Healthcare Challenges 2025
ESC Cardiovascular Roundtable April 25-26, 2012, Paris, France
What sort of industry can we expect in 2025? What sort of healthcare?
How will scientific communication be?
How will stakeholder interaction evolve in the coming years?
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What sort of industry can we expect in 2025? What sort of healthcare?
How will scientific communication be?
How will stakeholder interaction evolve in the coming years?
Healthcare sector shows resilience
Dow Jones World Healthcare Index up 8% YoY Dow Jones World Index is down 5% YoY
Healthcare spending solid despite uncertainty Favourable demographic drivers
Outstanding cash generation
Pharma market value stagnating
Continued legal challenges to Obamacare Medicare budget cuts ($365bn in 10yrs) FDA oversight still cause for concern
NIH spending still increasing
Still world’s second largest market Dominated by local players
Japanese companies expanding globally Slower rate of price cutting
Streamlining of regulatory processes
Eurozone crisis to dominate headlines Value-based pricing
Medical devices
Biosimilars and generics
Organic growth outpacing, US, EU & Japan Branded generics offer premium prices
India presents competition challenges
China behind 2020 universal coverage goal Arab Spring largely shrugged off
Increasing focus on health outcomes
Healthcare becomes more patient-centric
Regulatory focus on existing as well as new drugs R&D productivity/profit margins remain a challenge Industry centre of gravity shifts South & East
Consumers will be better informed wanting feedback Mobile personal healthcare records the norm
Whole genome sequencing at birth Networked genome data
Emergence of healthcare industry focusing on wellness
NO HEALTH OUTCOME – NO HEALTHCARE INCOME
Riskier bets...Pharma 2025
Embrace change as inevitable
Develop a vision for several potential future scenarios
Understand the inherent capabilities a company possesses Identify strategic bets that position company as a winner Adapt business model to support strategic direction
Biologics All major players
Comsumer healthcare/OTC SNY, GSK, NVS, JNJ, BAY
Generics SNY, PFE, GSK, NVS
Orphans SNY, GSK, PFE
Devices PFE, ABT
Services ABT, ROG
Biosimilars PFE
Diagnostics ROG
Nutrition & wellness ABT
Source: Scrip Intelligence
Pharma + Diagnostics – Matching right patient & medicine
Enabling personalised approach to patient care
Pharma + Consumer – Holistic approach to wellness
NVS & EU payors remotely monitoring hypertension for compliance
Pharma + More focused therapeutic areas for quick hits
NVS acquisition of Alcon and buildout of ophthalmology business
Healthcare costs are becoming unsustainable
Chronic diseases epidemic – unhealthy lifestyles, aging Cost containment will require behavioural changes
Health outcomes will move to the fore
Healthcare will become more patient-centric
“Any sufficiently advanced technology is indistinguishable from magic,”
Arthur C Clarke, Sci Fi author and futurologist
Disconnected healthcare systems of past will soon be a relic New norm will be highly accessible, interactive info system
Shifting from doctor’s office/hospital to where patient is Personal health technology revolution
Med device consumerisation/consumer device medicalisation Smartphone apps, sensors and real-time monitors
New roles and business models; patient centricity
Life expectancy doubled in past 200 years
We may be first generation not to outlive our parents All in healthcare will be in behavioural change business
Will need balance of paternalism & individual responsibility Life science sector will need to look to other industries
“New treatments face a tall order in many cases because
they are compared to existing drugs which have proven to be effective. It gets harder over time to show that medical
therapies are an improvement over what is already available” Dr Shari Ling, Deputy CMO, US CMS
“For many disease classes we have effective, cheap generics. In that sense, the industry is a victim of its past success”
Professor Patricia Danzon, Wharton School, Univ of Penn.
“Customers are unwilling to pay for products that are not sufficiently better than existing ones to justify the price
premium charged. It will not be enough to be the 12th or 13th
version of hypertensive drugs”
Dr Christopher-Paul Milne, Tufts University
Germany changed rules – one year to prove value UK hopes to enact some form of VBP by 2014
Now Then
Pharma firms Improved efficacy Patient outcome Bioservices firms Improved efficacy Patient outcome
Generic firms Volume used Volume used
Health insurers Improved QoL Improved QoL
Government payer Improved QoL Improved QoL
Regulatory agency Improved QoL Improved QoL
Source: Economist Intelligence Unit
Understanding what market wants and needs Clinical trials directive
Price Transparency directive Counterfeit medicines directive Innovative Medicines Initiative Trust and reputation
Doctor 88% Pharmacist 81% Academic/expert 72% Disease patient 65% Company expert 62% NGO representative 45% Regulator/Govt official 31% Journalist 29% Company employee 24% Company CEO 22%
Source: Edelman Trust Barometer 2012
Stakeholder Industry Patients
Doctors/Healthcare professionals 50% 46%
Scientists/Medical researchers 31% 23%
Biopharmaceutical companies 11% 5%
Patient advocacy groups 4% 12%
Health insurance companies 2% 4%
Regulator/Government officials 3% 6%
Source: Economist Intelligence Unit
Collaborate more closely with patient groups/med experts
Leaders 61% versus Industry average 38%
Collaborate more with companies with specialist expertise
Leaders 42% versus Industry average 36%
Focus on diseases of unmet medical need
Leaders 24% versus Industry average 31%
Make no significant change to R&D strategy to show value
Leaders 6% versus Industry average 19%
Source: Economist Intelligence Unit
Success will require stakeholders aligning around patient
Goes beyond individual company efforts to change business model
Need to focus broad stakeholder alliance on limited space
Common agenda, shared metrics, mutually reinforcing activities, continuous communication, a backbone support organisation
Establishment of disease networks
Collective impact alliances in which providers, academic medical centres, CROs, payers and life science companies form enduring relationships with patients to seek cures for certain diseases
Regulators & patients want more clinical data transparency
Positive and negative clinical data should be given same priority
Drive for more open access scientific publication
Funding bodies such as NIH and Wellcome Trust demand free-to-access publication of research – creates new publishing challenge
Public private partnerships will become more common
Following positive reaction in industry to Innovative Medicines Initiative, companies are likely to be more willing to reach out to other stakeholders in the healthcare ecosystem
Thank you
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