Fertile Ground

Basel as a Precision Medicine Cluster

The history of innovation shows to produce new products and services there often needs to be a critical mass of relevant skills and knowledge in close geographic proximity. The successive waves of Information Technology coming out of Silicon Valley, Watchmaking from Switzerland, Automobiles in Germany or Fashion from Paris and Milan and in fact Basel’s own history of dye making leading to chemical manufacturing leading to biopharma are a testament to the value of clusters. This paper describes Precision Medicine, the skills needed for it and sets out the reasons why Basel, long recognised as the leading Pharmaceutical and Life Science cluster in Europe is well placed to become the European hub for precision medicine.

 

Figure 1 Transformation of Basel Industries

Precision medicine can be defined as; "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person."[1] This means getting the right diagnosis and intervention, to the right patient at the right time, and increasingly the right disease prevention. It should use the full potential of available technology and knowledge and stimulate paradigm shifts in currents approaches. .

From this definition it is clear that Precision medicine will need a combination of skills from across and outside the Healthcare and traditional Life Science industries. This will not only include Healthcare Interventions (drugs, devices and other treatments), Diagnostics (molecular biomarkers, omics, imaging etc.) but also the feedback loops offered by the rapidly evolving digital tools including wearables, artificial intelligence and small and big data to allow for better disease prevention and treatment. This approach and definition puts the patient and their data and needs firmly in the centre. 

 

The Basel Region is strong in Healthcare Interventions with established and world leading medtech and biopharma as well as diagnostics industries. In the area of Life Science, particularly biopharmaceutical R&D, there are in fact only a few examples, like the Boston/Cambridge area, Cambridge UK and Singapore that are of the same size as Basel.  The new era of, precision medicine will however need a solid integration with the evolving and existing information technologies. This includes both the digitization of existing life science companies and also the addition of new bioinformatics companies and initiatives. This paper will show that this is in fact a neglected strength in the Basel region.

In addition to the companies working in Precision Medicine the Basel ecosystem of universities, academic institutes, hospitals, access to payors and regulators and support of start-ups means that the right ingredients are available for Precision Medicine to flourish.

Basel’s Strength in Life Science

Basel’s long history in Life Science is well known. Novartis, Roche, Actelion[2] and Syngenta were founded and grown in the Basel region and in addition to these giants there are a number of smaller successful biopharma companies headquartered in the Basel region such as Basilea Pharmaceutica, Evolva, Polyphor, Santhera Pharmaceuticals and Bachem. Bayer and Abbott also have significant commercial operations in Basel. In total there are over 100 biopharma organisations undertaking R&D and over 200 with commercial operations in the Basel Region.[3]  

Medtech is also well represented in Basel with companies such as Ascensia, Medartis, Bühlmann and Straumann founded in the region and Basel is also home to the European office of Cochlear and Resmed amongst others. There are approximately 90 medtech companies in the region with 30+ engaging in R&D.

All told there are over 300 Life Science companies with over 30,000 employees creating a deep talent pool in the region. The intensity of life science employment in the region is in fact unique in the world with over 7% of the workforce engaged in life science vs no more than 2% in similar regions like Oresund or Cambridge/Boston (US).[4]

Digitization of the Life Sciences

The digitization of the Life Sciences started about 25 years ago but has now really begun to penetrate daily business with a mix of new companies and new skills at existing companies. This includes the increased use of technology in existing processes i.e. biomarker discovery, imaging, clinical trials or multichannel marketing but also new uses of technologies to treat or monitor disease in new settings and use of data analysis in development

The use of ICT and digital tools in these fields is reflected in the fact that ~10% of staff at Life Science employees in Basel refer to IT or Digital in their Linkedin profile.[5] Roche has committed to bringing over 1,300 IT focused resources to a single campus in Kaiseraugst, just outside Basel.

Basel is well represented in the field of Bioinformatics with companies such as Genedata and Clinerion and 30 other companies working in the field.4 Genedata is a local success story focused on software solutions that support large-scale experimental processes in life science research. Founded in 1997 they have grown from their headquarters in Basel to now have over 200 employees in offices throughout Europe, the USA and Asia.

There are also a number of startups such as insights.md, a digital medical knowledge platform, Mininavident a camera and visualisation company, and MIMEDIS a custom bone implant company, both spinoffs from FHNW and University Hospital Basel and yBand and Visionarity, two digital health companies focused on rehabilitation and employee wellness respectively.

