10th National Conference for Clinical Research 2016

27 – 28 July 2016 | Hotel Istana, Kuala Lumpur, Malaysia

What about me? Will Big Data enable patient centricity?

Presented by:Karin Wellbrock

Senior Manager – Deloitte Consulting Pte Ltd

BIG DATA DRIVING CLINICAL RESEARCH

FOR HEALTH

All players in the healthcare ecosystem are zooming in on the patient

With the healthcare ecosystem’s focus on the patient, pharma companies have to overcome the barrier that regulators place limiting their access to patients

Understanding the patientsIn depth interviews ahead of launches and marketing – “Catalytic Contacts”

Engaging patientsUse of online and mobile solutions to engage patients – Digital Patient Journey

Providing financial supportProviding payment process support to patients – Guidance and Patient Support

Closing the gap between pharma companies and the healthcare consumers

Patient

Physician

Pharmacy

Pharma Co

Insurance Co

$

?

Patient Centricity

Source: Kantar Health Unlocking Rich Patient Insights, Vertex Guidance and Patient Support Programme Information, Deloitte Digital Patient Journey

• Actively seeks value• Financially prepared

• Prefers alternative medicine

• Cost-conscious• Least compliant

• Heavy healthcare users• Financially prepared

• Adheres to treatment recommendations

• Open to electronic communications

Patients are becoming more demanding and engaged healthcare consumers

Shop and Save

Out and About

Casual and Cautious

Sick and Savvy

Content and Compliant

Healthcare Consumer Segments

Trust in doctorsUse of online

resourcesUse of and interest in health technologies

SelectedFeatures

ModerateHigh Low

Source: Deloitte Center of Health Solutions Survey of US Health Care Consumers, 2009-2015

Size of Segment

11%

22%

6%

34%

8%

Online and Onboard19%

Deloitte study finds those health consumers most interested in digital are also in need of care

Level of engagement HighLow

High

Use

of

syst

em (

ne

ed f

or

care

)

Casual and Cautious

34%

Content and Compliant

22%

Sick and Savvy11%

Online and Onboard

19%

Out & About

8%

Shop& Save

6%

Consumers’ use of the health care system and level of engagement by segment Most digital users

43%39%

27%

18%

14% 20%

25% 43%

19% 18%

19%

15%

5%7% 17%

17%9%9%

8%6%10% 7%

2% 1%

Millennials Gen X Boomers Seniors

Segment profiles by age group

Casual and Cautious Content and Compliant Online and Onboard

Sick and Savvy Out and About Shop and Save

Source: Deloitte Center of Health Solutions Survey of US Health Care Consumers, 2009-2015

Big data enables better understanding of health consumers and will ultimately led to enhanced patient treatment

Big data will be critical at all stages of the patient and product life cycles of pharma companies and will enable patient centricity

Outcomes Demographic

Lab value

Diagnosis

Medical history

Hospital

dispensing

Prescriptions

Hospital stays

Procedures

Specialist

care

Future types of patient data

Sources: Mckinsey&Co Pharma Medical Affairs 2020 and Beyond, Tata Consultancy Services The New Frontier for the Pharmaceutical and Life Sciences Industry: Real Big Value from Big Data, SAS Real-world evidence: Why pharma firms are investing

Clinical Trials

Production &

distribution

Strategy

development

Launch

Lifecycle

management

Big data use in patient and product life cycles

Enables personalized medicationUse of demographics and genome sequence data

Improves patient care qualityThrough outcome feedback from multiple sources

Uncovers underserved marketsFrom disease trends and drug outcomes data

Enhances drug safety RWE helps to unveil undesirable drug effects early

Hospital / Specialist Care Primary Care Others

The Malaysian Healthcare vision should assist the players in the health eco-system to move towards patient centricity

Patient• Wellness• Registration• Health records• Self Monitoring• Health Apps

Clinics / Hospitals• Health Education• Counselling• School Health• Billing and Payment• Administration• Patient Management

Government• EMR• eGov Apps• Real world evidence• Health surveillance

Patient Centric

Data Driven

Mal

aysi

a’s

He

alth

care

Vis

ion

However, the current Healthcare IT landscape in Malaysia still needs to overcome hurdles to connect and link the players

