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ESF Forward Look - EHFG, 4-5 October 20121
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A Forward Look on Personalised MedicineStephane Berghmans
European Health Forum Gastein, 4-5 October 2012
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European Science Foundation
Member Organisations
ESF is an independent association
of 78 Member Organisations
• research funding organisations
• research performing organisations
• academies and learned societies
in 30 countries
ESF Forward Look - EHFG, 4-5 October 2012
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Standing Committee domains•Biomedical Sciences
•Humanities
•Social Sciences
•Life, Earth & Environmental
Sciences
•Physical and Engineering
Sciences
Expert Board/Committee domains•Marine Sciences
•Polar Sciences
•Space Sciences
• Radio Astronomy
• Nuclear Physics
• Material Sciences
& Engineering
ESF Forward Look - EHFG, 4-5 October 2012
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Forward Look on Personalised Medicine
ESF Forward Look - EHFG, 4-5 October 2012
● Multidisciplinary topics or
complex areas viewed at a
European level
● Medium to long-term scientific
perspectives
● Link scientists, stakeholders and
policy makers
● Wide consultation – identify
major opportunities and
constraints
● Produce major reports and
action plans
Foresight instrument
Governance
Chairs
• Aarno Palotie, Head of Medical Sequencing at the Wellcome Trust
Sanger Institute, UK; Director of the
Finnish Genome Center, University of
Helsinki , Finland
• Stephen Holgate, Medical Research Council, School of Medicine, University of
Southampton, UK
• Barbara Prainsack, Centre for Biomedicine & Society - CBAS Brunel,
UK
• Angela Brand, IPHG, Faculty of Health, Medicine and Life Sciences,
Maastricht University, The Netherlands
• Hans Lehrach, Max Planck Institute for Molecular Genetics, Berlin, Germany
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• Liselotte Højgaard EMRC, Chair
• Milena Zic-Fuchs SCH, Chair
• Michel Salzet LESC, member
• Rainer Kattel SCSS, core group member
• Jukka Corander PESC, representative
• Heyo K. Kroemer, DFG
Deutsche Forschungsgemeinschaft
• Jacques Grassi, Inserm
Institut National de la Santé et de la
Recherche Médicale
• Joaquin Arenas Barbero, MICINN
Spanish ministry for science and innovation
Scientific Committee Management Committee
ESF Forward Look on Personalised Medicine
ESF Forward Look - EHFG, 4-5 October 2012
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In-depth expert
interviews
ESF Forward Look - EHFG, 4-5 October 2012
Forward Look on Personalised Medicine
Methodology
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Forward Look on Personalised Medicine
TABLE OF CONTENT
1.Introduction
2.How do we define personalised medicine?
3.What can personalised medicine offer?
4.What are the technological considerations for personalised
medicine?
5.What are the disciplinary considerations for personalised
medicine?
6.What are the key issues affecting the development and
implementation of personalised medicine?
7.Recommendations
8.Can we predict a timeline for the development and
implementation of personalised medicine?
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Forward Look on Personalised Medicine
TABLE OF CONTENT
1.Introduction
2.How do we define personalised medicine?
3.What can personalised medicine offer?
4.What are the technological considerations for personalised
medicine?
5.What are the disciplinary considerations for personalised
medicine?
6.What are the key issues affecting the development and
implementation of personalised medicine?
7.Recommendations
8.Can we predict a timeline for the development and
implementation of personalised medicine?
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Forward Look on Personalised Medicine
80 recommendations
…
resulting in a
PersonalisedMedicine“Target”
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Forward Look on Personalised Medicine
“At the heart of
personalised medicine
lies the individual
citizen…”
PersonalisedMedicine“Target”
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Forward Look on Personalised Medicine
WHAT CAN PERSONALISED MEDICINE OFFER?