Another example of bioinformatics in Basel is the presence of the Data Co-ordination Centre of the Swiss Personalized Health Network (SPHN) in Basel. The Swiss Personalized Health Network is an initiative from the Swiss Federal Government designed to promote the development of personalized medicine and personalized health in Switzerland. Federal funds of 68 million CHF have been provided to support the SPHN in its work in making data available to researchers.

Outside of life science IT there is also a significant IT presence in the region with over 10,000 people working at ICT companies including Adobe who have a research centre in Basel, Magnolia a CMS company with global reach and Meteoblue a local startup success in weather prediction. In addition the IT intensive Insurance and Banking industries are present in Basel with Baloise, Sympany and the Bank of International Settlements. Zurich, a growing hub for software development, with 40,000 software developers[6] and the main Engineering campus for Google is also close by to Basel.

Combining the pieces

The presence of the building blocks of Precision Medicine is necessary but not sufficient to complete a circle of invention to stimulate innovation in a region. An invention can only lead to innovation when it finds application to real life problems. This in turn can only be achieved through collaboration between Industry, Academia, Research Technology Organisations (RTOs) Hospitals, Regulators and Patients themselves. The rest of this document looks at how these pieces come together in Basel.

Academia and Research Technology Organisations

Precision Medicine in Basel is well supported by Academia with over 6,000[7] students and researchers in the field of Medicine and Science at the University of Basel including the dedicated centre for Life Sciences, Department of Biomedical Engineering and the Department of Biomedicine a joint venture with the University Hospital Basel, The Swiss Tropical Health Institute, ETH-Department of Biosystems Science and Engineering (ETH-DBSSE), Friedrich Mischer Institute for Medical Research and the University of Applied Sciences and Arts Northwest Switzerland (FHNW) with four institutes in the areas of chemistry, bioanalytics, pharma, environmental technologies, biomedical engineering and medical informatics.  This offers a great talent pool for future innovation.

In applied research, the Swiss Centre of Electronics and Microtechnology (CSEM), is a world leading Research and Technology Organisation (RTO), active for more than a decade in the wearable technologies and IoT domain, and with the mission to transfer its IP and (micro-) technologies to the (Swiss) precision medicine industry cluster.

In addition to the Basel based institutions Basel’s close proximity to Zurich and Lausanne give access to ETH and the EPFL. Universities Ranked in the top 20 globally and top 10 in Europe.[8]  Other close by institutions include the Paul Scherrer Insitute and also the Strasbourg[9]and Freiburg[10] universities just across the border. An example that shows the collaboration with Basel and nearby ETH Zurich is 4Quant, a big imaging data start-up from ETH, and the University Hospital of Basel looking to automatically review and quantify patient imaging data and create a truly digital diagnostic department. These efforts are a supported by a long-term cooperation between the department of radiology and Siemens Healthineers.

Another example of collaborative work in the region is the MIRACLE project at the Department of Biomedical Engineering where interdisciplinary teams are working to reduce the negative impacts of surgery. This work is recognised internationally and is supported by the Werner Siemens foundation. Other leading work is that of the ETH-DBSSE particularly the Biotechnology and Bioengineering group working across biopharmaceutical manufacturing, gene therapy and tissue engineering.

The Institute for Medical and Analytical Technologies (IMA) at FHNW is a collaboration supporting the local hospitals in the field of reprocessing and medical data analytics. In cooperation with these institutions software was developed to visualize patient flows in the hospital and process data over the borders of hospitals and companies. Collaborations like this have previously led to CTI-projects and startups such as Mininavident and MIMEDIS.

Karger Publishing, is a Basel based academic publisher with over 105 biomedical journals and an increasing number of open access and online publications. They are in the process of launching a journal on digital biomarkers to support Precision Medicine and innovate the way the community shares information.

Healthcare

A strong Healthcare system is obviously key to the transfer of invention to an innovation. Basel has leading institutions such as the University Hospital Basel with over 7,000 staff and a number of other specialty and regional hospitals and world leading telemedicine innovators Medgate.

Medgate one of the global leaders in Telemedicine was founded in Basel in 1999 and now has partners and offices throughout Switzerland and in Abu Dhabi and Australia. It is an example of the value of collaboration across silos being co-founded by a Physician, Economist and IT professional. This innovative approach continues with the application of Artificial Intelligence to optimise patient flows today.

