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Personalized medicine:
some facts and a perspective




  Benjamin Sarda – Head of Marketing, Orange
  Healthcare
Agenda



    part 0   Orange Healthcare


    part 1   the evolution of personalized medicine


    part 2   down the road


    part 3   a prediction




2
Orange Healthcare
    joining up healthcare

       Orange helps modernize the healthcare infrastructure as well as
        healthcare systems as a whole, and equip healthcare facilities with
        communications solutions

       we are convinced that the medicine of tomorrow is connected
        medicine in which the management of healthcare data and medical
        information play an essential role

       at Orange Healthcare, we are using our expertise in communications
        to enable healthcare professionals to increase patient comfort and
        peace of mind




3   Orange Healthcare - 2012
in 2012, Orange has solutions to offer in 3 areas

           services for                remote healthcare                    preventive
            healthcare                    monitoring                         services
          professionals                    services

         professionals to                 professionals to                     patient
          professionals                       patients

    our services connect              our services allow patients    our tools allow individuals to
    infrastructure to improve         to keep in touch with          improve prevention by
    coordination, collaboration,      healthcare professionals,      managing their own health
    and information flow among        so professionals can           and well-being on a day-to-
    all the traditional players in    provide high-quality care      day basis
    the healthcare profession




    hosting and sharing of medical    remote monitoring of cardiac         drug authentication
    imaging                           arrhythmia


4     Orange Healthcare – 2012
                        - 2012       Orange Healthcare
Our value chain is tightly linked with key partners:
medical device manufacturers, health apps editors...


    Patients       Partners                     Partners
                    Medical      Orange           Health                  Healthcare
                                 Healthcare     Applications              ecosystem
                  Devices        Value
                               Chain




                                                Global
            Health               M2M,         Integration        Specific
          “Computin           Internation          ,           developmen
              g”                   al          Helpdesk,       ts (Security,
           (hosting)          backbones       services to         portals)
                              & Last mile     end users
                               Consulting, Integration

               Communication layer : voice and data transmission

5
1- The evolution of personalized medicine

           Today, personalized medicine is mainly
           about oncology


                                            Stakeholder concerns:
                                            Patients:   more effective with fewer side effects
                                            Pharmas: reduce drug failures in late clinical trials
                                            Regulatory: value for money




                                                   Today : over 50% of cancer
                                                   drugs in development are targeted




   6
1- The evolution of personalized medicine

          The emergence of new technologies allows for a
          larger view of personalized medicine




                 1           “Big Data”                       Prevention




                 2           Enabling access to information
                                                              Patient
                                                              empowerment




                 3           Monitoring patients anytime,
                             anywhere
                                                              New ways of
                                                              delivering care




   7
2- Down the road

          In a few years, DNA sequencing will be about $100


         $100 000 000



                                                                     Moore’s
          $10 000 000    Complete DNA                                law
                         sequencing cost
            $1 000 000




             $100 000



              $10 000




               $1 000
                         Jul 2002   Jul 2004   Jul 2006   Jul 2008     Jul 2010   Oct. 2011




   8
2- Down the road

          Predictive medicine for everyone.




   9
2- Down the road

          Personalized medicine in prevention:
          What are the advantages? The downside ?



                   2003            Today                       Tomorrow

          Human Genome Project
            International team                       Disease likelihood,
             $ 3 billion (US)                          adverse effects
                                                        Targeted drugs,
                                                       bespoke follow up


          Risk for payers:             Risk for patients:
          “health dictatorships”       What if I do not want to
          Competition between          know ?
          countries.                   57% of individuals at risk for Huntington’s
                                       Disease indicated an interest in testing before
                                       it was available. 16% took the test*

  10
                                           *Maat-Kievit et al. J Neurol Neurosurg Psychiatry 2000;69:579-583
2- Down the road

          Personalized medicine in prevention:
          The downside……




          How Super Bowl has made a $1,500 treatment (which
           costs $200) popular without any proof of efficiency
  11
2- Down the road

          Personalized medicine and patient empowerment
          The possibilities exist. What are the advantages?

