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From Complexity to Clarity: Communicating the Benefits of Personalised Medicine to Stakeholders in Europe


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From Complexity to Clarity: Communicating the Benefits of Personalised Medicine to Stakeholders in Europe

  2. 2. Overview of Presentation• Setting the stage: Complexity or confusion?• European healthcare landscape• How to advance adoption of personalised medicine – learning from other disruptive technologies• Five hypotheses about change• Four thought starters about communications strategies• Desired future stakeholder perceptions• Opportunities for EPEMED and its members 2
  3. 3. Complexity or Confusion? 3
  5. 5. EU Health and Pharmaceutical Policy Today Trends & ChallengesSustainability of European healthcare systems under threat:• Strong focus on cost-containment with healthcare reform and European austerity measures• Changing demographics – ageing population• Lack of recognition of the value of innovationRole and influence of policy makers and payer audiences continue to grow:• Rapid and unpredictable changes in government pricing policies• HTA evaluation to inform reimbursement decisionsEU Pharmaceutical Policy & Legislation EU Medical Devices Legislation• Reflection process on PM • Recast of Medical Devices Directives and• Revision Transparency Directive IVD Directive• Review Data Protection Directive• EMA Reflection papers and Consultations on Genomics and PM 5
  6. 6. EU Stakeholder Insights about Personalised Medicine• 70% of primary care physicians, neurologists and cardiologists expect personalised medicine to become routine in their own clinical practice within five years (EU and US survey) – 37% of oncologists claim to be „very familiar‟ with personalised medicine and only 6% of other specialists and 5% of PCPs – “Eye for pharma” website, 16 October 2012 eyes-physician• Personalised healthcare will deliver improved health outcomes (64% of 840 respondents) – Absence of clear regulatory guidelines is causing delay in marketing and authorisation of personalised health care products and services (over 60% of respondents) – Healthcare spending will increase short term - 5 years (58% of respondents), but will decrease long-term - 15 years (46% of respondents) – Europe-wide cooperation will be necessary for the development and adoption of personalised healthcare (80% of respondents) – “Health for All, Care for You,” Karolinska Institutet Survey on the Promise of Personalised Healthcare in Europe, 2010) 6
  7. 7. EU Stakeholder Initiatives Around Personalised Medicine• Some European hospitals are engaged in the development of new imaging technology and genetic tools, mostly in cancer, but state “major challenges including learning curve for doctors and consumer behavior” – Personalised-Medicine_February_2012.pdf• Few initiatives at the Member State government level – Ireland one exception citing personalised medicine as key area for commercialisation – “Research Prioritisation Report” recommends “mapping exercise to identify areas of strength and opportunity, e.g., personalised medicine/diagnostics, biomarkers…” –• Patients and patient organizations are largely absent from the public debate – with the exception of cancer advocacy groups 7
  8. 8. EU/US Comparisons• While there are many similarities, the single-payer European healthcare systems may provide a better foundation for personalised medicine, particularly population-based strategies – There are however large variations across Member States• European austerity measures will short term represent a significant challenge for investing in personalised medicine• Multi-tiered US health care system may enable advances in personalized medicine – However limited to better funded health plans, integrated delivery systems and upscale markets 8
  9. 9. Key Stakeholder Overview• Hope, but limited understanding – Continued general belief in the promise, but major obstacles due to limited understanding• Oncology is still the main focus, but less obvious – Growing controversy about the reality of the promise• Questions about physician readiness and clinical utility – GPs believe PM will eventually change medical practice, but limited experience• Consumer privacy concerns – Consumers are hopeful, but concerned about privacy implications• Policymakers on the fence – Policymakers are not clear about the relevance short term – Still waiting for the Commission‟s …omics report!• Cost is a concern – General concerns about increase in costs short-term• There is a huge information and communication gap – Limited, if any information in general consumer and business media 9
  10. 10. Summary of Opportunities and Challenges for Personalised Medicine in Europe BIG PROMISE BIG OBSTACLES “Personalised medicine offer Research, technology and standardstremendous opportunities for better Lack of common EU policycare and raise high expectations” and regulatory framework John Dalli, Former EU Health Commissioner Financial and reimbursement Reduce medical errors Lack of education of Improve patient outcomes physicians and patients Reduce total healthcare spending “European Perspectives in Personalised Medicine”, European Commission, 12-13 May, 2011 over 15 years “Health for All, Care for You,.” Karolinska Institutet Survey on the Promise of Personalised Healthcare in Europe, 2010 10
