#EAPM- Collaboration key to getting the ball in the health-care net

| August 23, 2018

It’s all about the teamwork… We hear that again and again when bosses praise their staff, when football managers are happy after a good result, when someone picks up an Oscar for Best Director. But is there really enough teamwork and collaboration happening,
asks European Alliance for Personalised Medicine Executive Director Denis Horgan?

The fact is, certainly in a health-care sense, there is certainly too little cooperation to tackle the problems that beset our ageing society, which include under-resourced health services, an age spent getting new drugs to market, an increase in chronic diseases, et al.

It’s difficult to solve these issues as a cohesive unit, of course, as health is a national rather than EU competence under the Treaties. But, still, there are solid arguments that what we need is more, not less, Europe – and for practical purposes that means less silo thinking and more co-operation, across borders and across disciplines.

Health care needs modernizing and, while top-down legislation on clinical trials, IVDs and data protection and sharing has helped in recent times, arguably the EU should be doing more from a centralized point, at the very least in encouraging the current EU-28 to share more information on health from data banks, cooperate way-more effectively, work to avoid research duplication and so on, for the benefit of the citizenry.  One step in the right direction is the European Commission’s recent proposal on Health Technology Assessment (HTA) across member states. This outlines plans for future co-operation among EU countries on determining the added value of new therapies.  Specifically, it heads in the direction of mandatory use of joint clinical assessments reports, and, in theory, it could go a long way to allowing necessary medical bodies to catch up with a scientific arena that is moving forward quickly.  By the end of the transition, “all medicinal products falling within the scope and granted marketing authorisation in a given year will be assessed”.

This also covers selected medical devices.  Several issues have been highlighted, including differences in methodology and procedures across member states, while it is noted that limitations to current systems – despite a decade of a certain level of co-operation – include low uptake of joint work and no sustainability of the current co-operative model. However, on the plus-side, achievements thus far include the development of trust between HTA bodies, capacity building, the development of joint tools and earlier dialogues.  A European Commission HTA Coordination Group will attempt to further this approach, meeting regularly to “provide guidance and steer the co-operation”.

It will be made up of member-state experts with sub-groups covering joint clinical assessments, joint scientific consultations, identification of emerging technologies and voluntary co-operation, and we all hope that the extra ‘working together’ will be of huge benefit.  We are in desperate need of innovation and it is clear that progress has brought about a greater need for adaptation through appropriate frameworks that must be designed by experts, in consensus – albeit with plenty of necessary input from regulatory bodies.

After all, we say that ‘sharing is caring’ and one example of collaboration, or at least a solid attempt at it, is currently being debated in the field of genomics.  EAPM’s MEGA concept (Million European Genomes Alliance) proposes the setup of a pan-European networked infrastructure for health information and to undertake a million genome flagship initiative as a co-ordinated effort across European countries.  The idea of the MEGA project grew from the utility of genomic data in improving health care and personalised medicine, plus the rapidly declining cost of genome sequencing.   Breakthroughs in genetics, calls for more and better screening, developments in imaging techniques and the emergence of what we now call ‘Big Data’ have already changed the world of health care for ever. All for the benefit of patients. But we need share more of these new scientific methods and enable higher levels of collaboration.

The possibility of generating a large genomic data set for researchers to use in the EU would also increase the ability to investigate questions across a large number of diseases in different populations, as well as providing more information for understanding the results for clinical care.  Better use of our increasing understanding of the genome is recognized as being one of the main determinants of future improvement in healthcare as part of personalised medicine and is already being increasingly deployed in routine clinical practice.

Sequencing of the all the genetic material of an individual, whole genome sequencing, is becoming an affordable and achievable test for clinical use and creates a powerful resource for research.  Although, as mentioned, health care is a national competence in the EU, EAPM is working on the idea that each member state (or at least a ‘coalition of the willing’) should develop a genome project proportionate to its population, for the benefit of all.  The availability of data from a large number of individuals increases the ability to investigate questions across a large number of diseases in different populations and also provides more information for understanding the results for clinical care in an individual.

Researchers would potentially be able to access millions of genetic markers and accelerate science towards better understanding of diseases and specific patients. Crucially, this would guide choice of therapy, prevention and screening programmes, increasing overall healthcare efficiency and patient outcomes.  It would be a perfect example of coordination, cooperation and teamwork.

And that would be one-nil to Europe.  Important among EAPM’s aims has always been the fostering of partnerships between member states, the health stakeholder community and, of course, those at the absolute centre of health care – Europe’s patients. Once again, as stated above, when it comes to the health of the EU’s citizens, we need more Europe, not less. And that means stepping up collaboration in all areas. Not to do so would represent an own-goal.


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Category: A Frontpage, EU, European Alliance for Personalised Medicine, Health, Personalised medicine

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