Journal of Science Policy & Governance
Volume 26, Issue 01 | June 16, 2025

White Paper
Precision Medicine and the Price of Equity

Kenna McRae1*, Josiah Yarbrough2*, Jonathan Judd3*
  1. Department of Biomedical Engineering,
  2. ​University of Minnesota, Minneapolis, MN, USA 2Stanford University School of Medicine, Stanford, CA, USA 
  3. Department of Genetics, Stanford University, Stanford, CA, USA 

*All authors contributed equally
​
​Corresponding author:   [email protected] ​​​
Keywords: precision medicine, equity, public health, innovation, federal, disparities
https://doi.org/10.38126/JSPG260104 ​

Executive Summary

Medicine has increasingly moved toward more personalized approaches that utilize individual patient characteristics to tailor therapeutic interventions and predict outcomes. While advancements in precision medicine have garnered significant attention, the ways that this budding subset of technology intersects with existing health disparities are often overlooked. Precision medicine holds tremendous potential to transform healthcare, but it risks widening existing disparities if not managed inclusively. We highlight three core issues that further marginalize underserved communities: high costs, limited accessibility of precision medicine, and insufficient diversity in research that produces these innovations. We also propose opportunities for state and federal policymakers to mitigate these issues. Without deliberate policy interventions, these innovations may remain accessible only to privileged demographics, excluding underserved communities from life-saving treatments. Key policy recommendations include restructuring reimbursement frameworks, reducing drug prices, fostering diversity in clinical trials, and building strong community partnerships. These measures are essential to transforming precision medicine from a selective advantage to a universally accessible health benefit.

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Background header image courtesy of Harvard
Kenna McRae is a PhD student in the Department of Biomedical Engineering at the University of Minnesota. She received her BS in Physics and BA in Global Health from Barrett, the Honors College at Arizona State University, as well as an MA in Bioethics and Science Policy from Duke University and an MS in Bioengineering from Stanford University. Her current work centers on applying data science methods to neuroengineering, and she is an officer for the University of Minnesota Graduate Women in Biomedical Engineering organization. She is interested in applying STEM, ethics, and science policy to health equity. 
​
Josiah Yarbrough is an MD candidate at Stanford University School of Medicine and received his PhD from the Department of Chemical Engineering at Stanford University. As a Health Innovation Intern with Stanford's Mussallem Center for Biodesign, he researches policy initiatives for pediatric medical technologies. He also directs operations for the Stanford Asylum Collaborative, supporting medical care for asylum seekers, and leads longitudinal education projects for unhoused parents through LifeMoves in the San Francisco Bay Area. He is interested in developing innovative solutions to challenges in healthcare delivery. 

Jonathan Judd is a PhD candidate in the Department of Genetics at Stanford University and received his BS in Chemical and Biomolecular Engineering from Johns Hopkins University. His work researches the role of genetic factors and socioeconomic status on prostate cancer risk in order to inform public health interventions aimed at reducing health disparities. Jonathan is the president of the Stanford Science Policy Group, an organization aimed at engaging the Stanford community in science policy and advocacy across a multitude of policy issues. 

Acknowledgements 
The authors thank Patrick Windham, Misha Angrist, and Arin Vansomphone for their valuable feedback on the paper throughout its development as well as the Stanford Science Policy Group for establishing an environment for the work to take place. 

Disclaimer 
The order in which the authors are listed does not represent the contribution of any individual author. All authors have contributed equally to this piece. Any views expressed in this article reflect those of the authors and should not be seen as official position statements by any of the affiliated institutions, departments or fellowship programs.
​

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