your patient flow as key for a reliable forecasting process with strategic value

Jurgen De Baerdemaeker – [email protected]

IM ASSOCIATES

Added value of Patient flow enabled forecasting

in healthcare

Why IM Associates?

IM Associates assures effective decisions are taken in the complex healthcare environment.We build trust by assisting healthcare professionals in approaching their markets with continuous innovation in order to achieve optimal results.

Our corporate values are Trust, Excellence, Impact, Inspiration and Persistence.

© 2013 IM Associates: Patient Flow enabled Forecasting

3

IM Associates service offering

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Strategic value of forecastingPatient flow dynamicAdded value of forecastingIM Associates’ stepwise approach

© 2013 IM Associates: Patient Flow enabled Forecasting5

Misquote

“I think there is a world market for maybe five computers.”

- Thomas Watson, IBM Chairman, 1943

Some forecasts really got it wrong…

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Support important decisions reg. business development:- Research;- Product acquisition;- Licensing,…

In today’s pharma business, forecasting has never been so critical.

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Understand the strategic importance of the patient flow: - Diagnostic rate;- Compliance;- Treatment duration;- …

Understand new markets / new indications with less data.

Better target your resources & promotional investment:- FF size;- Investmentin awareness, compliance, …

Managing uncertainties in the future:- Outcomes of clinical studies;- Decisions on reimbursement;- Healthcare reform.

Forecasting brings more than financial forecasts. It brings critical strategic value as it provides answers to following needs:


Forecasting: generating endless discussions or generating consensus?

Whether the forecasting model is complex or simple, people often disagree on the model and/or the forecasts.A rational and transparent model helps achieving internal consensus around future business evolution.

‘We are endlessly arguing on assumptions and their impact on the outcomes. How can we speak the same language?’

‘I’m not sure I’m using the right model for my forecast.’

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‘Forecasting is time-consuming, especially when we have to change assumptions frequently.”

‘Is it possible to make forecasting when we are missing many data?’


What is flow dynamic?

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Flow dynamic is the analysis of in-flows and out-flows over time.

This methodology uses concepts such as: Example

• Initial stocks 10.000 cars• Time dimension hours• Rates of in-flows and out-flows 500 cars per hours• Duration of stay in a stock 2 hours

Flow dynamics has many real-life applications:• Traffic management• Stock management• Supply planning (Energy industry)• Patient dynamic!


What is patient flow dynamic?

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Diagnosed patients

Flow dynamics provides a simple and flexible model to understand the patient journey and measures the number of patients:• at any moment of time• at any step of the flow

Popu-lation

Patients on product A

Patients on product B

New patients

Incidence rate

Diagnostic rate

New patient share

1.000 / month 80%

% Switch

% drop-out

% drop-out

% Switch

6 months

4 months

Patient flow (Simplified example)


In a standard patient flow approach, we first calculate the number of patients on treatment.

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Population Potentialpatients

Patients on treatment

Growth rate

Epidemiology

Symptomatic

Diagnosed

Access

Drug-treated



In a second step, market factors are integrated to calculate the number of patient on a specific product.

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Patients on product X

Growth rate

Epidemiology

Symptomatic

Diagnosed

Access

Drug-treated

Competition

Share

Adoption

Cannibalization

Patients on treatment Patients on product


Eventually, patients are converted into sales (units and values).

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Patients on drug

Patients on product X

Volume forecast

Sales forecast

Growth rate

Epidemiology

Symptomatic

Diagnosed

Access

Drug-treated

Competition

Share

Adoption

Cannibalization

Compliance

Persistence

Packs

Reimbursement

Price

Conversion

Patients on treatment Patients on product


Some parameters are critical to ensure accurate forecasts.

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Population + population growth;

Incidence

Prevalence

Switch rate (to other treatments/products)

Treatment drop out

Others…

ParametersImportant

Simplicity leads to accuracy!We avoid using too many parameters and complex flows.

Too complex flows are generating inaccurate results.

Complex Simple


IM Associates uses industry standard simulation software: Powersim

Starting from the flow-chart based patient flow, IM Associates translate the variables, flows, stocks, … into a simulation model in Powersim.Powersim is a best-in-class software product for dynamic simulation.IM Associates build the backgroundmodel and provide the client with an executive viewer front-end.

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http://www.powersim.com/main/mailinglist/campaign/


Connexion between Powersim and Excel offers flexibility and ease-of-use.

In Excel, we have full flexibility to model and modify parameters.Results (forecasted sales) are also exported to Excel.