  12. 12. Hypothesis #1: Social Change is a Real Barrier• While there are scientific, regulatory and financial obstacles to advancing personalised medicine, the major barrier to unlocking its potential is the human factor: – Personalised medicine represents a powerful, disruptive and radical change of social and cultural interactions and communications among all stakeholders in all aspects of the health care delivery chain – A typical example of moving a hot technology from the laboratory to market – Particularly in a conservative sector such as health care “ For the technology to be fully implemented and integrated across the healthcare value chain, stakeholders recognised both scientific and structural hurdles that needed to be overcome. In fact, without a “basic understanding of human biology and disease mechanisms” “ the majority of the stakeholders failed to see a smooth transformation from the traditional healthcare paradigm to personalised healthcare. “Health for All, Care for You,.” Karolinska Institutet Survey on the Promise of Personalised Healthcare in Europe, 2010) 12
  13. 13. From Newton to iPadApple Newton Apple iPad 1987 2010 13
  14. 14. Typical Adoption Cycle for Disruptive Innovation The iPadADOPTION The InternetACCEPT GenomicsAWARENESS TIME 14
  15. 15. Learning from Disruptive Innovation Cycles• Need to generate awareness and acceptance among users and consumers before adoption happens• Adoption is based on emotional attachment and experiences of personal value – not only a scientific or technical rationale We need to HUMANISE AND PERSONALISE genomics medicine 15
  16. 16. Hypothesis #2: Personalised Medicine is More than Genomics• Personalised medicine/healthcare is the use of information to tailor treatment to individual groups of patients. This can include using genetic data, diagnostic tests or patient databases for segments of the population to maintain health, prevent disease, improve the outcomes of therapy and patient safety while reducing costs “ In effect we are looking at refining the definition of health and disease – to the point where the current definitions will be obsolete. “ Ruxandra Draghia-Akli, Director-General for Research and Innovations, European Commission, “European Perspectives in Personalised Medicine, 12-13 May, 2011 16
  17. 17. Defining Personalized Medicine Drug- Genetics diagnostics Targeted Biomarkers pairing Therapies Patient- Centricity & Empower- ment Personal Technology Imaging Personal health technologies eHealth Data Knowledge 17
  18. 18. Leverage Personal Technologies to Drive Acceptance of Personalised Medicine• Personal technologies – from electronic personal health records to portable smart phones – represent opportunities for empowering patients in the management of their own health by accessing genomics data – Engage patients in the development of personalised medicine solutions: clinical trials, donations to tissue/biobanks, individual genetic tests – Engage consumers/patients in collaboration with physicians Integrate personal health technology AND personalised medicine strategies 18
  19. 19. Hypothesis #3: Broader Acceptance of PM with New Health Paradigm• Communication is more than a vehicle for educating stakeholders about the benefits of personalised medicine• Communication is an intrinsic driver of change• The personal and social involvement and engagement of stakeholders is the pathway to awareness, acceptance and adoption 19
  20. 20. The Current Disease ParadigmLevel of education andpersonal engagement Costs Health Early Disease Palliative Therapy education detection interception care Risk factors Pre-disease Diagnose Disease Morbidity Mortality Life style disease escalation 20
  21. 21. The New Personal Health ParadigmLevel of education andpersonal engagement Costs Health Early Disease Palliative Therapy education detection interception care Genomics and Empowerment & Selfcare & Chronic disease personal health behavior change involvement management technologies Risk factors Pre-disease Diagnose Disease Morbidity Mortality Life style disease escalation 21
  22. 22. Leverage Genomics and PersonalTechnologies to Create New Health Paradigm • Utilize technologies – genomics, personal health technologies, eHealth, etc. – to drive behavior change • Empower patients/consumers to take more control over their own health and engage in decisions about prevention, disease interception Improve HEALTH OUTCOMES AND QUALITY OF LIFE while reducing costs 22
  23. 23. Hypothesis #4: We Need a New Value Model – Oncology as ExampleCURRENT APPROACH FUTURE APPROACH Static Dynamic Retrospective Prospective Mono-therapy focus Multi-modality focus Single-disease Multi-disease Time-limited Continuous Product focused Patient-centric Hypothetical Real-life Single-patient view Population-based “Sustaining Progress Against Cancer in an Era of Cost Containment,” June, 2012. 23
