Innovation and the Convergence of Technologies in the 21 st Century: The Century of Life Science

November 24, 1859

Charles Darwin HMS Beagle and Captain Fitzroy Natural selection Immutability of species Church of England and Darwin’s mentors “ Tree of Life” Adaptation: “Species theory”

HMS Beagle and Captain Fitzroy

Natural selection

Immutability of species

Church of England and Darwin’s mentors

“ Tree of Life”

Adaptation: “Species theory”

1700’s: Biology Science through the Centuries

1700’s: Biology

1700’s: Biology 1800’s: Chemistry Science through the Centuries

1700’s: Biology

1800’s: Chemistry

1700’s: Biology 1800’s: Chemistry 1900’s: Physics Science through the Centuries

1700’s: Biology

1800’s: Chemistry

1900’s: Physics

1700’s: Biology 1800’s: Chemistry 1900’s: Physics 2000’s: Life Science Science through the Centuries

1700’s: Biology

1800’s: Chemistry

1900’s: Physics

2000’s: Life Science

1700 Science through the Centuries 2009 1700 - Van Leeuwenhoek Microscope Biology 1859 – Darwin Natural Selection Biology 1866 – Mendel Genetics Biology 1880 - Pasteur Bacteriology Biology 1802 - Dalton Atomic Theory Chemistry 1869 – Mendeleev Periodic Table Chemistry 1950 - Pauling Chemical Bonds Chemistry 1983 - Mullis PCR Chemistry 2003 - Collins Human Genome Life Science 1937 - Turing Artificial Intelligence Physics 1900 - Curie Radioactivity Physics 1850 – Kelvin Thermodynamics Physics 1700 - Newton Gravity Physics 1953 – Watson & Crick DNA Biology

Human Genome and Human Proteome

Human Genome Project

Human Genome Project

Forbes’ 2009 Fastest Growing Technology Companies in America

Healthcare Reform BILL SIMILAR TO SENATE'S Months of talks yield $894 billion package HOW AN INSURANCE MANDATE COULD LEAVE MANY WORSE OFF Costs Keep Rising BUOYANT DEMOCRATS UNVEIL HEALTHCARE LEGISLATION

Personalized Medicine

Personalized Medicine - Tamoxifen

Personalized Medicine

Tamoxifen Efficacy by Genetic Profile Personalized Medicine Percentage of Patients Relapse-free survival Overall survival

The US Healthcare System is Procedure-Based

The US Healthcare System is Procedure-Based

Help is on the Way Medco's New Idea: PGx Program for Generics to Dispense 'Smarter' Treatments and Increase Savings Breast Cancer: Genetics may hold key to prevention, treatment SAEC Conducting Feasibility Gene-Association Study with HMO Network's E-Records Medco Study to Gauge Whether PGx-Based Plavix Dosing is as Effective as Higher-Priced Effient Generation Health Emulates the PBM Model to Optimize Genetic Testing for Payors National Survey Shows Physicians See Value in Genetic Testing

Medco's New Idea: PGx Program for Generics to Dispense 'Smarter' Treatments and Increase Savings

Breast Cancer: Genetics may hold key to prevention, treatment

SAEC Conducting Feasibility Gene-Association Study with HMO Network's E-Records

Medco Study to Gauge Whether PGx-Based Plavix Dosing is as Effective as Higher-Priced Effient

Generation Health Emulates the PBM Model to Optimize Genetic Testing for Payors

National Survey Shows Physicians See Value in Genetic Testing

Predicate device model Not innovation-friendly Critical Path Initiative User fees “ Rearview Mirror Navigation” Review and reform underway Regulation: Strategic Considerations

Predicate device model

Not innovation-friendly

Critical Path Initiative

User fees

“ Rearview Mirror Navigation”

Review and reform underway

1700 Science through the Centuries 2000 1700 - Van Leeuwenhoek Microscope Biology 1859 – Darwin Natural Selection Biology 1866 – Mendel Genetics Biology 1880 - Pasteur Bacteriology Biology 1802 - Dalton Atomic Theory Chemistry 1869 – Mendeleev Periodic Table Chemistry 1950 - Pauling Chemical Bonds Chemistry 1983 - Mullis PCR Chemistry 2003 - Collins Human Genome Life Science 1937 - Turing Artificial Intelligence Physics 1900 - Curie Radioactivity Physics 1850 – Kelvin Thermodynamics Physics 1700 - Newton Gravity Physics 1953 – Watson & Crick DNA Biology 2009

Science through the Centuries 1700 - Van Leeuwenhoek Microscope 1859 – Darwin Natural Selection 1866 – Mendel Genetics 1880 - Pasteur Bacteriology 1953 – Watson & Crick DNA Physics 1802 - Dalton Atomic Theory 1869 – Mendeleev Periodic Table 1950 - Pauling Chemical Bonds 1983 - Mullis PCR Chemistry Century of Life Science Biology 1937 - Turing Artificial Intelligence 1900 - Curie Radioactivity 1850 – Kelvin Thermodynamics 1700 - Newton Gravity

R&D is Our Future NIH Budget 1990-2008 0 10 15 20 30 5 25 $ Billion

Progress Over the Last 100 Years *per Merck Manual 1899 1900 Present Death Rate per 100K Population, US 1,500 <800 Leading Causes of Death Heart disease, infectious disease Heart disease, cancer Treatment, Diabetes* Arsenic Insulin, BGM Treatment, Asthma* Tobacco Corticosteriods Treatment, Cardiac Disease* Cocaine Statins, stents, CABG Treatment, Insomnia* Cannabis Zolpidem, eszopiclone

Innovation and the Convergence of Technologies in the 21 st Century: The Century of Life Science