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bron: http://www.cbs.nlbron: http://http://www.nationaalkompas.nlbron: gipdatabank.nl 240.000 Spiriva gebruikers 2011, 75% COPD

bron: http://www.cbs.nlbron: http://http://www.nationaalkompas.nl

16.786.2791,70%62,5%

0,283%LAMA users 178.354

Inhabitants NL% Prevalence COPD% LAMA usage

% growth per year% incidence COPD per year 0,290%

% population growth pm 0,0235%% incidence per month (pm) 0,0241% Import

Export

Parameters

Forecasts



In Powersim, flows are modeled on a visual way.

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IM Associates’ approach is transparent, flexible and powerful.

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TransparentThe assumptions and their impact are easy to understand.Future sales are clearly split in existing/new/switched patients.

FlexibleParameters (launch data; treatment duration; compliance; switch rate;…) are modifiable and the impact on outcomes is immediately simulated.

PowerfulAble to model simple or complex patient flows.

Our approach Your benefits

You save time, as complex patient journey can be easily modeled.

You gain insight on the patient flow and the drivers influencing your sales (switch rate; compliance; duration of treatment;…).

You reach internal alignment on forecasts by discussing clearly defined parameters.

You manage future uncertainties by analyzing multiple scenarios and by refreshing the forecasting with the latest available data.

You get reliable forecast. This helps you setting the right marketing investment and SMART targets for your sales teams.

© 2013 IM Associates: Patient Flow enabled Forecasting

20

FORECASTING

Sales revenues

(financials)

Healthcare policy

Sales force size

Corporate direction(portfolio

mgmt)

Marketing programme

Forecasting – as a planning tool – is performed for many purposes.

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Forecasting gives you more than sales data. It provides insights in the types of patients which generates your sales.

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You can get all forecasted data at any month in the future!

With Powersim, we can get a picture of the stocks (number of patients in any step of the flow; sales;…) for any moment of time in the future.

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STEP 1Desk

Research

STEP 2Market

Research

STEP 3Preliminary

Process Design

STEP 4Validation Workshop

STEP 5Modeling the

Future

The forecast logic is built using a step-wise project design.

By using a stepwise approach, we deliver a customized forecast approach.Our excellence in traditional trend forecasting is catalyzed and extended with crucial insights in dynamic patient flows:• Not only do we identify all relevant drivers• The interrelations between the broad range of drivers are also identified• Next to this, we simulate the effect of all possible futures on commercial performance

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At start, insights are gathered in desk and market research

Step 1: desk research (secondary research)• Scan available market research studies• Search for existing information on the Web• Collection and consolidation of all data internally available : all departments (Medical;

Business Intelligence; Marketing; Sales) should be involved!• Identify the gap for a complete picture

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bron: http://www.cbs.nlbron: http://http://www.nationaalkompas.nlbron: gipdatabank.nl 240.000 Spiriva gebruikers 2011, 75% COPD

bron: http://www.cbs.nlbron: http://http://www.nationaalkompas.nl

16.786.2791,70%62,5%

0,283%LAMA users 178.354

Inhabitants NL% Prevalence COPD% LAMA usage

% growth per year% incidence COPD per year 0,290%

% population growth pm 0,0235%% incidence per month (pm) 0,0241%


At start insights are gathered in desk and market research

Step 2: market research – if needed (primary research)• Interview physicians in a stratified sample:

• You diagnose a patient as having an allergic reaction to grass polls.• Which drugs do you prescribe?• Which process goes on in your mind in order

to prescribe drug x?• Would you consider other treatments?• Why (won’t) you choose them?• …

The buying process is utilized to map the physician behavior

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The insights are translated into a flow model capturing the market dynamic

Step 3: preliminary process design• High-level visualisation of the conclusions from the primary & secondary research are

translated into a flow chart view.

Step 4: validation workshop with the client• Validate our process design with client’s feedback• Agree on a final process design

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In a workshop, the model logics and forecast scenarios are discussed, validated, adapted and endorsed.

Step 6: validation workshop with the client• The set of most realistic forecast scenarios is chosen by the client. Based on this choice

we determine the most probable forecast outcome.• Based on our tornado and waterfall diagrams, we also define the trigger points together

with the client • These trigger or leverage points are the drivers on which they can work to increase their sales

performance.

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Jurgen De BaerdemaekerDirector

[email protected]

+32 16 22 47 43

IM Associates assures effective decisions are taken in the complex healthcare environment.

your patient flow as key for a reliable forecasting process with strategic value

Marketing

value of patient flow

treatment patients

forecasting model

im associates service

im associates transla

standard patient flow

drug patients

diagnosed patients