digital transformation & pharma - goethe business …...pharma is producing record levels of...
TRANSCRIPT
Copyright © 2019 IQVIA. All rights reserved.
Dr. Frank Wartenberg
President Central Europe, IQVIA
House of Pharma & Healthcare / Goethe Business
School
3rd August, 2019
Digital Transformation
& Pharma
1
Pharma is producing record levels of innovation, but must address R&D costs which rise faster than net revenues
1. Top 25 pharma by 2018 global sales (figures are normalised)
2. NCE = New Chemical Entity
Sources: FDA; Reported Company financial statements; IQVIA analysis
Copyright © 2019 IQVIA. All rights reserved.
90
100
110
120
130
140
2010 2012 2014 2016 2018
32
46
59
10yr Avg 2017 2018
~2.0x
By volume of innovation By profitability of innovation (or both)
# of FDA Approvals of NCEs Top 25 Pharma Revenue & Cost Growth1
R&D
Expense
Net
Revenue
SG&A
Expense
~3%
~5%
~3%
5yr CAGR
2
Global demand for data storage
~33,000 Zettabytes
The scope, complexity and growth of healthcare data offers unique opportunities to improve productivity
Sources: IDC Research and Seagate Technologies whitepaper (“Digitization of the World”)
Copyright © 2019 IQVIA. All rights reserved.
Non-
Healthcare
Healthcare
6%
CAGR (2018-,m 2025)
Healthcare: +40%
Non-healthcare: +20%
Complexity of Healthcare Data
Genomics Case notes Medical images
Wearables Social CRM / call notes
Registries
Lab Rx data Literature
EMR Claims
Unstructured
Data
~80%
Structured
Data
~20%
3
The Patient’s Perspective
4
Digital technologies now build insight and improve treatment effectiveness across the entire patient journey
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
Electronic medical records
• Predictive analytics, who is at
risk for disease
Health-based
social platforms
• Patient querying
symptoms,
discussing disease
burden and care
opportunities
Electronic medical records
• Following patients longitudinally
• Clinical decision support
algorithms
Medical devices, mobile health
• Bringing treatment to the patients rather than patients
to the treatment
• Increasing importance of patient-relevant outcomes
Telehealth, wearables, sensors, apps
• Staying connected to the patient outside
of the healthcare providers office
Electronic medical
records, telehealth
• Predictive analytics
for relapse
Health-based social
platforms
• Patient discuss their
experience with
treatments,
providers and
payers
Pre-diagnosis
Diagnosis
Treatment
Monitoring
Remission
Health apps
• Prevention via life-
style management
5
RWD is expanding at both ends of the spectrum
Lab/biomarkerdata
Genomicsdata
Patient apps
Wearables/devices
Real-World Data
PayerClaims
Medicalrecords
PatientRegistries
HospitalEHRs
Pharmacydata
High science Consumer
Examples
• IQVIA/Genomics England
• Roche: Foundation Medicine/Flatiron
Examples
• Apple watch: ECG/cardio AI
• Digital therapeutics (eg Pear)
Enables molecular
stratification
Captures everyday life
setting, attitude, behaviours
Source: IQVIA European Thought Leadership
Copyright © 2019 IQVIA. All rights reserved.
6© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
Smart pills
for cancer care
Source: IQVIA Thought Leadership Analysis; https://www.businessinsider.com/digital-smart-pill-drug-sensor-company-expands-cancer-proteus-2019-1; https://econsultancy.com/internet-of-
things-healthcare/, Apple Homepage
• Sensor paired oral drugs track
whether/when a dose has been taken
and patients’ activity levels to improve
medication dosage and compliance
• First trial with colorectal cancer patients
started early 2019
• 40 different medications ranging from
infectious disease and mental illness to
diabetes under development backed by
investors like Novartis
Patients using devices for monitoring and/or improving compliance are producing compelling Real World data
Movement Disorder API
for Parkinson’s
• In 2018, Apple added a new ‘Movement
Disorder API’ to its Research Kit API,
which allows Apple Watches to
monitor Parkinson’s Disease
symptoms automatically and
continuously
• Apple’s ResearchKit has also been
used in a number of different health
studies e.g. in partnership with GSK
ECG on Apple Watch now CE
marked & available in Europe
• Takes an electrocardiogram, helping to
provide critical data to physicians
• Irregular rhythm notification feature
running in the background to identify
potential atrial fibrillation (AFib)
• Broad screening becomes possible.
“Triaging”, powered by AI
• Data stored in Apple Health App, can be
easily exported → Potential for broad
use as electronic medical record?
