Sanofi Press Breakfast on Behavioral Science
Friday 22 September 2017
Agenda
2 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
• 8.45 - 9.00 Welcome coffee
• 9.00 Kick-off
• 9.00 - 9.10 Introduction by Alexandra Rocca, Global Head of Communications
• 9.10 - 9.20 Reducing the efficacy gap between the clinical and real world settings, the impact of patient behavior in clinical outcomes. Anne Beal, M.D., M.P.H, Global Head of Patient Solutions, Sanofi
WHY UNDERSTANDING BEHAVIORS CAN UNLOCK CARE SUCCESS
• 9.20 - 9.35 How Sanofi is active in the space of Real World Evidence? Bernard Hamelin, M.D., Global Head Medical Evidence Generation, Sanofi
• 9.35 - 9.50 Evidation: a concrete case study to understand the technology behind behavioral science Christine Lemke, Co-founder and President, Evidation Health
• 9.50 - 10.20 Q&A with the floor
• 10.30 Close
Leveraging behavioral science to improve health outcomes
Anne C. Beal, MD, MPH Global Head of Patient Solutions, Patient Solutions Unit
Pharma is facing unprecedented change
4
In the real world, when people have to manage their conditions, they’re not skilled at self-management,
nor are they utilizing their treatments appropriately
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
• 50% of health outcomes are determined by behavior,
yet physicians are not well trained for this part of their job1
• 30% of people don’t fill prescriptions for chronic conditions2
• 50% of people with a chronic disease don’t take their
medication as prescribed3
Helps people to achieve improved health outcomes by supporting optimal
utilization of Sanofi products and services and enhancing their activation and
self-management
1Bipartisan Policy Center, 2012; Volpp, Kevin. NEJM Catalyst, 2016 2Tanblyn et al. Annals of Internal Medicine, 2014
3WHO, 2003
5
Leveraging behavioral science to close the gap between real world effectiveness & efficacy…
REAL WORLD
EFFECTIVENESS
CLINICAL TRIAL EFFICACY*
FACTORS CONTRIBUTING TO GAP:
PATIENT self-management, co-morbidities, concomitant medications…
PHYSICIAN patient interaction, care coordination, Rx behavior...
SYSTEM access (formulary, reimbursement, quality of care, affordability…
CONTEXTUAL SES, zip code, race, ethnicity, social support, family, etc.
Medical can bridge
this gap through
evidence-based
interventions by:
Understanding patient
factors behind the gap and
associate them with
outcomes
Designing interventions to
influence key factors that
will lead to improved
outcomes
OU
TC
OM
ES
GA
P
Behavioral Science can address clinical inertia, patient activation and non-adherence which are critical to improving outcomes
*Relative scale of impact for patient factors, HCP, health system, and contextual factors varies case by case. Broader results/ outcomes differences in clinical trial efficacy and real world effectiveness may vary on a case by case basis.
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Overwhelmed & disengaged
Becoming aware, but still struggling
Taking action
Hibbard: Patient Activation Measure (PAM)
6
Maintaining
behaviors
LEVEL 1
LEVEL 2
LEVEL 3
LEVEL 4
0-100 point scale
10-20% 10-20% 25-30% 20-25%
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Hibbard: Activation and Medication Adherence
7
Source: 2004 National Sample
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
8 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Advice and Input, Behavioral Science Toolkit
9
Selection of the strategic area of improvement
Recommendations for segmentation
Operational objectives highlighted
Exploration of Tips & Tools, Case studies and References
1 STRATEGIC AREAS OF IMPROVEMENT
(ex: improve adherence. develop patient self management skills etc)
THEN PLEASE SELECT YOUR SPECIFIC STRATEGIC AREA OF IMPROVEMENT, BY CLICKING
ON THE TOPIC
Access To Treatment
Patient Knowledge
Symptoms / Quality Of Life
Health Outcomes
Adherence
Patient Experience With Treatment
Management Of Side Effects
Acceptance Of Therapy
Self Management Skills
Patient Experience With The Service /
Patient Satisfaction
Habit Formation Improve HCP Experience / HCP
Satisfaction
Enhance HCP Management Of
Chronic Illness
Improve Patient’s Relationship With
HCP
Improve HCP Engagement /
Activation
Support HCP Dialogue
With Patients
Leverage Product Characteristics
Differentiate From Competitors
Generate Data On The Impact
Of The Service
Position As A Healthcare Provider
Support Market Access
Support Value
Enhance Efficiency Of Service
Delivery
PATIENTS HCP SANOFI
*Prior to accessing information on your chosen operational objective, you will be presented with key segmentation reminders
Enrollment Content Channels Monitoring
PHYSICIANS / NURSES /
OTHER HCPS
CHANNEL
PERSONALIZATION AND
AUTOMATIONHCP penetration
HCP activation /
engagement
Patient initiation
Patient persistence
Patient engagement
Peer experience content
Differential messaging
PATIENT
Educational content
Motivational content
Peer / Carer content
Differential messaging
Typology of channels
Number of interactions /
contact frequency
HCP Monitoring
Patient Monitoring
Outcomes
Value optimization
1
2
3
4
Recommendations for segmentation
Selection of the operational objective
Exploration of Tips & Tools,
Case studies and References
2 PRACTICAL OBJECTIVES
(ex: improve patient enrolment, physician engagement,
develop tool personalization etc)
Enrollment Content Channels Monitoring
PHYSICIANS / NURSES /
OTHER HCPS
CHANNEL
PERSONALIZATION AND
AUTOMATIONHCP penetration
HCP activation /
engagement
Patient initiation
Patient persistence
Patient engagement
Peer experience content
Differential messaging
PATIENT
Educational content
Motivational content
Peer / Carer content
Differential messaging
Typology of channels
Number of interactions /
contact frequency
HCP Monitoring
Patient Monitoring
Outcomes
