comparative effectiveness research collaboration and precision medicine

127 Key message Knowing and managing the cross cultural and multidisciplinary benefits and limitations of comparative effectiveness research (CER) will be the key component in building a strong foundation for the proof of concept in precision medicine.Unprecedented funding for CER is now available but this often favors national applicants even though the research is completed in other nations. There is a spill-over effect into low and middle income countries (LMIC), where device manufacturers , pharmaceutical companies, and regenerative technology corporations are investing in for the benefits of reduced site costs, supplies, and faster turn around times.Corporations ostensibly enjoy the opportunity to work in relative obscurity, thus protecting the proprietary aspects of development in a more lenient regulatory milieu with reduced ethical scrutiny. These organizations are clearly enjoying a benefit , but the question remains: how can research quality and medical benefit for the LMIC nations be enriched by these collaborations to improve the host nation's medical education, research program and national health care? Background for comparative effectiveness research (CER) and precision medicine