Review article based on reporting by Joyce Teo, The Straits Times (14 Nov 2025) © SPH Media Limited.
Singapore has entered Phase 3 of its National Precision Medicine (NPM) programme, a major expansion that will sequence the genomes of 400,000 to 450,000 patients by 2031. This phase, informally dubbed SG500K, aims to bring precision medicine out of pilot projects and into population-scale, routine clinical care.
From Reactive to Predictive Preventive Care
Health Minister Ong Ye Kung described this phase as a shift from a healthcare system that reacts to illness to one that aims to predict, prevent and delay disease. By combining:
- Genomic data (DNA),
- Lifestyle and environmental information, and
- AI-driven risk prediction,
Singapore hopes to build a system that keeps people healthier for longer, especially as the population ages.
What Phase 3 (SG500K) Will Do
Running from 2025 to 2031, Phase 3 will:
- Recruit 400,000–450,000 patients directly from public healthcare institutions.
- Cover a wide range of health conditions, allowing scientists to study how genes, lifestyle and environment interact in real-world clinical settings.
- Improve understanding of disease progression, enabling more targeted treatment and tailored care plans.
- Detect rare diseases and less common genetic variants more effectively due to the large sample size.
Coordination is led by Precision Health Research, Singapore (Precise), working with all three public healthcare clusters:
- NHG (National Healthcare Group)
- National University Health System (NUHS)
- SingHealth
When completed, more than 500,000 people – about 10% of Singapore’s resident population – will have had their whole genome sequenced.
Building on Earlier Phases: SG10K and SG100K
NPM began in 2017 as a three-phase effort:
- Phase 1 – SG10K: Created a pilot database of 10,000 Singaporean genomes.
- Phase 2 – SG100K (from 2021): Mapped the DNA of 100,000 healthy residents, laying the groundwork for understanding population-level genetic patterns.
- Phase 3 – SG500K: Expands to hundreds of thousands of patients with actual medical conditions, bridging research and routine care.
Early Clinical Impact: Familial Hypercholesterolemia & Drug Response
Research from NPM is already shaping national health initiatives, especially in cardiovascular disease prevention:
- Familial hypercholesterolemia (FH):
- A serious genetic condition that greatly raises the risk of early heart disease.
- New genomic assessment centres now offer earlier diagnosis and better management.
- Since June, more than 200 individuals have consented to FH genetic testing.
- Clinical pilots:
- Five pilots, involving over 6,000 patients, have tested how genetic data can:
- Guide drug choice and dosing (pharmacogenomics), and
- Improve risk assessment for certain diseases.
- Five pilots, involving over 6,000 patients, have tested how genetic data can:
Making Precision Medicine Affordable and Fair
To ensure access and trust, the Ministry of Health (MOH) is putting strong financial and ethical safeguards in place:
1. Subsidies & MediSave support
- Approved genetic tests will be subsidised and payable using MediSave.
- Any downstream treatments triggered by the test (e.g. specific medications) will also receive support.
- For FH genetic testing, the out-of-pocket cost is under $100 after subsidies and MediSave.
- Seniors aged 60 and above can use Flexi-MediSave (up to $400/year from their or their spouse’s MediSave) to fully cover out-of-pocket costs.
- Cholesterol-lowering drugs for FH, such as certain statins and PCSK9 inhibitors, are subsidised.
2. Protection against insurance discrimination
- Since 2021, a moratorium prevents insurers from using genetic test results in underwriting.
- This protection now explicitly covers all FH diagnostic genetic results under the national programme.
- Both diagnostic and predictive genetic tests are protected.
- MOH is working on new legislation to formalise and strengthen rules on the proper use of genetic data, including giving legal backing to the moratorium.
3. Support for advanced therapies
Financial assistance is also being extended to approved cell, tissue and gene therapy products (CTGTPs), such as:
- Kymriah – for B-cell acute lymphoblastic leukaemia, and
- Yescarta – for large or high-grade B-cell lymphoma.
Towards “Healthier SG 2.0”
Mr Ong framed NPM Phase 3 as the backbone of a “predictive preventive care” model that goes beyond traditional prevention. By combining:
- Detailed genetic risk,
- Lifestyle patterns, and
- Population health policies,
Singapore aims to chart a path towards a “Healthier SG 2.0” — a healthcare system that not only treats disease but anticipates and slows its onset across the population.
Source: Joyce Teo, The Straits Times, 14 November 2025.
Original article: “Phase 3 of Singapore’s mega gene-mapping effort to enrol at least 400,000 patients” — © 2025 SPH Media Limited.
