מיינונג: פערזענליכען מעדיצין - בויען אַ אי.יו. סטראַטעגיע

By David Byrne (פּיקטשערד ונטער), former European commissioner for health and consumer protection

We live, today, in a multi-state Europe that celebrates a rich diversity in culture and languages yet also relies upon our similarities and shared goals. The European Union of which we are all a part has, as one of its core values, the ideal of equality.

One way to measure this equality is through the well-being of all 500 million citizens spread across myriad borders enclosing 28 member states and, as part of that well-being, one key aspect is health.

In a Union that has an aging population, is going through economic struggles and makes space for many political viewpoints – as evidenced by the results of the elections to the European Parliament - it is difficult to think of a recent time when common strategies were more vital to stability and progress than they are right at this moment.

In the area of health much progress is being made scientifically, with breakthroughs in, for example, the way we can diagnose and treat rare diseases. New technologies are developing swiftly and coming more-and-more to the fore, while the potential value of 'Big Data' cannot be underestimated.

Many of the above bring their own attendant problems, such as a necessity for up-to-date incentives and rewards in research, better education for clinicians in respect of new methods, interoperability issues and, in the case of Big Data, collection and sharing complications as well as huge, fundamental questions concerning ethics and privacy.

While these can certainly all be overcome, at this moment in time they represent very real barriers to access for patients who need quick and efficacious assessment and treatment to help them live longer and healthier lives.

אַדווערטייזמאַנט

In my view it is incumbent upon all stakeholders in the realm of healthcare – and especially the policymakers and legislators – to ensure that every citizen of Europe has the same rights and access to the same high quality care as his neighbour, whether that be a neighbour just around the local block, or a neighbour four countries away across the EU bloc. That is the kind of equality that the Union is working hard to achieve and, if anything, we must work harder.

The EU’s role in the health of its citizens could be pivotal. At the moment we have different standards of health care in different countries, different price structures in many of them, and problems in affordability when it comes to cross-border access for patients trying to get the right treatment at the right time.

Add to this a great deal of duplication in research, a lack of infrastructure for sharing data (as well as agreed quality standards on that data and biobank samples), a reimbursement system that is way behind the times and fails to take into account the economics of developing new drugs, plus a long research, development, assessment, approval then, finally, to-market timeline that slows down the process of treating the citizens that need it.

What the European Union needs to do, without delay, is to create a regulatory environment which allows early patient access to novel treatments. Many cancer treatments, for example, do not work for everyone and we cannot rely on a one-size-fits-all model in a Europe of 500 million. The reality is, of course, that new drugs and treatments require expensive research and development, and the current system for incentives and reimbursement certainly needs an overhaul. Much is being achieved via public-private partnerships, such as IMI and IMI 2, but that must be seen as merely the start.

As I’ve suggested above, keeping the population of Europe healthy is an expensive business – and there are key questions about the cost-effectiveness of new and even existing treatments. Many readers will have heard the term ‘personalised medicine’. This is an innovative, speedily growing method of treating patients that uses as much available research, data and up-to-the-minute technology as possible to provide better diagnostics and follow-up for citizens than a one-size-fits-all model. In essence, personalised medicine, or PM, uses genetic information to discern whether a particular drug or regime will work for a particular person and, crucially, helps a clinician to quickly decide which treatment will be the most effective.

While I can already hear the cries of ‘too expensive!’, this is not the case in the medium- to long-term; better diagnostics will ease the burden on healthcare systems in two ways – firstly it will allow a more preventative approach in that gene technology will flag up the likelihood of a particular individual developing a particular disease and provide a good idea of how it will develop, thereby encouraging early intervention. Secondly, efficacious treatment means patients are much less likely to require expensive hospital beds and are more able to continue working and contributing to Europe’s economy.

Put bluntly, there is no point giving, for example, a cancer patient chemotherapy if there is a large chance that it will not work for him or her. This is both a waste of time and money and, potentially, a human life. It is far better to know in advance what the best treatment will be, to discuss it in a fully transparent way with the patient and then to point him or her in the right direction.

One of the hats I wear as a consequence of being involved for many years in Europe’s health issues is as co-chair of an organisation called עאַפּם. This stands for the European Alliance for Personalised Medicine and, through collaboration with a multitude of stakeholders such as patients, clinicians, researchers, academics, industry partners, member state affiliates, policymakers, lawmakers and more, plus its ongoing STEPs campaign (Specialised Treatment for Europe’s Patients) the partnership is striving to make PM part of the agenda for the next 20 years and beyond in the arena of EU policy.

With that in mind, EAPM will hold its יערלעך קאָנפֿערענץ אויף 9-10 סעפטעמבער at the Solvay Library in Brussels’ Park Leopold, close to the European Parliament. This will bring together all stakeholders, including new MEPs, and is timed to precede the appointment of the incoming European Commission.

Both the recently elected Parliament and the EC will, of course, have a major part to play in the future of EU health and, looking ahead, one vital thing that the EU as a whole can do is to embrace PM and help to facilitate its take-up in member states through education, suggestion and in some cases legislation.

I firmly believe that, with the help of the European Union, and with greater collaboration between all stakeholders, we can work towards building a healthier – and thus wealthier - EU for ourselves, our children and for generations to come.

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