Personalized medicine and Big data, the two ways to sustainability
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The pandemic emergency has left its mark, in individual and social behavior. And even the words have taken on new meanings. This is the case of a used and abused term, sustainability, which in the light of the last two years has been declined differently in the various fields. “The concept of sustainability referred to the health system has undergone a profound transformation, especially when it is combined with that of innovation”, says Francesco Frattini, General Secretary of the Roche Foundation, speaking at the presentation of the AdStore Human Report in Parma in recent days .
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At the beginning of the year 2000, the two terms seemed irreconcilable. “It happened when highly innovative therapeutic solutions emerged, such as monoclonal antibodies, drugs intended for unmet medical needs in medical sectors such as oncology, chronic neurodegenerative diseases and so on”, continues Frattini. Medicines that were beginning to weigh on health systems, especially in Italy where the public service provides citizens with essential medicines free of charge. Thus, the entry of these new drug classes has begun to put a strain on the accounts. But are they really antinomic concepts? “It was necessary to find a meeting point: the public and private sectors, ie the payer on one side and the industry on the other, had to find a way to reconcile the two worlds. Because innovation is necessary to meet the needs of the citizen, but it must be sustainable. For this reason – continues the Secretary General of the Roche Foundation – the industry has developed, in concert with the national regulatory agencies, models to make innovation more sustainable. I am talking, for example, of pay-per-performance agreements, risk sharing, systems capable of sharing the weight of innovation equally on the shoulders of the national health service, but also on those of industry ”.
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The way of personalized medicine to reduce costs
It is useless to hide, says Frattini, that the irreconcilability between the two concepts could be exacerbated given the aging of the population and the increasing costs of innovation produced by industry: a future for which we must be prepared. And the key word is personalized medicine. This, he continues, is the only way to reduce the waste of the National Health Service, ensuring that the patient is prescribed and administered a drug capable of responding to his therapeutic need and his pathological picture. If until a few years ago this was only a goal, today in the oncology field this approach is a reality, thanks to advances in diagnostics. Recently, even in the neuroscience sector progress is being made in this sense, identifying markers and receptors that will allow the industry to design the most suitable drug for different needs.
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The future in Big data
The role of a business foundation such as the Roche Foundation is therefore to contribute to the creation of an ecosystem that favors progress towards the goal of personalized medicine, for example by trying to promote public / private collaboration as much as possible. “It is now clear that to find the“ magic bullets ”, able to act in a targeted way on the patient’s disease, a great deal and varied knowledge is needed: not only those produced by the industry, but also those produced by the National Health Service. They are those relating to health data, the so-called Big Data ”, explains the Secretary General of the Roche Foundation. A gigantic mine of information present on the platforms of hospitals and healthcare companies, which if made available to those who do research, both in the public and in the private, would allow great progress in understanding diseases and in the definition of new therapeutic strategies. “Access to Big Data would allow us to combine the theoretical models produced by the industry with the evidence of the real world, that is, the experience of the patient treated”, says Frattini. An access which, however, is limited by the constraints of privacy. Limits that could be overcome, as the experience of Israel during the pandemic shows: in the face of the supply of vaccines at advantageous conditions, the Government made the data available to the companies that had developed them.
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“Implementing the relationship between the public sector and industry is at the center of the Foundation’s Agenda: at the end of last year, Frattini recalls, together with the Federation of Associations of Hospital Internists (FADOI) we produced a white paper on collaboration in biomedical research, to testify that if there is the will, difficulties and prejudices can be overcome ”. It is true, the pandemic has pushed the foot on the accelerator: “Together with the regulatory agency AIFA, we have developed in record time a clinical study to test the efficacy of a drug capable of controlling the acute phase of inflammation. But further steps forward are needed: soon we will publish a volume on the future role of data in health, exploring the topic from all possible angles: privacy, ethics, law and a look at the virtuous experiences of other countries. This is our role as a business foundation: talking about innovation and sustainability means offering tools and knowledge ”.
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