360 Degree CEO Perspective Of The Global Healthcare Industry

1. 360 Degree CEO Perspective Of The Global Healthcare Industry

2. Economic Trends & Issues Growth Process Emerging Technology Competitive Benchmarking ExternalIndustryImpact Emerging Competition CareerDevelopment Emerging Opportunities New Applications Cultural IndustryIntegration Non Customer Economic Trends Demo- graphics Political & Regulatory Industry Convergence EconomicThreats Disruptive Technologies Industry Expansion Potential IndustryShifts Behavior Competitor’s Customers Country Risk Competitive Strategy In-Direct Competition Growth Functions GrowthTeam The CEO’s Perspective Of The Complex Business Universe TECHNOLOGY TECHNOLOGY Identify geographic expansion opportunities, monitor the political and regulatory effects of doing business in another country; understand cultural implications and requirements Ensure a solid understanding of emerging technologies: affects and opportunities; plan for potentially disruptive technologies; leverage new products and/or applications for growth Maintain an effective Growth Plan for 3 - 5 years in the future; create and develop the Growth Team; ensure Growth Team members understand their functions and contributions to growth; leverage industry Growth Thought Leaders and best practices. BEST PRACTICES BEST PRACTICES GLOBAL GLOBAL INDUSTRY INDUSTRY CEO Maintain a solid grasp of your key industries and the industries that could have an impact on your business; identify factors that are causing new trends and changing buying behaviours; address industry convergence and integration; identify opportunities to expand within the market Identify unmet needs; tailor products and services to market needs; manage brand equity; identify emerging customer segments; keep track of changing cultural trends CUSTOMER CUSTOMER COMPETITIVE COMPETITIVE Know any and all emerging competition; identify alliance partners; benchmark your growth against the industry; refine competitive strategy; monitor market perceptions, changing processes, technologies, culture, etc. Pinpoint current and future economic trends; identify growing customer segments; take advantage of emerging opportunities; adjust for currency changes ECONOMIC ECONOMIC

3. 1. Top 10 Global Healthcare Trends The Triple Healthcare Crisis 2. Shifting Healthcare Expectations Convergence in Healthcare 5. Healthcare Paradigm Shift Hot Spots & Emerging Geographies 7. PESTLE Analysis 8. Opportunity Analysis – Major Areas Agenda A Global Healthcare Industry Outlook B Overview By Area 1. Pharmaceuticals & Biotechnology 2. Clinical Diagnostics 6. 4. 3. 3. 4. Medical Devices Medical Technologies

4. Top 10 Global Healthcare Trends The Triple Healthcare Crisis Shifting Healthcare Expectations Convergence in Healthcare Healthcare Paradigm Shift Hot Spots & Emerging Geographies PESTLE Analysis Opportunity Analysis Global Healthcare Industry Outlook

5. Top 10 Global Healthcare Trends More Info 2010 – 2020 High Impact Projected Impact on the Healthcare Industry Low Impact High Low Certainty

6. Patients Become Healthcare Kings And Queens, Medical Communities Become Interconnected, Doctor-Patient Relationship Goes Virtual Devices Become Monitors Power Patient Generation Patients Become Customers Personalised Healthcare Healthcare Globe Trotters Hospitals Go Virtual Smarter Drugs Prevention Before Cure CyberDocs Innovation vs. Knowledge Major Trend 2010 2015 2020 Patient centred care 1 2 3 4 5 6 7 8 9 10 Patients gain access to health quality information Patients become healthcare Kings and Queens Baby Boomer retirement starts Consumerism One stop shop Home services Customised products holistic health and well being Implementation of IT Precise therapy becomes reality Early treatment Genetic testing Information based medicine Wellness care Presymptomatic diagnostics & treatments Targeted clinical trials Major diseases understood at molecular level Private companies invest in facilities and services abroad "medical tourism" crosses the US$2 billion mark Immediate Treatment abroad becomes an option Non-invasive delivery Drug cocktails will enhance productivity, memory, and physical performance Medical communities (1°, 2° care) become interconnected Regional/Country-wide connectivity All departments/buildings within hospitals are connected Baby Boomer retirement starts Medical professionals keep up with knowledge growth War for medical talent Self-monitoring Remote patient monitoring Disease management Virtual face to face doctor- patient relationship Perform routine diagnostics with predictive precision Cheaper care available to more people in need