         Medical imaging in general practice 2010
         US: 68m X-rays, 42m MRI
                                                 Patients generate data
         Fr: 50m (X-rays + MRI)                  with professionals, or alone
         Patient record
                                                       The medical cloud
         Veteran Health Administration: 5.5m
                                                        is up and running
         France: dossier pharma > 15m




         It is not just about
         raw data, but also
         corporate decision
         making tools


  12
2- Down the road

          Personalized medicine
          as new ways of delivering care



           Asthma                                   A better follow-up for
           300M people worldwide (5%                the patient
           population),
                                                    You’ve been using your
           what triggers asthma attack remains
           unclear
                                                    inhaler twice as much as you
                                                    did last month - is everything
           1985: asthma epidemic hits               ok?
           Barcelona.
           All attacks occurred near the harbour,   A better
           when ships were unloading soya beans.    understanding of the
                                                    external causes
                                                    You might want to avoid
                 2011: chips inside                 getting too close to that crop!
           asthma inhalers


  13
2- Down the road

           Personalized medicine:
           consequences of “Big Data”




                                        •Massive
                                        amounts of
                                        data

                                        •New kind of
                                        follow up, with
                                        new medical
                                        challenges

                                        •New kind
                                        of jobs

  14
3- a prediction

            Personalized medicine will require the end of two myths:
            the omniscient physician,
            and the patient-led revolution in healthcare

        Data will be available
            But does it fit an existing healthcare process ?
            Is there someone to monitor & interpret this data?
            Are physicians ready to use data collected by their patient?


        We will be facing two challenges
                 Over-expectation: omniscient physician
                 Be sure that healthcare pros are leading the way ,




   15
thank you




16

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Orange Healthcare - Personalised Medicine

  • 1. Personalized medicine: some facts and a perspective Benjamin Sarda – Head of Marketing, Orange Healthcare
  • 2. Agenda part 0 Orange Healthcare part 1 the evolution of personalized medicine part 2 down the road part 3 a prediction 2
  • 3. Orange Healthcare joining up healthcare  Orange helps modernize the healthcare infrastructure as well as healthcare systems as a whole, and equip healthcare facilities with communications solutions  we are convinced that the medicine of tomorrow is connected medicine in which the management of healthcare data and medical information play an essential role  at Orange Healthcare, we are using our expertise in communications to enable healthcare professionals to increase patient comfort and peace of mind 3 Orange Healthcare - 2012
  • 4. in 2012, Orange has solutions to offer in 3 areas services for remote healthcare preventive healthcare monitoring services professionals services professionals to professionals to patient professionals patients our services connect our services allow patients our tools allow individuals to infrastructure to improve to keep in touch with improve prevention by coordination, collaboration, healthcare professionals, managing their own health and information flow among so professionals can and well-being on a day-to- all the traditional players in provide high-quality care day basis the healthcare profession hosting and sharing of medical remote monitoring of cardiac drug authentication imaging arrhythmia 4 Orange Healthcare – 2012 - 2012 Orange Healthcare
  • 5. Our value chain is tightly linked with key partners: medical device manufacturers, health apps editors... Patients Partners Partners Medical Orange Health Healthcare Healthcare Applications ecosystem Devices Value Chain Global Health M2M, Integration Specific “Computin Internation , developmen g” al Helpdesk, ts (Security, (hosting) backbones services to portals) & Last mile end users Consulting, Integration Communication layer : voice and data transmission 5
  • 6. 1- The evolution of personalized medicine Today, personalized medicine is mainly about oncology Stakeholder concerns: Patients: more effective with fewer side effects Pharmas: reduce drug failures in late clinical trials Regulatory: value for money Today : over 50% of cancer drugs in development are targeted 6
  • 7. 1- The evolution of personalized medicine The emergence of new technologies allows for a larger view of personalized medicine 1 “Big Data” Prevention 2 Enabling access to information Patient empowerment 3 Monitoring patients anytime, anywhere New ways of delivering care 7
  • 8. 2- Down the road In a few years, DNA sequencing will be about $100 $100 000 000 Moore’s $10 000 000 Complete DNA law sequencing cost $1 000 000 $100 000 $10 000 $1 000 Jul 2002 Jul 2004 Jul 2006 Jul 2008 Jul 2010 Oct. 2011 8
  • 9. 2- Down the road Predictive medicine for everyone. 9
  • 10. 2- Down the road Personalized medicine in prevention: What are the advantages? The downside ? 2003 Today Tomorrow Human Genome Project International team Disease likelihood, $ 3 billion (US) adverse effects Targeted drugs, bespoke follow up Risk for payers: Risk for patients: “health dictatorships” What if I do not want to Competition between know ? countries. 57% of individuals at risk for Huntington’s Disease indicated an interest in testing before it was available. 16% took the test* 10 *Maat-Kievit et al. J Neurol Neurosurg Psychiatry 2000;69:579-583
  • 11. 2- Down the road Personalized medicine in prevention: The downside…… How Super Bowl has made a $1,500 treatment (which costs $200) popular without any proof of efficiency 11
  • 12. 2- Down the road Personalized medicine and patient empowerment The possibilities exist. What are the advantages? Medical imaging in general practice 2010 US: 68m X-rays, 42m MRI Patients generate data Fr: 50m (X-rays + MRI) with professionals, or alone Patient record The medical cloud Veteran Health Administration: 5.5m is up and running France: dossier pharma > 15m It is not just about raw data, but also corporate decision making tools 12
  • 13. 2- Down the road Personalized medicine as new ways of delivering care Asthma A better follow-up for 300M people worldwide (5% the patient population), You’ve been using your what triggers asthma attack remains unclear inhaler twice as much as you did last month - is everything 1985: asthma epidemic hits ok? Barcelona. All attacks occurred near the harbour, A better when ships were unloading soya beans. understanding of the external causes You might want to avoid 2011: chips inside getting too close to that crop! asthma inhalers 13
  • 14. 2- Down the road Personalized medicine: consequences of “Big Data” •Massive amounts of data •New kind of follow up, with new medical challenges •New kind of jobs 14
  • 15. 3- a prediction Personalized medicine will require the end of two myths: the omniscient physician, and the patient-led revolution in healthcare Data will be available But does it fit an existing healthcare process ? Is there someone to monitor & interpret this data? Are physicians ready to use data collected by their patient? We will be facing two challenges  Over-expectation: omniscient physician  Be sure that healthcare pros are leading the way , 15

