Global Pharmaceuticals & Biotechnology Industry

360 Degree CEO Perspective of the
Global Healthcare Industry

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Agenda

A Global Healthcare Industry Outlook B Overview By Area

1. Top 10 Global Healthcare Trends 1. Pharmaceuticals & Biotechnology

2. The Triple Healthcare Crisis 2. Clinical Diagnostics

3. Shifting Healthcare Expectations 3. Medical Devices

4. Convergence in Healthcare 4. Medical Technologies

5. Healthcare Paradigm Shift

6. Hot Spots & Emerging Geographies

7. PESTLE Analysis

8. Opportunity Analysis – Major Areas


Top 10 Global Healthcare Trends

The Triple Healthcare Crisis

Shifting Healthcare Expectations

Global Healthcare Convergence in Healthcare

Industry Outlook
Healthcare Paradigm Shift

Hot Spots & Emerging Geographies

PESTLE Analysis

Opportunity Analysis


Top 10 Global Healthcare Trends
2007 – 2020

High Impact

Power Patient
Generation
Drugs get
Smarter
Shift to Personalised
Healthcare
Innovation vs. Prevention Before
Knowledge Cure

Healthcare globe
trotters
Projected Patients become
Impact on the Customers
Healthcare
Cyber Docs
Industry
Hospitals go Virtual

Devices become
monitors, monitors
become devices

Low Impact

Low High
Certainty


Patients become healthcare Kings and Queens, Medical communities become
interconnected while doctor-patient relationship goes virtual.

Major 2010 2015 2020
Trend
Power Patient Patients gain access to Patient Centred Care Patients become
1 Generation health quality information Baby Boomer Retirement Starts healthcare Kings and Queens

Patients Become Consumerism One Stop Shop
2 Customers Holistic health and well being Customised Products Home Services

Prevention
3 Before Cure
Early Treatment Implementation of IT Precise therapy becomes reality

Personalised Genetic Testing Information based medicine Wellness Care Presymptomatic diagnostics
4 Healthcare Targeted Clinical Trials Major diseases understood at molecular level & treatments

Healthcare Immediate Treatment abroad "medical tourism" crosses Private Companies invest in
5 Globe Trotters becomes an option the US$2 billion mark facilities and services abroad

Smarter Drug cocktails will enhance productivity, memory,
6 Drugs
Non-invasive delivery
and physical performance

Hospitals Go Medical communities (1°, 2° care) Regional/Country-wide
7 Virtual
All departments/buildings within
hospitals are connected become interconnected Connectivity

Innovation vs.
8 Knowledge War for Medical Talent Baby Boomer Retirement Starts Medical professionals keep
up with knowledge growth.

9 Devices Become
Monitors Disease management Remote Patient Monitoring Self-monitoring

Virtual face to face
10 CyberDocs
doctor- patient relationship
Perform routine diagnostics
with predictive precision
Cheaper care available to
more people in need


Healthcare is challenged by three interlocking crises that make
present healthcare systems unsustainable
Healthcare is challenged by three interlocking
crises that make present healthcare systems The Size of the Problem – Quality
unsustainable:
Rising Costs, 15% of patients admitted to hospital
Changing Demographics suffer an adverse event.

Quality 8% of adverse events result in death.

6% of adverse events result in
permanent disability.

10-20% of all adverse events is
caused by medication errors.

10-15% of hospital admissions
occur because providers do not have
access to previous care records.

20% of laboratory tests are requested
because the results of previous
investigations are not accessible.


If current trends hold, by 2050 health care spending will almost double
claiming 20 – 30% of GDP for some economies.

In almost all countries worldwide, per capita healthcare spending is rising faster than per capita income.
No country can spend an ever-rising share of its output on health care, indefinitely. Spending growth must eventually fall in
line with growth in per capita income.


The balance between young and old is shifting. Ageing related and chronic diseases, are
becoming significant. More people living with multiple long term illness and conditions.

