Tendências Tecnológicas com impacto na Cadeia …...10 Source: IQVIA Institute Digital Health...

Copyright © 2019 IQVIA. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States and various other countries.

Lisboa, 12 Janeiro 2019

Filomena Ribeiro dos Santos

Assoc. Director & Board Member IQVIA

Tendências Tecnológicas

com impacto na Cadeia

de Abastecimento

1Tendências Tecnológicas com impacto na Cadeia de Abastecimento | Filomena Santos | Jan 2019 | IQVIA

The Human Data Science Company

2

A IQVIA selecionou tendências tecnológicas com impacto na cadeia de Abastecimento Farmacêutica

Tendências Tecnológicas com impacto na cadeia de abastecimento

1. Tecnologias que aceleram a inovação no desenvolvimento de produtos

2. Tecnologias que promovem a evolução do interface com o paciente

3. Tecnologias que possibilitam novas formas de dispensa

Tendências Tecnológicas com impacto na Cadeia de Abastecimento | Filomena Santos | Jan 2019 | IQVIA

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Exemplos de aprovações da FDA em 2017 que representam avanços clínicos consideráveis

Brineura is a treatment for a specific

form of Batten disease, a rare disease

that can cause progressive

neurological impairments

Bavencio is a novel Anti-PD-L1 agent

in the treatment of merkel cell

carcinoma

Keytruda was approved to treat

patients whose cancers have a

specific genetic biomarker

Novartis's Kymriah CAR-T cell

therapy wins FDA approval as single

treatment for patients with acute

lymphoblastic leukemia

Rare disease Breakthrough therapy

Cell therapy Predictive Biomarker


5

Os novos lançamentos demonstram novos paradigmas


Características das Novas Substâncias Ativas aprovadas pela FDA em 2017

Predictive Biomarker (10)

Approval Based on Ph II (11)

Companion

Diagnostic (6) Single Arm Trial (4)

PRO Data on Label (18)

NAS Launches (42)

Orphan Designation (21)

Breakthrough Therapy (19)

Cell or Gene Therapy (2)

Sm

all

se

gm

en

ts

New testing

Clin

ical tria

l crite

ria

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Os Biológicos apresentaram um crescimento superior na últimadécada face aos não-Biológicos

2018

78%

22%

2008

32%

219

68%

199Biologic

Non-Biologic

European Biologics and small molecules

(Q3 2008-18) US$ Bn


664

70%

18%

82%

20182008

30%

1,008

Global Biologics and small molecules

(Q3 2008-18) US$ Bn

7

Biologic sales (Bn)EU Protection

expiry date

US Protection

expiry date

Expired (2023)

Expired Expired

Expired 2022

Expired 2018

Expired 2018

Expired Expired

Expired 2019

2019 2019

2024 2027

Expired Expired5,1

2,7

2,9

2,6

5,3

3,9

5,4

8,6

9,1

16,1

0,4

2,0

1,8

1,9

0,6

1,8

1,8

1,8

1,0

3,5

0,3

1,2

1,7

1,8

0,8

1,6

2,2

1,4

2,1

2,4

0 5 10 15 20 25

US Europe ROW

Rituximab (Mabthera)

Insulin glargine (Lantus)

Insulin aspart (Novorapid)

Etanercept (Enbrel)

Infliximab (Remicade)

Adalimumab (Humira)

Insulin Lispro (Humalog)

Immunoglobulin base (Privigen)

Bevacizumab (Avastin)

Trastuzumab (Herceptin)

Biológicos importantes que perderam ou estão a perderexclusividade

Global Top 10 Biologics SalesUS$ MAT Q3 2017


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Direct implications for community pharmacies

• Increased number of new specialty medicines, available only in the hospital

- Ability to make “rebate agreements”

• Increased importance in handling more complex products (e.g. cold chain)

- Financial risk in the event of incorrect handling

• Inventory management might lead to a very limited number of warehouse locations - sometimes not even one

in every country

- Ordering becomes more complicated

• Patient support needs are much higher for injectables

- Hospitals often have bottle necks to access

- Potential for injections in new types of locations and increased level of patient support services required

Indirect implications for community pharmacies

• High prices tend to drive search for savings in other areas

- Increased cost pressure on the pharmacies “core” business

Implicações para as Farmácias Comunitárias


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3. Tecnologias que possibilitam novas formas de dispensar




10Source: IQVIA Institute Digital Health Report 2017 (RHS); Recent research from the IQVIA Institute

O interface do paciente está a mudarAs ferramentas digitais de saúde revelam-se promissoras no futuro dos cuidados de saúde


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• Digital biomarkers are the use of connected

sensors, wearables and mobile devices and their

capture of biomarker data to predict the incidence

of disease or health conditions, track aspects of

these, or assess the effects and value of

treatments or interventions.

• The value of digital biomarkers derives from their

ability to be passively and continuously tracked to

explain, influence or predict health related

outcomes.

• Biosensors, as an overall category of devices,

collect information on a variety of health

parameters and vital signs by reading or

measuring energies from a person and transmit

that data via electric signals to be interpreted.

Os biomarcadores digitais impulsionam a recolha e armazenamento de informação do paciente

Source: IQVIA Institute Digital Health Report 2017Tendências Tecnológicas com impacto na Cadeia de Abastecimento | Filomena Santos | Jan 2019 | IQVIA

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- Over 318,000 health apps and over 340

consumer wearable devices are now available

worldwide, with over 200 health apps being

added each day.