Editor's Notes

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  4. presentation title presentation title presentation title Introducing the three pillars. Distribution: Two thirds: 20% to 10% Health management: list the diseases (diabetes, cardiovascular disease, kidney failure, etc.) En 2011: one billion euros; it is expected to double within five years.
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  6. presentation title The X Prize. $10 million to the first team to rapidly, accurately and economically sequence 100 whole human genomes The complete sequence of the human genome occupies about 1Gb.
  7. presentation title The complete sequence of the human genome occupies about 1Gb.
  8. presentation title The X Prize. $10 million to the first team to rapidly, accurately and economically sequence 100 whole human genomes The complete sequence of the human genome occupies about 1Gb.
  9. Left : Hines Ward, Right : Troy Polamalu Other eg : H1N1 in France, patients decided not to follow OMS recommandation, and to skip vaccination Conclusion : Patient community duty, physician must be part of the buzz, etc
  10. presentation title Patients like me : 100 000 patients in 2011, more than 500 diseases.
  11. presentation title In 1985 and 1986 an epidemic of asthma hit Barcelona. The city’s researchers first turned to the usual suspects, such as air pollution, pollen and mould. But a series of telephone interviews with the sufferers pointed to a much more precise cause. All the attacks had occurred by the harbour, and at times when ships were unloading soya beans. The cause was clear: soya-bean dust. So was the solution: the installation of filters on the harbour’s silos. Stories of success, like that of Barcelona, are rare. Part of the reason for that lack of clarity is inadequate data on where and when attacks happen. But David Van Sickle, an epidemiologist and medical anthropologist who once worked for America’s Centres for Disease Control and Prevention (CDC), has come up with a solution. This is to use the asthma inhalers carried around routinely by patients to record the time and location of symptoms as they happen. To develop his idea, Dr Van Sickle left CDC and founded a company, Asthmapolis, which is based in Madison, Wisconsin. The result is Spiroscout, an inhaler with a built-in Global Positioning System locator and (in advanced models) a wireless link to the internet. Whenever someone uses the inhaler, it broadcasts the location and time to a central computer. Asthmapolis plots and analyses the data, and sends weekly reports to participating patients and their doctors summarising the observations and making recommendations. Over the past three years Dr Van Sickle has run two pilot studies to test the new tool. Both of these showed useful improvements in patients’ management and understanding of their disease. They have also resulted in him questioning some longstanding theories about asthma, including the ideas that symptoms occur primarily at home and that the affliction is more prevalent in urban areas than rural ones. If those insights are confirmed, they will change the way asthma is managed. Commercialisation is planned for the autumn.
  12. presentation title Just like MRI, it’s a new way for healthcare.