Knowing and manag-

ing the cross cultural and multi-disciplinary benefits and limita-tions of comparative effectiveness research (CER) will be the key component in building a strong founda-tion for the proof of concept in precision medicine.Unprecedented funding for CER is now available but this often favors na-tional applicants even though the research is completed in other nations. There is a spill-over effect into low and middle in-come countries (LMIC), where device man-ufacturers, pharmaceutical companies