For Personalised Medicine to be effectively introduced stakeholders must be clear about its benefits
THE EUROPEAN CITIZEN
•Promise of safer, more effective treatmentsExamples in stratified medicines to treat specific tumour subtypes
•Longer-term promise: prevention of diseaseGenetic predictionMonitoring of physiological status over the life course
•Empowerment: more control over their own healthToday citizens don’t feel in control of decisions about their wellbeingIssues: less direct involvement of healthcare professionals
health literacy and access
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Forward Look on Personalised Medicine
“… the citizen’s health status
will be reflected by a new
disease taxonomy informed by
the multi-layered
characterisation of
physiological and
pathological processes”
PersonalisedMedicine“Target”
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Forward Look on Personalised Medicine
WHAT CAN PERSONALISED MEDICINE OFFER?
FOR THE HEALTHCARE PROFESSION
•Opportunities in diseases subclassificationPossible greater insight into complex & chronic diseasesMore effective use of existing drugsDrug efficacy in unstratified patient groups
•Potential for a life-course approach to healthcareIndividual baseline physiological dataImproved recognition of relevant pathological changesOpportunity for greater prevention; early intervention
For Personalised Medicine to be effectively introduced stakeholders must be clear about its benefits
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Forward Look on Personalised Medicine
PersonalisedMedicine“Target”
“Comprehensive, accessible,
and interoperable datasets
must be generated to
support the development of a
new disease taxonomy and
allow for its ongoing
refinement and
application"
ICTsolutions
ICTsolutions
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Forward Look on Personalised Medicine
WHAT ARE THE TECHNOLOGICAL CONSIDERATIONS FOR PM?
Defining feature of PM will be data integration
Global solutions
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Forward Look on Personalised Medicine
PersonalisedMedicine“Target”
“Models and decision-making
processes must be revised to
reflect a focus on the
individual citizen at all levels,
from assessment of the safety
and efficacy of interventions,
through HTA and
reimbursement, to diagnosis,
treatment and prevention”
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Forward Look on Personalised Medicine
WHAT CAN PERSONALISED MEDICINE OFFER?
FOR REIMBURSEMENT BODIES
•Will PM reduce health expenditure: promise or benchmark?e.g. investment in new technology and infrastructuree.g. drug reprofiling based on stratificationScepticism: PM has potential to increase healthcare expenditure
•Cost of increased emphasis on diagnostics and preemptive testing?Direct cost of investment in diagnostics technologyFalse-positive diagnosis (offset by long-term reductions through prevention?)
•Realistic promise and expectationsCost containment vs. cost reduction: improved return on investment
For Personalised Medicine to be effectively introduced stakeholders must be clear about its benefits
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Forward Look on Personalised Medicine
PersonalisedMedicine“Target”
“Emphasis must be placed on
stakeholder participation,
interdisciplinary interaction,
public-private and
precompetitive
partnerships, and
translational research in
order to develop the
frameworks that support the
vision of personalised
medicine and healthcare”
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Forward Look on Personalised Medicine
ESF Forward Look - EHFG, 4-5 October 2012
*approved by FDA as of September 2011
THE CHALLENGE OF
INTERDISCIPLINARITY
WHAT ARE THE DISCIPLINARY CONSIDERATIONS FOR PM?
ChallengeAchieve cross-disciplinary
consensus to allow PM challenges to be addressed
in each context
3 disease areas
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Forward Look on Personalised Medicine
PersonalisedMedicine“Target”
“Dedicated funding and
governmental support must be
provided to ensure the
availability of core
infrastructure, including
access to core technology and
frameworks for education and
training of professionals and
the wider community”
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Forward Look on Personalised Medicine
Personalised Health Care
Change Management
GlobalStakeholder Group
StakeholderEngagement
CriticalTiming Proof of
Principle
TransformationReform
...
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Formerly
Head of Unit
Biomedical Sciences
European Science Foundation
Stephane Berghmans
Currently
CEO
Center for Innovation in Medicine
Liege, Belgium