7
The Professional Side
8
Digitization impacts healthcare in three ways – all bear chances and risks alike
Novel engagementGreater efficiencyDeeper insight
Hospital operationsDiagnosis Telemedicine
R&D strategy &
trial design
Multichannel patient
experience
Orchestrated customer
engagement
Patient recruitment &
trial operations
Supply chain
Commercialisation
strategies
En
ab
lers
Ma
nu
fac
ture
rsH
ea
lth
ca
re s
tak
eh
old
ers
Virtual trials
Prevention
Pay-for-
performanceTPP develop-
ment
I0I0I00I0I0III00II
Data Technology Analytics Connectivity
Lean resource
models
Treatment
decisionse-Prescriptions
Digital
therapeutics
Payer operations
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved. F. Wartenberg - Digital Health - Chances and Risks in the Life Science Industry; PLCD Conference May 2019
Source: IQVIA
9
Digital and Real World Data touch every aspect of the pharmaceutical value chain
For pharmaceutical companies, digitization and opportunities coming from Advanced Analytics have far-reaching implications
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved. F. Wartenberg - Digital Health - Chances and Risks in the Life Science Industry; PLCD Conference May 2019
More EfficientClinical Development
RWD-Supported Market Access
Digitally SupportedLifecycle Mgmt.
• Next Gen trials: smart enrolment, site targeting, app-based monitoring
• Single arm trials with
synthetic control cohort
• Virtual trials, tech-enabled
• In-silico trials: Predicting
feasibility & outcomes
• Orchestration of multiple F2F and
digital touchpoints needed
• Focus on pathway effectiveness
(vs. product promotion)
− Patient identification
− Progression monitoring
− Therapy decision support
− Compliance/adherence support
• Include real world insights in HTA, e.g. following conditional reimbursement
• RWD enabled, outcomes-based contracting
• Adaptive licensing, supported by post-launch RWD capture
“Customer”-centric Commercialization
• Evidence arms race: continuous data generation via platform & collaborations
• RWD-supported indication expansion
• Adverse Event monitoring and reporting requirements extended to digital solutions
Source: IQVIA
10
+1,100 Medical Doctors
+1,400 PhDs
+2,500 Statisticians
+850 Epidemiologists /
RWI experts
Domain Expertise
Copyright © 2019 IQVIA. All rights reserved.
+600m non-identified
patient records
~1m data sources
+70b healthcare records
+85% of global drug
sales covered
UnparalleledData
+100,000 users on our
software platforms
TransformativeTechnology
+200 patents and
patents pending
+6,000 client
engagements / year
AdvancedAnalytics
11
Example: Effectively addressing the issue of patient heterogeneity in drug development
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
High-precision patient recruitment powered by Machine Learning
• Identifying unmet needs is challenging.
• Developing new therapies is expensive.
• Our client needed to overcome these hurdles by
evaluating target population heterogeneity and
optimizing all aspects of their drug development.
Challenge Result and Impact
Solution
• We used Real World Patient data to identify the target
patient population and build a comprehensive set of
attributes.
• We applied Machine Learning methods to discover
homogenous patient subgroups.
• Then we carried out a study to understand clinical
profiles and risk factors specific to each subgroup.
• We identified
homogenous
patient subgroups
whose medical needs
are unmet
• We understand the
clinical conditions
which impact their
outcomes
• We know which
patients are most
likely to respond to
the experimental
drug in both a trial
and real-world
setting.
12
Multichannel Marketing
13
The most commercially successful launches are now more multichannel – in Europe as well as Japan/US
Define successful launches
Use Channel Dynamics®
data to compare
use of digital channels
Insight
Step 1 Step 2 Step 3
• New Active Substance
Launches in the top 7
developed markets in a 5 year
window (2012-2017- 755
individual launches)
• “International Top Sellers”
were consistently in the top
quartile of launches based
on absolute sales in 2 or more
countries for the 1st year
following launch
• Compared international top
sellers against all other
launches on 4 key metrics of
multichannel activity
• Total volume of digital
contacts
• Profile of digital activity
• Richness of channel mix
• HCP perception of digital
engagement
• International Top Sellers
consistently have a higher
share of digital promotional
activity in their first year
• International top sellers also
supported by more sustained
digital and richer channel
mix
• However, the detail can be
more complex…
Source: IQVIA European Thought Leadership
Copyright © 2019 IQVIA. All rights reserved.
14
Higher digital share for the more successful launches
Source: IQVIA European Thought Leadership; ChannelDynamics® Q3 2017; MIDAS Q3 2017; Rx-only
HIGHER DIGITAL VOLUME SHARE
Internationally successful launches see
higher digital volume shares in the first year
across all countries
Avg. digital share of promo volume
International Top Sellers All Others
0%
5%
10%
15%
20%
25%
Quarters after launch
Ave
rage
dig
ita
l vo
lum
e s
ha
re (
%l
Q1 Q3Q2 Q4
64%Higher digital share
of total activity
Top 7 developed: New Active Substances 2012-2016
Copyright © 2019 IQVIA. All rights reserved.
