RESUMO
TITLE: Le patient-expert - Un nouvel acteur clé du système de santé. ABSTRACT: Dans les maladies rares, l'expertise est limitée, les connaissances restreintes, les parcours de soins incertains et les traitements inexistants ou peu efficaces. Pour améliorer les prises en charge, il est nécessaire de tirer parti de toutes les expertises disponibles, y compris celles des malades, certains d'entre eux étant devenus de véritables patients-experts.
Assuntos
Atenção à Saúde , Prova Pericial , Participação do Paciente , Competência Clínica , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Atenção à Saúde/tendências , França , Humanos , Defesa do Paciente/educação , Defesa do Paciente/psicologia , Defesa do Paciente/normas , Assistência Centrada no Paciente/organização & administração , Assistência Centrada no Paciente/normas , Assistência Centrada no Paciente/tendências , AutoimagemRESUMO
Recent advances in biomedicine are opening the door to new approaches, and treatment and prevention are being transformed by novel medicines based on genetic engineering, innovative cell-based therapies and tissue-engineered products, and combinations of a medical device with embedded cell or tissue components. These advanced therapy medicinal products (ATMPs) hold one of the keys to making a reality of genuinely personalised medicine. There are an estimated 450 companies across the globe working on the development of gene therapies and more than 1,000 clinical trials underway worldwide, and some 20-30 new ATMPs filings are expected in Europe annually over the next 5 years. But challenges confront the sector, complicating the translation from research into patient access. Scientific, clinical development and regulatory issues are compounded by limited experience with clinical and commercial use, limited manufacturing know-how, high costs, and difficulties in accessing development funding and investment. Pricing and reimbursement and market access issues are an additional challenge, particularly in Europe, where unfamiliarity with the technology and uncertainty over the use of real-world evidence induce caution among clinicians, health technology assessment bodies and payers. There is a need for a review of the suitability of the regulatory and market access framework for these products, focused development of data, public/private partnerships, and fuller collaboration governments, doctors, insurers, patients, and pharmaceutical companies. This paper makes specific recommendations for all stakeholders, ranging from early dialogue on potential products, linking of clinical data and patient registries or standardisation of control frameworks, to a comprehensive approach to evidence generation, assessment, pricing, and payment for ATMPs.