INVESTMENT TRENDS IN HEALTHCARE - DANILO MAZZARA CLICK TO EDIT MASTER TITLE STYLE - Meet in Italy for Life Sciences
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CLICK TO EDIT MASTER TITLE STYLE
INVESTMENT
TRENDS IN
HEALTHCARE
DANILO MAZZARA
Danilo Mazzara @DaniloMazzara
CLICK TOAGENDA
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1. KEY TRENDS FROM A GLOBAL PERSPECTIVE
2. OPPORTUNITY FOR ITALY
3. KEY TAKEAWAYS
2
MACROECONOMIC
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DRIVERS
TITLE
ARE
STYLE
LEADING TO AN UNPRECEDENTED
HEALTHCARE INDUSTRY CHANGE
HC rising faster Patent Cliff Digitization The outside-in
than GDP (Cloud, IoT, enterprise
Rise of generics Wearables)
Silver Tsunami globally M&A & New
and Chronic Changing Business
disease Rise of Consumer Models
specialized (Mobile/ Social/
Outcomes- medicine Gamification) The pivot to the
Based patient
Reimbursement Big Data (Adv
Analytics,
Genomics, AI)
3
INNOVATION
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DRIVING
MASTER
FUNDAMENTAL
TITLE STYLE CHANGE TOWARDS
PERSONALIZATION
Genetic Screening/Editing
$25B market by 2025
Diabetes $30B new
growth by 2020 Wearable devices
$19B market by 2020
Stroke Prevention in AF
$10B new market by 2020
mHealth & Home
Monitoring
$26B market by
Alzheimers disease
2020
BACE-1, Beta Amyloid,
Tau $10B by 2020
Convergence
Surgical Robotics
$20B market by 2020
HCV / Hepatic
$19B new market
by 2020
Patient Engagement
Immuno-Oncology Services
PD-1, CTLA-4, CART $14B market by 2020
$35B new market by 2020
Transcatheter Heart Valves
TAVI
Source: Accenture Research based on EvaluatePharma Sep-15 $2B by 2018
4
EMERGING
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DIGITAL
MASTER
TECHNOLOGIES
TITLE STYLEARE THE KEY ENABLERS, THEIR
CONTINUOUS COST DOWNSIZING MAKE THEM CHEAPER AND
AFFORDABLE
DNA sequencing cost Key emerging Technologies
Robotics/AR: Automating and Assisting
Surgery/training
2,7 BLN
3D Printing: Personalized and in the field custom
manufacturing
Medical IoTs: Connected devices, continuous
monitoring
AI/Machine Learning: Clinical Decision support,
10 MLN Accelerated R&D
Genetics: next generation, low cost high accuracy
1K LS tools
Bioelectronics: Small implantable devices targeting
specific organs
2000 2007 2014
Blockchain: anti-counterfeiting, health data
marketplaces, operations management and patient
identity
5
AI IN THE
CLICK TO HEALTHCARE
EDIT MASTER IS
TITLE
EXPECTED
STYLE TO HAVE AN EXPLOSIVE
GROWTH IN THE NEAR FUTURE
Health AI Market Size 2014-2021 AI disruptive use cases
Detecting skin cancer
In one trial, AI caught 95% of dangerous melanomas,
CAGR doctor got just 87%
+40% Helping coma victims
$6,6B AI predicted when a trauma victim would wake up,
getting nearly 90% of cases correct
Analyse eye scans
AI can diagnose as accurately as world leading
experts and can even explains its decision
Drug development
Big data and machine learning can devise and trial
new drugs much faster
Recognise depression
By analysing a person’s speech, AI can predict if they
are depressed
Robot doctors
$0,6B A robot doctor scored better than 96% of the class in
a Chinese medical exam
Spotting outbreaks of disease
An algorithm saw an Ebola outbreak 9 days before
2014 2021 the WHO announced it
Source: Artificial Intelligence: Healthcare’s New Nervous System, Accenture, June 2017
6
HEALTHCARE
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ONE OFTITLE
THE MOST
STYLEACTIVE INDUSTRY FOR
BLOCKCHAIN
Blockchain Products Deployed By Industry Examples Growth Initiatives In Healthcare
Roche started a Serialization pilot to track
and trace the passage of prescription drugs
35% with Chronicled (supply chain solutions)
Merck and SAP has developed the SAP
Pharma Blockchain POC app for verifying the
authenticity of returned drugs
Philips Healthcare discovered blockchain
17% applications like securing patient data in a
decentralized database with Tierion
Pfizer and Aimedis are levering blockchain for
a new patients therapy result sharing and
monitoring systems
Doc.ai found a way to incentivize patients to
contribute to research giving them tokens to
2016 2017 add their health data to a pool.