In 2000, 10% (606 million) of the global population was
aged 60+. By 2050 this will be more than 21% (2 billion).
People aged 60+ utilize 3-5 times more healthcare
services than younger people.
75% of people aged 60+ have one chronic
condition, while 50% have two or more chronic
conditions.
Chronic diseases account for more than 60% of all
health care spending.
Health economics dictate a shift in spending – away
from treating and towards predicting, diagnosing and
monitoring

Consumer experiences in other markets affecting expectations from healthcare

Greater variety of Retailing
providers, products and & Finance
services e.g. expensive Customer service
health plans and alternative Comparison Shopping Manufacturing
medicine services Self-Service & Distribution
Special Offers Faster time to market
Power patients have increased access Healthcare One Stop Shop
Anytime Anywhere Care
to computers and information Supply Chain Integration
through multiple channels to seek and
analyse health information
Entertainment
& Media
Customised Products
Home Services

Health care that is
customized to
monitor, diagnose, edu
cate, and intervene
Freedom to make regardless of location or
own decisions time-will be common.


Convergence in healthcare enables personalisation, targeted medicines, new drug delivery
mechanisms, virtual patient monitoring tools, allowing a preventative approach to healthcare

Bio Chips: Controlled Released Disease Management

Tailored Treatments- Telemedicine
Genomic/Proteomics based

Drug Delivery Health Management

Predictive tests
Remote Patient Monitoring
Gene Mapping &
Functional Analysis
Preventative Programmes Life Sciences
Nanotechnology
IT / Digital Information Systems
Delivery Systems

Technology…….Enables it

Economics………………Require it

Demographics………….Demand it

Medical Medical
Devices Technologies


Riding on a wave of technical innovations Healthcare will change from an acute
“find it and fix it” system to a “wellness tracking” system
Current Healthcare Systems Future Healthcare Systems
Suffer from the Must Apply a
“RADAR” Syndrome “GPS” Logic

Telehealth
Patient Appears for virtual
(falls sick) interactions

Patient is treated
“find it and fix it”
Patient is discharged Web portals
to EHR Sharable
Systems Personal
Patient then disappears from radar screen
Health
Patient Scan Records

Good Chronic
Disease care
System oriented to acute illness
Patient’s role not emphasised
Patient Provider
Follow up sporadic Support Support
Tools Tools
Prevention overlooked
Home monitoring devices Electronics Health Records (EHRs)
Personal Health Records Chronic Disease Management Systems
Web- based education and support Personal Digital Assistants
Disease Management Program


A modern healthcare system is on the horizon demanding
a Healthcare Paradigm Shift

...From ...To

Fragmented Patient Flow Integrated & automated

Invasive Diagnosis & Less invasive, Preventative,
Treatment image based

Provider Centric Focus Patient Centric

Centralised – Hospital Monitor De-Centralised–Shift to Community

One Size Fits All Approach Personalised Medicine

Therapeutics/Diagnostics/ “Theranostics”
Devices Tools

Treating Sickness Objective Preventing Sickness – “Wellness”


Threats arise from unconventional players outside the
traditional healthcare boundary

Agriculture & Food Companies
Biotech is the changing face of agriculture.
Biotech crops were planted in 18 countries in
2004. By 2010, it is projected that 15 million
Employers & Government
farmers will grow genetically modified crops on 2007 : Integrated Healthcare
up to 375 million acres in 30 countries. Management in the US has been
launched as the systematic application of
processes and shared information to
optimize the coordination of benefits
Chemical Companies and care for the healthcare consumer

2007:Roche and Toyama
Chemical enter licensing
agreement to develop potential Healthcare Companies
breakthrough drug to treat
rheumatoid arthritis

Consumer Product Companies
2007 : SUPERMARKETS in the UK are
increasingly becoming one‐stop‐shops for
everything by branching out into Telecommunication Companies
healthcare, with everything from in‐store
pharmacies to blood tests, blood pressure 2007 : Orange launches "Connected Hospital", its
first e‐healthcare offering designed to improve
checks and health checks on your lungs.
patient comfort and care quality
2008: Virgin Group launched a new
healthcare network. The first of six “one‐stop
shops” clinics will offer extra NHS and private
services including dentistry, screening, a
pharmacy and complementary therapies
alongside GP practices. Ultimately, offering
wider options for patients.

