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Doctor has no idea what patient adherence is
Patient has no idea of what their adherence is
Patient has inhaler without Smartinhaler
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Smartinhaler™ provides objective data to
clinicians. This is important in making
informed clinical decisions.
Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 6 - 17 years
Prescription:
Symbicort 2 puffs am, 2 puffs pm
Reminders: On
Comments:
Excellent adherence
Key: blue – reliever; red – preventer medications
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Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 6 - 17 years
Prescription:
Flixotide 2 puffs am, 2 puffs pm
Reminders: Off
Comments:
Poor adherence to treatment with the
daily adherence rate over 28 days of 3%
Key: blue – reliever; red – preventer medications
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Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 6 - 17 years
Prescription:
Seretide 2 puffs am, 2 puffs pm
Reminders: Off
Comments:
Excellent adherence to prescribed morning
preventer medication, poor pm adherence.
Some excessive dosing observed
Key: blue – reliever; red – preventer medications
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Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 16 - 64 years
Prescription:
Seretide 1 puff am, 1 puff pm
Ventolin use as needed
Reminders: Off
Comments:
Non adherence to preventer medication with
sporadic high use of reliever medication
Key: blue – reliever; red – preventer medications
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Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 16 - 64 years
Prescription:
Symbicort 2 puffs am, 2 puffs pm
Reminders: Off
Comments:
Poor adherence with intermittent
inhaler use
Key: blue – reliever; red – preventer medications
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Real Patient Profile from
the SmartinhalerLive™
database
Patient profile: Asthma
Age: 18 - 64 years
Prescription:
Seretide 1 puff am, 1 puff pm
Ventolin use as needed
Reminders: Off
Comments:
Poor adherence to preventer medication
coupled with frequent reliever use
Key: blue – reliever; red – preventer medications
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Physician judgement of patient medication adherence is
inaccurate1,2, patient self-report is unreliable and
overestimated1,3 and proxy measures such as prescription
refill data may not indicate ingestion and are vulnerable to
recording bias (from use of multiple pharmacies or
stockpiling)1
Electronic monitoring provides time and date of inhaler
actuations
This has resulted in key opinion leaders considering electronic
monitoring the GOLD STANDARD in adherence
assessment4-6
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Bender et al. Measurement of children’s asthma medication adherence by self report, mother report, canister weight, and Doser
CT. Ann Allergy Asthma Immunol 2000;85:416-21.
Jentzsch et al. Monitoring adherence to beclomethasone in asthmatic children and adolescents through four different methods.
Allergy 2009;64:1458-62.
Zeller et al. Physicians’ ability to predict patients’ adherence to antihypertensive medication in primary care. Hypertens Res
2008;31:1765-71.
Rand et al. Mediators of asthma outcomes. Journal of Allergy and Clinical Immunology 2012;129(3):S136-41
Boulet et al. Adherence: the goal to control asthma. Clin Chest med 2012;33:405-417
Burgess et al. Adherence with preventive medication in childhood asthma. Pulmonary Med 2011
Smartinhaler™
Gold standard electronic monitoring of respiratory medication
use
Globally Proven
Performance
Smartinhaler™ technology has been used by
organizations around the world for over 10 years
63
Clinical Projects
89k
Devices
>30
Countries
International regulatory approvals in place including
510(k) clearance to market & CE Mark
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Foster et al. (2014)
Inhaler reminders improve adherence with
controller treatment in primary care patients with asthma
Smartinhaler™ Improves
Clinical Outcomes
3 randomized control trials have demonstrated
improved adherence using the Smartinhaler™
improves clinical outcome in asthma, including
reduced exacerbations and improved quality-of-life
58.7%↑
Mean adherence
60.7%↓
In severe exacerbations
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Chan et al. (2015)
The effect of inhaler with ring tones on asthma control
and school attendance in children
Smartinhaler™ Improves
Clinical Outcomes
3 randomized control trials have demonstrated
improved adherence using the Smartinhaler™
improves clinical outcome in asthma, including
reduced exacerbations and improved quality-of-life
180%↑
Mean adherence
67%↓
Baseline asthma morbidity score
45.4%↓
Days reliever medication required
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Morton et al. (2015 Interim Data)
Smartinhaler™ Improves
Clinical Outcomes
3 randomized control trials have demonstrated
improved adherence using the Smartinhaler™
improves clinical outcome in asthma, including
reduced exacerbations and improved quality-of-life
Randomized control trial to investigate whether electronic
adherence monitoring with reminder alarms and feedback
can improve clinical outcomes in childhood asthma:
144%↑
Adherence in the Smartinhaler™ group vs
control arm;
37%↓
Oral steroid courses required in the 12
months from 2.7 to 1.7, a clear marker of
reduced severe exacerbations
100%
Restoration of lung function as measured
by FEV1 (mean forced expiratory volume in
1 second % predicted)
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The Research
Burgess et al. (2006).
