AMGEN S APPROACH TO VALUE- BASED HEALTHCARE IN EUROPE

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Sandra Carson
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1 AMGEN S APPROACH TO VALUE- BASED HEALTHCARE IN EUROPE HERB RIBAND VP INTERNATIONAL POLICY & GOVERNMENT AFFAIRS 16 OCTOBER 2017

2 TODAY S DISCUSSION FOCUSES ON THREE TOPICS 1. Mounting healthcare system pressures in Europe require new approaches to innovation and healthcare delivery 2. Europe can ensure sustainable, high quality healthcare systems by improving value ( value = improved patient outcomes / total cost ) 3. To achieve this we need to build win-win partnerships to measure and improve outcomes and recalibrate the policy environment 2

3 AGEING EUROPEAN POPULATIONS FACE A COSTLY AND GROWING BURDEN OF SERIOUS DISEASE But today live with unacceptably high variations in health outcomes 9x variation in radical prostatectomy complication rates within a country 7x variation in breast cancer re-operation rates within a country 4x variation in lung cancer 5-year survival across OECD countries Reasons: Focus on inputs (only), data fragmentation, clinical practice/care pathway variations, transaction-based incentives, different HTA/purchasing/cost containment mechanisms, etc. Health systems need to reduce inefficiencies and drive improved outcomes in relation to all 100% of HC budgets Source: EFPIA Healthier future (2016), citing BCG analysis of OECD and WHO data (2014) 3

WE NEED TO REORIENT THE THINKING IN EUROPE ABOUT SUSTAINABLE

Enhancing Value Innovation not affordable Focus on short-term

budgets) Disregard for quality & outcomes variations

patients and society Systems measure and improve outcomes in

4 WE NEED TO REORIENT THE THINKING IN EUROPE ABOUT SUSTAINABLE HEALTHCARE SYSTEMS From (today s focus): Managing Cost To: Enhancing Value Innovation not affordable Focus on short-term budget impact Systems measure inputs (spending, silo d budgets) Disregard for quality & outcomes variations Innovation that enhances quality and efficiency Value to patients and society Systems measure and improve outcomes in relation to total cost Holistic approaches to reduce variations and improve outcomes 4

WE CAN ENHANCE VALUE BY IMPROVING PATIENT OUTCOMES RELATIVE TO TOTAL COST VALUE 1 = Patient-relevant health outcomes achieved Cost of delivering the outcomes Improve outcomes Reduce overall costs

5 WE CAN ENHANCE VALUE BY IMPROVING PATIENT OUTCOMES RELATIVE TO TOTAL COST VALUE 1 = Patient-relevant health outcomes achieved Cost of delivering the outcomes Improve outcomes Reduce overall costs Increase value Starting point: Define, enhance and measure patientrelevant outcomes Better quality care can be less expensive over the long-term Better quality care at equal or lower cost leads to higher value for the system Value-based healthcare: Delivering highest value from a healthcare system point of view by focusing on best patient relevant outcomes/benefits 2 in relation to total cost to the healthcare system. 1. See the work of Porter et al: 2. Quality of life, improved productivity, cost avoidance, etc. 5

6 ENHANCING VALUE BRINGS BENEFITS FOR PATIENTS, HEALTHCARE SYSTEMS AND SOCIETY Health Status Survival Degree of health or recovery Process Time to recovery / return to normal activities Efficiency of care / treatment pathways (e.g., diagnostic errors, complications, ineffective care, waste) Sustainability Sustainability of health and avoidance of recurrences Reduced complications from therapy (e.g., care-induced illnesses) 6

7 AMGEN AIMS TO PROVIDE INNOVATIVE VALUE-BASED HEALTHCARE SOLUTIONS to help ensure that all appropriate patients benefit from our medicines that are truly patient-centric and valuable in the real world that are integrated across the patient care pathway, personalized to patient conditions, circumstances and tailored to their preferences and maximize quality and efficiency, proven through real-world evidence. 7

AMGEN IS DEVELOPING NEW APPROACHES TO ADDRESS DISEASES WITH HIGH UNMET NEEDS Diseases High Risk CV Multiple

Support & Adherence RWD Capabilities & Analytics Role of technology and data Clinical trial recruitment PV and

Milestone mapping EHR decision support Predictive analytics Adherence solutions Bluetooth monitoring Sensors

