Download - Nic Talbot-Watt Berlin 150611 PRESENTATION
Evolving Therapies Accurately Estimating Patient
Populations in a Changing Healthcare
Market
Forecasting Excellence, Berlin
June 15th 2011
Changing Paradigm of Healthcare…
• Reduction in spending
– Cost-containment
– Avoidance of unnecessary resource consumption
– Patient-lead disease management
• Prevention rather than cure
• Better compliance & monitoring
• New players in the game
• New targets
..from “Late Disease” to “Early Health”
Patient Utility (state of health) 100% 0%
Healt
hcare
Indust
ry K
now
ledge
Rudimentary
High /
Complete
Fully Preventative
?
2nd sequelae /
events
Onset signs &
symptoms
primary
chronic disease
Accumulation
of „damage‟ /
increased risk
state
Basic intervention
at point of fatal
event
Long term
management chronic
disease symptoms
Delay / halt
chronic disease
Intervention at
pre-disease state
Prophylactic
“treatment”
Delay
death
Consequences for Forecasting
• The majority of strategic level forecasts should
(and most do) include a patient population
• This base-line patient population is one of the
most significant drivers of the forecast
• It is CRUCIAL to clearly understand & define a
robust patient base upon which to build your
forecasts
Epidemiology
• Historically, it was enough to be able to
quantify a population fairly broadly, we took
prevalence (or incidence) and that formed the
basis for our forecast
• However…
Epidemiology
• Now the challenge is different
– New diagnostic procedures enable physicians to
make better decisions around patient management
– Regulatory & reimbursement environment leading to
more tightly defined product labels
– Patient adherence more closely monitored as
physicians manage to targets
– Novel drug targets linked to general biology
“It’s a question of identifying the right patient populations and technologies
once a target has been validated and if you don’t, you’re foolish” Dr. Zerhouni, Head of R&D Sanofi-Aventis
Diagnostics
Diagnostics:
• Impact on Patient Pool
– Earlier detection of primary condition
– (Possibly) earlier detection of „pre‟- condition
– Better profiling & identification of target patient
groups
• Forecast Considerations
– Diagnostic patient algorithm – current & future state
– How does the current algorithm deliver patients to
your therapeutic?
– How will the new algorithm re-direct patients?
Niche Product Labels
Niche Labels (1):
• Impact on patient pool
– Product use confined to specific subset of patients
that could be defined according to:
◦ Clinical profile
◦ Biomarkers
◦ Medical / event history
◦ Risk & genetics
◦ Line of therapy / previous therapy / combination with other
therapeutics
• Forecasting Considerations
– Identify the appropriate subset of the population
matching label criteria
◦ Co-morbid conditions
◦ Patient history
◦ Clinical markers
◦ Diagnostic work-up
– Adding clearer detail around how the physician
manages the patient, what decision points they take
& make & how your product fits into the flow
Niche Labels (2):
Pan-Disease Targets
Pan-disease targets:
• Impact on Patients
– Well… definitions are slightly trickier
– Seek help from qualified medical professionals!
• Forecasting considerations
– Question & role here are likely to require different
skills
◦ Helping to focus & direct development
– “Portfolio” approach
◦ Prioritising likely patient target populations
And so…
Equipped for the Future
Research
Team work
Broad vision
External awareness
Challenge