Source: Deloitte, 2017
7
THE RISING
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OF MASTER
DIGITAL HEALTH
TITLE STYLE
COULD GENERATE MARKET
DISRUPTION
VC investments in Digital Health Top 10 best funded digital health companies
(B$ - #deals) in 2017 (M$)
Amount Grail 914
# deals Guardant Health 360
Peloton 325
Auris 280
CAGR 23andMe 250
+31% Modernizing Medicine 231
794 Haodf 200
WuxiNextcode 165
647 658 SomaLogic 161
596 550 11,5 Bright Health 161
477
Corporate Venture Capital with focus on
8,2 Digital Health (selection)
7,2
6,2
500 mln $ CVC from Merck for Digital
Health startups
2,3 2,9
100 mln $ CVC driven by Novartis and
2012 2013 2014 2015 2016 2017 Qualcomm
GE Healthy imagination CVC focus on
imaging and diagnostic
Source: Global digital health funding report, Startup Health, 2017
8THANKS
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DIGITAL
MASTER
IMPROVEMENTS
TITLE STYLE MANY NEW THEMES ENTERED
INTO THE MARKET
Digital Health main themes
Patient Experience Personalized Health Big Data/Analytics
~$1,64 B ~$1,59B ~$1,39B
The access to and purchase of Genomic powered technologies Healthcare system benefits a lot
healthcare solutions is easier than revolutionize medicine through from getting valuable insight
ever as the whole healthcare advanced clinical services lowering from very large data sets to offer
ecosystem becomes more both risks and costs for the end predictive and prescriptive
consumer focused user analytics
Medical Device Insurance and services Workflow
~$01,37B ~$1,12B ~$1,07B
Smart objects, VR/AR visors, Powerful softwares allow data Technology is enhancing the
connected sensors and all other tracking and analysis of potential patient/health care relationship
digital electronic medical patients to offer data-driven, through clinical evidence and
instruments are proliferating widely customized services, such as advanced analytics to make better
and rapidly throughout the medical medical insurance clinical therapy decisions for
community. doctors and hospitals
Research (~$0,93B), Education and Training (~$0,75B) Population Health (~$0,70B) and Electronic Health Record –HER (~$0,40B) complete the list of the 10 most active digital
health market in 2017.
Source: Global digital health funding report, Startup Health, 2017
9DIGITAL
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IN DIABETES
TITLE STYLE
TREATMENT HAS INCREDIBLY
IMPROVED PATIENTS’ THERAPY MANAGEMENT
Selected Digital Disruptive Innovations
Portable Insulin Pumps Portable Glucose Meter First Continuous Glucose Artificial Pancreas
Commercialized Commercialized Monitor system approved System Approved
Digital Adoption Degree
1923 1949 1964 1966 1970 1978 1981 1983 1992 1999 2012 2016
Source: American Diabetes Association
10PEAR THERAPEUTICS
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LAUNCHES
TITLE STYLE
THE FIRST FDA-APPROVED
PRESCRIPTION DIGITAL THERAPEUTIC
reSET
reSET it's the first software-only digital therapeutic
the FDA has ever cleared (with claims) to improve
clinical outcomes for patients with substance use
disorder (SUD) and opioid use disorders (OUD).
Developed by PEAR Therapeutics, the product has
already attracted a lot of interest from industry players
which are engaging in new initiatives to leverage this
new tool.
11ACCORDING
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TOMASTER
OUR RESEARCH
TITLE STYLE
PATIENT CENTRICITY REMAINS THE
KEY TOPIC AND OFFERS HUGE OPPORTUNITIES TO START AN
INNOVATION JOURNEY
EXTRACT FROM RECENT
ACCENTURE RESEARCH
3
When patients are
2 aware of services,
4
Patients are generally not they use them. Patients value services
aware of services that are across all disease states.
available to help them.
1 5
Patients want healthcare
Patients want more professionals to be the primary
help before they are source of information on services
being treated. they need to manage their health.
12DESPITE
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THEMASTER
RISING TITLE
OF NEWSTYLE
TECHNOLOGY HEALTHCARE
PROFESSIONALS REMAINS THE PRIMARY SOURCE OF INFORMATION
FOR PATIENTS
Primary source of information Primary source of information
preferred by patients preferred by patients (country details)
Doctors/specialist 63% Healthcare Others
(including insurance and
Support staff within Professionals
10% pharma companies)
Doctors/Specialist practice
Dedicated patient-care 5%
85
want the
% Total 85% 10%
support team single point
Nurse
4% of contact to US 88% 7%
be their
healthcare
Pharmacist
3% professionals
Brazil 88% 9%
France 87% 10%
Germany 71% 25%
(insurance 19%)
Insurance company
6%
Pharmaceutical
companies 1% 10
others
%
UK 86% 5%
Other 3%
Insurance companies mentioned more in Germany
Note: a small number of respondents answered ‘don’t know’ (not shown).
Base: All (10,000) and all wanting one point of contact (8,688)
13NEW BUSINESS
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MODEL DRIVEN
TITLE STYLE
BY NEW TECHNOLOGIES AND NEW
CUSTOMER NEEDS WILL EMERGE ALSO IN THE HEALTHCARE
14CLICK TOAGENDA
TODAY’S EDIT MASTER TITLE STYLE
1. KEY TRENDS FROM A GLOBAL PERSPECTIVE
2. OPPORTUNITY FOR ITALY
3. KEY TAKEAWAYS
15LIFE SCIENCE
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MASTER
AN ITALIAN
TITLE
EXCELLENCE
STYLE WHICH CAN BE FURTHER
LEVERAGED AND VALORISED
Public and private Italian healthcare expenditure
Life science industry in Italy
Total: €153,9B
Pharma Med-Tech
7,8%
Revenue €31,2 B €11,4 B
Exports 79% 43% 16,2%
Employees 65.000 76.000
Graduated 79% 85% 76,0%
(university and
high school)
R&I investment €1,5 B €1,1 B
Primary care, Secondaty, Hospital Services,…
on Revenues 4,8% 9,6%
Pharma
Medical Devices
Source: elaborazione su dati Assobiomedica, Farmindustria, 2017 Source: VIII Rapporto RBM-Censis, 2018
16INNOVATION
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ECOSYSTEM
MASTER TITLE
IN ITALY
STYLE
IS GROWING THANKS TO STRONG
REGULATORY IMPROVEMENTS AND LIFE SCIENCES IS GETTING A
LOT OF ATTENTION
Selected Initiatives in
Some recent regulatory intervention
Italy
Tax deduction of invested capital in innovative Innovation
30% Contest
start-ups and innovative SMEs
Incubators/
Corporate Sponsorship (Start-up losses can Acceleration
NA programs
be deducted by parent company)
Venture Capital
€596 Simplified access to the “Central
(mln) Guarantee Fund” for bank credit
Public investments in innovative start-ups Collaboration
€900
through equity and debt (VC, Funds of
(mln)
funds and Smart & Start)
17MARKET
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EDIT
STILL
MASTER
GROWING
TITLE
BUT
STYLE
EXPENDITURE IS GRADUALLY
SHIFTING FROM PUBLIC TO PRIVATE
Italian Healthcare Expenditures per Payers (B€)
+54,1% 153,7
140,0 5,7
3,7 33,9
23,5 +44,2%
1 The rising of new stakeholders and payers
+1,1%
2 Healthcare consumerization
112,9 114,1
3 Changes in traditional channels
2010 2017
Private (Complementary Health Funds)
Private (Out of Pocket)
Public
Source: VIII Rapporto RBM-Censis, 2018
18IN THE TO
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INSURANCE
TITLE
PLAYERS
STYLE WILL BECOME KEY
STAKEHOLDERS
1 The rising of new stakeholders and payers
After a phase of consolidation, market is growing again due to
insurance players seeking new sources of value
Selected players such as RBM Salute, Allianz and Cattolica
are investing significantly, with important growth rates (up to
>15% YoY growth)
Strong pipelines around new connected health services, even
if still focus on “well being”
Source: Premi Del Lavoro Diretto Italiano 2017, ANIA, 2018 19PATIENTS
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ARE MORE
MASTER
INFORMED
TITLE STYLE
AND PROACTIVE IN THEIR HEALTH
CHOICES, AS SHOWED BY HEALTH TOURISM FLOW
2 Healthcare consumerization
4,6 B€
800-900 k
patients
20HEALTHCARE
CLICK TO EDITCONSUMERIZATION
MASTER TITLE STYLE
IS A CONSOLIDATED TRENDS IN
SOME MARKET AND PROBABLY IT WILL EXTEND TO OTHERS
2 Healthcare consumerization
Dental Clinics
Hearing Aids (from top 50 brands with more than 4 branches)
Hearing aids global retail market (B€)
CAGR
~4% Key growth factors: +22% 1040
~15 875
▪ Demographic factors 774
~12
sustaining the growth
577 650
~10 (aging population)
▪ Relevant market 295 367
under-penetration 214
2010 2015 2020
Hearing devices value chain 2012 2013 2014 2015 2016 2017 2018* 2019*
Suppliers Manufacturers Retailers *forecasted
Main Players
Value 133
distribution 99
65
45
Source: Keystone, march 2018 21IN THE TO
CLICK COMING
EDIT MASTER
YEARS WE
TITLE
WILL
STYLE
HAVE A DEEP TRANSITION IN
PHYSICIANS: THEY WILL BE LESS, YOUNGER AND WOMEN
PRESENCE WILL GROW
3 Changes in traditional channels
National health system physicians % Of female physicians per Age
retirements ‘18-‘28 (in 000) Group
Age
>= 55 31%
50 - 54 50%PHARMACIES
CLICK TO EDITENSURE
MASTERAN
TITLE
HIGHSTYLE
DEGREE OF SATISFACTION AND
LOYALTY AND WILL EVOLVE INTEGRATING MORE VALUE ADDED
SERVICES
3 Changes in traditional channels
Pharmacy is an highly preferred New Services
retailer
First instance analysis
(haemoglobin, cholesterol,
…)
IT Healthcare Medical device
(Cardiac rental
holter,…) Therapeutic
Education & adherence tools
prevention
Dietetic
Fidelity consultancy
programs
Nursing
Drugs delivery
Services
Home
assistance
Value added services
Most desired services
Source: La farmacia del futuro, Doxa, 2017 23INNOVATION
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IS MASTER
A KEY PRIORITY
TITLE STYLE
IN THE HEALTHCARE INDUSTRY AND
STARTUPS CAN HAVE A CRUCIAL ROLE IN DRIVING THE CHANGE
Share of Healthcare sector on ….
x2,5 Leverage digital technology along the
25,4% 1
whole value chain
2 Build services on top of product
11,8%
9,9% 3 Build and measure value across multiple
stakeholders
4 Be credible and take your time
GDP Global VC investments**
Market Cap* 5
Leverage the rising of open innovation
* Based on Global Standard and Poor's ** Based on USA and Europe (NVCA, EVCA)
Source: Accenture Elaborations on market data
24LEADING
CLICK TO LIFE
EDITSCIENCES
MASTER TITLE
PLAYERS
STYLE
ARE APPLYING DIGITAL
TECHNOLOGY TO ENHANCE THEIR BUSINESS AND OPERATING
MODEL
1 Leverage digital technology along the whole value chain
Digital Strategy Framework
Digital Customer
Digital Value Areas
Digitize Disrupt Business
Customer (Sub-)Market(s) Digital Customer: Apply digital
Experience technology to address customers in a
more sophisticated way to increase
revenues and profitability
External Focus
Digital Enterprise: Decrease costs of
the existing value chain’s primary
functions (e.g. R&D) as well as support
Digital
Enterprise functions (e.g. HR)
Digital Business: Digitize your current
business model or develop new
Digitize business models generating profits
Operations
based on digital technology
Internal Focus
Source: Accenture Strategy 25DIGITIZATION
CLICK TO EDITLEVERS
MASTERCAN
TITLE
BE STYLE
USED TO UNLOCK EBITDA
POTENTIALS ACROSS THE ENTIRE VALUE CHAIN
1 Leverage digital technology along the whole value chain (EBITDA upside x digitalization, 10 B€ Company)
Marketing & Research & Manufacturing &
Sales
340 m€ + Development 110 m€
Supply
365 m€
3% Increase
of EBITDA
Revenue
Increase
01. eDetailing - Digital Sales Rep
70
Enablement
02. Analytics-based Marketing
90
Insight Generation
06. Scientific Collaboration Platforms/ 09. Sourcing Process Automation 10
25
03. Digital Marketing Content Open Innovation
35
Management 10. Analytics-based &
65
Decrease
11. CollaborativeSC-Planning
Costs
07. Analytics-based Virtual Screening &
04. Internal Marketing & Sales 75
110 Simulation (in silico) 11. Digital-enabled Mfg. &
24% Increase
Collaboration Platform 250
of EBITDA
12. Asset Maintenance
05. Customer Information 08. eLabeling for Clinical Supply 10 12. Supply Chain Cockpits & Logistics
35 40
Self-Service Enablement Platforms
Support Functions 105 m€
13. Digital-enabled HRBUILDING
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SERVICES
MASTER
ON TITLE
TOP OFSTYLE
PRODUCTS IS A TOP PRIORITY TO
GENERATE REVENUES GROWTH AND STICKINESS
2 Build services on top of product
EXTRACT FROM RECENT
ACCENTURE RESEARCH
3
When patients are
2 aware of services,
4
Patients are generally not they use them. Patients value services
aware of services that are across all disease states.
