Oncology Dynamics - IQVIA

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Reimagining Healthcare: IQVIA Real-World
Data
Oncology Dynamics
Weronika Ficek

1
Meaningful insights based on large real-world data sources and advanced analytics. Robust
evidence to support treatments. A clearer picture of the patient journey. And insights that actually
lead to better commercial performance.
Oncology expertise powered by real-world insights
IQVIA Global Oncology Capabilities *Evaluate Pharma 2016

2
The three hurdles of high-quality
oncology data delivery:
1. Identifying and accessing
reliable and rich data sources
2. Finding solutions to secure,
cleanse, and structure the data
3. Deriving meaningful insights and
evidence from the data at hand
The oncology data-to-insights ecosystem is simple to define but
complex to deliver
IQVIA Global Oncology Capabilities
Oncology Dynamics: Survey data that
provides easy access to rich, structured,
multi-country, oncology anonymous
patient-level insights

3
Oncology Syndicated Solutions in IQVIA
• Larger sample and panel size overall
• Covers all cancers
• Predefined focused questionnaire
• Current treatment + most recent prior treatment
• Sample and projected data
• Data reported from medical records
• Covers specific cancer sub-type, stage or line of therapy
• Predefined detailed questionnaire
• Full treatment history
• Sample data
• Data reported from medical records
• Specific questions related to cancer types, treatment, patients,
outcomes, healthcare resource use, physician perception
• Customized questionnaire
• Sample data
• Data can/cannot be reported from medical recordsAn international team dedicated to optimal study design,
fieldwork, panel management, data collection, reporting
Oncology
Dynamics,
including OD
Boosts
Customised
Market
Research & PI
2
4
3
Oncology
Advantage
Oncology
Diagnosis
Insights
1 • All cancers, all stages, all lines of therapy
• Co-diagnosis related to certain supportive care treatments
• Specialties identified to be involved in the active treatment
• Prescription information (diseases, biomarkers, drug
treatment, patient profile, prescriber)
Oncology Diagnosis Insights

4
What type of questions can be answered with the aid of OncoDynamics…
Interested in the up-to-date clinical and treatment information
within oncology?
 Market Dynamics in Breast Cancer
 Patient Profiling and Treatment Patterns in Liver Cancer
 Treatment Landscape in Ovarian Cancer
 Treatment Patterns in Pancreatic Cancer
 Biomarker Testing Rates and Impact on Treatment Decisions in
NSCLC
 Market Dynamics for select Supportive Therapies
 Standard of care in Acute Myeloid Leukemia

5
EVALUATE
Current Standard
of Care
UNDERSTAND
Patient profiles &
sub-populations
EXAMINE
Drug Utilization &
Treatment
Patterns
BENCHMARK
Adherence to
Clinical Guidelines
INFORM
Study Protocols &
Feasibility
QUANTIFY
Cost of Drug
Therapies
Interrogate our syndicated patient database with little lead time and effort – Oncology Dynamics
Oncology cross-sectional surveys can address many RWE
questions – from strategy development to post-launch

6
Key business questions
How do healthcare stakeholders use oncology survey data
today?
Business
Intelligence
Team
HEOR
Team
Pipeline &
BD Team
Market
Access
Team
Brand
Team
Clinical
Operations
& Study
Teams
____________________
How does the patient journey and
standard of care differ across countries?
____________________
How is the testing rate for key biomarkers
evolving over time?
____________________
Which patient populations are underserved
with effective therapies?
____________________
How is the competitive landscape evolving?
____________________
How is my brand being used
in the real-world setting?
____________________
Does my clinical study protocol reflect
real-world populations and clinical practice?

7
Geographies
Variables
Diseases
Physician
specialties
+ Europe: France, Germany, Italy, Spain, UK, Romania. Belgium coming in Q2
2020.
+ Americas: Mexico, Brazil
+ Asia: Japan, China, South Korea, Saudi Arabia
+ Drug-treated cases of all cancers are collected at natural fallout and
projected to treated prevalence. A selection of key cancers are available in
Romania, Mexico, Brazil, and Saudi Arabia.
+ All drug-treating physician specialties working with oncology patients
+ Patient and clinical characteristics, including staging and biomarker status
+ Current and most recent previous drug treatments, including chemotherapy,
immunotherapy, endocrine and targeted therapies
+ Current supportive therapy
+ Indication-specific parameters
Features &
coverage
All patient data are de-identified and comply with relevant rules for patient privacy protection
Oncology Dynamics is a cross-sectional survey that collects
patient-level data from a representative panel of physicians

