09 April 2025 – In the frame of the ICPerMed Strategic Working Group on Internationalisation, Prof. Ondrej Slaby, Head of the Center for Precision Medicine and also the chairperson of the Czech Health Research Council, has presented the Center for Precision Medicine of the University Hospital Brno which was established in May 2024. The center predominately focuses on paediatric and adult precision oncology, and rare disease programmes.
The Center´s mission is to coordinate and develop research in precision medicine using a multidisciplinary approach with multi-stakeholder committees. The Center has a two Molecular Tumour Boards (paediatric patients, adults), utilises liquid biopsy, and developed a tool for the assessment of cancer genome variants of unknown significance. All predictive Next-generation sequencing (NGS) tests are fully reimbursed in the Czech Republic, with up to €2,500 coverage per patient for combined DNA/RNA NGS panels. Each patient could be tested one time per year. One in five patients discussed by the Tumour Board at the Center receives molecularly-driven treatment, and 89 % of these cases had the therapy fully reimbursed. Most of the ESMO (European Society for Medical Oncology) guidelines can be followed thanks to the innovative drug access and financial coverage for patients in the Czech Republic. Key research initiatives include the national GENESIS registry to collect and generate solid data from Molecular Tumour Boards for negotiations with insurance companies, the only Outpatient Clinic for Undiagnosed Paediatric Patients in Czech Republics to increase diagnostic rates, to end their diagnostic odyssey and improve clinical outcomes, and the BabyFox project (sponsored by Illumina) to perform trio whole-genome sequencing in rapid settings in critically ill neonates and paediatric patients from the Paediatric Intensive Care Unit (PICU) and Neonatal Intensive Care Unit (NICU).
Why a new center and why a specific one?
The main reason for establishing this Center was the continuous increase in the clinical implementation of precision medicine across various departments and medical disciplines at our university hospital, which created a need for coordination and an umbrella structure to ensure effective operations. The center is virtual, relying on existing departments.
How do you support neighbouring countries?
It is possible in two (2) ways. In paediatrics, we test international patients and then the tumour board discusses the results while the treatment happens in the country of the respective patient. The only bilateral agreement on treatment in the Czech Republic of a non-resident exist between the Czech and Slovak Republics, and only when the treatment is not available in Slovakia. For adults coming from foreign countries, only testing (diagnostics) can be provided and requires payment from the individuals. The costs issued are the same as the ones for insurance companies for the same service.
Do you have the possibility of evaluating the epigenetic factors during pregnancy?
This is not covered by the Center, but another center exists in the Czech Republic which maintains lifelong cohorts of 20K+ individuals. This center collects specimens during lifetime and cross those with environmental factors.
How is your outreach to stakeholders? How do you prepare the physicians and the public for more personalised or precision medicine?
General public: to inform them about personalised/precision medicine and treatment options, the center collaborates with industries that support public campaigns and education programmes for physicians. The Center has a Memorandum of Understanding with Roche for collaboration on awareness on personalised/precision medicine.
Stakeholder engagement and reimbursements: highly structured in the Czech Republic. There is an ongoing discussion and negotiation on reimbursement of diagnostic tests and treatments, and the diverse stakeholders (e.g. professional medical societies) are part of this discussion.
Involvement of European infrastructures: the center is connected with infrastructures linked to the European Strategy Forum on Research Infrastructures (ESFRI) and especially the node of the European Clinical Research Infrastructure Network (ECRIN) which helps a lot with health technology assessment (HTA) analysis. Potential reimbursement models for new treatments are discussed hence infrastructures are important stakeholders for exchanges with policy makers.
How do you try to consider in your work equity and diversity? Also, equitable access, how is it covered?
In the country, the whole population has the right to be cured equally. It is mandatory for each citizen to be covered by the health insurance system. However, in some isolated regions, there is unequal access to precision oncology and modern therapies with respect to others.
What support could be provided by ICPerMed?
Specifically, for discussions with policy makers, bigger initiatives are well placed. Considering the increasing of personalised/precision medicine approaches, there is the need to discuss new reimbursement methods, so it is very beneficial that initiatives like ICPerMed exist to address these issues.
Website: https://www.fnbrno.cz/en/cpm