Denis Horgan

Denis Horgan is the Executive Director of the European Alliance for Personalised Medicine (EAPM). As the Executive Director, he builds and promotes networks of collaboration between different stakeholders,  involved in developing an environment for personalized medicine at the EU and national level.  He supports successful policies that foster activities for a more effective, targeted and safer therapies for patients across Europe.Prior to working with the EAPM, Denis worked with the European Cancer Patient Coalition and in the European Parliament on broad array of health issue relating to the pharmaceutical area and patient access and with international NGOs on health development projects in Afghanistan, Mexico and Palestine.    He holds an LLM in International Criminal law and Masters in Management from London School of Economics. 

For me, one of the most intriguing health policy questions of our time is how to encourage citizens to embrace healthy lifestyles. Should we tax and punish bad behaviour or empower citizens with the information they need to make their own decisions? An interesting ‘league table’ caught my eye recently. Entitled the Nanny State Index , it charts how EU Member States and the European Parliament deal with issues of food, alcohol, smoking and the use of e-cigarettes. The index, devised and compiled by Christopher Snowden of the Institute of Economic Affairs, reveals enormous variation across the EU, ranging from the highly restrictive approaches taken in Finland, the UK and Ireland, to more laissez-faire policies of Slovakia, Germany and Czech Republic. Of course, the real question is whether nanny-state legislation makes Europeans generally healthier. The answer appears to be ‘no’: Germans have not suffered due to their government’s reluctance to impose high taxes on unhealthy lifestyle choices in the way that their more paternalistic neighbours have. An alternative approach is required. At the European Alliance for Personalised Medicine (EAPM), we believe that the focus should firmly be on empowering patients. This can be done through improved education. Clearly, modern technology and the Internet have created new ways to put the patient at the centre of medicine. We are even seeing better communication between doctors and patients, which leads to more co-decision as patient lifestyle, work and personal preferences come into play. This can be improved further. Our annual EAPM Summer School for healthcare professionals is among our contributions. New tools, new skills Hard facts alone may be insufficient to trigger behavioural change. We know that patients have access to more information than ever before. What they need now is the skills to differentiate between high quality health information and the...
Prevention
Empowering the citizen when it comes to healthcare involves several elements, writes European Alliance for Personalised Medicine executive director Denis Horgan . It can be education regarding what is actually out there in modern medicine (not least full-genome sequencing), leading to more up-to-date knowledge on the part of the patient and the healthcare professionals (HCPs), it can be better doctor-patient relationships, and it could be governments and doctors better encouraging the patient to be more proactive in taking care of his or her own health. Preventative medicine, which we certainly need a bigger focus on across Europe, can rely on some or all of the above, so let’s take them one by one, starting with the age-old concept of prevention being better than cure… One key aim of EAPM stakeholders is to focus on the right preventative measures to ensure reliable and sustainable healthcare for the long-term benefit of patients now and in the future. Personalised medicine tends to focus a great deal on targeted treatment but there is a need to zoom in, not just on the delivery of the right treatment for the right patient at the right time, but also on the right preventative measures to ensure reliable and sustainable healthcare. The long-term benefits are both fiscal and humanitarian. Currently, certainly in Europe, not only are patients failing to receive the best care, there is potential to cause them preventable harm. It is clear that investment is required in diagnostic approaches, such as the use of IVDs and more screening, certainly in lung cancer. A recent conference in Sofia (co-organised by EAPM) flagged up many issues on lung-cancer screening, and key to this were questions about how to effectively deal with such a killer disease. One of the conference’s aims was to put forward a recommendation to...
The argument has raged for some time and shows no sign of abating any time soon: screening for diseases, yes or no? Take the case of prostate cancer screening: Richard Ablin - the author of “The Great Prostate Hoax”, and the man who claims to be the first to have identified PSA (a protein created by the walnut-sized prostate gland that can easily be measured) - maintains that PSA testing can do, and often does, more harm than good. Ablin, of the University of Arizona, has noted that a man’s PSA levels may be high but that doesn’t mean that he has cancer. On the reverse side of the coin, a low PSA level doesn’t necessary mean that a potential patient’s worries are over in this regard.Yet the fact remains that around one-in-three men aged from 40-60 has traces of prostate cancer, and the risk rises with ageing. So all men should be regularly tested, right? Well, not necessarily… Ablin and others argue that over-testing can very easily lead to over-treatment, including unnecessary invasive surgery to remove the prostate gland. The over-treatment argument has also been used in respect of breast cancer screening, although the figures tend to show that it works very well in a preventative sense and even better in detecting early breast cancer in target age groups. Yet over-treatment is clearly an issue, with many women (plus those aforementioned men with early ‘signs’ of prostate cancer) simply wanting all traces of the disease, or potential disease, removed right away, regardless of the potential cost to them personally or, indeed, fiscally to society in general. So over-treatment is clearly something that cannot be side-stepped. The counter-arguments - and they are very strong ones - is that our ‘social contract’ has obligations to ensure the highest standards possible regarding...
“How much is my life worth?” Patricia Garcia-Prieto, professor of Organisational Behaviour at the Solvay Brussels School of Economics and Management and a mother of six and 11-year olds has asked this question multiple times. In her video , as a patient representative on a panel, she has been vocal about this thought that passed her mind every day. Patricia suffered from melanoma, a deadly skin cancer. Four of the five years, she was a stage IV melanoma patient. There are around 84,000 new cases of melanoma each year in Europe, out of which 20,000 patients do not survive it. It is an eye-opening statistics but one that has driven medtech to innovate. Genetic testing, specifically personalised medicine, has made targeted treatments a new reality. In cases where melanoma has metastasized or cannot be removed surgically (unresectable), a companion diagnostic genetic test can identify individuals with a particular type of melanoma that may respond to therapy with the new drug . Similar to an activist, Patricia Garcia-Prieto was on a quest for learning more about her disease and doing everything she can to stay alive. She looked up treatments, access to trials and vaccine studies. She dug up novel solutions current medicine could offer for her state. She was rejected many times, however, she fought on and finally got admitted to a trial study in another country. It was a road of never-ending meetings with oncologists, dermatologists, surgeons, radiologists and physiotherapists across multiple hospitals. And finally, after years of struggle she gained access to personalised therapy. “ I am alive thanks to personalised treatment - and my experience convinces me that the patient perspective has to be more closely integrated into the discussion of personalised medicine. The radical changes to healthcare that personalised medicine promises will happen only if patient...