how pharma can use digital health to drive value | medullan webinar
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How Pharma Can Use Digital Health to Drive Value
March 15, 2017
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Benjamin DeanDigital Strategy - Business &
Monetization
Todd Greenwood, PH.DDirector, Digital Strategy
tgreenwood@medullan.com bdean@medullan.com
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We’re Digital Health Experts.• 100% Healthcare since 2005• Driven by User-Centered Strategy
& Execution• Geared for Client Collaboration• Focused on Driving Outcomes
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Agenda
1 2 3Understanding Shift to Value
How Digital Enables RWE Collection & Drives Revenue
What it Takes to Get Started & Take Action
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Understanding the Shift to Value1
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Address healthcare costs, quality of care and patient outcomes
Financial
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1. Adapted Diagram from Valence Health
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Address healthcare costs, quality of care and patient outcomes
Financial
By 2020, 75% of commercial payments will be through value-based arrangements
Health Care Transformation Task Force (coalition of payers, providers, patients, purchasers)
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Performance Against
CompetitorsPayment
Dependent on Desired Outcome
Larger Rebate in Absence of Outcome
Indication Specific Pricing
Payment based on: Reduction in
hospitalizations
Aetna, Cigna, Harvard Health
Heart failure$5,475 per year
Higher Rebate if: Missed LDL goals
and utilization
Cigna, Harvard Health
High Cholesterol
$16,920 per year
Rebate based on: % A1C target vs.
other GLP-1s
Aetna, Cigna, Harvard
HealthType II Diabetes
$8,967 per year
Higher price in lung based on:
Better survival rates vs.
pancreatic cancer
Express Scripts
Lung & Pancreatic Cancer
$105,788 per year
9
Performance Against
CompetitorsPayment
Dependent on Desired Outcome
Larger Rebate in Absence of Outcome
Indication Specific Pricing
Payment based on: Reduction in
hospitalizations
Aetna, Cigna, Harvard Health
Heart failure$5,475 per year
Higher Rebate if: Missed LDL goals
and utilization
Cigna, Harvard Health
High Cholesterol
$16,920 per year
Rebate based on: % A1C target vs.
other GLP-1s
Aetna, Cigna, Harvard
HealthType II Diabetes
$8,967 per year
Higher price in lung based on:
Better survival rates vs.
pancreatic cancer
Express Scripts
Lung & Pancreatic Cancer
$105,788 per year
10
Performance Against
CompetitorsPayment
Dependent on Desired Outcome
Larger Rebate in Absence of Outcome
Indication Specific Pricing
Payment based on: Reduction in
hospitalizations
Aetna, Cigna, Harvard Health
Heart failure$5,475 per year
Higher Rebate if: Missed LDL goals
and utilization
Cigna, Harvard Health
High Cholesterol
$16,920 per year
Rebate based on: % A1C target vs.
other GLP-1s
Aetna, Cigna, Harvard
HealthType II Diabetes
$8,967 per year
Higher price in lung based on:
Better survival rates vs.
pancreatic cancer
Express Scripts
Lung & Pancreatic Cancer
$105,788 per year
11
Performance Against
CompetitorsPayment
Dependent on Desired Outcome
Larger Rebate in Absence of Outcome
Indication Specific Pricing
Payment based on: Reduction in
hospitalizations
Aetna, Cigna, Harvard Health
Heart failure$5,475 per year
Higher Rebate if: Missed LDL goals
and utilization
Cigna, Harvard Health
High Cholesterol
$16,920 per year
Rebate based on: % A1C target vs.
other GLP-1s
Aetna, Cigna, Harvard
HealthType II Diabetes
$8,967 per year
Higher price in lung based on:
Better survival rates vs.
pancreatic cancer
Express Scripts
Lung & Pancreatic Cancer
$105,788 per year
12
Value-based contracts are still rare in the USUnderlying Reasonso Fragmented U.S. healthcare systemo Plethora of EHR providers with some patient records still in paper! o Inability to track patient adherence to drug regimen and drug
effects on healtho Patient Privacy concerns
"The basic infrastructure of electronic medical records, let's call it 'real-world data', is going
to have to increase so that we can easily track and monitor outcomes”
-Novartis CEO Joseph Jimenez 1. http://www.fiercepharma.com/pharma/novartis-roche-ceos-see-performance-based-future-but-u-s-isn-t-ready-yet
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Value-based contracts are still rare in the USUnderlying Reasonso Fragmented U.S. healthcare systemo Plethora of EHR providers with some patient records still in paper! o Inability to track patient adherence to drug regimen and drug
effects on healtho Patient Privacy concerns
"The basic infrastructure of electronic medical records, let's call it 'real-world data', is going
to have to increase so that we can easily track and monitor outcomes”
- Novartis CEO Joseph Jimenez 1. http://www.fiercepharma.com/pharma/novartis-roche-ceos-see-performance-based-future-but-u-s-isn-t-ready-yet
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High-profile value based contractsYear Drugs Condition Pharma Payer2009 Januvia and Janumet Type 2 Diabetes Merck & Co Cigna2011 Rebif MS EMD Serono Cigna2012 Rebif MS EMD Serono Prime Therapeutics2015 Harvoni Hepatitis C Gilead /
CatamaranCigna
2015 Repatha Cardiovascular Amgen Harvard Pilgrim2016 Praluent Cardiovascular Sanofi / Regeneron Cigna2016 Repatha Cardiovascular Amgen Cigna2016 Ernesto Heart Failure Novartis Cigna2016 Ernesto Heart Failure Novartis Aetna2016 Januvia and Janumet Type 2 Diabetes Merck & Co Aetna2017 Enbrel Rheumatoid Arthritis Amgen Harvard Pilgrim
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Priorities are not aligned
o Immediate cost containment
o Real-world Evidence data (RWE)
o Comparative data sets
o Standard adherence and patient experience programs
o Data from randomized clinical trials against a placebo (RCT’s)
EY Progressions 2014: Navigating the payer landscape.