7. Healthcare Is Challenged By Three Interlocking Crises That Make Present Healthcare Systems Unsustainable • Healthcare is challenged by three interlocking crises that make present healthcare systems unsustainable: • Rising costs • Changing demographics • Quality The Size of the Problem – Quality • 15%of patients admitted to hospital suffer an adverse event. • 8%of adverse events result in death. • 6%of adverse events result in permanent disability. • 10-20%of all adverse events are caused by medication errors. • 10-15%of hospital admissions occur because providers do not have access to previous care records. • 20%of laboratory tests are requested because the results of previous investigations are not accessible.

8. If Current Trends Hold, By 2050 Health Care Spending Will Almost Double Claiming 20% – 30% Of GDP For Some Economies Unsustainable Levels!!! • In almost all countries worldwide, per capita healthcare spending is rising faster than per capita income. • No country can spend an ever-rising share of its output on health care, indefinitely. Spending growth must eventually fall in line with growth in per capita income.

9. Balance Between Young And Old Is Shifting, Ageing Related And Chronic Diseases Increase, People Living With Multiple Long Term Conditions • In 2000, 10% (606 million) of the global population was aged 60+. By 2050 this will be more than 21% (2 billion). • People aged 60+ utilise 3-5 times more healthcare services than younger people. • 75% of people aged 60+ have one chronic condition, while 50% have two or more chronic conditions. • Chronic diseases account for more than 60% of all health care spending. • Health economics dictate a shift in spending – away from treating and towards predicting, diagnosing and monitoring. 30% of the population consumes 90% of health care resources

10. Retailing • & Finance • Customer service • Comparison shopping • Self-service • Special offers • Manufacturing • & Distribution • Faster time to market • One stop shop • Anytime anywhere care • Supply chain integration • Entertainment • & Media • Customised products • Home services Consumer Experiences In Other Markets Affecting Expectations From Healthcare Greater variety of providers, products and services e.g. expensive health plans and alternative medicine services Healthcare Power patients have increased access to computers and information through multiple channels to seek and analyse health information Health care that is customised to monitor, diagnose, educate, and intervene regardless of location or time-will be common. Freedom to make own decisions

11. Technology…….Enables it Economics………………Require it Demographics………….Demand it Convergence In Healthcare Enables Personalisation, Targeted Medicines, Virtual Patient Monitoring, Enabling A Preventative Approach To Healthcare Disease Management Bio Chips: Controlled Released Telemedicine Tailored Treatments- Genomic/Proteomics based Health Management Drug Delivery Predictive tests Remote Patient Monitoring Gene Mapping & Functional Analysis Preventative Programmes Nanotechnology Delivery Systems IT / Digital Information Systems Life Sciences Medical Technologies Medical Devices

12. Riding On A Wave Of Technical Innovations Healthcare Will Change From A “Find It And Fix It” System To A “Wellness Tracking” System Sharable Personal Health Records Current Healthcare Systems Suffer from the “RADAR” Syndrome Future Healthcare Systems Must Apply a “GPS” Logic Telehealth for virtual interactions • Patient Appears (falls sick) • Patient is treated “find it and fix it” • Patient is discharged Web portals to EHR Systems Patient then disappears from radar screen Patient Scan Good Chronic Disease care • System oriented to acute illness • Patient’s role not emphasised • Follow up sporadic • Prevention overlooked Patient Support Tools Provider Support Tools Home monitoring devices Personal Health Records Web- based education and support Electronic Health Records (EHRs) Chronic Disease Management Systems Personal Digital Assistants Disease Management Program

13. ...From Centralised – Hospital Fragmented Treating Sickness Provider Centric One Size Fits All Integrated & automated Personalised Medicine Patient Centric Preventing Sickness – “Wellness” De-Centralised–Shift to Community Approach Monitor Patient Flow Objective Focus A Modern Healthcare System Is On The Horizon Demanding A Healthcare Paradigm Shift ...To Diagnosis & Treatment Less invasive, Preventative, image based Invasive Therapeutics/Diagnostics/ Devices “Theranostics” Tools