A Look at the Future: Patient Centric Health & Wellness Care

Web of Care
NanoCare

Mobile EHR
Implantable eCare

Smart eHomes
Wearable BioSensors

Health Robots Decision Support



EcoMedicine

Doctors
Friends
NanoMedicine & Medical
&
Team
Family
eHealth
Pre-emptive Medicine Advisor
Network
Coaches Online
Support
Regenerative Medicine &
Advocates Communities

Digital Medicine

Self Care My Health & Wellbeing
Databases

Diet Humor Lifestyle Mind Exercise
& & & Stress Body & &
Nutrition Joy Reduction Spirit Fitness


Hot Spots and Emerging Geographies
Canada
Relatively high government UK/Scandinavian Countries
spending on healthcare, small High government spending on
number of local market healthcare IT, large market, high
players, sizeable market number of healthcare IT players.

Hong Kong
Germany/Switzerland High government
U.S. High spending on spending on
Huge healthcare healthcare, large market with healthcare, small
market and not too many market domestic
growing, large players, increasing focus on market, gateway to
opportunities, niche eHealth and digitization China
players will be more India
successful Large market, low operating costs, excellent
local skills, high local
competition, Distribution hub to the Middle-
and South-East of Asia
Venezuela & Colombia
Constituting part of the
Andean Region are the
fastest growing countries
in many HC categories
due to large public
investment Sub-Saharan Africa
Limited current government
spending on healthcare Australia & New Zealand
IT, increases planned in the High government spending on
Brazil & Mexico
future. Private sector healthcare IT, small number of local
Two largest healthcare
developing increasing focus market players, increasing focus on
markets in Latin America and
on eHealth. Moderate number eHealth and digitization
growing at a sustained pace
of players mainly operating
from South Africa.


PESTLE Analysis – Timeline

2010 2015 2020

Growing Political Focus and Increasing harmonisation
POLITICAL Pressure on Healthcare Increase influence by regulatory bodies

Spend per capita on health globally grows
Reduction in pharma growth Global ‘Not for Profit’ Pharma
ECONOMIC (business model changes) Supply for developing countries
Divide between the EU, US and rest of the world grows

Patient Centric Healthcare
Ageing population
Health awareness (prevention)
SOCIAL Personalised healthcare Increasing pressure from patient groups
Raised consumer expectations Medical Ethics Health education Increasing customer awareness

Information Based Systems Internet Pharmacogenomics Genomic Drugs
TECHNO-
Direct to Patient Advertising Combined diagnostics and therapeutics
LOGICAL Health card / Smart Cards
Drug Design Customised treatments

Therapeutics>Theranostics (Rx/Dx) Privacy Genetic Discrimination
LEGAL Biogenerics/biosimilars Faster Drug Approvals Medical Errors / Safety

ENVIRON- Mergers and Acquisitions Development of specialist therapy providers
MENTAL Biotech companies transition to Pharma companies
Impact of HIV and other pandemics


Opportunity Analysis – Major Areas (Europe), 2007-2012

High Revenues
Pharmaceuticals

Projected
Revenues
In 2012
($ Billions)
Medical Devices

Drug Discovery Biotech
Low Revenues Clinical Diagnostics
Patient Monitoring Healthcare IT
Medical Imaging

Low High

Growth Rate (2007-2012)


Market Data

Snapshot of Potential Opportunities

Key Trends

Global
Emerging Markets
Pharmaceutical &
Biotechnology
Trends

?

Integrated Model,
Pharmaceuticals, Biotech, Generics, Gene Therapy,
Blockbuster Model Local Players Global Players


Changes in the Global Pharmaceutical Environment Require Pharmaceutical and
Diagram
Biotech Companies to Adapt to Changing Business Models
Pre 2005
2015
Blockbuster Model Preventative Healthcare & Wellness
Astounding growth in the vaccines
industry
2015
Opportunities Marketing of Value Added Services
in the Global
Niche Drugs and R&D Genomics and proteomics expected to
Pharma Market
reduce R&D times
‘In life testing’ will take over the current
2020 clinical trial process. Continuous data
monitoring can be done by the regulators
Integration & Supply Chain during the testing process. Clinical trials
will eventually become shorter