15
More sustained digital activity for the more successful launches: in all 7 countries
HIGHER DIGITAL VOLUME SHARE
Internationally successful launches see
higher digital volume shares in the first year
across all countries
SUSTAINED DIGITAL APPROACH
Strong launches consistently have “Courage
in Their Convictions” and are more likely to
have a sustained digital approach
Sustained digital effort over 1st year post launch
International Top Sellers All Others
Top 7 developed: New Active Substances 2012-2016
Sh
are
of la
un
ch
es w
/ su
sta
ine
d d
igital e
ffo
rt (
%)
0%
20%
40%
60%
80%
100%
Italy
23%
64%
Germany
62%
Japan
77%80%
US
23%
33%
France
93%
Spain
49%
42%
73%
47%
76%
UK
63%
Source: IQVIA European Thought Leadership; ChannelDynamics® Q3 2017; MIDAS Q3 2017; Rx-only
Copyright © 2019 IQVIA. All rights reserved.
16
The most commercially successful launches have a promotional mix suggestive of greater multichannel maturity
Source: IQVIA European Thought Leadership
Product Type
The most commercially successful launches, i.e. “International top sellers”, were all specialty products
Spend
Although specialty launches have lower promotional spend than primary care launches, international top sellers had higher promotional investment than other specialty launches
Digital Share
International top sellers have a higher share of digital contacts than other launches, and more sustained digital activity over time
Quality Engagement
A richer, more sophisticated use of digital channels could improve HCP perception and engagement
17
Nevertheless until recently, many players still considered themselves at early stages of multichannel and digital maturity
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved. F. Wartenberg - Digital Health - Chances and Risks in the Life Science Industry; PLCD Conference May 2019
Orchestrated
Customer ExperienceDeploying MCM campaigns
with automated journeys,
tailored to customer needs
and adapted based on their
feedback
Value from MCM
Dig
ita
l M
atu
rity
Service ProvisionDeveloping and seeking
reimbursement for a digital
device or app to support
brand commercialization
Field Force
Integrated ChannelsLeveraging additional
channels after a rep
interaction
Expansion of ReachNon-F2F activity against lower
priority HCPs
Capability AccelerationLeapfrog via partnering and
acquisitions4
3
2
1
13%of respondents
12%of respondents
75%of respondents
Examples
Source: Source: IQVIA European client survey 2017
Client survey: “Where do you see yourself on the journey to MCM maturity?”
18
Future commercial model
…while technology-enabled, multi-channel orchestration is fundamentally transforming the commercial model – at scale!
Orchestrated engagement
• Aligned across functions and customers
• Full spectrum, multi-channel approach,
integrating F2F and digital
• ‘Speak with one voice’, ensure
consistent customer experience
‘One truth’
• Technology-enabled, enterprise-
wide integration of multiple data
sets, diverse content (own, 3rd party)
Integrated customer-facing
team
• Multi-functional (incl. reps, MSL,
KAM, nurse support, public policy)
• Designed around patient journey
Standardised and automated
• Data analytics, commercial reporting
• Leveraging 3rd party scale
AIML-powered, prescriptive
• Next best action
• Individualised customer approach
Source: IQVIA European Thought Leadership
Copyright © 2019 IQVIA. All rights reserved.
19
Artificial intelligence, Machine learning and Predictive analytics
20
The AI health market is seeing explosive growth
Artificial intelligence (AI) and machine learning (ML) startups acquisitions are rapidly increasing
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
Source: IQVIA European Thought Leadership, White Paper: Artificial Intelligence and Machine Learning with Advanced Analytics, July 2019
Acquisitions of AI startups are
rapidly increasing while the
health AI market is set to register
an explosive CAGR of 40%
through 2021
Top 10 AI Applications
21
Predictive analytics and AI driving innovation in clinical development
Source: IQVIA Advanced Analytics; The Changing Landscape of Research and Development - Innovation, Drives of Change, and Evolution of Clinical Trial Productivity ~ Report by the IQVIA Institute for Human Data Science
Copyright © 2019 IQVIA. All rights reserved.
Neural Networks and
NLP
22
…leading to more precise & impactful
engagement to drive new diagnoses
Predictive algorithm identified a patient
pool ~4.5x larger than known diagnoses…
Commonly misdiagnosed, rare gastrointestinal condition
Example: Predictive analytics accelerate finding the patients for launch in Rare Diseases
Copyright © 2019 IQVIA. All rights reserved.
