COMMUNICATING THE POTENTIAL OF PERSONALISED MEDICINE TO STAKEHOLDERS IN EUROPE

From Complexity to Clarity:

EPEMED WebinarNovember 27th, 2012Stig AlbinusAPCO Worldwide

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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

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Complexity or Confusion?

EUROPEAN HEALTH CARE LANDSCAPE AND STAKEHOLDER INSIGHTS

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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 innovation

Role and influence of policy makers and payer audiences continue to grow:• Rapid and unpredictable changes in government pricing policies• HTA evaluation to inform reimbursement decisions

EU Pharmaceutical Policy & Legislation EU Medical Devices Legislation

• Reflection process on PM• Revision Transparency Directive• Review Data Protection Directive• EMA Reflection papers and Consultations

on Genomics and PM

• Recast of Medical Devices Directives and IVD Directive

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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 http://social.eyeforpharma.com/patients/personalised-medicine-%E2%80%93-through-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) http://www.sciencebusiness.net/pdfs/PM_survey_results.pdf

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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”

– http://www.hope.be/05eventsandpublications/docpublications/88_personalised_medicine/88_HOPE-PWC_Publication-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…”

– http://www.forfas.ie/media/ffs20120301-Research_Prioritisation_Exercise_Report.pdf

• Patients and patient organizations are largely absent from the public debate – with the exception of cancer advocacy groups

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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

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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

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BIG PROMISE

“Personalised medicine offer tremendous opportunities for better care and raise high expectations”

John Dalli, Former EU Health Commissioner

Reduce medical errors

Improve patient outcomes

Reduce total healthcare spending over 15 years

“Health for All, Care for You,.” Karolinska Institutet Survey on

the Promise of Personalised Healthcare in Europe, 2010

Summary of Opportunities and Challenges for Personalised

Medicine in Europe

BIG OBSTACLES

Research, technology and standards

Lack of common EU policy and regulatory framework

Financial and reimbursement

Lack of education of physicians and patients

“European Perspectives in Personalised Medicine”, European Commission, 12-13 May, 2011

HOW TO ADVANCE ADOPTION OF PERSONALISED MEDICINE?

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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.

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“Health for All, Care for You,.” Karolinska Institutet Survey on the Promise of Personalised Healthcare in Europe, 2010)

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From Newton to iPad

Apple Newton1987

Apple iPad2010

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Typical Adoption Cycle for Disruptive Innovation

AWA

RE

NE

SS

AC

CE

PT

A

DO

PTI

ON

The iPad

The Internet

Genomics

TIME

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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

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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

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Defining Personalized Medicine

Patient-Centricity &Empower-

ment

Drug-diagnostics

pairing

GeneticsBiomarkers

Targeted Therapies

Personal TechnologyImaging

Personal health technologieseHealth

DataKnowledge

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Integrate personal health technologyAND

personalised medicine strategies

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

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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

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The Current Disease Paradigm

Costs

Risk factorsLife style

Pre-disease Diagnose disease

Diseaseescalation

Morbidity Mortality

Level of education and personal engagement

Health education

Earlydetection

Disease interception Therapy Palliative

care

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Costs

Risk factorsLife style

Pre-disease Diagnose disease

Diseaseescalation

Morbidity Mortality

Level of education and personal engagement

Health education

Earlydetection

Disease interception Therapy Palliative

care

The New Personal Health Paradigm

Empowerment & behavior change

Selfcare & involvement

Chronic disease management

Genomics and personal health

technologies

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Leverage Genomics and Personal Technologies 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

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FUTURE APPROACH

Dynamic

Prospective

Multi-modality focus

Multi-disease

Continuous

Patient-centric

Real-life

Population-based

Hypothesis #4: We Need a New Value Model – Oncology as Example

CURRENT APPROACH

Static

Retrospective

Mono-therapy focus

Single-disease

Time-limited

Product focused

Hypothetical

Single-patient view

“Sustaining Progress Against Cancer in an Era of Cost Containment,” June, 2012.http://turningthetideagainstcancer.org/sustaining-progress-discussion-paper.pdf

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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

PM industry

Physicians

Medical societies

Patient groups

Policymakers

Payers

DRIVE CHANGE OF POLICIES AND HEALTH SYSTEMS based on stakeholder movements

THOUGHT STARTERS ABOUT COMMUNICATIONS STRATEGIES

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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 info graphics, 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

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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

– http://content.healthaffairs.org/content/31/4/667.full

• 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

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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

OUTCOMESCreate urgency about enhancing a dialogue and

initiatives across health care and business sectors to drive economic growth in Europe

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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

OUTCOMESCreate a vibrant social community for innovative

collaboration between scientists, clinicians, patients/consumers and policymakers

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DESIRED FUTURE STAKEHOLDER PERCEPTIONS

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Personalised healthcare is a new model that gives me the choice of the right treatment for my particular needs at the right time and empowers me to take more control over my personal health

Patient Perspective

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Physician Perspective

Personalised healthcare is a new model that gives me the professional satisfaction of helping my patient identify risks for disease and prevent, intercept and treat disease earlier so that I can help prolong my patient’s life and quality of life

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Policymaker PerspectivePersonalised healthcare is a new model that gives me opportunity to lead the development of new policies that improve health outcomes, enhance patient safety and longer term reduce health care spending

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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

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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

Discussion

Contact for further questions and discussion:Stig Albinus, APCO Worldwide, New York

salbinus@apcoworldwide.com

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