up to end, what next?

Ireland’s Health ‘Disconnect’

“Other countries were found to be far ahead in terms of sharing medical data seamlessly across their health systems and embedding this data in research to further benefit patients and citizens overall. This is something we in Ireland need to prioritise”

Ireland lags significantly behind on the delivery of personalised healthcare and was found to display a sharp disconnect between policy and implementation of this form of care. That’s according to the FutureProofing Personalised Health Index which ranked Ireland as 19th out of 34 other countries.1 The Irish public’s willingness to share data for medical research and care improvements was found to be low with a score of 4 out of 10.3

A panel of Irish healthcare and policy experts was brought together by Roche Ireland to interrogate the Index findings and develop a report with their recommendations for improving Ireland’s approach to personalised healthcare. The experts ultimately found that the deficiencies are due to a lack of infrastructure and delays in implementing data sharing policies, meaning Ireland is losing out on opportunities in research, clinical trials and advancements in genomic testing – to the detriment of patients and the Irish healthcare system. Ireland ranked 22nd out of 34 countries for ‘Health Services’ which includes the planning, organisation and delivery of services that will drive personalised healthcare.2 Commenting on the launch of the report, panel member Dr Nina Byrnes, GP, Medical Director Generation Health Medical Clinics, Media Medical Expert said, “The Index revealed significant scope for improvement in Ireland before fully integrated implementation of personalised healthcare can be achieved here. Other countries were found to be far ahead in terms of sharing medical data seamlessly across their health systems and embedding this data in research to further benefit patients and citizens overall. This is something we in Ireland need to prioritise. For example, telemedicine has advanced significantly here but for it to reach its full capability we need to utilise technology to capture medical data and share via unique patient identifiers, making it accessible to healthcare professionals and the research community across our health system.” Personalised healthcare means delivering care tailored to the specific individual, putting the patient firmly at the centre, and moving away from a ‘one-size-fitsDr Nina Byrnes and Mary Maguire, Personalised Healthcare Lead, Roche Products (Ireland) Ltd. at the launch of the FutureProofing Personalised Health Index

all’ approach to care. It promises efficiencies for the patient but also the healthcare system, as resources including diagnostics, data and analytics are used in a more effective manner. The Personalised Health Index analysed the health systems of 34 international countries to evaluate how healthcare is progressing towards a more personalised, digital and data-driven standard. Led by an independent panel of global experts in partnership with Roche, the Index measured a country’s performance based on four equally weighted ‘Vital Signs’: Policy Context; Health Information; Personalised Technologies; and Health Services. The experts found that while Ireland ranked below average across most of the Index measures, there were areas where advancements and improvements have been made since the Index data was collated, most recently due to the Covid-19 pandemic. Specifically, the use of telemedicine has grown exponentially out of necessity since the beginning of the public health crisis, while the introduction of electronic prescriptions has proven hugely beneficial and efficient for medical practitioners, pharmacists and patients alike. Additionally, the panelists agreed that the pandemic may have made the wider public more aware of the merits of clinical research and thus more willing to share their health data. Mary Maguire, Personalised Healthcare Lead, Roche Products (Ireland) Ltd said, “The Index serves to highlight the shortcomings that will need to be addressed if personalised healthcare is to become a reality in Ireland. By focusing on creating wider understanding of the power of civic participation we can improve on our willingness to share data for research and improved care. Roche is committed to collaborating with patients, stakeholders and experts from multidiscipline areas on a unified approach to address the data infrastructure challenges and improve access to life-changing research, clinical trials and medical advancements, to deliver truly personalised care.” The FutureProofing Personalised Health Index report outlines the following recommendations for Ireland to address the deficiencies highlighted by the Index and improve its approach to personalised healthcare: 1. The roll out of the national electronic health record (EHR) system is pivotal; it will enable an efficient healthcare delivery system and pave the way for digital health 2. Significant investment will be required, however Sláintecare, the cross-party plan for the future of healthcare, is the most suitable form of delivery of personalised care and could provide necessary funding for the upgrading of data and IT systems 3. The development of an

Interdepartmental strategy, aligning academia, medical schools, clinical research and primary/secondary/tertiary care towards the common goal of enabling personalised healthcare could overcome bureaucracy and put the patient first 4. A formalised national policy for genomic testing, as well as an appropriately funded genome resource. This will maximise the benefits of pre-existing and forthcoming targeted therapies and enable the use of data in ground-breaking clinical research

5. A coherent and extensive public awareness campaign to educate the broader public on the value of sharing data for the betterment of medical care and clinical research. To learn more and read the expert’s analysis and further insights into the Personalised Health Index results for Ireland visit www.futureproofinghealthcare. com/en/personalised-healthindex-ireland.