2020
Integrated packages of products and services Supply chain functions will evolve to a revenue
generating model. Products and services will be
Patient monitoring & compliance
marketed through the supply chain
Pharma and medical devices providing
Just –in time manufacturing, novel delivery
sophisticated and efficacious solutions
methods and direct to consumer distribution will
Integration of pharma, diagnostics, medical be adapted from other industries like the
devices, patient monitoring and healthcare IT automotive industry
Will result in a high profile, risk free, user Automated dispensing of drugs
friendly, low cost and safe healthcare solution
Smart cards / internet to store patients details


Cancer represents the highest potential for revenue generation
and growth in the future

High Revenues

Established
Treatments

Projected Unmet Needs
Revenues In
2012

Low Revenues

Low High


Increasing Focus on Biologics in the Future
Cancer Related Drugs Constitute Half of the Current Biotech Pipeline.
Phase III: 5-10 years to launch

Cancer Pipeline 2007 – Split by Phase III & I
Monoclonal Antibodies constitute half of the Phase III biotech
2007 pipeline. More Monoclonal Antibodies are likely to reach the
market in the next 5-10 years.

Phase I: 10-15 years to launch

Cancer vaccines are an emerging technology that are likely to
create the next wave of growth in the biotechnology industry
because of better safety profiles and minimal side effects
Other: Includes genetic disorders, skin disorders, eye conditions, growth disorders, transplantation

The Next Five Years will see more than 70 Major Drugs come Off-patent in the
Major Markets within US and Europe. Beyond 2011 Increasing Focus on Biologics
Beyond
2008 2009 2010 2011 2011………

US US US US Decreasing number
14 drugs lose patent protection Five major drugs lose The US patent for Lipitor Patent protection expires for 10
of small molecule
(include super blockbusters patent protection expires and for 12 other major drugs in the US (includes
drugs (includes the the superblockbusters Seroquel patent expires
Effexor and Fosamax, and (includes Prevacid)
blockbusters Levaquin, and Zyprexa, plus three other beyond 2013
potentially Advair)
Cozaar and Protonix) blockbusters)
EU Biologics will be the
Nine drugs lose patent EU focus within hospitals
protection in at least one of the Seven drugs lose patent EU EU in the injectables field
major European countries protection in at least one Five drugs become exposed Four of these, including
(including both Fosamax and of the major countries to generic competition with Zyprexa, lose patent protection Within the EU and US,
Effexor) (including Nexium, Keppra the most significant in three major European
there is increasing
Pantozol and Cozaar) of these countries, as do seven other
drugs, most notably Lipitor in competition from low
November 2011 cost competitors
Market Size (2007-2012)

Source: IMS

Gene Therapy will Drive the Market in the Longer Term. Technologies such as
Diagram
Pervasive computing are Important in Improving the Drug Discovery Process.

Smart
Tags
Petaflop Predictive
& Grid biosimulation
computing Future
Technology
Trends Advanced
Defining diseases more Pervasive
accurately and creating Gene therapy uses genes to treat or computing storage
prevent disease. In the future, this solutions
healthcare packages for
technique will allow doctors to treat a Web-scale
patients with specific disease
disorder by inserting a gene into a mining
subtypes. Resulting in
Premium Drugs and the patient’s cells instead of using drugs
launch of health care kiosks or surgery
A disease led approach creates a new discovery and
Opportunities

offering one-stop-shop development model. Technology will improve the process e.g.
services making in-life testing more cost efficient. This brings
significant changes for pharma companies in terms of time,
development costs and success rates to man.
Genomics /
Gene
Proteomics
Cellomics Therapy,

Biologics: Targeted
Treatment
Solutions, Integrated
Semi Block Solutions
Busters, Patent
Expiration
Strategies

Growth Rate


Shift in Growth from Mature Markets to Emerging Markets
Central and Eastern Europe China
High unmet needs in Cardiovascular and respiratory disease treatments API manufacturing hub
Increasing private healthcare expenditure – co-payments on the rise Increasing competency in R&D
Markets are dependant on parallel imports for innovative medicines outsourcing
Russia, Poland, Czech and Hungary demonstrating healthy R&D climate Anti-infectives and Cardiovascular
Turkey: Ability to produce active ingredients and finished products drugs – fastest growing markets
Improved IP laws – potentially
attractive climate for FDI

