EuroBioForum 2012 | 18 April 2012 Presentation by Robert Phillips, CEO, Integrated BioBank of Luxembourg (IBBL)

1. -
The Personalized Medicine Consortium of
Luxembourg: Driving Innovation in
Healthcare for Luxembourg

2. Goal

3. Small is beautiful
• Luxembourg has the potential to be a world leader in testing and
implementing new advances in personalized medicine into its health
care system
• 5 hospitals, no medical school, 1 university
• Small, but excellent scientific community – very collegial and embraces
partnerships
• Different Ministries work closely together on personalized medicine
initiative
• Ministry of Health believes that research will improve health
• Introduction of new innovation involves only one level of government
• One of three most expensive healthcare systems in world

4. Evolution of Personalized Medicine
Consortium (PMC)
• September 2010 – agree to support a major coordinated
initiative in personalized medicine focused on four priority
research areas:
– Cancer (lung, colon, and breast)
– Type 2 diabetes
– Parkinson’s disease
– Large population cohort
• Creation of Consortium to bring together all of the key
stakeholders under one umbrella
• Goal: Establish Luxembourg as a leader in the adoption of
new advances in personalized medicine

5. Transition from Traditional Medicine to Personalized
Medicine Will Require Radical Change
Worldwide
Data
Informatics
Centre
eHealth
Results Record
Tissue
Hospital and
Pathology labs Integrated
Information
Examine
Symptoms Doctor
Patient Clinical Tissue Molecular
Data Diagnostic lab Summary
Diagnosis Data Probable
Treatment Diagnoses
Examine +
Disease Recommended
Treatments
Patient Doctor
Best Treatment

6. Two Big Problems in Personalized
Medicine
1) How translate new knowledge into
innovation?
Translational research and clinical trials do
this step reasonably well
1) How transfer new innovation into a
healthcare system?
Need new research process here – topic of
Luxembourg Health Summit

7. Problem: Introducing Innovation into
Healthcare Often Fails
Discovery Research
Healthcare System
Research
Translational Research Innovation Benefits for
Very
PMC citizens of
small
benefits
Luxembourg
Successful research does not automatically lead to
successful innovation

8. Barriers to Change
• Patients/public – many effective interventions require
behaviour change (smoking, diet, screening)
• Hard to change widely held beliefs – risk of vaccinations,
genetically modified food, fluoridation of water, evolution
• Physicians – too many new guidelines for treatment;
changes often may impact income; require new knowledge
• Hospitals – change requires radical redistribution of work
• Government – concern that radical change will cost too
much and be too disruptive (making re-election difficult)

9. Missing Step in Innovation Process
Basic
Discovery
Research
Translational
Research
Clinical Trials
and Studies
Pilot Studies
Use in
inHealthcare
Healthcare
System

10. New Paradigm: Pilot studies followed by gradual
introduction into the health care system
Proposed new approach for innovation in healthcare in Luxembourg
Discovery Research
Benefits for all
Larger Pilot
Healthcare System citizens of
Luxembourg
Small
Pilot
Translational Research Good
PMC benefit Good
for few
benefit for
more
Research Innovation

11. Maimonides Project – Introducing
Innovation in Healthcare
• Ten countries are working together to test health
innovations in pilot studies in a real healthcare systems
• Develop process for introducing radical change into a
healthcare system
• Test new approaches in pilot studies on groups with 5,000
to 1 million participants
• Jointly plan pilots to bring best practices to all countries
• Share successes and failures
• The PMC is working with the Ministry of Health to explore
the possibility of joining this initiative

12. Maimonides Strategy
Think Big Act Small
• Luxembourg is leader in early • Small projects that can be
adoption of new advances in easily replicated anywhere
personalized healthcare • Partner with the most
• Strive to: innovative companies and
– Prevent the preventable research institutes
– Cure the curable • Use best practices from
– Manage chronic disease other countries and share
when necessary our experiences
(Big Dreams and Small Practical Projects)

13. Luxembourg Health Summit
May 2
• 40 Luxembourg opinion leaders will meet to discuss ways
for Luxembourg to introduce innovation into its
healthcare system. The goal will be to identify 3 or 4
projects that can be started this year.
Potential themes for projects:
• Healthcare Services
• Personalized Health
• Active Lifestyle for Health
• Diet and Stress Management
• Healthy and Aging Population

14. Questions and Comments

16. Organization of PMC
Composition of PMC
CRP-Santé Health
• Leaders of each program in
CIEC Economics
personalized medicine
• Leaders from each major partner PMC
• CIEC Cancer Diabetes
• Health economics IBBL
• Laboratoire National de Santé
Parkinson’s Normal
Disease Cohort
• IBBL accepts responsibility for the
administrative budget of PMC and
for coordination LCSB LNS
• PMC meets monthly
• Decisions made by consensus

17. Problems
• Healthcare system not aligned with current
health problems
• Most patients have chronic disease and
system was created to meet acute needs
• Health system responds well to small
innovations, e.g., new imaging technology,
new laboratory tests
• System not ready for radical changes to align
system with needs

18. Opt-in:
• To make Luxembourg the healthiest country on
earth
• To prevent diabetes
• To prevent heart disease
• To ensure the future health of your children and
grandchildren
• To make Luxembourg’s health system efficient,
innovative and user friendly
• To work closely with all groups striving to improve
health

19. Solutions Difficult to Implement
• Smoking – largest risk factor for preventable
disease - risks identified in 1938-1950; US Surgeon
General warning in 1964; still have 15-40% of adult
population smoking.
• Lumpectomy – never good data supporting
radical mastectomy. When data confirming
effectiveness of lumpectomy, still took 15 years to
obtain wide-spread use.
• Overuse of antibiotics – described as problem
over 30 years ago and still a problem
• Electronic Health Records

20. Components of Personalized
Medicine Initiative
1. Excellent, multidisciplinary research teams
a) focused on specific problems using systems biology
b) conduct the innovative research
c) coordinate the clinical testing of novel interventions.
2. Sophisticated technology platforms
a) collect high quality tissue and clinical data
b) high through-put technologies generate the large datasets
required by the teams.
3. State-of-the-art informatics
a) conduct informatics research
b) support the disease teams for data mining, data analysis and
model building.

21. IBBL – Integrated Concept
IBBL Vision: To be an international centre of
excellence in biobanking and to accelerate the
introduction of personalized healthcare for the benefit
of Luxembourg
• Tissue and data bank
• Technology hub
• Research
• Personalized Medicine
Consortium (PMC)