Public

Local Taxes Government General Revenue

Local Authority Ministry of Health

Government Health and Wellness Programs

Government Healthcare Providers

Local Health and Wellness

Programs

Other Ministries and Departments

• Hospitals• Clinics• Doctors

EPF and Soc.Security

Urban Population

General Population

Universal Coverage

Special Population

Groups

Private

Employers Individuals

Private Insurers, Managed care schemes

Private Providers

• General Practitioner

• Family Medicine Specialists

• Specialist Clinics• Hospitals

• Dentists• Pharmacies• Pathology Providers• Traditional &

Complimentary Medicine

Population that can afford private insurance

System

Funding Sources

Purchasers

Providers

Coverage

Community Health

Individual Health

Within the government between public health programs and

healthcare providers

Between public and private healthcare

providers

No interaction

We see pharma companies are increasingly more taking a holistic view on patient programs …

Patient engagement examples

• Research oriented by patient insights

• RWE driven development

• Personalization of packing to serve patient needs

• Direct patient supply (for rare diseases)

• Capture patient insights during trial

• RWE driven primary outcomes

• Patient managed services

• Personalized reimbursement

• Patient pathway analysis

• Education through remote technologies

• Patient reference groups

• Homecare collaboration

• Adherence programs

• Affordability programs

• Social listening• Patient

outcome & experience monitoring

Exploratory clinical development

Full clinical development

Production & distribution

Strategy development

LaunchLifecycle

management

R&DManufacturing

Logistics

Strategy

Market Access

Sales and marketing

Post LOE

… and their design spans across all phases of their product as well as patient life cycles

Source: Deloitte Research

Currently, the maturity levels of patient programs vary greatly and do not correlate with the maturity of

pharma organizations as such

Awareness of need for patient engagement but not defined strategy and/or lacking enabling technology to realize

Defined engagement strategy and enabled basic service offerings, such as• Patient websites with educational materials• Start-up assistance• Reimbursement support tools• Access to health care providers for questions (e.g., nurse hotline)

Integrated, cloud-based platform offering more complex services, such as • Self-tracking tools to help patients manage own care• Click-to-chat for on-demand support• Reminder/alert tools for treatment adherence• Portal access for both patients and providers

Leveraging analytics from data gathered and novel offerings, such as• Predictive interventions based on medication adherence behaviors• Site-of-care-matching based on patient location• Wearable therapy tracking and drug administration

1

2

3

4

Source: Deloitte Research

While maturing patient programs, pharma companies need to overcome multiple internal roadblocks

People, culture and organization within the

pharma organization

Governance and processes pertaining to

patient data

Technology adoption and democratization for big data

analytics

3 typical challenges impeding the realization of patient centricity

1 2

3

Usual challenges related to organization culture hindering patient centricity and use of big data are

Limited local presence in CXO teams

Skewed incentive structure across functions

No intra-team collaboration within pharma org

• Regional COEs take on functions of local organizations in South East Asia resulting in lack of in-depth local expertise

• SEA markets are used as leadership training grounds for global talent

• Mis-aligned objectives and resulting incentive structures for sales and medical affairs hinder realization of patient centricity

• Functions work in isolation on their interpretation of patient centricity and lack communication, e.g. R&D, Regulatory, Compliance, Medical Affairs, Government Affairs, Marketing and Sales

Patient centricity needs to embraced cross-functionally and programs tailored to meet the local patient needs

Source: Deloitte Research

Lack of data governance and poor internal and external linkages hinder effective use of big data

Decision Decision Decision Decision

Product MgerSales Mger

MSL Engineer External Partners

Source: Deloitte Research

The ‘asset’ data needs to be strictly governed yet made available to all stakeholders

R&DMarketing

& SalesMedical Affairs

EngineeringManufacturing

External

Researcher

Technology barriers impede optimal use of analytics to drive patient centricity

Analytics organizationin pharma companies

A pure technology function –disjoint from business needs

with no clear mandate

Business lacks empowerment to

employ analytics for their own insight generation

Technology decision not accounting for business

needs

Missing data ownership and data aggregation

A ‘single source of trust’ of patient data must be established and managed

Source: Deloitte Research

Connecting with patients to provide access to and support with treatment and care options

A holistic approach and common understanding within the organization allow effective use of big data

Making treatments affordable and providing resources to stay on therapy

Active engagement with patients during trials and assisting with transitioning from clinical to commercial drugs

Granting patients access to programs via traditional andemerging channels to support their unique treatment journeysand enable better long-term treatment outcomes

Delivering educational insights to patients for better decision making and behavior change

Underlying layer of big data

Contact

Karin Wellbrock

Deloitte Consulting Pte Ltd

6 Shenton Way, OUE Downtown 2, #33-00

Singapore 068809

kwellbrock@deloitte.com