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How Optimi Systems deliver effiecnt and effective business plans

How Optimi Systems deliver effiecnt and effective business plans

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  • 1. The Optimi product and its uses © Optimi Systems Limited 2010
  • 2. What Optimi does •  Optimi enables life science companies to improve the efficiency of their planning processes and the effectiveness of their plans for sales and marketing •  Optimi provides the tools to assemble and analyse the data, development programmes to improve the skills of the staff writing the plans, and an environment for team coordination and effective management review •  Optimi is built round a scalable data model and process that enables a consistent view from global forecast down to activity plans for major accounts •  Optimi draws data from the underlying transactions systems (Financial, CRM, clinical, market audit) and provides outputs into the corporate financial and business intelligence systems © Optimi Systems Limited 2010
  • 3. The Optimi tools enable companies to: •  Map the incidence and progress of disease and the impact of alternative treatments so that they can identify where demand may be available to them •  Map the complex treatment delivery and funding processes, match them to the disease and treatment information, and to identify where they need to take action to enable their products to be purchased and used. •  Understand the connections, motivations and procedures of the people taking and influencing key decisions and where they can take action to get decisions favourable to their products. •  Provide a common framework for actions, a consistent repository for market information, analysis and decisions, and planned actions, enhancing teamwork and effective management review. © Optimi Systems Limited 2010
  • 4. How Optimi fits with other systems Corporate financial management Corporate business intelligence / reporting The Optimi products Country portfolio for Major account Marketing planning Account selection product planning and strategy Optimise investment by country Competitive situation, Product portfolio for Market analysis, strategy selection, Account opportunity account decision making positioning, actions plans, financial forecasts analysis, strategy country at a product / country or region level process, account strategy selections, target setting Optimise investment by product and implementation plan Skill development processes Clinical management Financial and market CRM / closed loop selling systems systems audit systems Performance dashboards Cycle plans and KPI’s Investigator relationships Market research data Product sales by Sales rep diary hospital / brick management Sales by product / New product tracking Call plans customer Hospital / brick Indications / registrations Selling costs Doctor prescribing status tracking Doctor profile Clinical differentiation Marketing investment Webs / E- Call Sample Call Averts Events Health economics blogs detailing centre tracking report Market audits indicators © Optimi Systems Limited 2010
  • 5. Optimi processes and components © Optimi Systems Limited 2010
  • 6. The Optimi planning process flow Market data Financial data Customer data (ERP / Data warehouse) (CRM/ data warehouse) (various sources) Input including market audits, research studies Including sales, costs and profitability by Including size, capabilities, organisation product, market segment, geography and and procedures, company’s contacts and competitor analysis and informal sources customer relationships Transform and group into standard definitions for product, units, customer, and market Transform Integrate into models of markets and segments, customers and channels. Quantify market dynamics of segment, customer and channel Customer and channel Investment and results Market situation Alignment of sales and marketing effort to Quantified competitive situation and Attractiveness and business strengths with Analyse customer / in channel level of potential and results in relation to profitability In each market segment effort Market strategy Positioning Messaging By segment, channel, customer Proposition and benefits Content and medium Plan Action plan Investment Impact on sales Impact of investment on market share, What when and who Resources required, costs and timing persistence and decay Integrate and optimise mix and timing of possible actions Quantify Product P&L and ROI for 3-5 years projection Forecast Country plan Global product plan Customer plan Aggregate and optimise product portfolio in Aggregate and optimise product for group of Aggregate and optimise product portfolio for country geographies a customer © Optimi Systems Limited 2010
  • 7. Optimi modules to integrating the total process All components are available in English Account strategy and account planning tools and account planning e-learning are also available in French, German, Spanish, Italian and Russian Global product situation (Therapy maintenance) Country situation (Country maintenance) Global marketing Marketing planning management Plan for product in and account strategy Account strategy country for each country (Marketing planning) (Account management) Country marketing management Account planning Country portfolio Product portfolio Account plans for for each product for each country strategic accounts (Account plans) © Optimi Systems Limited 2010
  • 8. The benefits of Optimi © Optimi Systems Limited 2010
  • 9. Optimi planning delivers process and profit improvement How much time do you spend setting-up, modifying, and aggregating spreadsheets and presentation slides? How often do you lose control over where the numbers come from, or on what assumptions they are based? Focus on business choices not plan Optimi provides you with mechanics • Clear connection between assumptions, choices, and outcomes • Visible accountability for decisions • Version control and traceability • Simple update for forecast revisions and new year • Accessible from any secure intranet location • Integrated skill development Can you describe clearly where your opportunities are and what they could be worth? Do you understand how your resources are aligned to these opportunities and how productive your investments have been? Align resource and incentives to Optimi enables you to opportunity • Identify market opportunity by location • Analyse current business compared to the market by location and product • Analyse current business compared to amounts invested • Analyse allocation of sales resource compared to opportunity • Analyse resource mix in relation to market opportunity • Focus investment on opportunities with best growth Can all of your functions and every level of management see the same picture? Can they all contribute their insights to improve the plan? Optimi delivers Develop and deliver better products and • Shared process between marketing and sales • Product marking plans linked to sales plans services • Data shared consistently across the organisation • Local market insights captured in a consistent way • Linkage of product features, customer types, sales effort and results • Identification of what works and what needs improvement © Optimi Systems Limited 2010
