Presentation on the importance and impact of IoT Healthcare / Healthtech on the delivery of healthcare in Asia to the ETPL "IOT FOR HEALTH" PROGRAM cohort #healthtechasia

1. ETPL - IoT Healthcare Ÿ Powering The Future of Healthcare in Asia
8th April 2016 Ÿ Singapore Ÿ The Propell Group
ASIA HEALTHCARE
Powering The Future
@ThePropellGroup
#HealthTech

2. Julien de Salaberry
Co-founder & Managing Director
Galen Growth Asia: Asia’s HealthTech Connector!
julien.desalaberry@galengrowth.asia
@GalenGrowthAsia
www.galengrowth.asia
Founder & Chief Innovation Officer
The Propell Group
M: +65 9488 7334 Ÿ julien@propellgroup.biz
@ThePropellGroup
www.propellgroup.biz
Galen Growth Asia is an independent
organisation with the objective of
developing the healthtech ecosystem
across Asia Pacific through collaboration
between all interested stakeholders
The Propell Group is a boutique venture
investor and advisory firm focused on
early stage companies in healthtech

3. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
• HealthTech innovation is disrupting healthcare and its established players
• Technology is driving a new paradigm to create better health care
• New opportunities are opening to shape the new paradigm
• Developing countries can leapfrog their healthcare infrastructure limitation
• Healthtech innovation leadership role for Singapore
Healthcare is changing dramatically

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What is IoT Healthcare?

5. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
The convergence of digital technology with health:
ELEMENTS
Wireless devices
Hardware sensors
Bio-Sensing tech
Microprocessors
Integrated circuits
Internet of Things
Social Networking
Genomics
Personal genetics
Healthtech is the key driver
LEXICON
Wireless Health / mHealth
e-Patients / eHealth
Quantified Self / Self-tracking
Wearable Computing
Telehealth & Telemedicine
Personalized Medicine / QS
Point of Care Diagnostics
Connected Health
Big Data / Health Data
HEALTHTECH

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IoT Healthcare: Connected Health

7. “Healthcare isn’t a science problem,
it’s an information problem”
— Thomas Goetz —
Author of The Decision Tree: Taking
Control of Your Health in the New Era of
Personalized Medicine
Tech
Drivers
SECT ION 1

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• Data
• BioSensors
• Mobile Devices
• 3D Printing
• Frugal Innovation
5 Key Drivers of HealthTech

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Data: Insights to Transform Healthcare
Genomics
Next generation sequencing, data
management & analysis
Data Analytics
Data Analytics & Insights: working
with and mixing data sets
Public Awareness
Planning and Preventing: Using data
to reduce and prevent disease
Support Providers
Clinical & Non-clinical Intelligence:
Combining a greater variety of data
Digital Therapeutics
Patient Focused: Increase variety
and frequency of data
Health Eco-system
Collaboration: Pooling data from
many sources for bigger & better
results

10. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
Biosensing Wearables: Creating Context
Activity
Trackers
e.g. Fitbit, Misfit
Smart
Watches
e.g. Garmin, Apple
Smart
Clothing
e.g. Athos
Patches &
Tattoos
e.g. Zio, MC10
Ingestibles &
Smart Implants
e.g. Proteus
BioSensors
Devices that convert a
biological element into a
signal output
Wearables
Are on- or in-body devices
that enable user
experience

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Mobile Devices in Asia: Reach for Everyone
Source: Kleiner Perkins Caufield Byers, Nielsen
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Hong
Kong
Singapore Malaysia Australia China Thailand Indonesia India Philippines UK USA
Smartphone Non-Smartphone
DEVELOPED ASIA DEVELOPING ASIA OTHER
0
1
2
3
4
5
6
7
Hong
Kong
Singapore Malaysia Australia China Thailand Indonesia India Philippines Vietnam Japan S. Korea
Laptop/Desktop Mobile Device
Smartphone Penetration
Time Spent On The Internet
Average Number of Hours Per Day Spent by Internet Users on the Internet
Opportunity to Empower the Individual

12. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
• 3D printing or additive manufacturing is enabling both affordability and/or technical
leadership in medical device / hardware
• Rapidly moving from R&D and design activities to new therapies developing
around 3D printed products
3D Printing: Next Generation MedTech
AFFORDABLE MEDICAL EQUIPMENT
Glia Project - 3D printed stethoscope produced at
a cost of $5 performs as well as the $200
equivalent
LOW COST PROSTHETICS
University of Toronto, in collaboration with
Autodesk Research and CBM Canada, used 3D
printing to quickly produce cheap and easily
customizable prosthetic sockets for patients in the
developing world
DENTISTRY
Dentistry and orthodontics are already large users
of 3D printed devices with ~17 million clear
aligners produced p.a.
MEDICATION
Pharmaceutical company Aprecia, Spritam
(levetiracetam) is a new drug to control seizures
brought on by epilepsy. Approved by the FDA.
Uses 3D printing to create a pill which dissolves
more quickly on contact with liquid

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Micro sensor for long-term monitoring of cardiac
rhythms
Single-channel ECG recorder that is portable,
easy to use and low cost (FDA approved)
• Rolled out across Apollo hospitals in India
Point of care Dx:
Cost effective cervical cancer screening system
• Piloted in Nepal, Kenya, Mexico, USA
IV flow monitor for safe and accurate infusion
• Y Combinator Accelerator graduate
Reverse/Frugal Innovation: MedTech For All

14. Business
MODELS
SECT ION 2
“The business model clearly worked
- and up until 2001, ironically at
about the time of the human
genome breakthroughs, most would
have expected this trend to
continue. It has not. So we are
having to reinvent our industry.”
— Sir Andrew Witty —
CEO, Glaxo

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• Spending is inefficient or insufficient
• Increasing focus on outcomes, not volumes
• Patient empowerment is growing
• New business models are forming to address changes
• 76% of Fortune 500 companies are now in healthcare
The healthcare business landscape is shifting

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Partnership with Genomics England to mine information
to decode the genomes of 100,000 patients from NHS
patients with cancer and rare diseases to discover
personalised medicines:
• Year-long trial announced March 2015
Has announced 12 undisclosed partnerships with
academia and corporate:
• Signed collaboration with Pfizer for the study of Crohn’s
disease
• Signed a $60M deal with Genentech (Roche) for the
study of Parkinson’s Disease
Pharmaco Genomics: The future of drug design
The Past: Molecular screening libraries used by most large drug companies and academic centers
The Future: Identifying the root cause of, or critical aberrant protein associated with a particular disease
and use this template to design the antibody or molecule to block it

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Clinical Data: Next generation clinical trials
• Open-source platform that empowers researchers to design and
administer app-based health research
• Initial focus on breast cancer, diabetes, Parkinson’s disease, CV &
Asthma driven by leading teaching hospitals
• 5 year deal where AZ can access the patient-reported data to guide
R&D in respiratory disease, lupus, diabetes and oncology.
• Principal objective is to better understand patient experience and
perception
• Post launch real-time patient data from extremely large numbers of patients – n
equals millions
• Increasingly important data sets for market access and reimbursement
§ Velcade (J&J) for the treatment of Myeloma ($35,000 p.a.) was initially rejected by NICE
(UK). J&J agreed not to charge any patient not deriving benefit. Velcade was approved.

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New Entrants: Convergence of other sectors into healthcare
• Tech new entrants are disrupting the insurance business model
• Greater focus on disease awareness and prevention will create cost
advantages and greater customer centricity
• Convergence of digital and healthcare is creating significant
opportunity for technology companies to enter healthcare
• Tech and digital are lowering the barrier of entry into healthcare
• As the world pivots towards “virtualisation of care”, sectors including telco, tech and
retail are well positioned to offer disruptive breakthroughs
• Filling gaps between customer expectations and the current medical
infrastructure creates enormous opportunities for new entrants
Technology
Sector
Insurance

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Smart Nation: Next generation health system
• Preventative, personalized and participatory
• Enabling a rapidly growing ageing population
• Sharing the advantages and challenges of a modern health
system
• Hub and spoke configuration of assets
• Innovative way of determining who should do what & when
• Focus on outcomes rather than interventions
• Improve access to healthcare – capacity, capability & affordability
• Better allocation of limited resources
• Improve planning of future resources
• Harnessing technology to the fullest with the aim of collecting data and making sense of
information. Insights will contribute to shaping solutions that can help improve lives
• “Smart Health” will play an important role through opening new possibilities for integrating
data to manage the health system more effectively and empower citizens
Better
Governments
Smarter
Hospitals
Empowered
Patient

20. “For all emerging markets, the
conditions are very challenging.
But where we see challenges, I see
opportunity. In fact: our challenges
are your opportunities ”
— Joko Widodo —
President, Indonesia
Asia
PARADOXES
SECT ION 3

