Fractal Regeneron Hackathon

1. Regeneron Hackathon Next Best Patient Type 17-12-2021

2. 2 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Index 1. Problem Understanding 2. Solution Architecture 3. Exploratory Data Analysis 4. Feature List 5. Analysis 1. Clustering 2. Classification 6. Patient Profiles 7. HCP Target List 8. Impact

3. 3 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Problem Understanding Eylea is an anti-VEGF drug approved by the U.S. FDA to treat wAMD, a common cause of blindness in the elderly It’s observed that patients with wAMD continue the medication they started with as first line usage throughout their clinical journey BACKGROUND Regeneron wants to identify the patient profiles who may be suitable for Eylea as the 1st line treatment and also identify target HCPs to help enable the growth of Eylea as a brand of choice for 1st line treatment OBJECTIVE Areas of opportunity based on next best patient profile for Eylea which will result in growth in Rx and market share for Regeneron POTENTIAL BENEFITS

4. 4 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Frameworks Solution Architecture AI/ML Framework Features & Master Data Outcome Patient Profiles HCP List IQVIA Data Plan Data Providers Procedure Codes POS Code Patients Symphony Data Patients Product Data Cost Data Outlets Data Transactions The proposed solution architect is an amalgamation of descriptive and predictive analytics to generate patient profiles based on their demographic and clinical history and target HCPs based on their prescription pattern and network Master Data with 50+ features Raw Data

5. 5 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Total patients and claims distribution Total Patients Total 16.57 Mn wAMD 0.90 Mn Eylea (1L) 0.26 Mn Total 161.50 Mn wAMD 28.99 Mn Eylea (1L) 2.81 Mn Total Claims

6. 6 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Eylea is the 2nd most prescribed drug; has slightly high proportion in Medicare vs other payer types Only 581,678 patients out of 904,923 unique patients have NDC codes available for anti-VEGF drugs. A particular person may have used multiple drugs Most of the patients are covered under Medicare. A person may have multiple payers during their treatment.

8. 8 © 2021 Fractal Analytics Inc. All rights reserved | Confidential We created 50+ derived features using patient demographics & claims history Medical Features Provider tier data Claims Features General Features Claims count of last 6-12 months Claims amounts from last 6-12 months Claims for wAMD and Eylea patients Medical conditions of patients (e.g. Diabetes) Records of other diseases except wAMD Patient demographics Plan Type (Medicare or Medicaid) Medical history (Injection counts, Medication, etc.)

9. 9 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Cluster patients based on their first line of treatment Multiple approaches explored for building profiles Clustering Classification models to predict patients suitable for EYLEA first-line usage Classification Feature 1 Feature 2 Feature 3 … Input Prediction 1 Prediction 2 … Output Clustering could not segregate patient profiles i.e. EYLEA vs Other drugs Chosen Approach

10. 10 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Framework to create profiles for Eylea first line usage Base Population: Patients with pre-existing condition of wAMD Model predicts EYLEA first line usage for a patient 2018 & 2019 - training window (225306 patients) Shaply Plots give us important features which helps create member profiles Plan Data Providers Patients Data Claims Data Diagnosis Codes 2020 - evaluation window (84103 patients)

11. 11 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Shap Plot explaining feature significance • wAMD patient cost of Eylea first line users is ~1.3 times the wAMD patient cost for members on other drugs • Total count of wAMD claims for patients with Eylea first line usage is 18% higher than claims count for patients on other drugs • Eylea is more common with members aged 75 and above Patient Profiles Cost incurred for wAMD treatment Dosage amount Total Medical cost for a patient Count of wAMD claims Indicator for Medicare members Medclaims cost last 12 months Tier 3 Flag Preliminary Results

15. 15 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Claims Made Year-Wise Claims Data was Available from Sept. 2017 – Aug. 2021 There is no significant drop in the claims data even during the covid 19 period.

