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Pharma 3.0
Life Sciences Network Basel, 20 May 2010

Frank Kumli
Agenda

►   Ernst & Young – Global Life Sciences Center

►   Business model transformation
    ►    Pharma 1 0 to 3.0
                1.0 3 0


►   Pharma 3.0
    ►    non-traditional collaborations
    ►    business model innovation
    ►    execution




Page 2                           Progressions: Pharma 3.0
Who we are




Page 3
Ernst & Young’s major lines of business


                                                         Performance improvement:
                                                                                                                    External audit:
                                                         ►   Finance and performance                                                                       Financial accounting advisory service:
                                                             management                                             ► Audit of financial
                                                                                                                      statements, statutory                ► IFRS conversions and support
                                                         ►   Supply chain                                             accounts and pension
             Risk:                                                                                                                                         ► IPO readiness
                                                         ►   Customer                                                 funds
             ► Business process controls auditing                                                                                                          ► Accounting support for due diligence
             ► Controls and process remediation
                                                         ►   Change management                                                                                services
             ► Information systems security,             ►   IT advisory                                                                                   ► Accounting control / process support
                controls and governance
             ► Real estate asset planning and                                                                     External                                          Fraud investigation and dispute services:
                optimization                                                                                       audit                                            ►  Marketing, sales and research compliance
                                                                                          Performance
             ► IT Risk                                                                    improvement                                                                  assessments and reviews
                                                                                                                                    Financial
                                                                                                                                   accounting                       ► Electronic discovery and document retention
                                                                                                                                    advisory
                                                                                                                                    ad isor                         ► Government investigations
                                                                                                                                     service
      IT risk:                                                                  Risk                                                                                ► Compliance gap analyses
      ► IT risk management                                                                                                                                          ► Internal fraud investigations
      ► Application controls and security
                                                                                           Advisory                  Assurance                Fraud
                                                                                                                                           investigation            ► Litigation and arbitration support
                                                                      IT risk
      ► Information management and analysis                                                                                                 and dispute             ► Brand protection, counterfeiting, diversion and
                                                                                                                                             services
                                                                                                                                                                       gray markets
                                                                                                            Client
                                                                                                        relationships
                                                                                                                                                                                 Commercial and financial due
  Business and indirect tax services:                                                                                                       Commercial                           diligence:
                                                                      Business                                                             and financial
  ►   Annuity tax provisioning/ tax accounting                       and indirect                                                          due diligence                         ►   Market and industry research
      calculations                                                   tax services
                                                                                                 Tax              Transaction                                                    ►   Validation of strategic assessments
  ►   Business tax advisory
                                                                                                                                                                                 ►   Corporate strategy assessment
  ►   Income tax compliance                                                                                                       Transactional
                                                                                 International                                     integration                                   ►   Assessment of sustainable earnings
  ►   Customs and international trade advisory                                    tax services
                                                                                                                                                                                 ►   Analysis of key revenue and cost
  ►   VAT/sales tax advisory and compliance                                                                                                                                          drivers
                                                                                                  Human            Valuation
                                                                                                  capital
                                                                                                     it l
           International tax services:
                                                                                                                                                                    Transactional integration:
           ►   Cross boarder corporate tax
               advisory                             Human capital:                                                                                                  ►   Synergies analysis and investment
                                                                                                                                                                        requirements
           ►   Transfer pricing                     ►   Global mobility tax and                                         Valuation:
               documentation and advisory               administration services                                                                                     ►   Assess impact to forecast
                                                                                                                        ►   Business valuation services             ►   Assess integration challenges, risks
           ►   Supply/distribution chain            ►   Global equity
               advisory                                 compensation planning                                           ►   Tangible/intangible asset valuation         and resolution strategies
                                                        and compliance                                                      services
                                                    ►   Performance and rewards                                         ►   Accretion/dilution analysis




Page 4
Ernst & Young’s Global Life Sciences sector

The Global Life Sciences sector brings together a worldwide team of professionals with deep industry and technical experience in
providing assurance, tax, transaction and advisory services. Our goal: to position Ernst & Young as the trusted advisor for our life
sciences priority accounts and their key executives by our active involvement assisting teams to execute for success in their
transitions and transformations.

                                    Ernst & Young’s Global Life Sciences area contacts
 As an industry sector center we
 focus resources on the following    Global Pharmaceutical Sector Leader
                                              Carolyn Buck Luce
 key priorities:
                                     Global Biotechnology Sector Leader
                                                                                                                       Nordics
                                               Glen Giovannetti                                              Denmark Benny Lynge Sorensen
 ►   Building internal and                                                                                      Sweden - Björn Ohlsson
                                          Life Sciences EMEIA Leader
     external networks of key                    Patrick Flochel
                                                                                                                Norway - Willy Eidessen
                                                                                                                      y      y
                                                                                                                 Finland - Timo Virkilä

     opinion leaders of the life
     sciences industry
                                                                                                                                      Netherlands
                                                                                                  Belgium                            Jules Verhagen
                                                                                               Thomas Sileghem                                                                                CIS
                                                                                                                                                                                         Dmitry Khalilov
                                                                                         United Kingdom
 ►   Assist our accounts to                                                              Pamela Spence/
                                                                                                                                            Germany
                                                                                                                                         Elia Napolitano/
                                                                                         Chad Whitehead*
     provide industry trends and          Canada
                                                                                             Ireland
                                                                                                                                        Siegfried Bialojan*

