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EuroBioForum 2013 - Day 1 | Pierre Meulien


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EuroBioForum 2013 2nd Annual Conference
27-28 May 2013 - Hilton Munich City, Munich, Germany



Genomics and personalised health in Canada

Dr Pierre Meulien, President and CEO at Genome Canada


Published in: Health & Medicine
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EuroBioForum 2013 - Day 1 | Pierre Meulien

  1. 1. EuroBioForum 2nd Annual ConferenceA Collaborative Approach to Personalised MedicinePierre Meulien, President and CEOGenome CanadaMay 27th -28th 2013Munich
  2. 2. Canadian Environment●Publically funded health care system●Provincially delivered (Regional Health Authorities)●Costs the country around $160 Billion per year●Growth in cost is around 4-7% annually (NOT sustainable)●Biomedical research very strong in Canada●Canada spends about 2% of government funded global research butproduces 3% of the highest impact factor publications●Strong clinical networks across the country and - for some diseases - hasamong the best outcomes in the world●However our ability to move the latest technology into healthcare deliveryis low and the way technology is assessed across the country is veryheterogeneous●New technologies are often seen as just an added cost and economicanalyses performed are not convincing enough for the payers
  3. 3. The Heart of Canada’s Genomics EnterpriseThe MetabolomicsInnovation CentreU. Vic./Genome BCProteomics CentreVancouverTorontoMontrealVictoriaGenomics InnovationCentre at the BCCA GSCEdmontonThe Centre forApplied GenomicsB.C.AlbertaPrairieGenomeCanadaOntarioAtlanticMcGill University &Genome QuebecInnovation Centre• 6 Regional Genome Centres• 5 Science and TechnologyInnovation Centres• 160+ Genomics Projects• $2 Billion Investment• 7 Key Economic Sectors:Agriculture, Energy, Environment,Fisheries, Forestry, Health andMiningQuébec
  4. 4. Sequencing Genomes is truly disruptive• Technology that has – over the past 10 years-decreased in cost by 1 million fold• Is perturbing the status quo as reflected by many,many questions being askedWhat can your genome tell you about your healthstatus?What can it tell you about your health future?Who owns your genome data?Who has access to it?How will it be used?• Will require massive change to an already stressedsystem if we want genomics to be part of personalhealth records
  5. 5. Personalized MedicineSpectrum of Genetic Contribution to DiseaseVery rare single genedisordersMore common singlegene disorders• Cystic Fibrosis• Hemophilia• Huntington’s Disease• Muscular DystrophyDisorders with prominentgenetic contribution• Childhood cancer• BRCA 1/2 Breast cancer• Some forms of autismspectrum disorders• Adverse drug reactionsGenetic susceptibility tocertain common diseases• Colon cancer• Certain cardiovasculardiseases• Certain forms of AlzheimerMost commonchronic diseaseswith many geneticfactors but alsomajorenvironmentalfactors contributingto disease onset
  6. 6. So how do we translate when we need toconsider a lot of complex issues?• How good is the technology? (clinical validation)• In a fast moving field, when do we decide that “now isthe time for transfer”• Is it easy to adapt existing clinical laboratorystructures?• Who will be making these decisions? (and based onwhat criteria?)• Technology assessment based on sound economicsand clinical benefit?• Who will pay?• How can behavioural change be accelerated
  7. 7. What we need now• Demonstrations that the technology candeliver real value to patients• Demonstrations that integrating thetechnology within the healthcare system willbe cost effective
  8. 8. How many human single genedisorders remain to be discovered?Single-gene disordersgene known~2900gene unknown~3600suspected single genedisorders~4500300DisordersProposed
  9. 9. 1 Story… Undiagnosed Neurodegeneration 4, 2011
  10. 10. 2012 Large-Scale Applied ResearchProject CompetitionGenomics and Personalized Health• Program partnered with the Canadian Institutes of HealthResearch• $71 Million of federal money more than doubled throughpartnerships for a total of $150• Required teams to provide an economic analysis and rationalefor why their particular application will demonstrate value tothe health system• Required relevant Economic, Environmental, Ethical, Legal andSocial (GE3LS) research• Teams were requested to provide detailed development planfor integration into the HC system• Teams had to have buy-in from the payer and clinicians andmust have considered the regulatory frameworks existing inCanada• 17 projects funded – announced – March 26th.
  11. 11. Some examples of approved projectsIncreasing effectiveness of drugs, lowering adverse drugreactions and/or defining intervention strategies bystratifying patients according to molecular profiles Epilepsy Autism Lymphoma, Breast Cancer, Glioblastoma, andother cancers Rare diseases Stroke HIV Inflammatory Bowel Disease Cardiovascular
  12. 12. Integration of Genomics intothe Healthcare System• Develop receptor capacity for technology pull (capacity forclinical and translational research)• Involvement of the private sector• Educate and train healthcare professionals to be proficientusers of the technology• Ensure information systems are modern and harmonizee-patient records• Role of patients and advocacy groups in demanding evidencebased medicine• Robust technology assessments focused on improvement onclinical outcomes and economic benefit analyses• More balance between prevention and treatment• Legislation to “encourage” behaviour change in the youngerpopulation
  13. 13. •Partnership•Case studies including economic rationale• Canadian model of health delivery (publicallyfunded- provincial- central regulation)WHAT CAN WE OFFER?
  14. 14. Learning what other jurisductions are doing• E-health records and how genomics data can beintegrated• How data from large cohort studies can beinterrogated (new international platform beingconsidered?)WHAT ARE WE LOOKINGFOR?
  15. 15. 1. We need many demonstrations (to payers) thatPM offers sustainable value (this will be the onlyway to generate “pull” in the system)2. We need to “solve” health the informaticsconundrum3. We need to move genomics to the clinical spacein a more “urgent” mannerTOP 3 recommendationsfor achieving tangible results
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