Transcript Trends Influencing the Future of Healthcare

Australian healthcare trends
Suite 15/20 Young St
Neutral Bay NSW 2089
Consultations With ...
General Practitioners
Pharmacists
Specialists
Representatives
KOLs
Health consumers
Nurses
Carers
Overview
Global Themes
End of Blockbuster drug era
Industry Responses
Medication Of Risk
Drug Re-positioning
Greater investment in Orphan Drugs
Pressure to cap rising public health
spend
P-Health Initiatives
Technology-Based Monitoring
Overview
Global Themes
Industry Responses
Rise of Functional Foods & Bevs
Increased Consumer Engagement
Personalised Medicine
Increased Demand for Rx Choices
Increased Consumer Influence on Rx
Rising promotion & use of natural
and alternative therapies
Increased pharma engagement with
consumers
End of Blockbuster
Drug Era
The Patent Cliff
•
20 years ago, many new and powerful
drugs launched
•
Many now coming off patent
In US, >$100 billion of branded drug
sales expected to go generic 2010 2015
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•
In Aus, Lipitor predicted savings to
Govt of
•
•
$529 mill in 2012-13
$546 mill in 2013-14
The Medication Of Risk
•
medication to prevent illness
•
people educated to expect health/ well being benefits that
REMOVES the NEED FOR PERSONAL RESPONSIBILITY
Eg nicotine patches
•
increased role for drugs that modulate emotions and behaviour
•
Next Steps
•
Products for memory enhancement
•
Multi-function drugs
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e.g. Sanofi’s Acomplia
Medications for social anxiety disorder & generalised anxiety
disorder and for ‘naughty kids’
Big Pharma & Natural Therapy co’s seeing unprecedented
profits in disease prevention
Orphan Drug Pipeline increasingly active
• Probability of market approval ~13%.
• 1988, 253 orphan drugs -> 36 approved
• 2011, 2507 orphan drugs -> 393 approved
Pharma increasingly working with rare-disease
support orgs to advocate for market access and
cement relationships
Govt Preparedness to Pay for Orphan Drugs
High In Aust
Higher likely re-imbursement than many other markets
Pressure to cap rising
public health spend
Public Sector - Initiated P-Health
•
To combat rising health costs, incl rising spend on originator drugs
•
Govt Public Health Aims
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Developing new foods to prevent illness
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Finding new ways to diagnose disease early
•
Using genes & proteins to predict & prevent ill health
Objectives
•
Help Australians live longer
•
Reduce rising cost of health care
Public sector becoming an important competitor in disease
prevention products
Encouraging Consumers to Self-Regulate
•
Nutritional Analysis Kiosks and software
•
for specific medical conditions (e.g. diabetes/ special diets)
Earlier Identification
Intelligent toilets
• test urine for glucose, kidney disease
(eventually even cancer)
•
Test faeces to measure weight and fat content
•
let you know if there's anything unusual going
on
Diagnosis Outside Healthcare Settings
Treatment & Monitoring Outside Healthcare
Settings
Remote Patient Monitoring
Increased consumer
engagement
Rise in patients blogs / forums
Bio-oil 600 Youtube videos
Increased Information Access -> Empowerment
•
Customer switching costs are low
•
Don’t define themselves as patients
‘Person Living with .....’ rather than ‘patient’ given it references
the individual’s complete experience
•
a ‘chronic condition’ rather than ‘disease’
Consumers becoming more educated and discerning,
Health Is No Longer Just Physical
Physical Health
• Heart disease
• Physical Appearance
• Food Scares
Mental/Emotional
Health
• Stress
• Depression &
Anxiety
Environmental
Health
• Animal Welfare
• Soil erosion, pollution
• Toxins
• Better For You products
• Herbal Products
• Vegetarian Products
• Weight loss products
• Aromatherapy
• Natural
• Cosmeceuticals
• Vitamins & Minerals
• Organics
• Nutraceuticals
Concept of Health has come a long way from
Norm’s ‘Life Be In it’ message
Failure of western medicine to solve major
health issues
Realisation that it
• does not have all the answers
• Is one of a range of options
Greater Willingness to Try Alternatives
Pharma Brand Positioning Much More
Important
•
•
Pharma manufacturers are concerned to raise their
parent brand image
Significant spend
Consumer Empowerment means pharma brands need to have
good corporate image to engender long term support
Increased Prevention &
Treatment Choices
Rise of Functional Foods & Beverages
XANGO
•
The whole fruit puree of the
Mangosteen fruit
•
Powerful natural
antioxidant & antiinflammatory
Why would anyone use a drug, if you can get the
same benefits from a food?
