Digital Transformation & Pharma - Goethe Business …...Pharma is producing record levels of...

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


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”)


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


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?

https://econsultancy.com/internet-of-things-healthcare/

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


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


+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


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…



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


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


16

The most commercially successful launches have a promotional mix suggestive of greater multichannel maturity


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


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



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


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


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


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


• 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


• 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


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


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

[email protected]

@ FrankWartenberg

© 2019, IQVIA Commercial GmbH & Co. OHG

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Digital Transformation & Pharma - Goethe Business …...Pharma is producing record levels of...

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