     identify appropriate           Paul Karamanoukian
                                                                                       Edwina Fitzmaurice/
                                                                                         Nick Redmond
                                                                                              Redmond*
                                                                                                                                                          Austria
                                                                                                                                                 Isabella Schwartz-Gallee/
                                                                                                                                                                                             Korea
                                                                                                                                                                                         Yong Sup Hyun*

     resources globally
                 l b ll                                                                    Switzerland
                                                                                                                                                       Erich Lehner*
                                                                                                                                                                                             Japan
                                                                                          Patrick Flochel/                                                          Poland               Hironao Yazaki
                                                                                                                                                                 Mariusz Witalis
 ►   Providing industry relevant         United States
                                       Carolyn Buck Luce/
                                                                                           Jürg Zürcher*


     thought leadership and             Glen Giovannetti*                              France
                                                                                  Virginie Lefebvre/
                                                                                                                                                                  CESSA
                                                                                                                                                              Magdalena Soucek

     attending or speaking at               Mexico                                 Pascale Augé *                                                 Turkey
                                                                                                                                               Erdal Calıkoglu
                                        Frederico Aguilar
     industry events
                                                                                                                          Southeast Europe                                              Hong Kong/China
                                                                                                Spain                     Themis Lianopoulos                                               Francis Lai/
 ►   Creating l
     C ti relevant   t                                                                   Manuel Gi lt H
                                                                                         M    l Giralt Herrero                                                                            Cherrie Che*
                                                                                                                                     Israel
     knowledge and learning                                                                                Italy                Yoram Wilamowski
                                                                                                        Lapo Ercoli
     programs for Ernst & Young
                                                 Brazil                                                                                                                                 Singapore
                                        Jose Francisco Compagno                                                                                                                         Swee Ho Tan
                                                                                                                                                          India
     professionals                                                                                                                                    Hitesh Sharma

                                                                                                                                                                                           Australia
 ►   Solutions development to                                                                                                                                             New Zealand     Winna Brown
                                                                                                                                                                           Jon Hooper
     meet emerging client needs
                                               Centers: New Jersey, Boston and Basel            * Biotechnology




Page 5
Thought Leadership - Life Sciences

Annual Reports                                                 Surveys
           Progressions Pharma 3.0                                        Pharmaceutical Companies and working capital management
           ► Global pharmaceutical report                                 ► Survey on working capital performance and strategies
                                                                            Business Risk Report 2009 Life Sciences
                                                                            ► Life Sciences focus within the Global Risk Survey
                     Beyond Borders
                     ► Global biotechnology report
                                                                                  2009 global pharma associations sales and
                                                                                  marketing code matrix for US and EMEA
                                    Pulse of the Industry                               ► synopsis of selected pharmaceutical
                                    ► Global medtech report                             industry
                                                                                           guidance




Technical Reports                                                        National Reports
           Prescriptions series                                                          Swiss Biotech Report 2009
           ► Series of articles on Life Sciences
           topics                                                                             Biotech in Denmark 2008
                 bio*link and medtech*monitor series
                 ► Series of articles on biotechnology and                                         German Biotech Report 2009
                 medtech topics


                            The Smoke Detector® report
                            ► Series of summarized compilation on
                              Life Sciences topics




Page 6
Pharma 3.0




Page 7
Progressions: Pharma 3.0
 Global pharmaceutical report 2010

                                                                   Bayer Meets Nintendo as Drugmakers Seek New
                                                                   Routes to Customers

                                                                                                                 Pharmas Must Tie with Techs
                                                                                                                 February 11, 2010
                                                                    Medicines not working? There's an
                                                                    app for that

                                                                   PharmaTimes                                 Ernst & Young Puts the Spotlight
                                                                                                               n Pharma 3.0
                                                                   Pharma needs to work with non-
                                                                   t ad t o a partners
                                                                   traditional pa t e s to su
                                                                                           survive
                                                                                                 e


                                                                                                         Pharma Turns to Tech for Marketing Aid


                                                                   Report: Future Drugmakers Must also Deliver
                                                                   Healthy Outcomes
                                                                                                         Daily Finance
                                                                                                         Pharma 3.0: Drug Companies Slowly
                                                                                                         Adapt t the N
                                                                                                         Ad t to th New T h World
                                                                                                                          Tech W ld
                                                                   Drugmakers look to collaborate with
                                                                   nontraditional partners

                                                                                                        Pharma 3.0 - Drug Makers Must Adapt To An
                                                                                                        Outcomes-Focused World, E&Y Reports
                                                                   And the Future for Pharma Looks Like….

    ► Based on interviews with 30 executives from the         Key themes
      pharma industry and from “non-traditional” players
    ► Features quotes from numerous executives and             ►   Changing ecosystems: Pharma 3.0
      over 100 company examples
    ► Worldwide launch at The Economist Conference,
                                                               ►   Emerging business models
      London                                                   ►   Building the future business via innovative collaborations


Page 8                                               Progressions: Pharma 3.0
Pharma 3.0
From drugs to healthy outcomes

 Drivers of                  ►   R&D productivity            ►   Health care reform
 change                      ►
                             ►
                                 Patent cliff
                                 Globalization
                                                             ►
                                                             ►
                                                                 Health IT
                                                                 Consumerism
                             ►   Demographics                ►   Value mining
                             ►   Pricing &
                                 reimbursement



 Business
 Models
 Value         Pharma 1.0                       Pharma 2.0                      Pharma 3.0
 p p
 proposition   Blockbuster drugs
                              g                 Diversified drug portfolios     Healthy outcomes




 Customer
                                                                                               Payor
               Physician
                                                                                             Patient


Page 9                                     Progressions: Pharma 3.0
Progressions 2008
Pharma 1.0 to 2.0

 Patents                                  The               R&D productivity

 Pricing pressure                         science           Personalized medicine


 Compliance commitments                   The               Globalization
                                          customer          Customer redefinition


                                          The               Products vs. services
 Reduced growth
                          Impact of
                                          offer             Building brand

                            hange
 Margins squeezed
                                          The
                           ch
 Reputation in decline                                      Talent pipeline
                                          people            Celebrating diversity


                                          The               Enterprise vs. extraprise


 R&D productivity                         organization      Alternative business
                                                            models

 Commercial structure                     The               Return vs. revenue

 Customer relationships                   value created     Financial strategy
                                                            Risk management
                                                                            gy



Page 10                          Progressions: Pharma 3.0
Pharma 2.0
Four strategic pillars
 Emerging markets                      Commercial models




 Product i
 P d t innovation
             ti                        Product di
                                       P d t diversification
                                                   ifi ti




Page 11                  Progressions: Pharma 3.0
Pharma 2.0
Emerging markets: growth gap

          The growth gap
          Pharmerging and tier-2 emerging markets will contribute three quarters of global growth in 2009

               Mature       Pharmerging           Tier-2
                                                  Tier 2 emerging          Rest of world
   100%
                 9%              10%               10%                                 11%
    90%                                                             17%                        2009 market share, US$
                 5%               6%
                                                   9%
                 7%
    80%
                                 11%                                10%                22%                          Rest of
                                                                                                                    world
    70%                                            19%
                                                                                                             Tier-2    12%
                                                                    21%                                     emergin
    60%
                                                                                                               g    6%
    50%                                                                                           Pharmerging
                                                                                                                  11%
                                                                                       51%                                    Mature
    40%         79%
                                 73%                                                                                           71%

    30%                                            61%
                                                                    52%
    20%

    10%
                                                                                       16%

     0%
               2001              2003             2005              2007             2009(f)
          Source: IMS Health, Market Prognosis, March 2009




Page 12                                                             Progressions: Pharma 3.0
Pharma 2.0
Tailoring commercial models to market
 Moving towards differentiated „geo-tailored“ commercial models with a tailored value
 proposition for each market and customer
 Optimizing resources to address all key stakeholders
 Integrated key account model in restrictive markets; traditional sales force in open markets
 I t    t dk           t   d li      t i ti     k t t diti      l l f         i          k t


                          Share of field force                              KAM, local manager                       Pricing, listing
  Field force
                                                                            ► multibrand
  ► brand, multibrand


                        Information                                           Value                           Influencers*
                                                   Geo-tailored
     Physician          Tools                      approach                   proposition
                        Training                                              Pricing
                                                                              • volume
                                                                              • outcome                          Payors
                                                                              • value
                                                        Pharma

                                                                              Risk sharing                      Managed
                                                                                                                 Care
                        Communication                                         E-tools

      Patient           Information
                                                                              Programs
                        Compliance
                        programs                                              Training                            Retail



                                                                                             *employers, providers, academia, government




Page 13                                          Progressions: Pharma 3.0
Pharma 2.0
Innovation


                                                                                   ►     Targeting new disease areas
                                                                                   ►     Personalized medicine
                                                                                   ►     Creating more market-driven
                                                                                         pipelines
                                                                                   ►     Restructuring R&D units to
                                                                                         allow greater autonomy
                                                                                   ►     Splitting up
                                                                                         Splitting-up large, monolithic
                                                                                         organizations into smaller
                                                                                         units
                                                                                   ►     Virtualization. Incorporating
                                                                                         niche players to stimulate
                                                                                         innovation, share risks and
                                                                                         reduce costs
1.Represents cAGR2008 2013
1 Represents a cAGR2008-2013
2.lndicates probability of entry of generics in the segment
Source: Datamonitor, New Approaches to Pharma R&D



Page 14                                                       Progressions: Pharma 3.0
Pharma 2.0
Diversification


                                                                                                               J&J
                     Business line diversification

                                                                                GSK                         GSK

                                                                                                Novartis
                                                                                                           Pfizer
                                                                             Novartis
                                                                                               Sanofi      Wyeth
                                                                                                             y

                                                                              Sanofi
                                                                                              Pfizer



                                                                BMS
                            s




                                                                                              Pfizer
                                                                               Roche


                                                                               Astra        Astra
                                                                Roche         Zeneca       Zeneca

                                                     BMS




                                                              Geographic diversification                        2006   Target
                                                                                                                          g

Source: Societe Generale: Pharmaceuticals Beyond the crisis



Page 15                                                                 Progressions: Pharma 3.0
Pharma 3.0
From drugs to healthy outcomes

 Drivers of                  ►   R&D productivity            ►   Health care reform
 change                      ►
                             ►
                                 Patent cliff
                                 Globalization
                                                             ►
                                                             ►
                                                                 Health IT
                                                                 Consumerism
                             ►   Demographics                ►   Value mining
                             ►   Pricing &
                                 reimbursement



 Business
 Models
 Value         Pharma 1.0                       Pharma 2.0                      Pharma 3.0
 p p
 proposition   Blockbuster drugs
                              g                 Diversified drug portfolios     Healthy outcomes




 Customer
                                                                                               Payor
               Physician
                                                                                             Patient


Page 16                                    Progressions: Pharma 3.0
Pharma 3.0
Health outcomes as currency for health care systems

                                     Consumerism
                                     ►   Health literacy
                                     ►   Empowerment




          Health care reform
          ►   Access                  Health                    Health IT
          ►   Rebates/discounts                                 ►   Digital data
          ►   Value-based approach   outcomes                   ►   Social data
          ►   Health
              H lth IT                                          ►   Mobile health




                                     Value mining
                                     ►    Value-based P&R
                                     ►    Comparative
                                          effectiveness
                                     ►    Risk-sharing
                                                     g
                                          agreements



Page 17                              Progressions: Pharma 3.0
Pharma 3.0
From drugs to healthy outcomes
 Drivers of                 ►   R&D productivity           ►   Health care reform
 change                     ►   Patent cliff               ►   Health IT
                            ►   Globalization              ►   Consumerism
                            ►   Demographics
                                D            hi            ►   Value i i
                                                               V l mining
                            ►   Pricing &
                                reimbursement



 Business
 Models
 Value         Pharma 1.0                      Pharma 2.0                    Pharma 3.0
 proposition   Blockbuster drugs               Diversified drug              Healthy outcomes
                                               portfolios



 Customer
                                                                                          Payor
               Physician
                                                                                        Patient


Page 18                                   Progressions: Pharma 3.0
Pharma 3.0: non-traditional collaborations




Page 19
Pharma 3.0
The healthy outcomes ecosystem



                                            Providers         IT
                                                                       Information
                               Physicians                               companies
                                                                                     Social
                                                                                     media
                                            CROs
                       Academia                                                           Health
                                                                                          records

                                                                                            Medical
                   Pharma                          Patients
                                                                                          technology


                                                                                              Telecom
                        Biotech           Med
                                         device
                                                                               Governments

                                  Food
                                                                        Insurers
                                             Retailers   Consumer
                                                         electronics




          Pharma 1.0 (drugs)                        Pharma 2.0 (diversified drug portfolios)            Pharma 3.0 (outcomes)


Page 20                                                  Progressions: Pharma 3.0
Pharma 3.0 is happening - eHealth

  Mondobiotech – 23 and me                    Novartis – Proteus Biomedical




                                              Source: www.ft.com
 Source: www.23andme.com




  Bayer - Ni t d
  B       Nintendo                            UCB – patientslike me
                                                       i    lik




Source: www.bayerdidget.co.uk/                 Source: www.patientslikeme.com




Page 21                          Progressions: Pharma 3.0
Pharma 3.0
Delivering on health outcomes
  Building communities                                                          Expanding products
  ►   UCB — PatientsLikeMe                                                      ►   Pfizer — Aurobindo

  Developing technologies                                                       Developing technologies
  ►   Lifescan (J&J and A l )
      Lif             d Apple)                                                  ►   Novartis — V d f
                                                                                    N    ti    Vodafone — IBM

  Measuring outcomes                                                            Innovative distribution
  ►   Fresenius Medical Care                                                    ►   Novartis — Indian Post Office


                         Managing patient outcomes                              Expanding access
                         ►   Driving compliance                                 ►   Underserved markets
                         ►   Health care delivery                               ►   Emerging markets
                         ►   Patient stratification                             ►   Uninsured populations
                                                                 Health
                                                                outcomes
                                                            Meeting unmet
                                                            medical needs
                                                            ►   Complex indications
                                                            ►   Underserved medical fields
                     Leveraging data                  Public-private partnerships                        Partnership with payors
                     ►   MondoBiotech — 23and Me      ►   GSK — Global TB alliance                       ►   Novartis — NICE

                     Optimizing R&D                   R&D risk sharing                                   Creative financing
                     ►   GSK — Pfizer                 ►   Eisai — Quintiles                              ►   Eli Lilly — TPG-Axon Capital —
                                                                                                             Novaquest (a division of Quintiles)
                     Orphan d
                     O h drugs                        Pre-competitive R&D
                                                      P        titi
                     ►   Pfizer — Protalix            ►   Enlight Biosciences


Page 22                                                      Progressions: Pharma 3.0
Pharma 3.0: business model innovation




Page 23
Scenario planning
Deal simulations
                        Deal A                                                         Deal B



  Partners                    InfoTechCo         PharmaCo             InsuranceCo             DirectSalesCo       PharmaCo              FoodCo




                                                                    Understanding of
                                Platform                                                      Sales forces       Drug portfolio      Broad product
  Resource                                      Drug portfolio            risk
                             Personal health                                              Customer intimacy     Efficacy insights       portfolio
  capabilities                                 Efficacy insights         Patient
                                 records                                                     and reach                              Nutrition insights
                                                                      stratification




                                               Health outcomes                                                 Health outcomes
  Value                                           Enabling                                                    Enabling outcomes/
  propositions                                    outcomes                                                          access



                                                   Patients                                                        Patients
  Customers
  C t                                               Payors                                                         Payors
                                                                                                                   P
                                                 Governments                                                    Governments



         “While high-level business models are easily articulated, the discussion around the execution of the deals reveals a high
         level of complexity. What creates more value? And what provides more value over time? Who owns the intellectual property?”