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The Oncology Dynamics survey can be carried out in other countries
Interested in new geographies?
• A dedicated international fieldwork team operating in
over 20 countries
• A large and stable panel of oncologists and cancer
treating specialists participating to multiple IQVIA
studies
• A global and standard methodology applied across
all countries
• A syndicated questionnaire applicable to most countries
*Europe: 5EU, Austria, Belgium, Denmark, Ireland, Netherlands, Poland, Russia, Sweden; Americas: Brazil, Canada, Mexico; APAC: Australia, China, Japan, South Korea, Taiwan, Philippines
 Over 10 years experience in conducting
international syndicated & customised
oncology survey based studies
 Over 100 customised cancer-specific
surveys conducted in last 10 years
 Data collected for over 20 countries*

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Easily access rich, structured, multi-country, oncology
anonymous patient-level data
Compare KPIs across tumour types, drugs, and countries
through a consistent methodology
Make confident decisions based on data from a stable
and representative source
Derive insights and understand trends in cancer care
• 150,000+ patient cases
collected each year
• 1,500+ specialists per year
• Statistically driven study
design
• Consistent methodology
applied across all
countries
• Frequent updates
The product enables healthcare stakeholders to…
Oncology Dynamics is a syndicated survey collecting
comprehensive and clinically relevant oncology patient data

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 No derived
variables
 No data period
gap
Capture & measure
unobservable data
(e.g. line of therapy,
drug preference)
Collect same data
parameters from
different sites
Structured data
Collect standardized
measures
Regular updates
 Easy to query
 Simple to
analyse
 Consistent
comparison
across healthcare
settings and
providers
 No derived
variables
 Relatively free
from several
types of errors
Structured, Easy to Access, Consistent, Up-to-date
Key Features of Oncology Dynamics Data

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Four Key Characteristics of the Oncology Dynamics Offering
Fully
Anonymised
Patient Data Secondary
Data
Market
Research
Survey
Syndicated
Data are fully anonymised and no patient identifier
is collected. Comply with personal data protection
regulation GDPR Regulation EU 2016/679
No primary data is generated or
collected. Reporting of individual
Adverse events is not required
(EMA Guideline on Good
Pharmacovigilance Practices
GVP Module VI - Management
and reporting of adverse
reactions to medicinal products)
Information is collected to
satisfy multiple clients’ needs.
Hence, it is not required to
follow PMR regulations.
Comply with the market research code of
conduct (EphMRA Code of Conduct 2017)
(Regulation of the European
Parliament and the Council
on the Protection of
individuals with regard to the
processing of personal data
and on the free movement of
such data)

12
Patient records are
collected during consultation
Data are transmitted
to IQVIA and processed
QuestionnairePatient record Clients
Physicians fill in
the online questionnaire
Data are delivered to clients
via applications and reports
Snapshots of medical records are reported by the physician through a web-based questionnaire
Data collection methodology
IQVIA
• Large and stable panels of physicians participating in multiple IQVIA studies
• Fieldwork and data collection managed by a dedicated international team
Over 400 quality controls are conducted during each data production cycle

13
Physicians and cases are selected based on specific criteria
*Physicians surveyed are enrolled in the IQVIA One Key & MEBOS panel (representing >80% of the universe).
**Hospitals physicians in France, Italy, Spain, UK, China, South Korea, Japan. Hospital and office-based specialists in Germany.
***The consecutive order of cases collected ensures a random un-biased collection of cases. This criteria does not apply to Saudi Arabia
Case selection criteria
• Patients with a current diagnosis of cancer (any stage)
• Patients currently receiving any cytotoxic therapy, targeted therapy, gene therapy, hormonal or immunotherapy
• First consecutive cases personally treated by the surveyed physician during the reporting period (length of period
depending on the country) up to a maximum defined number of cases***
Panel selection criteria*
• Clinicians must have personally drug treated cancer patients during the last reporting period (length of period
depending on the country)**
• Targeting a maximum of 3 clinicians from the same hospital in order to avoid any cluster effect and potential
duplication of patients