Brazil
Latin American hub for FDI and
exports to neighboring nations
Government policies favour
generics use – branded drugs’
revenues are low Korea
Recognized potential for CRO and Innovative capability
CMO growth – still in and well developed
development phase India
industry
Highly skilled labor and low costs – attractive
market for partnerships (CRO, CMO) (APIs)
Pharmaceutical companies with global presence
US FDA approved labs – preferred destination
for R&D outsourcing
Weak IP protection – a concern
Argentina
Approval of ‘Generics law’-
patients choose between
branded and generic drugs Singapore

Marketing strategy focused on US-Singapore FTA – Asia-Pacific Manufacturing hub
patients, moving away from Highly competent facilities for clinical trials and drug
physicians development
Emerging market with huge Favorable investment policies – Asia-Pacific
potential for R&D outsourcing headquarters of major foreign pharma companies


Market Data


Key Trends

Global PEST Analysis

Clinical Diagnostics
Trends

Integrated with
Neglected sector Hottest area other HC sectors


Increased patient driven initiatives have secured diagnostics considerable market
Diagram
growth potential causing significant healthcare cost savings
2005
Demand Volume
Secondary Care Affordability
Waiting Lists
Changes in
2010
Public Anxiety
the demand
for healthcare Development of demand
diagnostics Primary Care management policies and
strategies e.g. demand
driven financing

2015
Home Care/ Self Testing

Pharmaceutical /
Patient Driven Biotechnology
Available personalised healthcare and choice
Patient knowledge through multiple channels
Public pressure on government Information IVD
Imaging
Technology
One stop shop
Consumer responsive providers, products and services.


Snapshot of Potential Opportunities - Global

High Revenues

Projected
Revenues In
2012

Low Revenues

Low High


The next 10 years will witness the Integrations of in vivo, in vitro, and IT in the
advancement of personalised medicine
IN VIVO
IN VITRO IN VIVO IT
IN VITRO

e.g. e.g. CT,MR e.g. e.g. CT/MRI radiation
PCR, Immunoas , PET/CT and PACS, electronic treatment, Mammograph
say Nuclear health records y IVD Test and PET/CT
medicine and medication new marker
management

Predict Diagnose Inform Treat

Diagnosis Surgery Therapy Earlier Diagnosis
Screening and
guidance
evaluate risk pre- Prognosis/Asses Monitoring long Gain more specific
disposition sment Therapy term disease
selection
Symptom based General Staging Follow up information
diagnosis Therapy Diagnosis of
Surgical Staging Define best
planning recurrence
individual therapy
PHARMA Knowledge based
decision support
through integrated
IT
INTEGRATION of in vivo, in vitro, and IT in the advancement of
personalised medicine


Earlier diagnosis, less invasive testing and adverse drug reactions drive clinical
Diagram
acceptance of pharmacogenomic tests.
Opportunistic Segments

Pharmacogenomics

Molecular Testing
Efficient Decision Making
and Optimisation of
Cancer Testing
Treatments through POCT

Automation is a One Earlier Diagnosis
Time Investment Point-of-care Testing
Concept Less Invasive Genetic Testing
Encourages Patient Screening.

Instrumentation and Adverse and Ineffective Drug
Automation Reactions Drive Clinical Acceptance
of Pharmacogenomic Tests

Growth Rate


PEST Analysis of the Global Clinical Diagnostics Market

2007 2010 2015
Political
More regulatory
challenges Increased harmonization
in the global market
Concerns over global harmonization of
IVD regulations

Economical Reimbursement for Challenges likely to More understanding
new tests prevail from payer groups

Less skilled laboratory More adoption of pre Total laboratory
technicians analytical automation automation

Demand for quality healthcare
Social Bio threat
Ageing population Tele medicine
POCT
Increasing incidence of diseases Evidence based
Focus on public health from
Emerging infections the government diagnosis

Technological ELISA POCT Isothermal based amplification
PCR techniques
Lateral flow tests Nano-diagnostics
Microarrays


Market Data


Key Trends

European PEST Analysis

Medical Devices
Snapshot

?