14. Healthcare Companies (Devices, Pharma, Biotech, Diagnostics, IT) Threats Arise From Unconventional Players Outside The Traditional Healthcare Boundary Biotech is the changing face of agriculture. Biotech crops were planted in 18 countries in 2004. By 2010, it is projected that 15 million farmers will grow genetically modified crops on up to 375 million acres in 30 countries. 2010 : Integrated Healthcare Management in the US has been launched as the systematic application of processes and shared information to optimise the coordination of benefits and care for the healthcare consumer Agriculture & Food Companies Chemical Companies Employers & Government 2010:Roche and Toyama Chemical enter licensing agreement to develop potential breakthrough drug to treat rheumatoid arthritis Telecommunication Companies Consumer Product Companies 2010 : SUPERMARKETS in the UK are increasingly becoming one-stop-shops for everything by branching out into healthcare, with everything from in-store pharmacies to blood tests, blood pressure checks and health checks on your lungs. 2008: Virgin Group launched a new healthcare network. The first of six “one-stop shops” clinics will offer extra NHS and private services including dentistry, screening, a pharmacy and complementary therapies alongside GP practices. Ultimately, offering wider options for patients. 2010 : Orange launches "Connected Hospital", its first e-healthcare offering designed to improve patient comfort and care quality

15. A Look At The Future: Patient Centric Health & Wellness Care eHealth Advisor Network Web of Care NanoCare Mobile EHR Friends & Family Implantable eCare Smart eHomes Wearable BioSensors Health Robots Decision Support EcoMedicine Doctors & Medical Team NanoMedicine Pre-emptive Medicine PatientGP Online Support Communities Coaches & Advocates Regenerative Medicine Digital Medicine My Health & Wellbeing Databases Self Care Diet & Nutrition Humour & Joy Lifestyle & Stress Reduction Exercise & Fitness Mind Body & Spirit

16. Hot Spots And Emerging Geographies Canada Relatively high government spending on healthcare, small number of local market players, sizeable market UK/Scandinavian Countries High government spending on healthcare IT, large market, high number of healthcare IT players. Hong Kong High government spending on healthcare, small domestic market, gateway to China Germany/Switzerland High spending on healthcare, large market with not too many market players, increasing focus on eHealth and digitisation U.S. Huge healthcare market and growing, large opportunities, niche players will be more successful India Large market, low operating costs, excellent local skills, high local competition, Distribution hub to the Middle- and South-East of Asia Venezuela & Colombia Constituting part of the Andean Region are the fastest growing countries in many HC categories due to large public investment Israel Computerized HMOs. Project to determine regulations/law for national EHR Sub-Saharan Africa Limited current government spending on healthcare IT, increases planned in the future. Private sector developing increasing focus on eHealth. Moderate number of players mainly operating from South Africa. Australia & New Zealand High government spending on healthcare IT, small number of local market players, increasing focus on eHealth and digitisation Brazil & Mexico Two largest healthcare markets in Latin America and growing at a sustained pace

17. PESTLE Analysis – Timeline 2010 2015 2020 POLITICAL Growing Political Focus and Pressure on Healthcare Increase influence by regulatory bodies Increasing harmonisation ECONOMIC Spend per capita on health globally grows Reduction in pharma growth (business model changes) Global ‘Not for Profit’ Pharma Supply for developing countries Divide between the EU, US and rest of the world grows SOCIAL Patient Centric Healthcare Ageing population Health awareness (prevention) Increasing pressure from patient groups Personalised healthcare Medical Ethics Raised consumer expectations Health education Increasing customer awareness TECHNO-LOGICAL Information Based Systems Genomic Drugs Internet Pharmacogenomics Direct to Patient Advertising Combined diagnostics and therapeutics Health card / Smart Cards Customised treatments Drug Design LEGAL Genetic Discrimination Therapeutics>Theranostics (Rx/Dx) Privacy Biogenerics/biosimilars Faster Drug Approvals Medical Errors / Safety ENVIRON-MENTAL Development of specialist therapy providers Mergers and Acquisitions Impact of HIV and other pandemics Biotech companies transition to Pharma companies

18. Opportunity Analysis – Major Areas (Europe), 2010-2012 High Revenues Projected Revenues In 2012 ($ Billions) Low Revenues High Low Growth Rate (2010-2012)