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OncoDynamics captures a substantial part of the oncological
patient treatment journey
Time
Current Disease Status
ECOG, current stage/grade
May 2017
Current drug treatment
Regimen, line of therapy,
planned duration, dosage, cycles
Demographics & Clinical Characteristics
Age, gender, smoking status, comorbidities
Most recent prior drug treatment
Regimen, duration,
Cycles given, side effects
Oncology Dynamics relies exclusively on the usage of secondary data and no primary data is generated or collected. As per EMA Guideline on Good
Pharmacovigilance Practices (GVP) Module VI, “Management and reporting of adverse reactions to medicinal products”, the offering does not require search or
reporting of individual Adverse events or any other special reporting situation
Jan 2019
Surgery
Initial diagnosis (histology, cancer type, stage& grade)
Tests (chromosomal abnormalities, biomarkers)
Current treatment start dateMost recent previous treatment start date
Survey time

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Many of the key cancer-specific variables are collected in
Oncology Dynamics
Current drug therapy
– Molecule & regimen
– Line of therapy
– Planned duration and dosing
Most recent prior drug therapy
– Molecule & regimen
– Line of therapy
– Duration
– Side effects
– Reason for discontinuation
Non-drug therapy
– Surgery
– Radiotherapy
– Stem cell transplant
Supportive therapy
– Anti-emetics
– Growth factors
– Erythropoietins
– Bone-targeted agents
Core information
– Cancer type
– Histology
– Stage/grade at diagnosis
– Stage/grade at current treatment
– Relapse/progression
– Date of diagnosis
– Gender
– Age
– Smoking status
– Clinical trial enrolment
– ECOG status & comorbidities
Tumour-specific attributes
– Hormone refractory status (prostate)
– PSA level (prostate)
– Platinum status (ovarian)
Tumour-specific biomarkers & tests
– Time of test (e.g. at diagnosis)
Therapy initiator specialty
Treatment perception
– Overall therapy satisfaction
– Treatment alternatives considered by the
physician
Measure AttributesTHERAPY ASPECTS
PATIENT PROFILE
PHYSICIAN ATTRIBUTES

16
Robust sample size for most key cancers across all countries
Global Cancer Coverage in Oncology Dynamics
*MAT Q3 sample counts provided where possible, estimates provided otherwise
**Italy: sub-regional data collection requiring larger sample than other countries
***Semesterly collection
Country
Hem.
Cancers
M.
Myeloma
Breast NSCLC Prostate CRC Bladder Kidney Stomach Pancreas Ovarian Liver Melanoma
Head &
Neck
SCLC
Other
Cancers
Annual
count*
France 2,950 890 3,399 2,252 2,282 1,497 824 1,056 222 763 495 487 413 802 118 2,036 20,486
Germany 3,369 810 3,195 2,438 4,778 1,827 2,024 1,626 473 981 696 340 1,135 305 458 2,580 27,035
Italy 7,162 1,549 3,725 4,103 3,304 3,153 2,231 1,359 674 1,112 1,409 650 929 778 619 2,895 35,652**
Spain 4,663 1,228 2,452 1,875 2,163 1,650 1,212 945 260 604 403 228 520 590 264 2,895 21,952
UK 3,142 756 2,730 2,311 2,621 1,383 1,296 1,047 298 634 496 306 818 551 345 3,018 21,752
China 1,567 367 2,150 3,588 530 2,616 465 266 1,280 407 651 943 31 683 504 1,950 17,998
Japan 946 195 1,352 2,330 1,463 1,468 174 402 1,449 730 299 778 238 214 157 1,018 13,213
South Korea 822 159 696 756 467 769 54 85 637 150 313 536 22 66 104 634 6,270
Mexico
1,072
ALL, CML,
CLL, NHL
196 1,924 359 1,236 641 277 476 — 205 416 — 131 — — — 6,933
Saudi
Arabia***
Yes
(NHL)
New 2019 Yes Yes — Yes —
RCC New
2019
— — — — — — Yes — ~2,060
Romania — Yes Yes Yes Yes Yes — — — — Yes — Yes — — — ~4,300
Brazil
CML, NHL,
AML, CLL
Yes Yes Yes Yes Yes Yes Yes — Yes Yes — Yes — — — ~6,180