  24. 24. Hypothesis #5: Strategic Sequencing and Partnerships• We need the buy-in from clinicians, medical societies, healthcare professionals and patient associations before we can get policymakers‟ and payer‟s attention Physicians PolicymakersPM industry Medical societies Payers Patient groupsDRIVE CHANGE OF POLICIES AND HEALTH SYSTEMS based on stakeholder movements 24
  26. 26. Thought Starter #1: Humanise Genomics• Create and tell human and emotionally powerful stories about the experiences of patients utilising genetic tests and targeted therapies• Expand focus and education beyond oncology• Engage scientists and clinicians as partners in story telling to tell their personal story• Utilise infographics, animation and video to simplify and humanise complex science around genomics OUTCOMES Create an emotionally exciting image of what personalised medicine means to the individual 26
  27. 27. Thought Starter #2: Communicate and Drive Adoption of New Value Model• Demonstrate the benefits of personalised medicine on patients and populations through health economic modeling – Utilize prospective modeling of future health and socioeconomic scenarios for Europe – Build on study of the value of cancer care comparing US and Europe in Health Affairs, May 2012 - utilise data from EUROCARE registriesPhilipson et al: An Analysis Of Whether Higher Health Care Spending In The United States Versus Europe Is „Worth It‟ In The Case Of Cancer –• Communicate the new value model to build understanding of the value of investing short-term in personalised medicine in Europe to drive significant, longer term positive impact on the economies, productivity and patient survival – pilot in specific disease states and geographies OUTCOMES Create tangible vision about a new, personalised health care system in Europe 27
  28. 28. Thought Starter #3: Connect PM Innovation to Business Growth• Map and identify opportunities for the development of personalised medicine, diagnostics and biomarkers as important drivers of commercialisation, business growth and jobs creation• Highlight advances in science, innovation and technology to engage the PM industry in dialogue with industry, business leaders and policymakers about the strategic role of health innovation in the economic recovery and future growth in Europe• Leverage the priorities of the upcoming Irish presidency of the EU to initiate new initiatives around PM, innovation and economic growth OUTCOMES Create urgency about enhancing a dialogue and initiatives across health care and business sectors to drive economic growth in Europe 28
  29. 29. Thought Starter #4: Build Ecosystem• Take a page from the technology industry and create an open, social eco-system for collaboration around personalised medicine (SAP, Intel, others)• Engage all key stakeholder groups – physicians, patients, consumers, payers, policymakers – in ongoing conversations and exchange of experiences• Stimulate Transatlantic dialogue and networking• Sponsored by industry, but with free exchange of ideas and opinions OUTCOMES Create a vibrant social community for innovative collaboration between scientists, clinicians, patients/consumers and policymakers 29
  31. 31. Patient PerspectivePersonalised healthcare is a newmodel that gives me the choiceof the right treatment for myparticular needs at the right timeand empowers me to take morecontrol over my personal health 31
  32. 32. Physician PerspectivePersonalised healthcare is a new modelthat gives me the professional satisfactionof helping my patient identify risks fordisease and prevent, intercept and treatdisease earlier so that I can help prolongmy patient‟s life and quality of life 32
  33. 33. Policymaker PerspectivePersonalised healthcare is a newmodel that gives me opportunity to leadthe development of new policies thatimprove health outcomes, enhancepatient safety and longer term reducehealth care spending 33
  34. 34. Opportunities for EPEMED and Its Members• Conduct survey among policy and opinion elites on how to communicate about personalised medicine• Map and identify new and disruptive ways of communicating the potential benefits of personalised medicine, for example – Humanizing the benefits – Integrating PM with personal health technology revolution – Demonstrating the economic benefits of PM – Connecting PM innovation with economic growth• Pilot new ecosystem for multi-stakeholder engagement• Drive Transatlantic Dialogue 34
  35. 35. Conclusions: Escalating Momentum• A disruptive technological innovation such as personalised medicine requires disruptive communications and social engagement• We need to unlock the emotional drivers and barriers to achieve broader adoption• Integrating personal health technologies and personalised medicine represents a strategic opportunity• It will take time, and the process is not linear, but it will happen• It will continue to be a complex process and not always as clear as we hope… But industry innovators have a huge opportunity for escalating the momentum, leading and driving change 35
  36. 36. DiscussionContact for further questions and discussion: Stig Albinus, APCO Worldwide, New York @apcoworldwide 36