esf forward look on personalised medicine

ESF Forward Look - EHFG, 4-5 October 20121

www.esf.org

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


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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


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Forward Look on Personalised Medicine


● 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


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In-depth expert

interviews



Methodology

7 ESF Forward Look - EHFG, 4-5 October 2012


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




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


7.Recommendations

8.Can we predict a timeline for the development and




80 recommendations

…

resulting in a

PersonalisedMedicine“Target”



“At the heart of

personalised medicine

lies the individual

citizen…”




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



“… the citizen’s health status

will be reflected by a new

disease taxonomy informed by

the multi-layered

characterisation of

physiological and

pathological processes”





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





“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



WHAT ARE THE TECHNOLOGICAL CONSIDERATIONS FOR PM?

Defining feature of PM will be data integration

Global solutions




“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”




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





“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”

19



*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




“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”



Personalised Health Care

Change Management

GlobalStakeholder Group

StakeholderEngagement

CriticalTiming Proof of

Principle

TransformationReform

...


Formerly

Head of Unit

Biomedical Sciences

European Science Foundation

Stephane Berghmans

Currently

CEO

Center for Innovation in Medicine

Liege, Belgium

esf forward look on personalised medicine

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personalised medicine

heart of personalised

personalised medicineoffer

personalised medicinewhat

school of medicine

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technological considerations

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