17
Cancer-specific diagnostic and prognostic biomarkers are
collected for solid cancers
Solid tumours
Available
from
Bladder Brain Breast
Bronchus &
Lung
Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver
ALK 2016 l
BRAF 2016 l
BRCA1/2 2016 l
BRCA origin Q1 17 l
BRCA1/2 test performed Q1 2018 l
Circulating Tumour Cells 2016 l l l
C-KIT 2016 l
C-MET 2016 l l l l l
Current PSA 2016
EGFR
2016
(GBM Q1 17) l l l
EGFR test performed Q1 2018 l l
FGFR 2016 l l l
NOTE: Not all biomarkers are collected in Italy for the cancers listed above
*NEW indication
l Mutation
KEY l Over expression / elevated / gene amplification
l Other

18
Solid tumours
Available
from
Bladder Brain Breast
Bronchus &
Lung
Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver
HER2 status 2016 l
Hormone receptors ( ER and PR) 2016 l
TNBC 2016 l
Ki-67 antigen level 2016 l l
K-RAS 2016 l l
Microsatellite instability
All tumours from
Q3 17
l l l l l l l l l l l
Mitotic index 2016 l l
N-RAS 2016 l
PD1/ PD-L1/PD-L2
Q4 2016
all tumours
collected from
Q1 18
l l l l l l l l l l l
PIK3CA Q1 2019 l l
Platinum status 2016 l
RET rearrangement Q3 17 l
ROS-1 gene alteration Q3 17 l
tp53 mutation Q3 2019
TRK expression Q2 2019 l l l l l l l l l l l
Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l l
*NEW indication
l Mutation
l Other

19
Solid tumours
Available
from
Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid
ALK 2016 l l
BRAF
2016
(NSCLC Q4 16 )
l l
BRCA1/2 2016 l l
BRCA origin Q1 17 l
BRCA1/2 test performed Q1 2018 l
Castration-resistant 2016 l
C-KIT 2016 l l
C-MET 2016 l l l l l l
Current PSA level 2016 l
Circulating Tumour Cells 2016 l l l
EGFR
2016
(GBM Q1 17)
l l
EGFR Type of mutations
(Exon19Del, L858R, T790M
Q2/Q3 17 l
l Mutation
l Other

20
Solid tumours
Available
from
Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid
FGFR 2016 l l l
Gleason Score 2016 l
HER2 status 2016 l
Ki-67 antigen level 2016
K-RAS 2016 l l l
Microsatellite instability from Q3 17 all
solid tumours
l l l l l l l l l l
Mitotic index 2016
N-RAS 2016 l
PD1/ PD-L1/PD-L2
Q4 2016
all tumors
collected from
Q1 18
l l l l l l l l l l
Platinum Status 2016 l
RET rearrangement 2016 l l
ROS-1 gene alteration 2016 l l
tp53 mutation Q3 2019 l
TRK expression Q2 2019 l l l l l l l l l l
Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l
l Mutation
l Other

21
Indications added in Q1 2018
collected
Cancers Available from
Connective & Soft
Tissue
Gall Bladder GIST Mesothelioma NETs
Myelodysplastic
Syndromes
C-KIT Q1 2018 l
Ki-67 antigen level Q1 2018 l l
Microsatellite instability Q1 2018 l l l l l
Minimum residual disease Q2 2019 l
Mitotic index Q1 2018 l l l
PD1/ PD-L1/PD-L2 % expression Q1 2018 l l l l l l
TRK expression Q2 2019 l l l l l
Tumour Mutational Burden (TMB) Q1 2019 l l l l l l
While we might have back data for these indications , we will not have all biomarkers in these indications –
these have been created as new indications in Q1 2018 so biomarkers will be aligned from then.
l Mutation
l Other

22
The sample can be boosted for a tumor, subpopulation, and lines of therapy of choice
Additional ovarian cancer and melanoma patients are collected
each quarter to ensure a robust sample in later lines of therapy
Custom OD Boost
• Population of interest
• Select lines of therapy
Running Boost: Melanoma
• Advanced or metastatic stage
• 2nd and 3rd+ lines of therapy
• EU5: since Q1 2019 and running
Running Boost: Ovarian cancer
• Advanced or metastatic stage
• 2nd and 3rd+ lines of therapy
• EU5: since Q2 2018 and running
Oncology
Dynamics

23
Drug-treating specialties contributing to the Oncology Dynamics survey
Global Panel Coverage in Oncology Dynamics
Specialties* France Germany Italy Spain UK Japan China South Korea Mexico
Saudi
Arabia
Romania
New for 2019
Brazil
New for 2019
Dermatology
ENT
GI medicine
Gynecology
Hematology
Hepatology
Oncology
Pulmonology
Radiotherapy
Urology
Surgery
Total** 231 246 475*** 222 221 418 750 130 102 45 76-81 73-91†
*Specialty distribution design derived from findings of a large IQVIA survey conducted in 2015 & 2017
**Quarterly targets for 2019
***Large panel due to sub-regional offering available in Italy
†Q2–Q3 2019 range

