27-28 May 2013, Munich, Germany

EuroBioForum 2013 2nd Annual Conference

What’s keeping medicine…

from becoming personalized?

Menno Kok

• Appr. 14.000 employees, of which > 1500 medical and scientific staff

• > 40.000 patients admitted

• > 500.000 visits to outpatient clinics

• 27,700 operations (incl. day treatment)

• Appr. 3000 medical students

• 28 medical specialty training courses

• > 1000 PhD students

• > 400 transplantations/y

• 400-450 new clinical trials/y

• Budget € 1.3 billion

Erasmus University Medical Center, Rotterdam

Top Reference and Top Clinical Care:

Cardio-Vascular (Thorax Centre)

Clinical Genetics

Gastero-Enterology

Infectious Diseases, Virology

Oncology (Daniel den Hoed Clinic)

Pediatrics (Sophia Children’s Hospital)

Transplantation (Liver, Kidney, Heart,

Lung, Bone Marrow)

Traumatology

Research:

Cardiovascular

Oncology

Cell Biology & Genetics

Immunology & Haematology

Neurosciences

Pediatrics

Medical Technology/Imaging

Epidemiology and Public Health

Health Policy and Management*

Erasmus University Medical Center, Rotterdam

Personalized Medicine

Personalized medicine generates and uses all the relevant information

available on the individual patient to make informed choices between

treatment options and fine-tune these subsequently.

Main activities of Erasmus MC:

- Cancer (breast, colon, lung, prostate, skin, brain, leukemia);

- Cardiovascular dis.;

- Medical Informatics (phase IV); Bio-informatics

- Imaging, -omics

- HTA

Collaborative efforts:

- All strategic research in national and mostly international collaboration;

- Epidemiological research (coupled cohorts);

- String of pearls 8 13 disease area’s, connection to electronic patient files.

Personalized Medicine

Personalized medicine generates and uses all the relevant information

available on the individual patient to make informed choices between

treatment options and fine-tune these subsequently.

is it really all about genetics?

Personalized Medicine

Genetic variation

Epigenetic variation

Age (life stage) Food intake

Circadian clock

Stress

Impaired organ function

Other confounding conditions

Body size Microbiome

Previous exposure

Physical and mental activity

Function

Personalized Health

Life phase: I II III IV

Function

Annual cost

Personalized Health

Inclusion in

clinical trials

Life phase: I II III IV

Personalized Health

Personalized Health generates and uses all the relevant information

available on the individual citizen to provide him/her with advice on health

issues, life style, work-life management, physical and socio-psychological

capacity building and (other) preventive options.

Main hurdles:

At research level: evidence base

At implementation level: reimbursement models

At execution level: acceptance and adherence

Personalized Medicine generates and uses all the relevant information

available on the individual patient to make informed choices between

treatment options and fine-tune these subsequently.

Personal perspective

Empirical (genetic) data changes the way individuals perceive themselves and

their families, and change the way others see them (Taylor, 2008)

Self management: personalized health shifts the responsibility for good health

from government and collectives to the individual, who becomes responsible

for his/her own health or disease (Savond, 2013).

Patient centered medicine requires patient centered decision-making, health

literacy, trusted information sources, and better communication to start with.

1. Innovation in clinical trials;

2. Develop point of care devices and technologies;

3. Promote personalized health.

TOP 3 recommendations: