Benjamin Sarda – Head of Marketing, Orange Healthcare Fjord Kitchen - October 2012

Personalized medicine: some facts and a perspective

2

Agenda

part 0 Orange Healthcare

part 1 the evolution of personalized medicine

part 2 down the road

part 3 a prediction

3 Orange Healthcare - 2012

Orange Healthcare joining up healthcare

Orange helps modernize the healthcare infrastructure as well as healthcare systems as a whole, and equip healthcare facilities with communications solutions

we are convinced that the medicine of tomorrow is connected medicine in which the management of healthcare data and medical information play an essential role

at Orange Healthcare, we are using our expertise in communications to enable healthcare professionals to increase patient comfort and peace of mind

4 Orange Healthcare - 2012Orange Healthcare – 2012 Orange Healthcare

our services connect infrastructure to improve coordination, collaboration, and information flow among all the traditional players in the healthcare profession

our services allow patients to keep in touch with healthcare professionals, so professionals can provide high-quality care

our tools allow individuals to improve prevention by managing their own health and well-being on a day-to-day basis

hosting and sharing of medical imaging

remote monitoring of cardiac arrhythmia

drug authentication

in 2012, Orange has solutions to offer in 3 areas

services for healthcare

professionals

remote healthcare monitoring

services

preventive services

professionals to professionals

professionals to patients

patient

5

Healthcare ecosystem

Orange Healthcare Value Chain

Health Application

s

Health “Computi

ng” (hosting)

PartnersPartners Patients

Consulting, Integration

M2M, Internatio

nal backbones & Last

mile

Global Integratio

n, Helpdesk, services to end users

Specific developme

nts (Security, portals)

Our value chain is tightly linked with key partners:medical device manufacturers, health apps editors...

Medical Devices

Communication layer : voice and data transmission

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1- The evolution of personalized medicine

Today, personalized medicine is mainlyabout oncology

Stakeholder concerns: Patients: more effective with fewer side effectsPharmas: reduce drug failures in late clinical trialsRegulatory: value for money

Today : over 50% of cancer drugs in development are targeted

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1- The evolution of personalized medicine

The emergence of new technologies allows for a larger view of personalized medicine

123 Monitoring patients

anytime, anywhere

“Big Data”

Enabling access to information

New ways of delivering care

Prevention

Patient empowerment

8

In a few years, DNA sequencing will be about $100

2- Down the road

Jul 2002

$100 000 000

$10 000 000

$1 000 000

$100 000

$10 000

$1 000Jul 2004

Jul 2006

Jul 2008

Jul 2010

Oct. 2011

Moore’s lawComplete DNA

sequencing cost

9

Predictive medicine for everyone.

2- Down the road

10

Personalized medicine in prevention:What are the advantages? The downside ?

2- Down the road

Disease likelihood, adverse effectsTargeted drugs,

bespoke follow up

2003 Today Tomorrow

Human Genome Project

International team $ 3 billion (US)

Risk for payers:“health dictatorships”Competition between countries.

Risk for patients: What if I do not want to know ?57% of individuals at risk for Huntington’s Disease indicated an interest in testing before it was available. 16% took the test*

*Maat-Kievit et al. J Neurol Neurosurg Psychiatry 2000;69:579-583

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Personalized medicine in prevention:The downside……

How Super Bowl has made a $1,500 treatment (which costs $200) popular without any proof of

efficiency

2- Down the road

12

Patients generate data

with professionals, or alone

The medical cloud is up and running

Medical imaging in general practice 2010 US: 68m X-rays, 42m MRIFr: 50m (X-rays + MRI)

Patient record Veteran Health Administration: 5.5mFrance: dossier pharma > 15m

Personalized medicine and patient empowerment The possibilities exist. What are the advantages?

2- Down the road

It is not just about raw data, but also corporate decision making tools

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Personalized medicine as new ways of delivering care

2- Down the road

Asthma300M people worldwide (5% population), what triggers asthma attack remains unclear

1985: asthma epidemic hits Barcelona.All attacks occurred near the harbour, when ships were unloading soya beans.

2011: chips inside asthma inhalers

A better follow-up for the patientYou’ve been using your inhaler twice as much as you did last month - is everything ok?

A better understanding of the external causes You might want to avoid getting too close to that crop!

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Personalized medicine: consequences of “Big Data”

2- Down the road

•Massive amounts of data

•New kind of follow up, with new medical challenges

•New kind of jobs

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Personalized medicine will require the end of two myths: the omniscient physician, and the patient-led revolution in healthcare

Data will be available

But does it fit an existing healthcare process ?Is there someone to monitor & interpret this data?Are physicians ready to use data collected by their patient?

We will be facing two challenges

Over-expectation: omniscient physician

Be sure that healthcare pros are leading the way,

3- a prediction

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thank you