Source: Ernst & Young 2010


Page 24                                                            Progressions: Pharma 3.0
Business model innovation
Commercial trials

                                                  Commercial trials
Stickiness
High margins and success of current
model make large leaps difficult                  Pilots                   Rapid
                                                  To explore business      prototyping
                                                  opportunities            Commercial trials will
                                                                           need to be fast and
                                                                           efficient                      Upside
Unchartered territory                                                                                    Business model
Difficulty and risk of developing new offerings                                                        innovation has the
from scratch with unknown partners                Open innovation          Flexible control         potential for considerable
                                                  Use of external          Alliances structures     upside (e.g. compliance)
                                                  networks                 that allow quick
                                                                           response to new
                                                                           challenges and
                                                                           opportunities
Changing ecosystem
Current ecosystem is changing rapidly in          Portfolio management
unprecedented and unpredictable ways              Optimize network value




     “How do you actually go about the building of new business models from the ground up? How do you pick the right
     strategies and experiments for your company when the very ecosystem in which you operate is changing in
     unprecedented, and unpredictable, ways?”


Page 25                                                    Progressions: Pharma 3.0
Commercial trials
From strategy to commercialization

          Drug development




                                                                                                 pt
           Therapeutic focus                               Discovery and early
                                                                   y         y                        Late development
                                                                                                                 p                           Commercialization




                                                                                                                                        ct
                                                                                   Proof of concep
                                         Disease areas
                                                     s




                                                                                                                           pproved produc
                                                              development



           Number of leads




                                                                                   P




                                                                                                                          Ap
                                                                                                                          New busine model
                                                  gments




                                                                                             oncept
           Number of ideas




                                                                                                                                   ess
                                                                                   Proof of co
                                         Market seg




                                                                                                         Pilots and                            Scale-up and
           Strategic/risk assessment                       Market assessment                            partnerships                              larger
                                                                                                                                               partnerships

          Business model development
          B i        d ld    l     t
          I. Strategic focus           II. Proof of concept                      III. Development                        IV. Commercialization
          Areas and business           Ideas that work in                        Most promising pilots.                  Service or product
          models that are a            concept.                                                                          offerings
          strategic fit for the        “Does it work and is it
                                        Does                                     “Is it commercially
                                                                                  Is                                     “Can it be scaled and
                                                                                                                          Can
          organization                 safe?”                                    feasible?”                              replicated across
                                                                                                                         markets?”

Page 26                                                          Progressions: Pharma 3.0
Pharma 3.0: Execution




Page 27
Pharma 3.0
Challenges and readiness for executing nontraditional alliances




Page 28                 Progressions: Pharma 3.0
Challenges every step of the way
New ways of partnering
  Strategy,                                      Accounting        Talent and                Operations,
structure and          Due      Valuation       and financial       change         Risk      supply chain
 governance         diligence     and             reporting       management    management   management
                                modeling




What creates most value?
                                                                Whose d t is it anyway?
                                                                      data i          ?

                   How is success defined?
                                              Who owns the intellectual property?
     IFRS       or US GAAP?
                                                                       What are the tax implications?
What should the debt and equity mix consist of??
                                  What are the water, power, waste and cleantech approaches?
Page 29                                     Progressions: Pharma 3.0
Guiding principles for Pharma 3.0

     Define             Co-create                Experiment.               Prepare
     your Pharma 3.0    value with partners      Think small. Fail fast.   for success.
     Brand              and patients
                            patients.

     The ecosystem is   More than ever,          There is no one           Our survey and
     becoming more      firms will need to       right answer.             interviews
     complex.
     complex            combine unique           Companies will            indicate that
     Incentives are     assets and               develop solutions         pharma
     changing. New,     attributes to build      by experimenting          companies aren’t
     nontraditional     relevant offerings       with large                fully prepared for
     players are        for the healthy          numbers of                the challenges
     entering.          outcomes                 “commercial trials”       that these
                        ecosystem.               — and culling             creative new
                                                 those that don’t          alliances will
                                                 work.                     bring.




Page 30                              Progressions: Pharma 3.0
Contact Details




           Dr. Frank Kumli, MBA
           Business Analyst - Global Life Sciences Center

           Tel    +41 58 286 86 37
           Mobile +41 58 289 86 37
           Fax    +41 58 286 83 60
           Email frank.kumli@ch.ey.com
           E il f k k li@ h




Page 31                    Progressions: Pharma 3.0
Ernst & Young

Assurance | Tax | Transactions | Advisory

About Ernst & Young

Ernst & Young is a global leader in assurance, tax,
transaction and advisory services. Worldwide, our
130,000 people are united by our shared values and an
unwavering commitment to quality. We make a difference
by helping our people our clients and our wider
               people,
communities achieve potential.

For more information, please visit www.ey.com.




© 2010 Ernst & Young - all rights reserved.
Proprietary and confidential. Do not distribute without written
permission.

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Ersnt & Young Pharma 3.0 Business Model