References on request

When it comes to your patients’ psoriasis treatment goals

High skin clearance matters to patients: Patients who achieve and maintain high levels of skin clearance (PASI 9099 or PASI 100) have significantly better HRQoL than those with lower levels of skin clearance (PASI 75-89).2

Sustaining high skin clearance or complete skin clearance is associated with incremental and durable benefits in HRQoL and mental health of psoriasis patients.2

What means everything to the patient? The potential for nothing left on their skin.*

* Nothing on the skin: Defined as 75% achievement of PASI90 at Week 16 and ≥50% achievement of PASI 100 at Week 52 in UltIMMa-1 and UltIMMa-2.1

PRESCRIBING INFORMATION (PI)

SKYRIZI®▼ (risankizumab) 75 mg solution for injection in pre-filled syringe. Refer to Summary of Product Characteristics (SmPC) for full information before prescribing. PRESENTATION: Each pre-filled syringe contains 75 mg risankizumab in 0.83 ml solution. INDICATION: For treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. DOSAGE AND ADMINISTRATION: Intended for use under guidance and supervision of a physician experienced in diagnosis and treatment of psoriasis. Dosage: The recommended dose of Skyrizi is 150 mg (two 75 mg injections) by subcutaneous injection at weeks 0, 4, and every 12 weeks thereafter. Consider discontinuation of treatment in patients showing no response after 16 weeks of treatment. Some patients with initial partial response may subsequently improve with continued treatment beyond 16 weeks. Special Populations: Elderly: No dose adjustment required. Renal or hepatic impairment: No dose adjustment required. Paediatric Population: No data available. Overweight patients: No dose adjustment required. CONTRAINDICATIONS: Hypersensitivity to any of the active substances or excipients. Clinically important active infections (e.g. active tuberculosis). SPECIAL WARNINGS AND PRECAUTIONS: See SmPC for full details. In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded. Skyrizi may increase the risk of infections. In patients with a chronic infection or history of recurrent infections, or known risk factors for infection, Skyrizi should be used with caution. Treatment with Skyrizi should not be initiated in patients with any clinically important active infection until the infection resolves or is adequately treated. Patients should be evaluated for tuberculosis infection prior to initiating treatment. Anti-TB therapy should be considered prior to initiating Skyrizi in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Completion of all appropriate immunisations should be considered prior to initiating therapy. If a patient has received live vaccination (viral or bacterial), it is recommended to wait at least 4 weeks prior to starting treatment with Skyrizi. Patients treated with Skyrizi should not receive live vaccines during treatment and for at least 21 weeks after treatment. If a serious hypersensivity reaction occurs, administration of Skyrizi should be discontinued immediately and appropriate therapy initiated. Skyrizi contains 68.0 mg sorbitol and less than 1 mmol sodium (23 mg) per 150 mg dose. INTERACTIONS: The safety and efficacy of Skyrizi in combination with immunosuppressants, including biologics or phototherapy have not been evaluated. PREGNANCY AND LACTATION: Women of Childbearing potential: An effective method of contraception during treatment and for at least 21 weeks after treatment should be used. Pregnancy: Limited data available. It is preferable to avoid the use of Skyrizi during pregnancy as a precautionary measure. Lactation: It is not known whether Skyrizi is excreted in breast milk. Human IgGs are known to be excreted in breast milk during the first few days after birth, which decreases to low concentrations soon afterwards; consequently, a risk to the breast-fed infant cannot be excluded during this short period. A decision should be made whether to discontinue/abstain from Skyrizi therapy, taking into account the benefit of breast-feeding to the child and the benefit of Skyrizi therapy to the woman. Fertility: The effect of Skyrizi on human fertility has not been evaluated. ADVERSE REACTIONS: See SmPC for full details on adverse reactions. Very common adverse reactions (≥1/10): Upper respiratory infections. Common adverse reactions (≥1/100 to <1/10): Tinea infections, headache, pruritus, fatigue and injection site reactions.

▼ This medicinal product is subject to additional monitoring. This will allow quick identification

of new safety information. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance; Website: www.hpra.ie. Suspected adverse events should also be reported to AbbVie Limited on 01-4287900.

LEGAL CLASSIFICATION: POM (S1A). MARKETING AUTHORISATION NUMBERS/PRESENTATIONS: EU/1/19/1361/001: Skyrizi 75 mg solution for injection in pre-filled syringe (Pack of 2 pre-filled syringes). Further information is available from: AbbVie Ltd., 14 Riverwalk, Citywest Business Campus, Dublin 24. DATE OF REVISION: March 2020. PI/1361/002 HRQoL, Health-Related Quality of Life; PASI, Psoriasis Area Severity Index. REFERENCES: 1. Gordon KB, et al. Lancet 2018; 392: 650-661. 2. Ryan C et al. Poster presented at the 27th European Academy of Dermatology & Venerology (EADV) Congress 2018; September 12–16; Paris, France. Skyrizi® Summary of Product Characteristics, available on www.medicines.ie. Date of preparation: September 2020 | IE-RISN-190074