- Health apps can be divided into two main

categories:

› those focused on “wellness management,”

› those which specifically focus on “health

condition management” which supply

information on diseases and conditions,

enable access to care and enable treatment

protocols.

- Apps can help in the remote monitoring of

human health, faster diagnostic testing,

monitoring use of medicines.

Number of Digital Health Apps 2013, 2015

and 2017

Source: IQVIA Institute Digital Health Report 2017

As apps de Saúde eram apenas gadgets, agora surgem como o standard nos cuidados de saúde


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- Artificial intelligence (AI) in healthcare is the use of

algorithms and software to approximate human

cognition in the analysis of complex medical data.

- The primary aim of health-related AI applications is

to analyze relationships between prevention or

treatment techniques and patient outcomes.

- Access to a data (self reported from the patient and

through the healthcare provider) is becoming more

common and available, allowing AI to be used more

to:

› Support the decision making directly to the patient

and via a Health Care Professional

› Change the methods of research and

personalization of medicine

A Inteligência Artificial como o motor do aumento da informaçãorecolhida


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• The pharmacists ”advantage” when it comes to data access is rapidly diminishing

- Historically the pharmacist was one of the primary handlers of patient information. Today, patients drug usage is

being tracked more efficiently by other sources.

• A significant limitation is that many patients still want the human “so what” interpretation

- There is still a need for face to face interaction provided by the pharmacist, especially within certain populations

(e.g elderly)

• AI can be a significant tool for pharmacists to support giving advice

- Can the pharmacist become the recognized expert on being the link between the patient and the AI tools?



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O relógio está a contar ...

A Diretiva dos Medicamentos Falsificados


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A prescrição eletrónica foi implementada em vários paíseseuropeus, trazendo benefícios aos Sistemas de Saúde

Source: university of oxford policy paper, 2016

Economic, health and social benefits of E-

prescriptions:

• Efficiency gains for prescribers, particularly for repeat

prescriptions

• Efficiency gains for dispensers

• Enables transparency, which makes doctors more

accountable for what they prescribe

• Reduction in false prescriptions

• Reduced error rates in medications

• Better accessibility of medicines

• Improved adherence as automated reminders

generated through e-prescription systems may help to

remind patients to pick up refills of their medication

• Improved convenience for the patient


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• Community pharmacy Seven Brothers in Finland

used digital tools to develop a new service model

in a community pharmacy in 2018

• Virtual shelves give information about products,

which can be ordered using a logistics robot

• A humanoid robot serves customers in the

reception

• The pharmacy uses a one-stop model where

every customer takes a queuing number when

entering the pharmacy. There are separate

queues for self-care customers, prescription

customers and those with an appointment.

• The customer can use live chat, videopharmacy,

netpharmacy or come to the pharmacy

• The whole dispensing process is digitilazed

Existe potencial para desenvolver Serviços e procedimentos das Farmácias Comunitárias


19Tendências Tecnológicas com impacto na Cadeia de Abastecimento | Filomena Santos | Jan 2019 | IQVIA

O E-commerce cresce 12% no mercado de retalho europeu

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O crescimento do foco da Amazon na Saúde esta bem visível

January 2018

Amazon-JPM-Berkshire

Hathaway announcement

February 2018

Launch of Basic Care (OTC)

June 2018

Acquired PillPack

July 2018

1. Reported talks with Xealth /

hospitals for a pre-fill of OTC

medical supplies for patients

upon discharge

2. Job posting to lead outreach for

medical-products manufacturers

and service providers

3. Reported acquisition talks for

MedPlus

September 2018

B2B sales now at

$10bn run rate vs.

$1bn run rate in

2016

Source: Fortune


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Connected pharmacies enables a move towards centralized pharmacy system, patient data and support systems

- Central system risk to change the ownership of data

- Central system enables a higher degree of use of Artificial intelligence both from the point of access to broader data and

spreading the development cost

- Central system increases the issues of data privacy

Pharmacy Automation offers opportunity to rationalize and save cost with the same or higher quality/less errors

- Pharmacy automation offers the ability to do new things previously not possible, allowing for new business opportunities

- However it requires investments, and new skills/training – not always possible to do alone

E-commerce opens up for new types of pharmacies e.g. ”Amazon”

- E-commerce builds on differentiation but requires scale

- In Europe, price advantages are only possible on self-pay – Consumer Health, OTC, and limited Rx


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• Os novos lançamentos caracterizam-se por medicamentos mais caros para populações-alvo mais reduzidas

• Novas tecnologias permitem terapêuticas mais direcionadas e eficientes

• A tecnologia para desenvolver e produzir Biológicos está a tornar-se mais madura


• Biomarcadores digitais promovem o aumento da monitorização dos pacientes

• As apps de Saúde estão a ser cada vez mais utilizadas por pacientes e profissionais de saúde

• Ferramentas online auxiliam no diagnóstico de pacientes

• A Inteligência Artificial como o motor do aumento da informação recolhida

3. Tecnologias que possibilitam novas formas de dispensar

• As Farmácias estão mais “conectadas”

• Prescrição eletrónica começa a ser o standard

• Potencial para diferenciar e expandir os serviços e procedimentos das Farmácias

• A Automatização nas Farmácias pode reduzir custos e aumentar a eficiência

• O E-commerce cresce e desenvolve-se apostando na diferenciação




Copyright © 2019 IQVIA. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States and various other countries.

Filomena Ribeiro dos Santos

IQVIA Portugal

Boa sorte na Vossa Jornada

e desfrutem!

Tendências Tecnológicas com impacto na Cadeia …...10 Source: IQVIA Institute Digital Health...

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