DrPatrickDixonChairmanGlobalChangeLtdFellow,CentreforManagementDevelopment,LondonBusinessSchool

Digital-InspiredHealthCareoftheFuture

Expectcompe;;onbetweenpharma,biotech,medtechandinfotechinfindinganswerstomajor

condi;ons

Butmanyofthegreatesthealthinnova;onswillcomefromsynergies

betweenthesedisciplines

The future is about

The future is aboutEMOTION

Agility

Yet many trends changing more slowly

than people think

Cash growing - bank branches continue -

music, fashions, food - homes look the same, pharma R&D efficient halves every 9 years

RealityNHS digital records

Alzheimers / devices

Demographicswillbegreatestpredictorof

futuredemand

85% of world population will be living in emerging

markets in 10 years

1% owns 50% wealthAccess to health ?

1 billion will migrate over next 30 yearsMore spend on infrastructure in 30 years than in all human history

Europe Dying 4 couples to produce single great-grand child

1 million in Italy over 90 years old by 2026

Title Text• Body Level One

– Body Level Two

• Body Level Three

– Body Level Four

» Body Level Five

!23

>65%spend>65yearsold>1billion>60by2020

ChronicCondi;ons–Mul;pleNeeds

•80%ofhealthspending•88%ofallprescripFons•70%ofphysicianvisits

AlmostallcausedbypeoplegeOngolder

Expectmajorglobaldemandforpreven;onandtreatmentforcancer,heart,

brain,chronicwounds,infec;ons,infer;lity,arthri;sanddiabetes

Manyhealthcostswill

FALL

PatentExpiryondrugsalesworth$225bn2011-2016

PharmaCompanies

WILLfindnewblockbusterse.g.Alzheimers/Obesity

AlzheimerscommonestcauseofdeathinUKwomen

2010-2050demen;a

1in3babiesinNewYorkwilldevelopadult-typediabetes-cost$100bnayear

An;-Ageingwillbeaglobal

obsession-withrapidprogress

Performance

Shift in retail health care from health treatment to life enhancement

from performance to health e.g. exercise benefits

Want to look better - $200bn pa by 2020

may be

Want to think better......

•20%studentsinUS/UKusememorydrugstopassexams

OrganRepairwillberou;neusingowncells

Heart / Brain / Retina / Spine / Teeth

Rod photoreceptors (in green) within a "mini retina" derived from human induced Pluripotent Stem Cells in the lab. Courtesy of Johns Hopkins Medicine

Re;nacellsfromadultskincells

Chip connecting above or below retina

Newinsulincellsincapsulestoprotectfromimmunesystem

Repair Pancreas in diabetics

46

Competition from implanted digital devices releasing insulin

7mechanismsofageinginanimalandhumancells

•Celllossoratrophywithoutreplacement•NuclearmutaFonsandepimutaFonsthatcausecancer•MitochondrialmutaFons•Cellsenescence(deathresistance)•Junkinsidecells•Junkoutsidecells•Cross-linksbetweencells(egelasFn)

Worn out Mitochondria – Energy Boost

R-alpha-lipoic acidAcetyl-L-carnitine

Treatment which restores and maintains the youthful elasticity of

hardened arteries – and helps wrinkled skin. Global sales?

Low blood pressure and total body lift

Alteon

Monkeysondietlivelonger•AOer20years-80%alivev50%onnormalcalories• Lesscancer,diabetes,heartdisease,strokes,braindecay

50

Slow or no ageing is a reality

• Rockfish, Turtles, some Whales

• No signs of getting old

Rougheye rockfish (Sebastes aleutianus) — 205 years Aldabra Giant Tortoise — 255 years Lobsters are believed to live 100 or more years Ocean Quahog clam — 405 years

Some animals do not “age” in normal way

Less than £1000 per person

•Software•Mathematics•Ultra-fast processing•Robotics•Biochemistry•Genetics• Immunology

$1,000genome-IlluminaHiSeqXTenSequencer

Ottawa Hospital, Ontario - 3000 ipads Mayo Clinic - 2000 ipads

400,000deathsayearinAmericafromavoidablemedicalerrors

Whyarewecollec;ngdata-forpa;entuseortokeepsomeoneoutofhospital?

Genescreeningwilldominatediseasepreven;onand

treatment

Confidential

HSV1causescoldsores.WhenengineeredasSeprehvir(HSV-1716),itisharmlesstohealthy@ssue.

•Oncolytic viruses • Infect and kill cancer tumour cells •No damage to healthy tissue •Evidence of impact in clinical trials •Able to deliver new genes into cancer cells

Viruses to cure cancer

FutureofHospitals

Beferdigitalimagingandanaly;cswill

transformdiagnosisandtreatment

Digitallyenhancedmicro-surgerywillalsotransformhospitalcare

• $75bn endoscopy market by 2022

• 125,000 stents or carotid surgery a year in US

Lengthofhospitalstay

willfall10-20%by2025

RapiddischargeandsupportPreven;onofadmissions

HomeCarewillgrowveryfastespeciallyforoldpeople

Growthcommunitynursing

Enhancedcareassistantss

250millionwearabledevicesby2023

$20bnto$70bnby2025

WearableHealthDeviceswillbealmost

universal

• Diabetes, congestive heart failure, obstructive pulmonary

• 2.2 million at home

• > $22bn by 2015

•Mobile telephony

Home Tele-Monitoring

16yearsofcontracep;vesonsinglechip

Cough,respira;on,wheeze,heartrate

Automated Device for Asthma Management, or ADAM, by Health Care Originals

Mostpa;entswillhavemoredatathantheirphysiciansabouttheircondi;on

e.g.DrEd.com50,000paidordersamonth

3000diagnosesadayinUKcomparedto30,000toNHShelplineMoreaccuratethanDoctorsorNurses

50,000videoconsulta;ons

Impactonmedicaltraining

85% of world population will be living in emerging

markets in 10 years

1% owns 50% wealthAccess to health ?

Inves;nginDigitalforaHealthierWholeWorld

Expectrapidinnova;onaswellasmul;plesynergies,withintegra;onintoeveryaspectofhealthcare

Dr Patrick Dixon Chairman Global Change LtdFellow, Centre for Management Development, London Business School

Future of MedTechImpact of digital innovation on MedTech and Health Care