16.286
73.989
~4.5x
~$87M ~$322MRx Spend
Next-best call alerts
ROI monitoring
~50K Target HCPs
~9K Clinics
Pilot algorithm in
leading centres
Targeted educational
campaigns
~90K Total HCPs
Known Diagnosed
Patients
Predicted
Patients
Clinics
CRM /
Marketing
23© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
Sales teams can
optimize the impact of
multi-channel
promotional investments
by analyzing the
response rates from past
campaigns. They can
focus on the right
healthcare professional
(HCP), segmenting them
into the right channel at
the right time
AI and ML transforming the sales and marketing process in the EU’s healthcare landscape
Identify highly-
specific patient
populations
Customize digital
engagement
Predictive analytics can
provide insight into
prescribing patterns for
precision medicine
candidates through
patient genomics and
biological data. The
technology can identify
which patients should
start treatment. This
helps sales teams to
accurately target the
most relevant physicians
AI & ML powered digital
engagement solutions
can optimize channel
effectiveness,
recommending the
timing, frequency, and
content of email
messages. This targeted
approach at the
individual HCP level
reduces physician churn
rates and maximizes the
impact of digital
campaigns
Many drugs have
multiple indications and
are distributed through
multiple channels. AI &
ML-powered analytics
can paint a clearer
picture of how multi-
indication products are
used. Teams can track
product performance by
indication, specialty,
region and source of
business to inform their
future marketing efforts
Local retail pharmacy
sales analytics can
deliver precise targeting
lists highlighting
individual pharmacy
sales potential and
behavioral profiles that
prioritize marketing and
inform strategies — i.e.
offer discounts in price-
conscious markets
versus value-add
opportunities in high
sales shops
Optimize MCM
activities
Leverage multi-
indication analyticsEnhance HCP
profiling,
segmentation and
targeting
Source: IQVIA European Thought Leadership, White Paper: Using AI & Machine Learning to Drive Commercial Success in the EU March 29, 2019
24
Babylon claims its chatbot beats GPs at medical exam
AI-Based Medical Diagnostics
Copyright © 2019 IQVIA. All rights reserved.
• Free chat to Babylon,
anytime
• Monitor your health
• Option to buy tests and
kits, book one-off
consultations or access
clinical records
• Subscribe to get unlimited
GPs appointments and
access to chatbot for £9.99
a month
Source: IQVIA European Thought Leadership, www.babylonhealth.com
25
The power of physicians will be diminished, with new influencers emerging
The transformation of clinical decision making by data and AI in particular will create a more deterministic world
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved. F. Wartenberg - Digital Health - Chances and Risks in the Life Science Industry; PLCD Conference May 2019
• Increasingly complex treatment landscape– >300k treatment options in oncology; fragmentation
into smaller patient sub-segments
– Difficult for HCPs to navigate
I0I0I0I0I0I0IIII00II0
• Health systems under cost pressure– Need for cost-effective health resource deployment
– Eliminate waste, eg non-response to treatment
– Savings through early diagnosis and prevention
• More demanding patients– Optimal treatment response and outcomes
– Overall care experience
Challenges
Data
Advanced
analytics
• Evidence-based, optimised clinical decisions
• Guidance considers clinical effectiveness and
cost effectiveness (eg HTA assessments)
• Creates boundaries to physician freedom
• Ultimately, more deterministic healthcare
Decision
support
Future model
Power shiftFrom HCPs to stakeholders who shape
decision support tools, eg guideline setting
bodies, data gate keepers, tech companies
This future model stands and falls with high quality evidence
Copyright © 2019 IQVIA. All rights reserved.
26
IPFuture business model of innovators still centering on IP but extending beyond traditional focus on molecular entities
• Innovators will continue to be defined by their IP
• However, they will derive value beyond developing NMEs,
via proprietary therapeutic techniques and
processing of information
• Majority of digital data is not owned by pharmacos;
collaborations with 3rd party data owners (registries,
hospitals, vendors, tech firms) will be a critical enabler
© 2019, IQVIA Commercial GmbH & Co. OHG. All rights reserved.
What’s the next source of value?
Novel modes
of action?
Different diseases
in focus?
Novel ways of
data/tech usage?
Novel partnerships &
collaborations?
NASH? Alzheimer's?
iPSCs?
Bionic tissue?
Bioprinted organs?
Senescence
manipulation?
Source: IQVIA
Pharma moving from “Medicines Developer“ to “Provider of Outcomes“
Digitization is disrupting the status quo
Bold innovators have everything to gain
If they get execution right
For further information, contact
Dr. Frank Wartenberg
President Central Europe
+49 (0) 69 6604-0
@ FrankWartenberg
© 2019, IQVIA Commercial GmbH & Co. OHG
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