  • 10. Examples of the use of Optimi © Optimi Systems Limited 2010
  • 11. Responding to changes in management of purchasing by major hospitals - Diagnostics in Europe Hospitals are merging and developing purchasing processes that give them greater control of supplier and product selection. For example in Germany 8 major national chains now run over 120 hospitals, in France public hospitals have merged by city so Paris now Situation has 34 hospitals under common administration, in UK hospitals over 500 hospitals have been merged into 179 trusts. The sales force, used to selling on clinical performance to doctors, must now also sell on economic performance to administrators. Understand the development of the new organisations and their relative importance in the market. Understand the new decision making processes and the key decision makers involved. Provide national and regional sales management with the tools to plan Business solution strategy and allocate resource in the new situation including realigning the sales force to reflect the new customer organisation. Provide a mechanism to co-ordinate activities with customers that have a wide geographical spread of hospital locations. Increase the skill level of sales staff in managing larger and more complex sales on an economic as well as a clinical platform. For 18 counties in Europe. Identified major hospitals groups (accounts) and buying groups used by independent hospitals to gain purchasing leverage on suppliers. Assessed the relative buying power of each major account. Aggregated sales and call activity by Project scope hospital management group to establish the relationship between potential, effort invested and results achieved for each account. Worked with sales management to develop new strategies. Worked with sales forces to develop account plans for major accounts and to change selling processes. Tools Skills Key Optimi Data integration for sales data, call data, and market data E-learning and case study - Introduce concepts and test understanding Account portfolio analysis tools to develop strategy Sales management workshops – Develop strategy by country capabilities used Account DMU analysis to understand buying process and Account manager workshops – Embed planning and new selling skills relationships with key decision makers Account planning tool to develop implementation plan Greater clarity as to the relative importance of accounts and the competitive situation within them Business benefits Clear account level strategy for each country and the allocation of resource in line with that strategy Fuller understanding of the decision making process in each account, and of the product proposition and relationships required Clear action plan for each account for the implementation of the national strategy Improved coordination between sales management and all of the people interacting with any part of each major account © Optimi Systems Limited 2010
  • 12. Structure for account management project Senior manager sponsorship Signed off by Regular overall Set-up workshop •  Facilitated by Miol senior team review process in each region Data collection & analysis Market & sales Sales force Financial data Account data •  Facilitated by Miol data data Managers’ programme Account Managers’ •  In English screening, E-learning on workshop Coaches’ •  Facilitated by Miol overall process workshop selection Planners’ programme •  In local language E-learning for Planners’ Implementation •  Facilitated by coaches planners workshop to and further plans •  Coaches facilitated by Miol develop first plan © Optimi Systems Limited 2010
  • 13. Consistency in product marketing plans – Pharmaceuticals in emerging markets Following a merger the client wanted its major products managed on a global basis for greater consistency. The product and business plan process needed to deliver global consistency to the maximum extent possible, but have flexibility to accommodate local Situation conditions where necessary. The project needed to be roll out with considerable speed and at low cost. Excel spreadsheets and Powerpoint slide had been the tools used historically. Define a consistent process that provides the output necessary for corporate consolidation and the management review processes while accommodating the diversity of the countries involved. Provide the tools to facilitate the process. Provide a skill enhancement Business solution process so that product managers and the country and regional marketing management understand how to analyse their market, select suitable strategies, develop implementation plans and make financial forecasts based on those plans. 75 countries in Asia, Eastern Europe, Middle East, Africa and Latin America with over 1,000 product managers. Many had medical qualifications but limited commercial experience. Project scope E-learning course on marketing planning integrated with a detailed case study using the planning tool to test understanding for product managers and marketing managers. Workshops building on the case study and transferring the learning into real business situations. A web based planning tool enabled central definition of the market and assumptions to be merged with local market information to provide a product / market specific analysis, development of strategy and implementation plan and financial forecast. Tools Skills Key Optimi Definition of market, products and global strategy E-learning and case study - Introduce marketing and planning concepts capabilities used Definition of country treatment delivery and funding and test understanding for product and marketing managers Market analysis for product in country Strategy development, creative implementation and team building Strategy and action plan development workshops based on case study material and real business situations. Sales and marketing investment plans, financial forecasts Remote management review and approval of plans Provided a consistent methodology and process across products and geographies Business benefits Common definitions and process promoted sharing and team building Plan development and review could continue when staff were working out of the office Identified widespread shortage of skills in market research and use of financial information Increased the transparency of business operations to senior management, although this caused significant resistance at country from country management © Optimi Systems Limited 2010