Value optimization
1
2
3
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Sanofi and Real World Evidence
Bernard Hamelin, MD – Global Head of Medical Evidence Generation
Pharma is facing unprecedented change
11
Vocal patient
populations
Tougher regulatory
controls; societal
expectation
Rising
development
costs
Digital
Health Revolution
Greater
requirements
for post-
marketing
evidence
Payors
pushing for
Real World
Evidence
Shifting
global
demographics
Increased
transparency
expectations
Physicians
seeking
peer-peer
interaction Evidence
generation
needs
to evolve to
better
understand
and improve
patient
outcomes
Increasing
safety
concerns
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Evidence requirements are increasing
12
Evid
en
ce
re
qu
ire
d
Sub- mission
Pricing Review
New Competition
Competitor goes generic
New Indication / Formulation
Understand standard of care
Post-marketing commitments (safety etc.) Budget impact
Adherence Unmet need/ disease burden
Patient recruitment
Trial design
Utilization/ prescribing
patterns Long-term safety, clinical outcomes
Head to head safety, comparative effectiveness
Target populations
Differentiation in sub-populations
Effects of switching on outcomes
Usage difference
Differentiate with or vs. protected formulation
Development Launch
Development Growth Phase Mature Phase
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Evidence generation methodologies
13
Randomised Clinical Trial
Pragmatic Clinical
Trial
Observational Study
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
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Real World Evidence is based on data from multiple sources
RCT
Source : jama, 22 may 2014
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
What we do: methodologies we use and partners we work with
15
Methodologies Partnerships
Propensity-score matching Meta-analysis
Traditional RWE statistics
OMOP data modelling
Traditional analytics
Machine learning
Predictive modelling Unsupervised clustering
Natural Language Processing (NLP)
Advanced analytics
Rule extraction Model bootstrapping
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
New data, new platforms, and new analytics make new insights possible
16
NEW SOURCES OF DATA
NEW PLATFORMS AND VISUALIZATION
NEW ANALYTICS
Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Quantifying impact of behaviors on health outcomes
Evidation Health is a technology and services company that helps individuals and healthcare companies understand the link between everyday behaviors and health outcomes.
18 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Patients and their outcomes have been characterized by using limited data sets based on what was visible to the system.
Visible & Episodic (in clinical settings)
Invisible & Continuous (in real life)
DATA POINTS
TIME
19 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
Evidation captures previously invisible everyday behavior data and combines it with traditional clinical data sets to understand behaviors and health outcomes.
clinical trial
data
patient-reported
metrics (symptoms, outcomes,
anytime, anywhere) contextual data
(weather, pollen
count, geolocation,
census data,
occupation, etc.)
behavior data
(activity, sleep, diet, social
media, cognition,
technology interaction,
etc.)
REAL LIFE OF
THE PATIENT
REAL WORLD
PRACTICE
provider system
registries
EHR data
pharmacy and
medical claims
TRIALS
20 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
This explosive new data source - behavior data - shows promise to quantify health outcomes more quickly and observe new effects.
Digital Biomarkers
to identify and
quantify:
Social
Location
DEMOGRAPHICS
Lifestyle
PLACES
WEATHER
Voice/Speech Heartrate
Activity
Weight
OTHER..
Sleep
Other… TREATMENT EFFECTIVENESS
EMR CLAIMS
LABS OTHER..
BEHAVIOR
CONTEXT
CLINICAL
Evidation Platform Applications
CONDITION ONSET
INTERVENTION WINDOWS
CONDITION PROGRESSION
Data Analytics for
discovery
21 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
It requires a scalable system to connect directly with individuals to gather, contextualize, and combine behavior data with clinical data.
QUANTIFIED IMPACT
CONNECTED POPULATIONS
REAL LIFE DATA
>3 MILLION
patients on the platform,
across multiple therapeutic
areas
>1.5 BILLION
new activity events recorded each
month
22 Sanofi Press Breakfast on Behavioral Science - 22 September 2017 - Paris
…and services combined with a platform to reach individuals for permission-based data sharing
Find people
10x faster
Design research
studies
Execute privacy safe, virtual
study protocols
Interpret and
deliver results
Peer review standard
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Results: faster, more proactive care
Digital Biomarker
Discovery
Digital Evidence
Generation
Digital Biomarker
Discovery
Challenge Understand medication
adherence in patients
with diabetes
Assess the effectiveness of
medication adherence
application
Quantify cognitive
decline through voice
and speech signals
Data inputs Weight, activity,
adherence measured
through pharmacy claims
data
Connected monitors,
engagement data, patient
reported outcomes
Voice, speech, clinical
data
Results Discovery of behavior
pattern that led to
adherence drop
Recruited and observed
400+ patients, recruited 10x
faster
Predict cognitive decline
scores solely based on
voice and speech
(research embargoed)
Application Monitor patients and
deliver diabetes
education at right time
Evidence package for use in
market commercialization
Improved screening,
monitor therapeutic
impact (e.g. oncology)
24 Sanofi Press Breakfast on Behavorial Science - 22 September 2017 - Paris
Questions
September 2017
evidation.com
christine@evidation
Thank you
Q&A
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