In vitro evaluation of an asthma dosing device: the smart-inhaler
Patel et al. (2012)
Device Reliability
Six-month in vitro validation of a metered-dose inhaler electronic
monitoring device: implications for asthma clinical trial use
Foster et al. (2014).
97-100% accuracy in recording device actuations
with 100% accuracy in reminders
5 studies have demonstrated high reliability
The reliability and patient acceptability of the SmartTrack device: a
new electronic monitor and reminder device for metered dose
inhalers
Gradinarsky & Loof (2014).
Inhalation adherence monitoring using smart electronic add-on
device: Accuracy evaluation using simulated real-life test program
Pilcher et al. (2015).
Three-month validation of a Turboinhaler electronic monitoring
device: implications for asthma clinical trial use
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The Research
Further potential clinical
application: warning
system for life-threatening
attacks
Electronic monitoring of reliever medication use as
a predictor of severe exacerbation
Post-hoc analysis of 16 patients in the SMART study2 who
suffered severe asthma exacerbations requiring hospital
attendance. Smartinhaler devices used to measure reliever
medication use 14 days prior to hospital attendance1
An increase in reliever medication use was observed in these
patients, indicating a potential use as a warning system1
An increase in reliever medication use was observed in these
patients, indicating a potential use as a warning system1
1 Patel et al, (2015). "The use of β2-agonist therapy before hospital attendance for
severe asthma exacerbations: a post-hoc analysis." NPJ Primary Care Respiratory
Medicine,
doi:10.1038/npjpcrm.2014.99
2 Patel et al, (2013). "Efficacy and safety of maintenance and reliever combination
budesonide–formoterol inhaler in patients with asthma at risk of severe
exacerbations: a randomised controlled trial." The Lancet Respiratory Medicine, 1.1:
32-42.
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Individual patterns of daily asthma medication use
Dotted line - threshold of reliever medication use per day above which self-management plans recommend medical review
ED – Emergency department visit
Taken from Figure 3e & 3f from Patel et al, (2015). "The use of β2-agonist therapy before hospital attendance for severe asthma exacerbations: a post-hoc
analysis." NPJ Primary Care Respiratory Medicine 25.
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Why Adherium®
Transforming Patient Health in Chronic Disease
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Leading Digital Health Solutions
Adherium’s 1st solution Smartinhaler™, is a digital health solution for
inhaled medicines used in the treatment of chronic respiratory diseases
Proven in Clinical Trials
Smartinhaler™ technology has been supplied to the global clinical trials
market for >10 years
Positioned for Growth
Positioned for strong growth with AstraZeneca Supply & Development
Agreement and increasing demand from clinical trial and commercial
channels
Strong Financial Position
Adherium® listed on the Australian Securities Exchange (ASX) in August
2015 and raised US$25M, resulting in a current market capitalisation of
US$65M.
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Why Adherium® ?