24
Oncology Dynamics data are projected based on a robust
projection methodology
Sample patients are projected to an aggregated annual treated prevalence figure at the key cancer and
specialty level within country.
Physicians Patient Prevalence
Physician Universe Treated Prevalence
The number of physicians in the panel
is projected to the universe for that
specialty
The number of patients treated by
the physicians in each specialty is
projected to the universe to provide
national prevalence in each cancer
and country
*A large study conducted in 2015 & 2017. Data from a large sample of nearly 5,000 physicians across all specialties were collected to evaluate the prevalent
treated population and the specialties treating cancer patients. The study was conducted in France, Germany, Italy, Spain and the UK.
• The IQVIA Physician Universe Study* is used to define the right mix and weighting of specialties which allows more accurate
projections to market level
• The projection methodology takes into account varying workload levels of participating physicians
OD Physician Panel OD Physician Workload

25
Type of Facility by Country
G5 EU Sample Base: 891 Facilities
72%
29%
90%
85%
97%
15%
13%
8%
10%
15%
3%
63%
155 202 263 143 128
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
France Germany Italy Spain U.K.
PUBLIC PRIVATE NO PROFIT PRIVATE OFFICE BASED PRACTITIONER

26
Status of Facility by Country
65%
22%
82%
34% 36%
35%
14%
18%
66% 64%63%
155 202 263 143 128
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Non University University Office Based Practitioner

27
Facilities by Bed Range
25%
39% 40%
25%
20%
25%
14%
29%
30%
25%
50% 47%
30%
45%
55%
155 74 263 143 128
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
< 250 250 - 500 500 >

28
Facilities by Country
12%
7% 8%
11%
23%
63%
88%
61%
1%
30%
4%
28%
63%
202 263 143 128
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Germany Italy Spain U.K.
CANCER HOSPITAL MAIN CANCER UNIT NO CANCER UNIT OFFICE BASED PRACTITIONER

29
249
273
572
265
286
169
230
298
158
154
20486
27035
35652
21952
21752
FRANCE
GERMANY
ITALY
SPAIN
U.K.
0 5000 10000 15000 20000 25000 30000 35000 40000
No.Patients No. Facilities No. Respondents
Sample Summary MAT Q3 2019
Patient, Facilities and respondent sample size

31
While oncologists are the main therapy initiations for
gastroenteropancreatic neuroendocrine tumors treatment in EU5,
surgeons take the lead in Benelux
-10 -5 0 5 10 15 20 25 30 35 40 45 50 55 60 65
-10
-5
0
5
10
15
20
30
35
40
45
50
55
60
65
Benelux
Oncologist
Surgeon
EU5
Endocrinologist
Gastroenetrologist
Illustrative (dummy data)

32
Therapy initiators for Somatuline by ICD-10 indication in the UK&I
C7A.020 C25.8 C26.9
OncologistsPulmonologists
Onco-Haematologists
Radiotherapists
Dermatologists Endocrinologists
Illustrative (dummy data)

33
Interesting findings published in the medical domain using
Oncology Dynamics data
NSCLC pts with brain metastases are not
treated as expected (lack of guidelines, no
clinical trial data available). Abstract accepted
at American Oncology conference 2018
Unexpected immune related side
effects for innovative targeted
therapies. Presented at European
Oncology Conference 2017

34
Deliverables
• Dataview database
– Allows advanced data manipulation and groupings
• OD Easy Access: Web-based Microstrategy® application.
– Core application with pre-defined reports
Syndicated
• Customised reports
– Developed to meet specific clients’ needs: Excel,
PowerPoint, customized dashboards that can be built
using the Microstrategy Visual Insights solution
• OD Custom View:
– Customised analyses based on parameters not included
in Dataview or in the web-based application e.g. time gap
analysis, treatment duration, dosing, multi-variables
patient profiling analysis, volume use by indication,
more…
Customised

35
For further information, please contact:
Weronika Ficek
Business Development Specialist, Secondary Care Solutions
+44 7880 378081
Weronika.Ficek@iqvia.com
Thank you

Oncology Dynamics - IQVIA

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