Reduced Hospital Holistic solutions
Hospital based Integrating pharma,
stay and increase diagnostic
Intervention
in homecare & monitoring elements


Buying Power: The changing priorities of Customers changes device markets
2005
Price, After sales service, “Opportunities for differentiation move
Reliable, frequent deliveries into emphasis on safety, comfort and
mobility along with delivery and service”
Changing
Customer
2007
Safety, comfort and mobility,
Focus
Delivery and service, Price

2010
Comfort, mobility & safety, efficiency,
One-stop combination solutions The ambulatory, homecare and public access
Opportunity market expands rapidly

Large scale purchasing orders give buyer
Challenge advantage and often result in price squeeze
“Efficiency in sourcing becomes and/or bundling type practices
more important, hence complete
Increased awareness of infection control strategies
solutions and comprehensive Opportunity opens alternative product differentiation avenues
portfolios are preferred” “Pricing will
Cost-containment initiatives reduce profit
Challenge become less
margins
important in the
Cost-cutting in purchasing opens up opportunities
sense that price
Opportunity for low cost producers matching will
become easier
Challenge Fast diffusion of innovation heats up
competition
as companies
become more
Outsourcing in production base and/or
nimble”
Opportunity services reduces production costs

Snapshot of Potential Opportunities – Europe, A Rapidly Expanding Market

High Revenues

Projected
Revenues In
2012

Low Revenues

Low High


Aligning Market Vision: Opportunities in the Medical Devices Market

Raw Markets
Developing/Growing Markets
Disease management

Patient
vs. device centred

Monitoring Mature Markets

Therapeutic Device
Medical Procedure

Scandinavia
Initial Event
Russia

At Risk
Ireland
UK
Wellness Poland
Germany
Czech
Future France
Republic
Hungary
Tissue engineering and combination devices. Merging
devices with biological elements Croatia Serbia
Italy
Implanted diagnostics and monitors enabled by sensors Albania
Disease management approach
Novel drug delivery platforms in unmet needs and
indications – Hep C, Chronic Pain, Depression

Taking Stock and Looking Forward: PEST Analysis

2007 2010 2015
Political Medical tourism and
Moving production base
Changes in the Medical standardisation of medical
and/or outsourcing results in
device directive and other provision changes market
trade agreements and
standardisation measures potential and emphasis on
political overtures
regulate markets a global basis

Economical Single currency stimulates Pan- Rationalisation and reduction of hospital
European trade resources creates additional pressure
Changes in the dynamics of healthcare provision
Diagnosis Related Groups rationalise the affect funding and change routes of patient care
purchase and use of devices

Social An increasingly aging European
Migration and changes in genetic make-up of
population has implications for
populations affects healthcare strategies
healthcare provision
Ambulatory and user-friendly devices along with combination
devices expand the scope of medical device equipment

Minimally invasive surgical
Technological Patient data management systems and freedom of
techniques along with information change supply management strategies
combination devices increase
level of technical sophistication Fast diffusion of technologies in medical devices leads to rapid rate
of obsolescence and increased emphasis on technical research

Revenues

Key Trends

Key Opportunities

Global
Future
Medical
Technologies
Trends

Disparate/Modular Personal Health
Clinical Systems Management Tools
Systems


Interoperability Key to Adoption in an Increasingly
Patient-centric Healthcare Delivery Model
2007
Medical Healthcare
Volumetric Imaging Systems Imaging IT
Web Based PACS

Medical
2010
Imaging
Multimodality Systems Patient
Mobile/Roaming PACS Monitoring

The 3 areas are converging driven by a reorganization of HC
2015 delivery. From large scale hospital care with high density of
Image Enabled Electronic Health specializations and technologies to a network of competence
Records centres achieving high quality outcome and economies of
scale, linked with primary and long term care facilities.

2007 2007
Networked Modular Systems Clinical Systems

Patient
2010 2010
Healthcare Next Generation Integrated
Monitoring
Move from Critical Care
IT
towards Sub Acute Care Clinical & Financial Systems

2015 2015
Monitoring of Patients at Home Personal Health Management
Systems & Tools