  • 14. Improving the effectiveness of new products introductions – Pharmaceuticals global The development of a globally consistent commercialisation plan for a new product from phase 3 trials. The plan needs to be solidly based on evidence and to develop a strong long term position for the product that will work in all of the major countries. Outside of Situation a small central group no resource can be dedicated to the product until it is closer to launch. Marketing time available from managing current products is limited and has to be used to maximum effectiveness. Use a central group with medical, marketing, market research and health economic skills. The core group to develop initial positioning. They then test this positioning and expand the market data in several rounds adding at each stage more major countries Business solution with disparate healthcare systems. Use the results to improve the positioning and prioritise countries for launch time and investment. Using the structured process to share with each new group to be involved the work done to that point and to be clear about the additional information and analysis required thus minimising the time required at a country level. Using the information and analysis done in the development phase to provide the platform for detailed launch plans. Management of the pre-launch phase for a product. See the flow diagram for the process followed Project scope Tools Skills Key Optimi Clinical and treatment delivery and funding maps Market data analysis capabilities used Market sizing and dynamics. Workshop facilitation Market life cycle analysis E-learning on marketing planning and market research Needs analysis and needs based segmentation Product positioning and pricing Global and country level strategy It is expected that this process will develop a more sustainable positioning for the product. It will also enable management to make better choices as to the order in which countries should introduce the product, and the most effective way to allocate the marketing Business benefits investment. The sales and marketing organisations that have to launch the product are better informed and able to target the marketing investment more effectively. The process minimises disruption to current operations. © Optimi Systems Limited 2010
  • 15. New product process Activity Process Output Pre-work Preliminary definition of market, competitors, patients Core definitions 3-4 Outline total process. Understand current clinical process / clinical map. Key needs by customer, provisional months Workshop 1 Identify unmet needs. Provisional product profile. Possible positions product positioning Quantified patient flows. Treatment delivery and funding map. Quantification of opportunity and Data Collection 1 country Market size and dynamics. Quantification of needs test of position in one market How robust is the provisional positioning. Should it be modified. Identification of major information gaps. Workshop 2 Identify major gaps in information Update of provisional positioning 3-6 Quantified patient flows. Treatment delivery and funding map. Quantified opportunity and test of Data Collection 4 countries Market size and dynamics. Quantification of needs. position in range of key countries months How positioning works in different healthcare systems. Significant Refined product positioning. Clinical and Workshop 3 differences and their impact. Identify key decision makers and economic data required to support position evidence required to support positioning. identified. Top level OL cascade E-learn / workshops for E-learning, case study and workshop to introduce country and Country marketing management introduced 6-12 other major countries marketing management to process and results to date to the process and product months Data collection other major Use of MP tool to quantify market. Needs based Quantification of opportunity and provisional countries segmentation. Map buying processes. Initial investment plan investment requirements by market Aggregation of market opportunity and investment Roll-out priorities and levels of investment by Global roll-out plan (workshop) needs. Preferred launch sequence and allocation of country. Major implementation issues identified Annual investment funds between countries from 2 Use MP tool for market analysis, strategy selection and Launch plan, critical issues, forecast investment Country marketing plan development of implementation plan. and results by country years pre- Use AS tool to assess relative attractiveness of launch Account selection accounts and current connections. Prioritise and Priority accounts identified and resource allocated allocate resource Use AP tool to map decision making. Prepare Detailed implementation plan by account to deliver Major account plans detailed implementation plan the country plan LAUNCH © Optimi Systems Limited 2010
  • 16. Integrating sales of multiple products to a hospital – Medical equipment in the UK A large medical equipment company that has built its business by acquisition and has six business units and over 40 major product lines most of which are being sold to common customers. Each of the Business units, and many of the product lines have retained Situation their own sales forces so that in some cases more than 40 sales people were involved on the same account. Despite the number of salesmen involved the relationships with the senior managers in most hospitals are weak. The company wanted to provide better integrated offerings that used the breadth of the product range to differentiate themselves from competitors They also wanted to reduce selling costs. The appointment of strategic account managers each covering 3 or 4 major customers with a remit to improve overall medium term Business solution sales performance in the selected accounts. They assembled and analysed information on the business and relationships with each of these key accounts. They understood and documented the hospital’s business situation and future plans and its decision making processes. They identified the senior management relationships that needed to be strengthened and activities that could raise the company’s profile in a positive way. Sharing this analysis with the Business Unit heads they identified major projects that would be more profitably