Functional Foods & Beverages
•
Mainstream manufacturers making functional products
•
Disease prevention claims (e.g. anti-cancer) currently restricted
Functional foods an increasingly popular alternative to
preventive medicines
“
Natural Therapies
•
Australians spend ~$2.3 billion a year (4 x their spend on
pharmaceuticals)
•
120% increase in spend since 1993
•
Over half of Australians use
•
~40% with chronic diseases use
•
60% of women & 44% of men (and increasing) visit alternative
practitioners
Significant and growing use reflecting consumer
preferences
Colonic irrigation
Vit C injections
Oxygen therapy
Naturopathy
Chiropracty
Lycopene
Zinc
Ginkgo Biloba
Natural Therapies
Patterns of Use
Beliefs
•
Look for safety above proven
clinical efficacy
•
To complement rather than
replace conventional treatment
•
Wide availability from nonpharmacy outlets and derivation
from natural products has
promoted perceptions of safety.
•
pragmatically select treatments
to best fit particular medical and
health problems
•
Upsurge in use as
• anti-depressants
• cholesterol reducers
•
improving CV health
The ‘wellness’ market often demonises
pharmaceutical products
Reasons For Growth
•
Disillusionment with orthodox medicine/ hospitals given
perceptions of reduced quality of care.
•
Dissatisfaction with doctor-patient interactions
•
Practitioners regarded as more convincing, informative,
considerate and available
•
many using evidence-based methods
Consumers increasingly dissatisfied with using just
prescription pharmaceuticals
Strong DTC Advertising Presence
Increased consumer influence on
treatment decisions
Self-Dx & Treatment A Growing Possibility
Will Growing Availability of Cheap OS product erode
local sales?
A challenge for Pharma and HCPs
•
pressure to increase counseling & support
•
nurses and allied HCPs’ increasingly important in providing credible
patient information
Industry Responses…
Patient Support Programs?
Personalised Medicine?
Personalised, Integrative Medicine
•
‘the capacity to predict disease development and influence decisions
about lifestyle choices or to tailor medical practice to an individual’
•
Uses knowledge of individual metabolism or genetic make-up
History
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•
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ABX resistance testing (bacterial infection)
Viral resistance testing (eg HIV)
Genomic Medicine
•
Gene Sequencing
•
Genetic Mutation testing (eg breast cancer, IBD)
•
Drugs targeted to narrower indications, hence limited populations
•
Well established in Europe & US
Personalised, Integrative Medicine
Can facilitate disease prediction, prevention and treatment :
•
determine if increased risk of disease, followed by promotion of and
support for compliance with prevention
•
Diagnosing earlier using optimal surveillance, allowing more effective
interventions or treatment options;
•
enhancing therapeutic efficacy by ensuring the most appropriate drug
is used and that dosing takes into consideration any genetic variants,
which may influence metabolism of the drug;
•
avoiding preventable drug related complications and side effects
Personalised, Integrative Medicine
•
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Opened Aug 2012
Incorporates a wellness centre offering complementary therapies eg
acupuncture, massage, mind body therapy.
Genea Holistic
•
to add safe and comprehensive complementary healthcare to our world
leading fertility science and care – giving you the best possible chance of
conceiving a healthy baby.
•
aims to deliver you the maximum benefit from complementary healthcare to
give you the best possible chance of a healthy baby.
•
individualised programs that address your particular needs and incorporate
the most appropriate treatments for you
 Earlier identification and treatment of risk factors for disease
 Increase in self-prescription & self-medication
 Convergence of pharmaceuticals, complementary medicines, functional
foods & beverages
 Increasing community adoption of preventive health measures
At point of purchase:
 Self-service computer technology to help diagnose, prescribe
and dispense on-line
 Self-service terminals in supermarkets
• Consumers can plug in age, family medical history &
lifestyle
• Provide a printout of recommended vitamins, herbs,
supplements and food choices
 One-stop shop model of product purchase
 Specialised pharmacies
Pharma Industry Opportunities
Closer relationships with end-users
 Increasing consumer awareness of Big Pharma’s community involvement
 Complementary medicine partnerships to
 boost consumer perceptions of a ‘holistic health’ provider
 better monitor/control disease management
 Sponsoring ‘wellness’ clinics and disease screening services
 Micro-chip technology (implants) to record health/disease status and monitor
drug intake
Capitalising on the political trend towards disease prevention
Micro Chipping Consumers
VeriChip™ - There when you need it
• Used to access a subscriber-supplied database providing personal
information
• Cannot be lost, stolen, misplaced or counterfeited.
• Can be scanned when necessary
• Provides instant access to a Subscriber Registry - secure, password
protected web access.
Future potential to track brand-switching …?