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Asia Paradoxes: Facing many healthcare challenges
Developed Economies: Rising healthcare costs is an ongoing challenge
Developing Economies: Lack of healthcare access is a growing problem
Challenges in
Developed
Economies
Challenges in
Developing
Economies
Rising healthcare costs
Ageing population
Lack of healthcare
access
Increasing chronic
disease prevalence
Lack of
infrastructure
Increasing chronic
disease prevalence

22. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
Asia Paradoxes: Unmet Needs & Underserved
1.1B people
50+ years of age by 2025
~3.7B people
51% of world’s population
lives in APAC
65M babies
Born each year (equivalent
to UK population size)
2B people
In consuming class by 2025
(~50% of whole of APAC)
2/3 global disease burden
For major chronic
respiratory diseases
Inadequate Infrastructure
India will take 85 yrs to achieve
OECD physician diversity
Regulatory Capability
China’s regulatory staff workload
20x relative to the US
Intense Competition
Both global & local
Affordability Levels
80% of developing APAC population
cannot afford solutions designed
for mature markets
Frugal Spending
Average healthcare spending
per capita
APAC
EU
US
$ 376M
$ 4,018M
$ 9,146M
Source: McKinsey&Company, December 2015

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Asia Paradoxes: Developed Asia Healthcare Challenges
Expenditure Time Bomb
Source: United Nations, World Bank, OECD, IMF, IPSS Japan
Percentage of Population aged 65+ Retirees per 100 Adult Workers
Predicted Change in Public Healthcare Spending as % GDP
0 10 20 30 40 50 60
Japan
Hong Kong
Singapore
S. Korea
China
Indonesia
India
2000
2050
0 5 10 15 20
Japan
S. Korea
China
India
Indonesia 2006-2010
2060

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• Continuing to deliver the standard of healthcare which is the envy of
neighbouring countries will hinge on the ability to innovate radically
• Growing emphasis on health outcomes will require greater access to
data to drive better insights
• Achieving this goal requires the harnessing and adoption of new
technologies and openness to competition from new business
models
• Clear business case for the creation of a healthtech technology and
business model development hub in SG
Developed Asia: Innovation Leadership

25. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
Asia Paradoxes: Developing Asia healthcare challenges
Immature Healthcare Infrastructure
Doctors (per ’000 population)
Non Communicable Diseases (All NCD Deaths per
100,000)
Nurses (per ‘000 population) RTAs (Death per 100,000)
Source: World Health Organisation
Large Unmet Medical Needs
899
785 775 767
651
619 604
560
443
359
326
0
100
200
300
400
500
600
700
800
900
1000
Philippines India Indonesia Myanmar China Malaysia Vietnam Thailand Cambodia Australia Singapore
38
25 25
21
19
18 17
15
9
6 5
0
5
10
15
20
25
30
35
40
45
Thailand Malaysia Vietnam China India Indonesia Cambodia Myanmar Philippines Australia Singapore
0.1
0.3
0.6
1.6
2.2 2.3
3.0
3.5
6.8
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Kenya Bangladesh India China Japan UK US France Germany
0.1
1.1 1.1 1.3
7.9 8.0 8.1
9.3
11.4
0.0
2.0
4.0
6.0
8.0
10.0
12.0
Bangladesh China Kenya India France UK US Japan Germany

26. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
% OOP: Private Expenditure on Health
% of Online Shoppers via smartphone
0
25
50
75
100
Asia Consumer / Patient: Seeking Choice & Value
Source: World Bank, Nielsen
31%
Thailand
25%
S. Korea
23%
Philippines
21%
China
20%
Malaysia
18%
Singapore
18%
Vietnam
16%
Hong Kong
14%
Indonesia
10%
Taiwan
10%
USA
10%
Australia
7%
UK

27. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
• Development path of mature economies health systems is not feasible
nor desirable for developing economies
• Leapfrogging over arduous & expensive development stages is only
practical way for developing economies to establish better health
systems
• Achieving this goal requires innovation in order to accelerate
development, be cost effective and be scalable
• Leapfrogging will be achieved through new technologies, new
business models and new behaviours
Developing Asia: Opportunity To Leapfrog

28. Asia
HEALTH TECH
“We have to link to what the global
trends are. This means looking at the
emerging sectors, verticals like
technology, healthcare, and biotech”
— Teo Ser Luck —
Minister for Trade & Industry, Singapore
SECT ION 4

29. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
HealthTech: Asia Startup Landscape
Nascent But Thriving Ecosystem
HealthTech Startup Categories
Big Data &
Analytics
4% Genomics &
Precision Medicine
3%
Consumer Health &
Wellness
18%
Navigating the
Healthcare System
20%
Patient
Engagement
19%
Practice
Engagement
14%
Sensors &
Diagnostics
17%
Telehealth &
Remote Monitoring
5%
HealthTech Startup Geographies
Australia
5%
Indonesia
3%
Singapore
9%
Malaysia
2%
Hong Kong
3%
India
29%
Philipines
2%
Vietnam
1%
China
40%
South Korea
1%
Thailand
1%
Japan
3%
Taiwan
1%
Source: Health Startups Asia, a The Propell Group company!

30. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
Venture Funding: Asia Key Trends
Noteworthy Asia HealthTech Funding Rounds
Target Category
Funding Size
($M) & Stage
Principal
Investor(s)
Guahao (CH)
Navigating The
Healthcare System
394.0
Series D
• Tencent
• Hillhouse Capital
• Goldman Sachs
Practo (IN)
Navigating the
Healthcare System
90.0
Series C
• Tencent
• Google
• Sequoia
Portea Medical (IN)
Sensors &
Diagnostics
37.5
Series B
• Qualcomm
• IFC
• Accel Partners
Meet You (CH)
Consumer Health &
Wellness
35.0
Series B
• Matrix Partners
• K2 Partners
PICOOC (CH)
Sensors &
Diagnostics
25.0
Series A
• Tencent
• Gobi Partners
1MG (IN)
Consumer Health &
Wellness
20.0
Series B
• Sequoia Capital
• Intel Capital
Target Category
Funding Size
($M) & Stage
Principal
Investor(s)
Lybrate (IN)
Navigating the
Healthcare System
10.2
Series B
• Tiger Global
• Ratan Tata
• Nexus Venture
Prenetics (HK)
Genomics 10.0
Series A
• Ping An
• Ventura Capital
ConnexionsAsia (SG)
Consumer Health &
Wellness
8.0
Series A
• NorthStar
Investments
• BioVeda
• The Propell Gp
Reka Health (SG)
Sensors &
Diagnostics
4.0
Series A
• Tembusu
Partners
Our Health Mate (SG)
Navigating the
Healthcare System
1.0
Seed / Pre A
• LeoTech
mClinica (PH)
Patient Engagement 1.0
Seed / Pre A
• KickStart
Ventures
• 500Startups
Source: The Propell Group!

31. ©2016 by The Propell Group - All rights reserved. Proprietary and Confidential.
Asia Healthtech: Accelerator Landscape
Most Asia accelerators have a broad sector focus
Next 12 months will likely see the launch of additional healthtech focused accelerators
• There are 100+ incubators &
accelerators across Asia –
virtually none are 100%
focused on healthtech
• Growing maturity of the
ecosystem vs. 115 healthtech
accelerators worldwide (87 in
the US)
• Putting Asia / Singapore on
the map
• Emergence of corporate
incubators with a healthtech
focus
Incubator! Accelerator!
Focused!
Broad!
Clearbridge
Accelerator
(SG)!
MetLife
(SG)!
Independent!
Captive!
JFDI Asia
(SG)!
BioFactory
(SG)!
SPRING SSA
MedTech
(SG)1!
SparkLabs
(KR)!
rockstart!
(SG)!
Modern
Ageing!
(SG)3!
Muru D!
(SG)!
Other Asia
Accelerators2!
Note 1: Zicom MedTacc and Med Tech Alliance, together with SPRING Singapore will co-invest S$60 million to develop promising medical technology ventures!
Note 2: A number of accelerators exist in Asia e.g. GSF India which operate on a similar model to JFDI Asia but have no deliberate focus on healthtech!
Note 3: Modern Ageing is a pre-Accelerator!
EVA !
(IN)!
AIA!
(HK)!
AIA !
Konica
Minolta!
(SG)!
Catalyst!
(AU)!
Source: The Propell Group!
T-Hub!
(IN)!

32. • HealthTech is disrupting healthcare and its stakeholders
• Technology is driving a new paradigm to create better healthcare
• New opportunities are opening to shape the new paradigm
• Developing Asia will innovate faster & leapfrog its infrastructure
Healthcare is changing dramatically