16. 16 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Column name Description Method of generating Age Age of the patient Subtracting the Patients birth year from a from a reference year Gender Gender of a patient … Eylea_firstline Patients who got treated with Eylea as First as First line Sorting on ‘service_date’ and then filtering for filtering for ‘Eylea’ ndc code and then dropping the duplicates based on patient_id Other_Drug_firstline Patients who got treated with other drug as drug as First line Sorting on ‘service_date’ and then filtering for filtering for ‘drugs other than Eylea’ ndc code Eylea_flag Patients who got treated with EYLEA Filtering for ‘Eylea’ using ndc code and then and then dropping the duplicates based on based on patient_id Features Creation

17. 17 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Column name Description Method of forming wAMD_flag Patients who got diagnosed with w-AMD Filtering using provided icd codes for wAMD wAMD on diag. codes column and then then dropping the duplicates based on on patient_id Tier_1, Tier_2, Tier_3 Number of times a patient got treated with with Tier 1, 2 and 3 providers respectively Joining claims and provider data over ‘provider_id’ and ‘month_id’ and doing doing groupBy on ‘patient_id’ while aggregating for each tier counts Medicare, Medicaid, Cash, Medicare_Part_B, Flags for the patient_ids who got treated treated under any of these payers: Line of Line of business Joining claims and plan_type tables over over ‘plantrak_id’ and filtering for each of each of these payer-kinds and then dropping dropping the duplicates based on patient_id. Svc_chrg_amnt Total amount claimed by the patient for all for all the claims filed by the patient Doing groupBy on ‘patient_id’ while aggregating for sum of svc_chrg Contd…

18. 18 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Column name Description Method of forming wamd_svc_chrg Total amount claimed by the patient under under wAMD condition Filtering using provided icd codes for wAMD wAMD on diag. codes column and doing doing groupBy on ‘patient_id’ while aggregating for sum of svc_chrg Eylea_svc_chrg Total amount claimed by the patient for for EYLEA medication for wAMD condition Filtering for ‘Eylea’ using ndc code and doing and doing groupBy on ‘patient_id’ while while aggregating for sum of svc_chrg Total_claims, wamd_claims Wamd_eylea_claims Total number of claims filed by the patient, patient, under wamd condition and for eylea for eylea medication respectively Doing groupBy on ‘patient_id’ while aggregating for count of Distinct claims. For claims. For wamd, filtering on diag_grp_desc diag_grp_desc and for eylea filtering on ndc on ndc codes and proc_grp_desc Conditions Flags (20 Conditions) Flags associated for a particular condition Condition flags are generated by matching matching the ICD codes of those particular particular conditions with 4 diagnosis code code columns in the claims data Contd…

19. 19 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Column name Description Method of forming Claims_count_0_x, Claims_count_0_x_eylea, Claims_count_0_x_eylea, Claims_count_0_x_wamd Total claims count of the patients for the last 6 the last 6 -12 months, for the patients with with wamd condition and for patients with with eylea medication Filtering on the service from date for the last the last 6 and 12 months and then doing the doing the necessary aggregations to convert convert it from claim level to patient level. Claims_cost_0_x, Claims_cost_0_x_eylea, Claims_cost_0_x_eylea, Claims_cost_0_x_wamd Total claims cost filed by the patients for the for the last 6 -12 months, for the patients patients with wamd condition and for patients patients with eylea medication Filtering on the service from date for the last the last 6 and 12 months and then doing the doing the necessary aggregations to convert convert it from claim level to patient level. Injection count Totals injections taken by Patient Aggregating the injection counts at claims claims level to member level Have_ndc Wamd patients who have either ndc code code available or proc_grp_desc in claims claims data Combining both ndc code and proc_grp_desc proc_grp_desc column and then filtering filtering patients with Non null values in the in the new column. Contd…

20. 20 © 2021 Fractal Analytics Inc. All rights reserved | Confidential Clustering Fallbacks Clustering was not leading to perfect segregation of the Eylea First Line users into one cluster and other drugs users to different cluster Cluster Cluster Size Eylea First Line (Green) %age 1 55,672 28,628 51.42% 2 538,548 133,406 24.77% Distribution of Eylea First line users by Cluster Cluster 1 Cluster 2

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