  • 1. Pharma 3.0 Life Sciences Network Basel, 20 May 2010 Frank Kumli
  • 2. Agenda ► Ernst & Young – Global Life Sciences Center ► Business model transformation ► Pharma 1 0 to 3.0 1.0 3 0 ► Pharma 3.0 ► non-traditional collaborations ► business model innovation ► execution Page 2 Progressions: Pharma 3.0
  • 4. Ernst & Young’s major lines of business Performance improvement: External audit: ► Finance and performance Financial accounting advisory service: management ► Audit of financial statements, statutory ► IFRS conversions and support ► Supply chain accounts and pension Risk: ► IPO readiness ► Customer funds ► Business process controls auditing ► Accounting support for due diligence ► Controls and process remediation ► Change management services ► Information systems security, ► IT advisory ► Accounting control / process support controls and governance ► Real estate asset planning and External Fraud investigation and dispute services: optimization audit ► Marketing, sales and research compliance Performance ► IT Risk improvement assessments and reviews Financial accounting ► Electronic discovery and document retention advisory ad isor ► Government investigations service IT risk: Risk ► Compliance gap analyses ► IT risk management ► Internal fraud investigations ► Application controls and security Advisory Assurance Fraud investigation ► Litigation and arbitration support IT risk ► Information management and analysis and dispute ► Brand protection, counterfeiting, diversion and services gray markets Client relationships Commercial and financial due Business and indirect tax services: Commercial diligence: Business and financial ► Annuity tax provisioning/ tax accounting and indirect due diligence ► Market and industry research calculations tax services Tax Transaction ► Validation of strategic assessments ► Business tax advisory ► Corporate strategy assessment ► Income tax compliance Transactional International integration ► Assessment of sustainable earnings ► Customs and international trade advisory tax services ► Analysis of key revenue and cost ► VAT/sales tax advisory and compliance drivers Human Valuation capital it l International tax services: Transactional integration: ► Cross boarder corporate tax advisory Human capital: ► Synergies analysis and investment requirements ► Transfer pricing ► Global mobility tax and Valuation: documentation and advisory administration services ► Assess impact to forecast ► Business valuation services ► Assess integration challenges, risks ► Supply/distribution chain ► Global equity advisory compensation planning ► Tangible/intangible asset valuation and resolution strategies and compliance services ► Performance and rewards ► Accretion/dilution analysis Page 4
  • 5. Ernst & Young’s Global Life Sciences sector The Global Life Sciences sector brings together a worldwide team of professionals with deep industry and technical experience in providing assurance, tax, transaction and advisory services. Our goal: to position Ernst & Young as the trusted advisor for our life sciences priority accounts and their key executives by our active involvement assisting teams to execute for success in their transitions and transformations. Ernst & Young’s Global Life Sciences area contacts As an industry sector center we focus resources on the following Global Pharmaceutical Sector Leader Carolyn Buck Luce key priorities: Global Biotechnology Sector Leader Nordics Glen Giovannetti Denmark Benny Lynge Sorensen ► Building internal and Sweden - Björn Ohlsson Life Sciences EMEIA Leader external networks of key Patrick Flochel Norway - Willy Eidessen y y Finland - Timo Virkilä opinion leaders of the life sciences industry Netherlands Belgium Jules Verhagen Thomas Sileghem CIS Dmitry Khalilov United Kingdom ► Assist our accounts to Pamela Spence/ Germany Elia Napolitano/ Chad Whitehead* provide industry trends and Canada Ireland Siegfried Bialojan* identify appropriate Paul Karamanoukian Edwina Fitzmaurice/ Nick Redmond Redmond* Austria Isabella Schwartz-Gallee/ Korea Yong Sup Hyun* resources globally l b ll Switzerland Erich Lehner* Japan Patrick Flochel/ Poland Hironao Yazaki Mariusz Witalis ► Providing industry relevant United States Carolyn Buck Luce/ Jürg Zürcher* thought leadership and Glen Giovannetti* France Virginie Lefebvre/ CESSA Magdalena Soucek attending or speaking at Mexico Pascale Augé * Turkey Erdal Calıkoglu Frederico Aguilar industry events Southeast Europe Hong Kong/China Spain Themis Lianopoulos Francis Lai/ ► Creating l C ti relevant t Manuel Gi lt H M l Giralt Herrero Cherrie Che* Israel knowledge and learning Italy Yoram Wilamowski Lapo Ercoli programs for Ernst & Young Brazil Singapore Jose Francisco Compagno Swee Ho Tan India professionals Hitesh Sharma Australia ► Solutions development to New Zealand Winna Brown Jon Hooper meet emerging client needs Centers: New Jersey, Boston and Basel * Biotechnology Page 5
  • 6. Thought Leadership - Life Sciences Annual Reports Surveys Progressions Pharma 3.0 Pharmaceutical Companies and working capital management ► Global pharmaceutical report ► Survey on working capital performance and strategies Business Risk Report 2009 Life Sciences ► Life Sciences focus within the Global Risk Survey Beyond Borders ► Global biotechnology report 2009 global pharma associations sales and marketing code matrix for US and EMEA Pulse of the Industry ► synopsis of selected pharmaceutical ► Global medtech report industry guidance Technical Reports National Reports Prescriptions series Swiss Biotech Report 2009 ► Series of articles on Life Sciences topics Biotech in Denmark 2008 bio*link and medtech*monitor series ► Series of articles on biotechnology and German Biotech Report 2009 medtech topics The Smoke Detector® report ► Series of summarized compilation on Life Sciences topics Page 6
