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Opinion: The votes are in - what next for EU health?

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Helmut_Brand_photoBy Professor Helmut Brand (pictured), co-chairman of the European Alliance for Personalised Medicine

In the wake of what has been a higher election turnout than in 2009, Europe’s voters have decided upon the composition of the next European Parliament, the eighth legislature since direct polling was introduced in 1979.

As well as an intake of new MEPs we will also (a little later) know the names and faces of the upcoming College of Commissioners plus, of course, the new Commission president as José Manuel Barroso completes his second term. So, theoretically at least, it’s all change.

While, at the time of writing, we don’t yet know who will hold the top Commission post in the arena of health, we do know how the European Parliament will look - with big gains for populist and far-right parties even forcing a top-down rethink of the ‘State of the Union’ as a quick response to widespread dissatisfaction among Eurosceptics.

But despite all the soul-searching let us not forget that pro-European parties are still in the majority and, once all the navel gazing is over, the EU remains strong and must move on. And this is just as well, as there is much to be done, not least in respect of the health of the 28-nation bloc’s 500 million citizens.

In fact, keeping Europe healthy can assist greatly in the plans, schemes and dreams that are likely to come out of the ongoing high-level talks. According to European Council President Herman Van Rompuy, member state leaders have agreed, in light of the election results, to put the economy at the heart of future discussion. Van Rompuy added that “as the Union emerges from the financial crisis it needs a positive agenda of growth”.

Well, of course. And two things occur to me here; firstly, a healthier Europe will mean citizens spending less and less time in hospitals under expensive treatment regimes, often at a direct cost to the taxpayer, and it will also mean that people receiving the right treatment at the right time are more able to stay in the workplace, thus generating wealth rather that whittling it away. By the same token, a shift towards preventative medicine will reduce costs still further.

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Secondly, a focus on research into new medicines and cutting-edge treatments will also create jobs – whether they be in research itself, education, design and manufacture of in-vitro products or within the pharmaceutical industry. Such a focus will clearly benefit society and, if Europe is in the vanguard of developing new ways of keeping citizens healthy, it will inevitably attract investment from outside of the bloc.

It’s fair to say that the financial crisis challenged the principle of solidarity in Europe. Austerity measures are always unpopular wherever they occur and the impact upon citizens is abrupt and painful. Governments often opt for the short-sharp-shock solutions and focus on the ‘easy’ targets. Health care (and the people who need it) is always one of the first victims. But this is a short-sighted view, as I’ve outlined above. The maths doesn’t work.

So how can we ensure a healthier Europe coming out of these tough times? As a co-chair of EAPM (the European Alliance for Personalised Medicine) I believe that the road we must follow has to have personalised medicine as its destination. Essentially, personalised medicine, or PM, is an innovative method of treating patients that utilises research, data and up-to-the-minute technology to provide better diagnostics and follow-up for citizens than is currently the case. It uses genetic information to discern whether a particular drug or regime will work for a particular patient and assists clinicians in deciding which treatment will be the most effective. It can also have a huge impact in a preventative sense.

If, through genetic profiling, a doctor knows that Drug A will not work for 30 percent of his patients, for example, prescribing that drug would be a waste of money, time and, in a worst-case scenario, possibly a life. Without doubt it is far better to know in advance what the best treatment will be, to inform the patient, and to let him or her weigh the choices.

But, despite huge leaps in recent years, we are still quite a distance away from achieving the goals of PM. Some of the challenges facing patients and the health systems and industries that care for them include issues with different standards of health care in different countries, different price structures in many of them, and affordability problems when it comes to cross-border access for patients trying to get the right treatment at the right time.

On top of this we have this a large amount of duplication in research, a lack of infrastructure for sharing data, a lack of agreed quality standards on that data as well as, for example, biobank samples, an out-of-date reimbursement system that fails to take into account the economics of developing new drugs, plus a long process that causes unnecessary delays in getting new drugs to market.

So, given that it is incumbent upon the EU to maintain its values and principles of access to good-quality care, equity and solidarity, what can the Union do as a whole? When it comes to health, it clearly must do something radical to tackle the ‘Big Problems’ as it has become abundantly clear that these problems cannot, in the main, be overcome by member states acting alone.

As a very good start, what the European Union needs to do, without delay, is to create a regulatory environment which allows early patient access to novel treatments. We can no longer rely on a one-size-fits-all model in a Europe of 500 million as it patently does not work. Of course, new targeted drugs and treatments require expensive research and development, but the current system for incentives and reimbursement needs a fairly drastic makeover. The EU is already achieving a great deal through public-private partnerships, such as IMI and IMI 2, but more needs to be done.

Together, the new Parliament and Commission are in a unique position to push the health agenda forward and, with that in mind, EAPM will hold its annual conference on 9-10 September at the Solvay Library in Brussels’ Parc Léopold, close to the European Parliament. This will bring together all stakeholders, including new MEPs, and is timed to precede the five-year term of the incoming European Commission.

EAPM, through its 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) is striving to make PM part of EU health policy for the next 20 years and beyond.

With the backing of the European Union, I believe we can work towards building a healthy and wealthy Europe, one worthy of its stated goals - not only for our current 500 million citizens, but for generations to come.

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