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Discover the New challeNges of RegeneRative Medicine and genoMicsinterview with Serge Morelli, ceo of aXa assistance, and Xavier Blanchard, ceo of aXa assistance, asia region.

I n recent years, there has been a rise in regenerative medicine and gene-based medicine, that is, personalised medical treatment plans based on individual gene sequences and stem

cells. While the topic of stem cells still remains an issue of public and ethical debate, scientists around the world have been studiously working on cracking the code of re-growing organs and changing the genetic make up of diseases for better prognosis.

The current landscape of regenerative medicine and genomics is already being largely adopted for the treatment of some cancers, with breast and prostate cancer being a large focus of studies. By identifying key molecular switches, researchers have been able to stop cancer cell growth or kill the cancer cells directly.

In order to make sense of what this means for real-world application, InfoMed spoke to Serge Morelli and Xavier Blanchard, CEO of AXA Assistance and Asia Region CEO respectively.

inFoMed: there’s been a lot of work done in regenerative medicine and genomics. What does the real-world application look like in asia for the next three years?aXa: There are two big questions to that. First, is what will be “off the shelves” in three years from now and two, what will be specific to Asia? Genomics medicine is more about adapting the research to the genomic

“Asian teams are leading the race in some of the clinical trials.”

profile of individuals and is progressing very well in terms of accuracy, costs, and usage in treatment plans. It is already mainstream in the treatment of some cancers and will progress continuously.

Regenerative medicine is understood as the usage of stem cells to regenerate organs or functions, which are deteriorated by a disease or accident, and is still in its fledgling stages of research. Even though it’s progressing and the number of clinical trials are growing exponentially, it is still at the research stage. This means it’s not yet ready to be adapted into current practices for a good decade as trials must be replicated and clinical advantages proven.

Additionally, the level of success differs from one organ to another and the question of costs compared to classic treatments will still be there.

And then there’s a question of what will be the place of Asia in this landscape? Major, definitely, when you see the share of Asia in clinical trials. Look at Japan, who are are leading the race in hepatocytes (liver cells) and macular degeneration research.

inFoMed: With advancements in genomic screening and testing, will this be a part of standard medical insurance plans, like aXa’s Health insurance, covering diagnosis, treatment and screening tests?aXa: It starts with compliance with each country’s legal

Serge Morelli CEO of AXA Assistance

environment and data protection. Genomic screening and testing is not always legal due to these compliance issues. Beyond that, the available information and consequences to patients are unclear.

And a question we have to ask is do they even want their insurance company to be involved in such testing, and at what conditions? The question of financial coverage by insurance plans comes only after these questions have been answered, which will probably vary market to market. The only thing certain at this stage is that insurance companies must be aware of these progresses and detect when each specific treatment leaves the status of clinical research and becomes an actual medical option.

inFoMed: What is the economic impact of regenerative medicine and genomics to preventive medication and disease treatment, especially on the user? aXa: In terms of economics, the answer varies from individuals to individuals and from disease to disease. To give some perspective, regenerative medicine in orthopedics will definitely open some competition in terms of treatment plans between prosthesis and regenerating bone cells. Down the road, we can look at regenerating pancreas cells as an alternative to life-long insulin treatment. The potential economic impact of such technologies is huge but is only theoretical at

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this stage. In the genomic field, the impact is already visible in the pharmaceutical industry, with some pharmaceutical companies proposing to be paid based on the success rate – which is linked to the genomic profile.

inFoMed: How can companies like aXa assistance make these options an integrated part of one’s personal health plan?aXa: By advising our customers on the value of such procedures, comparing the advantage with more traditional approaches and by giving them the option when it becomes relevant for our customers pathologies. We see access to complex information and capability to explain treatment options easily as key benefits in the future for our customers.

inFoMed: as a company that provides medical insurance, how does aXa contribute directly to research and development efforts in the field of healthcare?aXa: AXA is a key player in the field of research through the AXA Research Fund (ARF). The ARF is the science philanthropy initiative of the AXA Group that seeks to advance knowledge on global risks for the benefit of Society.

Created in 2007, this fund will spend a total of €200M from 2007 to 2018. At this stage, the ARF has spent €131M on 449 projects, supported with 250 institutions, granted to 50 nationalities of researchers working in 32 countries.

Life risks represent around one third of its activity in terms of budget and number of projects supported.

inFoMed: tell us about the elite Medical network, and how it will be a game-changer in the field of medicine.aXa: The Elite Medical Network project started three years ago from the need of our customers to get proper guidance when it comes to the best clinical options worldwide. It became clear to us that there was no such thing as a global ranking of medical teams for any pathology. Such rankings and orientation systems existed at country level, but when it came to comparing medical institutions at global level, there was no trustworthy tool or publication.

For these reasons, we created a list of the best medical teams worldwide for each division of medicine. This was done through numerous interviews, comparison of answers from different continents, crosschecking of names given by our experts, accumulation of knowledge on equipment, research, and specificities of each team vying for global leadership. Our medical board composed of deans from prestigious medical universities representing America, Europe and Asia validated this pragmatic and ethical approach.

As a result, we know now which are the teams globally have the highest level of excellence. More importantly, with insurance mutualisation a second medical opinion by an elite expert costs only a few euros for each individual who subscribes to it.

inFoMed: What are things aXa does personally, in terms of practices that are aimed to benefit and raise the standard of healthcare within its organisation?aXa: AXA health plans and benefits vary from one country to another depending on local laws and market standards. One of the things AXA employees around the world are encouraged to do is practise a physical activity during the corporate social responsibility week. All the physical exercise practised during this week is converted in monetary grants to charitable institutions and direct physical improvement for the employees. This is just one example, of course.

inFoMed: How can employers play a part in raising the healthcare standards of the community?aXa: Employers are a leading force in the evolution of the healthcare industry. Through the benefits they grant their employees, they shape the evolution of healthcare provision. Providing second medical opinions programmes, organising treatment abroad when necessary, encouraging wellness and healthy living programmes, educating the workforce on behavioural risks and benefits: a lot can be done with good enrollment results and clear return on investment through the health and motivation of the workforce.

Xavier BlancHard Asia Region CEO