  • 8. Progressions: Pharma 3.0 Global pharmaceutical report 2010 Bayer Meets Nintendo as Drugmakers Seek New Routes to Customers Pharmas Must Tie with Techs February 11, 2010 Medicines not working? There's an app for that PharmaTimes Ernst & Young Puts the Spotlight n Pharma 3.0 Pharma needs to work with non- t ad t o a partners traditional pa t e s to su survive e Pharma Turns to Tech for Marketing Aid Report: Future Drugmakers Must also Deliver Healthy Outcomes Daily Finance Pharma 3.0: Drug Companies Slowly Adapt t the N Ad t to th New T h World Tech W ld Drugmakers look to collaborate with nontraditional partners Pharma 3.0 - Drug Makers Must Adapt To An Outcomes-Focused World, E&Y Reports And the Future for Pharma Looks Like…. ► Based on interviews with 30 executives from the Key themes pharma industry and from “non-traditional” players ► Features quotes from numerous executives and ► Changing ecosystems: Pharma 3.0 over 100 company examples ► Worldwide launch at The Economist Conference, ► Emerging business models London ► Building the future business via innovative collaborations Page 8 Progressions: Pharma 3.0
  • 9. Pharma 3.0 From drugs to healthy outcomes Drivers of ► R&D productivity ► Health care reform change ► ► Patent cliff Globalization ► ► Health IT Consumerism ► Demographics ► Value mining ► Pricing & reimbursement Business Models Value Pharma 1.0 Pharma 2.0 Pharma 3.0 p p proposition Blockbuster drugs g Diversified drug portfolios Healthy outcomes Customer Payor Physician Patient Page 9 Progressions: Pharma 3.0
  • 10. Progressions 2008 Pharma 1.0 to 2.0 Patents The R&D productivity Pricing pressure science Personalized medicine Compliance commitments The Globalization customer Customer redefinition The Products vs. services Reduced growth Impact of offer Building brand hange Margins squeezed The ch Reputation in decline Talent pipeline people Celebrating diversity The Enterprise vs. extraprise R&D productivity organization Alternative business models Commercial structure The Return vs. revenue Customer relationships value created Financial strategy Risk management gy Page 10 Progressions: Pharma 3.0
  • 11. Pharma 2.0 Four strategic pillars Emerging markets Commercial models Product i P d t innovation ti Product di P d t diversification ifi ti Page 11 Progressions: Pharma 3.0
  • 12. Pharma 2.0 Emerging markets: growth gap The growth gap Pharmerging and tier-2 emerging markets will contribute three quarters of global growth in 2009 Mature Pharmerging Tier-2 Tier 2 emerging Rest of world 100% 9% 10% 10% 11% 90% 17% 2009 market share, US$ 5% 6% 9% 7% 80% 11% 10% 22% Rest of world 70% 19% Tier-2 12% 21% emergin 60% g 6% 50% Pharmerging 11% 51% Mature 40% 79% 73% 71% 30% 61% 52% 20% 10% 16% 0% 2001 2003 2005 2007 2009(f) Source: IMS Health, Market Prognosis, March 2009 Page 12 Progressions: Pharma 3.0
  • 13. Pharma 2.0 Tailoring commercial models to market Moving towards differentiated „geo-tailored“ commercial models with a tailored value proposition for each market and customer Optimizing resources to address all key stakeholders Integrated key account model in restrictive markets; traditional sales force in open markets I t t dk t d li t i ti k t t diti l l f i k t Share of field force KAM, local manager Pricing, listing Field force ► multibrand ► brand, multibrand Information Value Influencers* Geo-tailored Physician Tools approach proposition Training Pricing • volume • outcome Payors • value Pharma Risk sharing Managed Care Communication E-tools Patient Information Programs Compliance programs Training Retail *employers, providers, academia, government Page 13 Progressions: Pharma 3.0
  • 14. Pharma 2.0 Innovation ► Targeting new disease areas ► Personalized medicine ► Creating more market-driven pipelines ► Restructuring R&D units to allow greater autonomy ► Splitting up Splitting-up large, monolithic organizations into smaller units ► Virtualization. Incorporating niche players to stimulate innovation, share risks and reduce costs 1.Represents cAGR2008 2013 1 Represents a cAGR2008-2013 2.lndicates probability of entry of generics in the segment Source: Datamonitor, New Approaches to Pharma R&D Page 14 Progressions: Pharma 3.0
  • 15. Pharma 2.0 Diversification J&J Business line diversification GSK GSK Novartis Pfizer Novartis Sanofi Wyeth y Sanofi Pfizer BMS s Pfizer Roche Astra Astra Roche Zeneca Zeneca BMS Geographic diversification 2006 Target g Source: Societe Generale: Pharmaceuticals Beyond the crisis Page 15 Progressions: Pharma 3.0
  • 16. Pharma 3.0 From drugs to healthy outcomes Drivers of ► R&D productivity ► Health care reform change ► ► Patent cliff Globalization ► ► Health IT Consumerism ► Demographics ► Value mining ► Pricing & reimbursement Business Models Value Pharma 1.0 Pharma 2.0 Pharma 3.0 p p proposition Blockbuster drugs g Diversified drug portfolios Healthy outcomes Customer Payor Physician Patient Page 16 Progressions: Pharma 3.0
  • 17. Pharma 3.0 Health outcomes as currency for health care systems Consumerism ► Health literacy ► Empowerment Health care reform ► Access Health Health IT ► Rebates/discounts ► Digital data ► Value-based approach outcomes ► Social data ► Health H lth IT ► Mobile health Value mining ► Value-based P&R ► Comparative effectiveness ► Risk-sharing g agreements Page 17 Progressions: Pharma 3.0
  • 18. Pharma 3.0 From drugs to healthy outcomes Drivers of ► R&D productivity ► Health care reform change ► Patent cliff ► Health IT ► Globalization ► Consumerism ► Demographics D hi ► Value i i V l mining ► Pricing & reimbursement Business Models Value Pharma 1.0 Pharma 2.0 Pharma 3.0 proposition Blockbuster drugs Diversified drug Healthy outcomes portfolios Customer Payor Physician Patient Page 18 Progressions: Pharma 3.0
  • 19. Pharma 3.0: non-traditional collaborations Page 19
  • 20. Pharma 3.0 The healthy outcomes ecosystem Providers IT Information Physicians companies Social media CROs Academia Health records Medical Pharma Patients technology Telecom Biotech Med device Governments Food Insurers Retailers Consumer electronics Pharma 1.0 (drugs) Pharma 2.0 (diversified drug portfolios) Pharma 3.0 (outcomes) Page 20 Progressions: Pharma 3.0
