclusions for genetic disorders but did not specify coverage for genetic testing itself.
2022-Present – Despite the legal shift, genetic testing remains largely uncovered due to the lack of clear insurance frameworks for preventive healthcare. Insurance covers inpatient diagnostics but not preventive tests like genetic screening.
Potential Benefits: Genetic tests can help insurers assess risk and tailor premiums based on a person’s predisposition to diseases like cancer,
Global Trends: In countries like the U.S., genetic tests such as BRCA screening for hereditary breast and ovarian cancer are covered by insurance for high-risk individuals. These policies incentivize early detection, reducing long-term treatment costs. Similarly, European insurers are integrating genetic testing into personalized health plans.
Future Outlook: If structured correctly, insurance companies could drive the genetic testing market by incentivizing preventive screenings for high-risk individuals.

A Thought Question: With major healthcare providers like Apollo Hospitals promoting genetic screening services, should insurers rethink their stance? If hospitals incorporate precision medicine into routine diagnostics, will insurance providers follow suit and expand coverage? Would expanding genetic test coverage actually lower long-term insurance costs by reducing chronic disease burdens?

The Role of Biobanks: A Critical Component

Biobanks store biological samples like DNA, blood, and tissues alongside genetic data, enabling disease research and the development of targeted therapies. However, for precision medicine to be effective, biobanks must be large and diverse; otherwise, research outcomes will remain limited to a small subset of the population.

India currently has 19 registered biobanks storing various biological specimens, including cancer cell lines and tissues. The GenomeIndia project, which sequenced 10,000 genomes from 99 ethnic groups, is a major step toward identifying treatments for rare diseases. Additional initiatives like Phenome India and the Paediatric Rare Genetic Disorders (PRaGeD) mission aim to improve disease prediction and develop targeted therapies for children.

The Regulatory Hurdles: Challenges in Biobanking

Unlike countries like the U.S., U.K., Japan, and China, which have well-defined frameworks covering informed consent, privacy, data protection, and withdrawal rights, India’s biobanking regulations remain fragmented and inconsistent.

Lack of Individual Rights Protection: While India has the Digital Personal Data Protection (DPDP) Act, which governs data privacy, there is no dedicated law governing how biological samples and genetic data are used, stored, or shared.
Ethical and Privacy Concerns: Existing guidelines (such as those from ICMR and DBT) do not clearly define who has access to genetic data or how long it can be stored, raising concerns about data misuse and discrimination.
Lack of a Centralized Authority: India lacks a single regulatory body to oversee biobanks, leading to risks of sample mishandling, unauthorized data sharing, and ethical violations.
Pharmaceutical Companies’ Role: Without clear regulations, foreign pharma firms can access Indian biological samples without ensuring benefits flow back to Indian donors.

Conclusion: Unlocking India’s Potential in Precision Medicine

India has a unique opportunity to emerge as a global leader in precision medicine, backed by initiatives like GenomeIndia, expanding biobank networks, and AI-driven diagnostics. However, for this vision to materialize, several challenges need to be addressed:

Stronger Regulatory Frameworks – Establishing a centralized authority for biobank governance, genetic data privacy, and ethical research standards is essential to prevent data exploitation and ensure patient rights.
Insurance Integration & Cost Reduction – Precision medicine can only be impactful if it is financially accessible. Expanding insurance coverage for genetic testing and targeted therapies could drive early disease detection, ultimately reducing long-term healthcare costs.
Scalability & Infrastructure Development – While India has strong capabilities in generic drugs and biologics, scaling precision medicine requires specialized genetic labs, skilled professionals, and AI-powered bioinformatics to make personalized treatments widely available.

If these barriers are addressed, India has the potential to not only lead the global precision medicine market but also set a precedent for inclusive, data-driven, and ethical genomic healthcare. The next decade will determine whether India emerges as a global innovator in precision medicine—or if these breakthroughs remain out of reach for the majority of its population.

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