Payers Want Pharma Provides
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Randomized Clinical Trials (RCTs)
Real World Evidence (RWE)
o Prospective data collectiono Limited segment of the population is
eligibleo Good patient adherence and
complianceo Important for demonstrating efficacy &
safetyo Limited ability to investigate costs
o Prospective and/or retrospective data collection
o Broader more representative of the patient population
o Real world patient adherence and complianceo Shows benefits of drug in everyday clinical
practiceo Ideal for showing value within local health
economy
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RWE takes a robust platformSteps to RWE Acquisition
1. Generating patient-centered data
2. Compiling existing data from disparate sources including Pharmacy POS, utilization claims, EHR claims and notes
3. Leveraging data for contracting and patient-centric purposes
NEHI: Real World Evidence: A New Era for Health Care Innovation
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How Digital Enables RWE & Drives Revenue2
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The Digital ContinuumIncreasing Complexity, Connectivity, Comprehensiveness, and Points of
Engagement
Appo Standalone producto Discrete focuso Limited enterprise
support & integration
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o The right combination of technologies and ecosystem partners
o Behavior changing interventions and content
o Digital and non-digital (multi-channel) set of components
The Digital ContinuumIncreasing Complexity, Connectivity, Comprehensiveness, and Points of
Engagement
Appo Standalone producto Discrete focuso Limited enterprise
support & integration
Solution
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o The right combination of technologies and ecosystem partners
o Behavior changing interventions and content
o Digital and non-digital (multi-channel) set of components
o A first-class operation around bringing the solution to market
o Focused on continuous improvement of outcomes
o Strategic asset of real world evidence for clinical studies and value-based leadership
The Digital ContinuumIncreasing Complexity, Connectivity, Comprehensiveness, and Points of
Engagement
Appo Standalone producto Discrete focuso Limited enterprise
support & integration
PlatformSolution
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What Digital Offers Developing medicine in better
waysDeveloping better medicine
– Accelerated clinical trials – Improved patient tracking– Real world outcomes– Learning health systems– Clinical research as a care
option– Virtual trials
– Personalized medicine (genomics, proteomics, metabolomics)
– Companion digital therapeutics– Adherence controls– Inter-disciplinary therapies
Two sides of the same coin
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Product Lifecycle
MedicalR&D Product Supply
Comm. Launch
Modeling / simulation
Genomics
RWE packaging
E-clinical Recruitment
Digital monitoring
Medical
information
AE Reporting and
Social Listening
e-Safety
Smart factory with IoT
Digitized supply chain
Omni-channel
Post-marketing monitoring
Patient marketing
Digital therapeutic
Data Analytics, Storage and SecurityTreatme
nt
Patient Journey
Fitness/Wellness
Tracking
Genomics
Social media
Electronic health
records
Remote monitoring
Telemedicine
Patient communities
Diagnosis
Self-care
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Monetization Potential of Digital Technologies
Epidemiology underlying Drug
Forecasting
Prevalence
Incidence
Seeking Treatment
Prescribed Drug
Compliance
Sales
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Behavioral Change Opportunities
o Increase incidence through screening
o Drive patients to seek treatment through education and campaigns
o Influence Rx habits by educating and raising awareness of both patients and providers
o Improve compliance through behavioral therapy
Monetization Potential of Digital TechnologiesPrevalence
Incidence
Seeking Treatment
Prescribed Drug
Compliance
Sales
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Freemium Set Monthly Fee Reimbursement
Performance-based Gain-Share Bundled as PSP
Sample Business Models
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What it takes to get started3
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5. Anticipate needed investment for the latter half of the year
How can you get started down this path?
4. Test a “Fail Fast, Succeed Faster” Mindset
3. Establish a baseline for existing channels and tools
2. Seek and drive internal alignment
1. Measure the success of your current workflow
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Thank You.Director, Digital StrategyTodd Greenwood, PhD
tgreenwood@medullan.com
@medullan
Digital Strategy – Business & Monetization
Benjamin Dean
bdean@medullan.com
@Ben_Dean
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