Upload
medullan
View
37
Download
0
Embed Size (px)
Citation preview
1
How Pharma Can Use Digital Health to Drive Value
March 15, 2017
22
Benjamin DeanDigital Strategy - Business &
Monetization
Todd Greenwood, PH.DDirector, Digital Strategy
33
We’re Digital Health Experts.• 100% Healthcare since 2005• Driven by User-Centered Strategy
& Execution• Geared for Client Collaboration• Focused on Driving Outcomes
44
Agenda
1 2 3Understanding Shift to Value
How Digital Enables RWE Collection & Drives Revenue
What it Takes to Get Started & Take Action
55
Understanding the Shift to Value1
6
Address healthcare costs, quality of care and patient outcomes
Financial
1
1. Adapted Diagram from Valence Health
7
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)
8
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
13
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
14
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
15
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
16
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
17
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
1818
How Digital Enables RWE & Drives Revenue2
19
The Digital ContinuumIncreasing Complexity, Connectivity, Comprehensiveness, and Points of
Engagement
Appo Standalone producto Discrete focuso Limited enterprise
support & integration
20
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
21
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
22
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
23
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
24
Monetization Potential of Digital Technologies
Epidemiology underlying Drug
Forecasting
Prevalence
Incidence
Seeking Treatment
Prescribed Drug
Compliance
Sales
25
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
26
Freemium Set Monthly Fee Reimbursement
Performance-based Gain-Share Bundled as PSP
Sample Business Models
2727
What it takes to get started3
28
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
29
Thank You.Director, Digital StrategyTodd Greenwood, PhD
@medullan
Digital Strategy – Business & Monetization
Benjamin Dean
@Ben_Dean