8 AMGEN IS DEVELOPING NEW APPROACHES TO ADDRESS DISEASES WITH HIGH UNMET NEEDS Diseases High Risk CV Multiple Myeloma/ Oncology Osteoporosis Areas for Innovation Clinical Development Patient ID & Diagnosis Patient Support & Adherence RWD Capabilities & Analytics Role of technology and data Clinical trial recruitment PV and safety New clinical end points Digital biomarkers Genomic data mining and R&D FH Patient ID EMR Integration Milestone mapping EHR decision support Predictive analytics Adherence solutions Bluetooth monitoring Sensors and devices Connected health Tailoring tech to homecare RWD partnerships RWD science Emerging analytics technology Examples 8

9 AMGEN IS LAUNCHING VBHC PROGRAMS IN TEN EUROPEAN COUNTRIES Multiple myeloma patient care pathway High risk CVD patient identification; adherence Cancer/bone mets care pathway Osteoporosis patient identification; adherence 9

CASE STUDY (UK): IMPROVING THE CARE PATHWAY FOR

Cancer Centre NHS Foundation One of UK s largest

FB, native of Liverpool; 46 years old Small business

10 CASE STUDY (UK): IMPROVING THE CARE PATHWAY FOR CANCER PATIENTS WITH BONE METASTESES Clatterbridge Cancer Centre NHS Foundation One of UK s largest cancer networks Serving 2.3 million people Mrs. FB, native of Liverpool; 46 years old Small business owner, wife and mother Diagnosed with metastatic breast cancer 10

11 PREVIOUSLY THE SITUATION WAS SUBOPTIMAL FOR ALL STAKEHOLDERS Travelling ~2 hours to hospital Personal / travel costs ~ 200/mo. Inferior IV therapies at hospital Chemo unit and beds at capacity National targets at risk ( fines) Hospital costs 8-10X higher NHS QIPP program (2012--) Seeking ~ 20 billion in savings Difficult to achieve! PATIENT HOSPITAL NHS 11

administration; reinvest cost savings in innovation Safety first: focus on patient safety-health with

12 A REDESIGNED, PATIENT-CENTRIC SERVICE AIMED FOR BETTER CARE, CLOSER TO HOME Patient choice: hospital, local clinic or home injection via mobile nurses Hospital efficiency: outpatient pharmacy to supply drugs for home administration; reinvest cost savings in innovation Safety first: focus on patient safety-health with ongoing physician/nurse guidance Integrated approach: clinical governance and protocols for check-ups, tests, etc. 12

patients per national guidelines Reinvesting cost savings 100% patient satisfaction!

13 TODAY THE SITUATION IS DRAMATICALLY IMPROVED FOR ALL CONCERNED Cancer and bone complications under control Best therapy, convenient setting Saving time and each month Freed-up capacity to treat patients per national guidelines Reinvesting cost savings 100% patient satisfaction! Proof: QIPP can work well Lower overall costs 100% patient (voter) satisfaction! PATIENT WIN!! HOSPITAL WIN!! NHS WIN!! 13

THE VALUE OF THIS PARTNERSHIP HAS BEEN RECOGNIZED AT UK AND EU LEVELS Clatterbridge/Amgen partnership recognized as best practice 2015 National Pharmacy Mgmt.

14 THE VALUE OF THIS PARTNERSHIP HAS BEEN RECOGNIZED AT UK AND EU LEVELS Clatterbridge/Amgen partnership recognized as best practice 2015 National Pharmacy Mgmt. Forum (NHS payer conference) award: Best Industry/NHS Partnership -- Dept. of Health, NHS England now working to replicate this program 2016 EU Health Collaboration Award 14

approach Patients: Agree to share data Payers: Evidence-based reimbursement; pay for outcomes

15 TO BE SUCCESSFUL WITH VBHC, WE NEED ALL HEALTH SYSTEM STAKEHOLDERS TO ENGAGE AND COMMIT Industry Providers: Evidence-based medicine Policymakers: Outcomes-based HC systems Commit to a new approach Patients: Agree to share data Payers: Evidence-based reimbursement; pay for outcomes Demonstrate value Focus on patient outcomes Proactively engage stakeholders Optimize the product life-cycle 15

16 THANK YOU

Driving the value of health care through integration. Kaiser Permanente All Rights Reserved.

Driving the value of health care through integration February 13, 2012 Kaiser Permanente 2010-2011. All Rights Reserved. 1 Today s agenda How Kaiser Permanente is transforming care How we re updating our