Precision Medicine meetup — how to tailor our available treatments
Our third meetup this year was unconventional as Health Hub Vienna held a hybrid event (both on-site and digital) on precision medicine. The physical event took place under the beautiful roof of the University Wien Arkadenhof. Our digital event was one of our most attended and most interactive ones, with a possibility for the audience to engage with the speakers and experts on site, as well as participate in hybrid common activities including a hands-on Patient Journey Workshop. Our speakers were researchers, founders, clinicians, public players, and corporates. Whether stepping on the physical stage or tuning in digitally, they could seamlessly debate on this fundamental topic.. Overall, the event was a huge success with over 200+ registrations from relevant stakeholders worldwide.
Precision medicine will reinvent medical professions and transform the patient experience
Precision medicine (PM) is a new way of prevention, diagnostics and treatment that aims to replace the one-size-fits-all strategy of conventional medical practice. In conventional medicine, treatment plans were considering individual factors such as age and gender, pre-existing conditions, and other circumstances. What really sets precision medicine apart is “the degree of reliance on data — especially genomic data — to make decisions about specific treatment paths that may be more or less effective for the individual at hand.” The applicability of precision medicine extends from prevention to treatment: involving every step of the patient journey, most importantly including whether a person becomes a patient at all. Combining genetically stratifying information with lifestyle and other individual factors and observing patterns of treatment efficacy and considering subjective outcomes is a typical workflow for precision medicine. Regardless of the uniqueness approach, the conclusions and effectiveness of a preventative, diagnostic or therapeutic tool must be validated via extensive clinical trials for safety and potential applicability for public reimbursement. One obvious benefit to PM is to boost the potential to predict what unique genetic factors make certain people vulnerable for illnesses and at the same time, increase the likelihood to predict which treatment will be most effective for individual patient.
Receiving earlier and more precise diagnostics and treatments, as well as putting increased focus on prevention together has a huge potential to improve healthcare services while lowering costs, making it highly beneficial for all players involved — a true win-win.
“Ideation without execution is just hallucination” — Keynote speakers to highlighting the importance applied precision medicine.
The event kicked off with Dr. Vonda Wright’s impulse keynote. She is a practicing orthopaedic who strives for engagement and innovation in medicine. Her basic science and prevention focused clinical research has resulting in multiple grants, presentations and peer -reviewed publications as well as several books. Dr. Wrights speech focused on the importance of bringing the technical innovation from the bench to bedside and focusing on execution. Her insight on how to pivot from the “watch and wait” mindset to application were manifold. Firstly, she suggested to consider the patients as a whole person instead of offering ailment and organ-based care. Secondly, entrepreneurs should involve clinical champions early, since the ideas need to be confronted by the experienced users. This prompts her third notion to form partnerships early, since precision medicine is only feasible if all stakeholders work together on bettering the patient journey. Finally, Dr Wright recommended to be like the Avengers, ideate for the future, which is especially important considering the amount of time it takes to get from prototype to a reimbursed solution, and by that time some of these approaches can become obsolete.
Our second keynote speaker, Dr. Thomas Wilckens is an internationally recognized entrepreneurs of precision medicine. Dr. Wilckens is a CEO of InnVentis Ltd., a company using omics (including genomics, proteomics, metabolomics, clinical data, literatur mining & artificial intelligence) to focus on finding personalised treatment solutions for inflammatory chronic disease. His talk focused on inspiring stakeholders to replace intuition-based medicine with data based analytical approaches. Through several examples, he highlighted the importance of changing reimbursement models from pill-based to outcome-based approaches. He urged that digitalization is key in all other successful business ventures (“Airbnb doesn’t have their own homes, Uber doesn’t own cars”). And that stakeholders must accept that sufficient quality and amount of health data does not come cheap and without collaborative efforts.
Panel discussion — innovation needs three things: data, data, data (and reimbursement)
The impulse keynotes were followed by a vivid conversation between members of different fields of healthcare and related academic, private, and public sectors. Lack of standardisation in data collection, availability, and motivation to contribute from the healthcare and patient side, as well as the severe need for robust data to make reimbursement decision was the main topic of the panel discussion,
How to use existing data for prevention? The difficult case for upfront costs
Insufficient implementation of available data Dr. Birgit Vogel, a postdoctoral research fellow and cardiovascular imaging fellow works at the Icahn School of Medicine at Mount Sinai (New York) and was present at the event virtually. One example for lack of tailored prevention and diagnosis from the field of cardiovascular disease that it is a known fact that women are somewhat protected until the menopausal age, and so the risk of female individuals are severely underestimated, even though young women have worse prognosis than age matched males in cardiovascular disease. Dr. Nikolaus Krall, founder and CEO of Allcyte, a biotech start-up company focused on functional drug testing in primary human material brought a more pragmatic perspective to the panel by drawing attention to the fact that healthcare innovation does not only have to overcome a long and hard regulatory process, but solutions addressing prevention and diagnostics are much harder to get funding for due to the lack of reimbursement or sustainable business models as compared to selling pills. Dr. Krall pointed out that since we have limited resources for healthcare innovation, it seems that much more is possible technically that the public system can afford. Dr. Vogel seconded that by bringing up an example for a low-cost CT technique that could aid the preventative decision on a patients care, which is not reimbursed yet due to excessive focus on ailment as opposed to preventative care. Dr. Krall suggested outcome-based payments, whereby the patients’ perceived wellbeing after the treatment should be considered in the renumeration.
Finding and agreeing on new standards for data collection
Professor Tanja Stamm, Head of Section for Outcomes Research at the MediUni Wien, Institute of Outcomes Research agreed the idea that reimbursement models need to change and emphasised that healthcare systems can only work on a value base if we have sufficiently standardised way to measure good amounts of relevant data. Only standardised data collection methods can enable the cross cohort, wide range insight precision medicine needs to rely on. The outcomes measured should include factors measuring what is making the patient’s life better (psychosocial factors), not only biomarkers.
Making decision on adopting techniques require hard facts for taxpayers and HCPs
Martin Brunninger, Director General of the Austrian Federation of Social Insurances contributed with the valuable perspective of the public sector. He called attention to the fact that reimbursement can only happen with solutions where the outcome is clear and the evidence stemming from clinical research is solid. He added that the enabling technologies (which aim to make the practitioners life easier or are in support of already existing tools and techniques) of precision medicine, such as surgical robots are more easily reimbursed then a novel screening or treatment approach lacking hard evidence for working better than the already existing ones. Alexandra Reich-Rohrwig who is responsible for PremiQaMed Group’s business development especially regarding pharmacokinetics explained the importance to consider individual factors such as how does an individual metabolise a drug in choice of medication as well as finding the right dose. This is particularly important and can save a lot of time effort and inconvenience for patients for example dealing with mental health problems, as their correct treatment regimen (right medication, right dose) can take up to 1.5 years to find. The main barriers according to her remain the education of the doctors and patients about the available treatments, reimbursement (as for example pharmacokinetic tests are currently not supported) and being open to accept and adopt innovation.
The precision medicine bucketlist: what would be your wish for the future?
Lastly, the panel was discussing a potential wish that could ease these barriers and make the adoption and reimbursement of the available therapies faster. The panel was in unison about emphasising the importance of interoperability and standardised data collection initiatives, truly individualised diagnostic, and therapeutic solutions instead of putting the patients into smaller and smaller buckets, then applying one size fit all approach and a more rational public discussion and debate on data security and privacy, that includes the patients.
What would be your #1 wish to accelerate precision medicine?