Payors and Regulators

The better alignment of incentives with outcomes is likely to be key to the adoption of Precision Medicine as it often goes beyond the traditional reimbursement model. A number of Insurers including Sympany are present in Basel and the global insurance hub of Zurich is close by when knowledge is needed.

Swissmedic, the Swiss Agency for Therapeutic Products is the single authority for the approval of both pharmaceuticals and medical devices in Switzerland. They are aligned with but separate to the European Medicines Agency enabling some freedom for more innovative approaches in the future and is located close to Basel in Bern.

Patient Data

The Patient and Patient Data will be crucial both to the development of Precision Medicine and the future implementation of any innovations. Since 2015 the Swiss law on Electronic Patient Dossier (EPD) has been in effect. This will build a future framework for the exchange of patient data across providers and the 26 Swiss Cantons. Basel-Stadt and Basel-Landschaft and key players in the region have joined in the  eHealth Nordwestschweiz: Trägerverein (North West Switzerland ehealth Foundation) to promote the smooth implementation across as large a number of patients and organisations as possible.

Healthbank.coop and midata.coop [11]  are 2 bottom up initiatives that aren’t waiting for the EPD to be rolled out across Switzerland. They both combine Patient data along with non-medical data to be used in medical research. Together with the SPHN these are a number of the exciting new opportunities for the use of patient data in Switzerland.

Putting the pieces together.

The value of a cluster comes not from simply having the pieces in the same geographic region but also in the process of collaboration between the institutions and individuals and support to grow when needed.

Government support is available through BaselStadt and the BaselArea.Swiss that promote collaboration in the region. This also includes the Switzerland Innovation Park Basel Area, the Technologie Park Basel and recently launched BaseLaunch accelerator for biotech companies. In addition, DayOne-the innovation hub for Precision Medicine, is a bottom up initiative to break down the silo mentality of healthcare innovation formally launched in 2017. This group is working to promote collaboration through events and collaborative projects amongst stakeholders in the region.

Access to financial support to go to the next level is also possible in the region with a life science angel network and also the presence of venture capital investors such as BiomedPartners, BayCity Capital as well as the Novartis and Roche Venture funds.

How does Basel compare?

Basel is on a global level well placed when it comes to the key ingredient of Employees working in the key sectors of Life Science, R&D and ICT. Compared to a number of regions in the table below it is clear that Basel has the highest share of employment in Life Sciences and the fastest growth rate in Life Sciences and R&D. The ICT Sector in Basel though lower than a number of other regions in absolute numbers is ranked 4th of the 12th regions in growth.

Basel and surroundings have the critical mass of talent, companies, academia, healthcare providers, payers and regulators needed to develop and deliver innovations in the field of Precision Medicine. The attractiveness of the region is strong and growing as evidenced by the recent moves to the region from Patients Like Me, Cray Computing, Roivant Sciences and BC Platforms setting up research and commercial offices in the region.  24 Life Science in fact moved their global or European headquarters to the region in 2016.

[1]US National Institute of Health https://ghr.nlm.nih.gov/primer/precisionmedicine/definition. This is associated with the concepts of Personalized Medicine, Genomic medicine etc. and these are all part of the process of moving away from the imprecise medicine of the past. In this document we use Precision Medicine as it appears to have gained ascendency of use over these other terms.

[2]The purchase of Actelion by Johnson & Johnson was completed in June 2017. The commercial operations became part of Janssen Pharmaceuticals and a separate research focused company Idorsia was founded with the research operations.

[3]Initiative Life Sciences Cluster Region Basel, 2016

[4]BAKBASEL 2016

[5]Linkedin analysis of keywords IT, Digital for Roche and Novartis employees in the Basel region. In a similar analysis 18% refer to Marketing and 12% to Clinical.

[6]Stackoverflow insights. 2016 report

[7]Organisation websites

[8]https://www.topuniversities.com QS University rankings

[9]Ranked 59th in Life Sciences Times Higher https://www.timeshighereducation.com

[10]Ranked in top 100 globally and in Engineering https://www.timeshighereducation.com

[11]https://www.healthbank.coop/ and  https://www.midata.coop/index.html

[12] BAKBasel 2016, CAGR = Compound Annual Growth Rate

 

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