available to help them.
1 5
Patients want healthcare
Patients want more professionals to be the primary
help before they are source of information on services
being treated. they need to manage their health.
27THE NEW
CLICK TO VALUE
EDIT MASTER
EQUATION
TITLE
REQUIRED
STYLE TO CROSS MULTIPLE VALUE
DRIVERS SIMULTANEOUSLY FOR SEVERAL STAKEHOLDERS
3 Build and measure value across multiple stakeholders
General government gross debt on GDP
New Value Equation
(selected advanced economy 2018)
United States 108
United Kingdom 86,3
Spain 96,7
Singapore 110,2
Portugal 121,2
Netherlands 53,5
Japan 236
Italy 129,7
Greece 191,3
Germany 59,8
France 96,3
Digital creates transparency, requiring
Canada 86,6
businesses to solve for all Stakeholders
Source: IMF,2018 28NEW KEY
CLICK TO STAKEHOLDERS CANSTYLE
EDIT MASTER TITLE BE ENGAGED TO BUILD NEW “WIN
WIN” SOLUTIONS
3 Build and measure value across multiple stakeholders
B2B/
B2G 2
System Integrator & Corporate Welfare
Tech Plyers
Business Relationship
(Client Type)
IOT and digital Transformation
Large
1 Corporate
3
Connect Home
Utilities player
Insurance Players
5G
Telco
B2C
Inside Healthcare Focus Outside
29LONG TIME
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ANDMASTER
BIG INVESTMENT
TITLE STYLE
ARE NEEDED TO BE IN THE
MARKET, PLAN YOUR EFFORTS CONSISTENTLY, FIND THE RIGHT
SKILLS MIX AND LOOK FOR SUSTAINABLE PARTNERS
4 Be credible and take your time
Time* for approval Medical Device
Real example on med tech start up
(USA vs EU in months)
2) Clinical Trial
Device Class USA EU 1) Pre- and 3) Pre 4)
clinical supply chain in Launch Launch
Class I 3
Source: Elaboration based on Forbes, 2013 30THE RISING
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OF MASTER
OPEN INNOVATION
TITLE STYLE
IS AN OPPORTUNITY TO VALIDATE
AND FAST PROTOTYPE NEW SOLUTIONS
5 Leverage the rising of open innovation
How company can connect with Innovation ecosystem
+ Venture Capital Joint Venture Corporate Venture Capital
Capital allocation on industry-specialized funds Financial investment aimed to the achievement of a Setup of a financial entity, aimed to invest on
shared project behalf of the company
Financial capital
Sponsorship Contest Corporate Accelerator
Specialized support to selected start-ups in
Financial support on different kind of activities Innovation contest with cash and visibility as prizes order to facilitate the Route to Market
Facilitator/ Networking Showcasing Lab
Support to selected start-ups by acting as a bridge Facility where clients and other visitors can Setup of a R&D facility run in collaboration with
to accelerator, incubator, investors, mentors, etc. experience cutting edge innovation start-ups, universities and industry partners
-
- Competences / Industrial Assets +
31CLICK TOAGENDA
TODAY’S EDIT MASTER TITLE STYLE
1. KEY TRENDS FROM A GLOBAL PERSPECTIVE
2. OPPORTUNITY FOR ITALY
3. KEY TAKEAWAYS
32CLICK
KEY TAKEAWAY
TO EDIT MASTER TITLE STYLE
The Healthcare is one of most impacted industry by
technology breakthrough
Life Science in Italy is an excellence which can be
further leveraged and valorized
Startups can have a key role in bringing innovation
and accelerating the change
Danilo Mazzara @DaniloMazzara
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