Snapshot of Potential Opportunities – Europe

High Revenues

Projected
Revenues In
2012

Low Revenues

Low High


Next Generation clinical, administrative and financial IT systems & applications
enable medical error reduction, clinical optimization and evidence-based medicine
Critical Care
Mainstream Adoption by 2012 IT Systems
Integrated Clinical/
Personal Health Financial Systems
To facilitate and standardize care Management Tools
delivery, investment will go into sophisticated
clinical, administrative and financial systems Personal
such as the EMR, CPOE, PACS, ERP and “Cradle to Grave”
EMR Access Through
Health Records
Enterprise Scheduling Systems. Bedside Multimedia
Terminals
2012-2020
The use of wireless devices within hospitals will ICU
Tele-Pathology Telemedicine
increase to the point where coverage and
quality-of-service issues will almost disappear.
Patient
Self-Service Ambulatory EMR
Kiosks
Disaster Recovery &
Business Continuity
Emergency Dept
Automation
Enterprise
Physician &
Patient portals
Scheduling Mainstream Adoption by 2020

Regulatory compliance will have a slow but steady
PACS/RIS
ERP for influence, particularly in the area of disaster recovery and
Healthcare business continuity.
2007-2012
Cardiology Clinical vendors offer more-comprehensive and affordable
PACS/CIS
CPOE remote-hosting and high-availability options

Organizations that have already made the leap to “Next
EMR
ePrescribing Generation” systems will be looking to further leverage
their investments through physician and patient
Remote
eVisits Monitoring portals, remote access applications and mobile
extensions.

Next Generation clinical, administrative and financial IT systems & applications
enable medical error reduction, clinical optimization and evidence-based medicine
Semantic Web

Semantic
While “return on investment” Grid Computing Interoperability
remains a critical factor for Health
organizations when deciding IT
Data Lifecycle
Bluetooth
investments, it will not become the Management
Wireless
2012-2020 Networking
sole factor in determining the value
of IT on service quality or outcomes.
Service Oriented
Architecture RFID

Home Health
Services HL7 V3 Messages

Business Process
Management
Distributed
Antenna Systems Home healthcare could evolve from a
Biometrics
Speech Recognition
sporadic practice today to a
Electronic Data
mainstream care delivery model in the
Interchange Hand-writing
Recognition
next 5-10 years.
2007-2012
Natural Language
Services like Online
Tablet PCs
& PDAs Processing Consultations, In-home Vital Signs
Monitoring and Online Disease
VoIP Context Management
CCOW Protocol Management increasingly gaining
Enterprise MPI momentum.


With the goal of creating a single view of a patient’s health information, hospitals are
investing in technologies to pull together all departmental systems into an integrated EHR
GPs/Physicians
Integration cost represents
Cardiology Intensive Care 15–20% of hospital IT budgets
Main cause is lack of adequate
Home Care Emergency Room healthcare IT standards
Current messaging and technology
standards are not universally used
Radiology
EHR Nursing in all product portfolios,
interoperability between systems
using all or some of these
Rehabilitation Surgery
standards has not been
convincingly validated, while some
Laboratory Pharmacy
of the standards conflict with one
and other.
Billing/Finance

Regulations Governing Healthcare Stakeholders

Legislation Standardisation Initiatives Business Compliance

95/46/EC Messaging Standards JCAHO & NCQA Corporate Compliance

HIPAA Terminology Standards CEN TC 251 Business Continuity

Single Market Regulations Integration Interfaces 21 CFR 11 IT Security


Strong Foundations Required to Foster Widespread Adaptation of eHealth Models
Medical Technologies Industry has the Opportunity to Build & Shape the Future

Add Value for
Patients & Providers
High Quality, Safe Lower Cost
Health Care Health Care

Security & Improved Public
Fraud Detection Health

Individuals Self- Personalized
Manage their Health eHealth Health Care

Foster
Adoption
Enable Policies Encourage Large
Scale Pilots

Ensure Clinician Use Internationally
Buy-in Accepted Interoperability
Standards


The magnitude of growth, the need for fast retrieval, 24/7 availability and improved
record management is forcing a new look at operational data management.
The amount of data generated, used and stored in the modern healthcare environment is increasing
dramatically every year.

No other industry in the past has Enterprise-wide databases are
required such a phenomenal amount expected to grow 30-fold during the
Data Storage next decade.
of data to be stored for such long
periods of time.