Medical
Device,
Sensor Design
&
Development
Data
Management,
Security &
Analytics
App
Development
Our capabilities
Cloud Software,
Portals & UI
Internationalization
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IP Development,
filings and
management
Regulatory
Approvals
Volume
Manufacturing
Technical
Support
AstraZeneca Global Supply And
Development Agreement
Long term, global agreement
10 years, worldwide, all AZ affiliates
Pharma as a Customer
Connected Devices the New Playing Field
Fierce Medical Devices, September 25, 2015 | By Stacy Lawrence
“
“
In latest biopharma-med tech pairing, Teva
snaps up respiratory compliance tracker Gecko
Supply & Development
Devices, Software, Data, Innovation, Embedded
Solutions
Data Analysis
Commercial Model for Data Monetization
Investment
5.64% Shareholder
US$3m Investment in IPO
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Business Model
Channels to Market
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02
03
Global Pharma Companies
Global MedTech Companies
Payers & DMO’s
AstraZeneca
Market evaluation study in progress with
multinational client
Insurance Agencies
Multiple commercial and development
projects underway
Disease Management Organizations
Distribution to Hospital, Physicians,
Pharmacies and Patients
Governments
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Threefold Approach
Addressing Major Unmet Market Needs
Respiratory
Respiratory
•
•
Market dominance with Smartinhaler™
US$34B Annual Preventable US Healthcare Costs
US$34B
Other Chronic Diseases
Other Chronic Diseases
•
•
US$200B
New chronic diseases and drug delivery modalities
US$200B Total US Savings Opportunity from IoT
Technologies
Data
Data
US$X
•
•
Monetize exponentially growing database
The impact of data on the global healthcare system
is expected to be profound
Source: “The Digital Revolution comes to US Healthcare” Goldman Sachs (2015) Internet of Things. Vol.5.
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The Market
Every Year in the US Asthma and COPD Cause More Than...
Asthma causes …
COPD causes …
14m
1.5m
Doctors visits
ED Visits
439,000
699,000
Hospital Stays
Hospital Stays
US $56B
US $50B
Cost of Asthma to US Society
In the US, Total Cost COPD
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The Market
The Internet of Things and Chronic Disease Management
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8/10 healthcare dollars are spent
on chronic disease
Total US Healthcare Savings
from Digital Technologies
estimated at US$300B+
54% Americans 50-64 & 27% of
Americans older than 65 use
smartphones
The Healthcare Internet of Things
can create a $30B+ market by
2025
Adherium®
Going Forward
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Going Forward
Application of Adherium ® Platform to Other Chronic Diseases
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02
03
Targeting New Disease Areas
Leverage Whole-of-Platform Knowledge
Accelerate Commercialization
through Partnerships
Target new disease areas where annual
disease costs are >$5k per patient per
annum e.g. Cardiovascular disease,
Diabetes
Leverage whole-of-platform knowledge
Leverage existing and new commercial
relationships beyond the inhaler
Key skill sets in understanding of patient
behavior
Identify and secure key development
partners
Sensors, design, validation
Growth by acquisition
Software, applications and data
analytics
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Going Forward
Market Leaders Through Innovation and Product Development
01
Smaller, Sleeker, Faster, Better
02
Smartinhaler™ inside
Miniaturization, Increased sensors,
Industrial design, Greater feature Sets
Embedded solution for blockbuster
treatments
03
04
Software & Applications
Mobile applications for iOS & Android
Integration Web Services, Data
Management, Data security
Delivering value from data
Data mining & Analytics
Performance data for commercial
customers
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Going Forward
Monetizing the Data Asset
01
Smartinhaler™ data ownership
resides with Adherium®
02
Expand Smartinhaler™ databases
through international
commercialization
Tens of thousands of devices deployed
globally report data back to our servers
on a daily basis
Substantial and rapidly growing
respiratory data sets
03
04
Develop & deploy new market
leading devices into
international markets
Data generating devices contribute to
the Adherium® Internet of Things,
exponentially growing the data asset
base of the company.
Leverage data to realize value
New commercial and scientific
breakthroughs only achievable through
a critical mass of data
Data Analytics and provision of large
dataset reports to key channels to
market
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Thank you