  • 21. Pharma 3.0 is happening - eHealth Mondobiotech – 23 and me Novartis – Proteus Biomedical Source: www.ft.com Source: www.23andme.com Bayer - Ni t d B Nintendo UCB – patientslike me i lik Source: www.bayerdidget.co.uk/ Source: www.patientslikeme.com Page 21 Progressions: Pharma 3.0
  • 22. Pharma 3.0 Delivering on health outcomes Building communities Expanding products ► UCB — PatientsLikeMe ► Pfizer — Aurobindo Developing technologies Developing technologies ► Lifescan (J&J and A l ) Lif d Apple) ► Novartis — V d f N ti Vodafone — IBM Measuring outcomes Innovative distribution ► Fresenius Medical Care ► Novartis — Indian Post Office Managing patient outcomes Expanding access ► Driving compliance ► Underserved markets ► Health care delivery ► Emerging markets ► Patient stratification ► Uninsured populations Health outcomes Meeting unmet medical needs ► Complex indications ► Underserved medical fields Leveraging data Public-private partnerships Partnership with payors ► MondoBiotech — 23and Me ► GSK — Global TB alliance ► Novartis — NICE Optimizing R&D R&D risk sharing Creative financing ► GSK — Pfizer ► Eisai — Quintiles ► Eli Lilly — TPG-Axon Capital — Novaquest (a division of Quintiles) Orphan d O h drugs Pre-competitive R&D P titi ► Pfizer — Protalix ► Enlight Biosciences Page 22 Progressions: Pharma 3.0
  • 23. Pharma 3.0: business model innovation Page 23
  • 24. Scenario planning Deal simulations Deal A Deal B Partners InfoTechCo PharmaCo InsuranceCo DirectSalesCo PharmaCo FoodCo Understanding of Platform Sales forces Drug portfolio Broad product Resource Drug portfolio risk Personal health Customer intimacy Efficacy insights portfolio capabilities Efficacy insights Patient records and reach Nutrition insights stratification Health outcomes Health outcomes Value Enabling Enabling outcomes/ propositions outcomes access Patients Patients Customers C t Payors Payors P Governments Governments “While high-level business models are easily articulated, the discussion around the execution of the deals reveals a high level of complexity. What creates more value? And what provides more value over time? Who owns the intellectual property?” Source: Ernst & Young 2010 Page 24 Progressions: Pharma 3.0
  • 25. Business model innovation Commercial trials Commercial trials Stickiness High margins and success of current model make large leaps difficult Pilots Rapid To explore business prototyping opportunities Commercial trials will need to be fast and efficient Upside Unchartered territory Business model Difficulty and risk of developing new offerings innovation has the from scratch with unknown partners Open innovation Flexible control potential for considerable Use of external Alliances structures upside (e.g. compliance) networks that allow quick response to new challenges and opportunities Changing ecosystem Current ecosystem is changing rapidly in Portfolio management unprecedented and unpredictable ways Optimize network value “How do you actually go about the building of new business models from the ground up? How do you pick the right strategies and experiments for your company when the very ecosystem in which you operate is changing in unprecedented, and unpredictable, ways?” Page 25 Progressions: Pharma 3.0
  • 26. Commercial trials From strategy to commercialization Drug development pt Therapeutic focus Discovery and early y y Late development p Commercialization ct Proof of concep Disease areas s pproved produc development Number of leads P Ap New busine model gments oncept Number of ideas ess Proof of co Market seg Pilots and Scale-up and Strategic/risk assessment Market assessment partnerships larger partnerships Business model development B i d ld l t I. Strategic focus II. Proof of concept III. Development IV. Commercialization Areas and business Ideas that work in Most promising pilots. Service or product models that are a concept. offerings strategic fit for the “Does it work and is it Does “Is it commercially Is “Can it be scaled and Can organization safe?” feasible?” replicated across markets?” Page 26 Progressions: Pharma 3.0
  • 28. Pharma 3.0 Challenges and readiness for executing nontraditional alliances Page 28 Progressions: Pharma 3.0
  • 29. Challenges every step of the way New ways of partnering Strategy, Accounting Talent and Operations, structure and Due Valuation and financial change Risk supply chain governance diligence and reporting management management management modeling What creates most value? Whose d t is it anyway? data i ? How is success defined? Who owns the intellectual property? IFRS or US GAAP? What are the tax implications? What should the debt and equity mix consist of?? What are the water, power, waste and cleantech approaches? Page 29 Progressions: Pharma 3.0
  • 30. Guiding principles for Pharma 3.0 Define Co-create Experiment. Prepare your Pharma 3.0 value with partners Think small. Fail fast. for success. Brand and patients patients. The ecosystem is More than ever, There is no one Our survey and becoming more firms will need to right answer. interviews complex. complex combine unique Companies will indicate that Incentives are assets and develop solutions pharma changing. New, attributes to build by experimenting companies aren’t nontraditional relevant offerings with large fully prepared for players are for the healthy numbers of the challenges entering. outcomes “commercial trials” that these ecosystem. — and culling creative new those that don’t alliances will work. bring. Page 30 Progressions: Pharma 3.0
  • 31. Contact Details Dr. Frank Kumli, MBA Business Analyst - Global Life Sciences Center Tel +41 58 286 86 37 Mobile +41 58 289 86 37 Fax +41 58 286 83 60 Email frank.kumli@ch.ey.com E il f k k li@ h Page 31 Progressions: Pharma 3.0
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