Data Generation Data Access and Communication

Exa Bytes
Integration Images for On the Move
Context Based Medicine Data Access
2020 2020
3D – 4D Images
Enterprise-wide PACS
Video Images
2015 2015

Digital Cardiology Tera Bytes Cardiology PACS
2010 2010

Digital X Rays Radiology PACS
2005
Giga Bytes 2005


PACS & Software Services to Drive Growth in Medical Imaging Market

Image management
tools and services to
contribute to greater
market share.
Modality markets not
likely to show
considerable growth


Move from Critical Care to Sub-Acute Care Evident


Russia & China High Growth Markets for Patient Monitoring Equipment


Major EHR Tenders are Being Issued & Planned Almost on a Weekly Basis
Around the World – Your Challenge is to be Prepared…
Canada England
Infoway set up to design Connecting for Denmark
National EHR - $1.2 Health – more National EHR
billion of government than $10 billion since 2006
backing until 2010
Sweden
Developing a
National EHR
France
EHR Mandatory China
Germany
USA by 2008 Plans to develop a
E-Health card national EHR
Government is
since January
promoting NHIN and
2007
RHIO’s investing Netherlands
$140 million to date. 88% of GPs Hong Kong
have an EHR
Territory wide
Master Patient
Index
Mexico
No EHR but
aim for HL7 Singapore
Integration Malaysia EMR system
Lifetime Health being tendered
Record by 2010
Brazil
National Health
Card Project.

Australia
Argentina HealthConnect developing a
South Africa
Focus on digital National Information
radiography. EHR No EHR – but Network.
infrastructure being New Zealand
also being
considered developed. National EHR
system in place


Appendix


Power patients actively shaping future healthcare systems
Personalisation, Mobility and Consumerism coming fast into play
1. Power Patient Generation: By 2012, 25% of patients will be power patients. More educated, wealthier, more demanding.

2. Patients become Customers: Customer services become a defining factor for the choice of providers, products and
services. “In short, it is the healthcare payers, not the drug makers, that are now defining the threshold of innovation”.

3. Prevention Before Cure: Investing in early diagnostic tools and implementing modern IT systems to manage and deliver
information, and introduce treatment earlier, so therapy can be more precise.

4. Shift to Personalised Healthcare: Emerging of extremely specialised and highly personalised treatments based on
individual’s genetic make-up.

5. Healthcare globe trotters: Numerous countries are actively developing and promoting their medical capabilities in
response to medical tourism. Cost of comparable treatment in South & West Asia i.e. India is on average between 10-
20% of those in the West.

6. Drugs get Smarter: Personalised dosages, non-invasive delivery methods etc.

7. Hospitals go Virtual: Hospitals breaking physical silos to create virtual care networks. Bio connectivity devices become
the standard.

8. Innovation vs. Knowledge: Cutting edge research offer novel methodologies, treatments and drugs faster than ever
before. Pace of knowledge grow is outstripping the amount and quality of skills set.

9. Devices become monitors, monitors become devices: Internet connected medical devices enter the healthcare
industry. A furious pace of innovation comes to dominate the healthcare device and medical technology industries.

10. CyberDocs: nonhuman intelligence agents, will dispense medical care to patients and doctors worldwide to save money
and share expertise.


Oncology / Hematology, Antibiotics / Antivirals and Cardiovascular Lead the way
in the Global Pharmaceutical Market in 2012 in terms of Market Size
New markets will continue to emerge in obesity, aging. Targeted therapies will drive the well-established cancer and cardiovascular indications.

Global Mortality
Cardiovascular Disease
Secondary prevention measures
New threats to health like Pandemic and new therapies are shifting
avian flu and SARS treatment from inpatient to
ambulatory care setting.

Number of diabetes patients Cancer
globally to reach 350 million
by 2025 The treatment model is
changing from acute to chronic
disease management as
mortality rates fall. New
treatments likely to have
significant costs. Demand likely
to grow in primary care
settings.

Respiratory Disease
No major treatment improvements
on the horizon. Unmet needs
exist.

Diabetes
Source : SG Cowen Cell therapy, better monitoring
and new pharmacological
Others: Include Transplant, Sleep Disorders, Alzheimer's, Incontinence, Orphan treatments should reduce
Diseases, Sex Dysfunction, Ophthalmology, Obesity, Pain mortality in the long term.


Global Pharmaceuticals & Biotechnology Industry

Global Pharmaceuticals & Biotechnology Industry

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