tackled on a cross business basis and set-up cross product line teams to deliver them. Work with the new strategic account managers as a group and individually to understand their needs and guide their activities. Work Project scope with the project analyst to extract and organise data on the selected accounts from multiple systems. Validated the selection of accounts for strategic management. Collated public data on the hospitals and worked with the strategic account managers to identify critical issues for the selected hospitals and the business opportunities that could flow from those issues. Facilitated account team meetings to investigate opportunities and plan suitable responses. Tools Skills Key Optimi Data integration for sales and market data Workshops on strategic account management capabilities used Account portfolio analyser Complex data analysis Account DMU and relationship mapping Facilitation and coaching Account situation analysis Started to move from responding to requests for tenders and current quarter closings to identifying probable opportunities far Business benefits enough in advance to be able to build the necessary relationships, influence the tender content, and put together more complex and imaginative proposals. Identified many organisational and system issues that will need to be addressed to enable fully integrates sales and service delivery to major customers. © Optimi Systems Limited 2010
  • 17. Selling to diverse customers with many products over a complex geography – Vaccines in Russia Company sells a varied product range to several different types of customers including federal and state healthcare organisations, government agencies and companies, private health insurers, private companies and individuals. The states and many of the Situation government agencies and private companies are spread across a massive geography and many of the wealthiest areas are in locations that are hard to access. Demand is growing fast and the market is moving from serious supply shortages to a more normal balance. The company has a geographically based sales force with regional sales managers based at HQ. These Regional Sales Managers also managed directly the major accounts. The sales operation needed to be reconfigured an skilled to take advantage of the developing opportunities. Understand the customers and their needs. Prioritise the possible customers and develop a portfolio strategy. Determine the sales force organisation required to manage such a portfolio and the skills and support infrastructure necessary to effectively deliver this Business solution strategy. Assess 100 potential major customers over 7 product lines. Integrate the market, sales and sale force activity data available on these potential customers. Train the sales managers on account management processes. Facilitate workshops with sales managers to Project scope develop an overall portfolio strategy for customers. Train sales manager on the development of account plans and facilitated the construction of plans for selected major customers. Considered the overall performance of the sales force and made recommendations for the development of the organisation, skill levels and procedures. Tools Skills Key Optimi Data integration for sales calls and market data E-learning on account management and account planning (in Russian) Account portfolio analysis and strategy selection Data analysis capabilities used Account DMU and relationship mapping Workshop facilitation Account situation analysis The client understood the need for substantial change in the way in which major accounts are managed including the recruitment of dedicated account managers for major accounts. The project led to a reconsideration of the relationships between regional sales Business benefits managers, the new account managers and the territory sales representatives. The project identified major growth points and the realignment of resource required to deliver from them. © Optimi Systems Limited 2010
  • 18. New product introduction – New hospital product in UK A VC backed US pharmaceutical company making is first ever product launch. They wanted to run a substantially virtual operation and had contracted a sales force for the launch phase. The product had many uses within a hospital setting particularly in post Situation operative care. In order to sell the product in most hospitals the company required to get the product onto each hospital’s treatment protocols and formularies. The sales force was too small to address more than 30% of the available hospitals in the launch phase, and had two months pre-launch time for investigative work. Identify the group of hospitals into the trusts that controlled protocols and purchasing. Quantified the surgical throughput of each trust (in-patient and day case), and its capacity in terms of OR’s and consultants. Ranked hospitals in terms of potential to select the Business solution initial target list. Sales reps use account planning tool to record each account’s decision making process and key people, and to assess the time required to get the necessary approvals. Every 2 weeks the findings were summarised and accounts ranked in terms of potential and time to get access. At the end of the pre-launch phase management were able to review the quality of the implementation plans, and to make sales estimates based on a clear understanding of customer’s key decision points. One product, 10 sales representatives selecting 70 hospital trusts out of a possible 220. Project scope Tools Skills Key Optimi Accounts management Data set-up and analysis Facilitation and coaching capabilities used Account planning Clarity as to target accounts Clarity as to the key processes and events that customers had to do to allow them to purchase Business benefits Action plans for the sales teams with clear objectives, timing and responsibilities Management knew what specific actions they had to do in support of the sales team © Optimi Systems Limited 2010
  • 19. Developing marketing skills in emerging markets Following the introduction of a product planning process and development of planning skills it became apparent that in many emerging market countries the level of skill in market research and financial analysis was very low. In many of these markets there Situation were relatively few high quality market research agencies to whom the work could be contracted, and even where contracting was possible a higher standard of briefing and interpretation was needed. The managers concerned were widely spread geographically, and cost of delivery precluded extensive workshop based training. E-leaning modules on market research and financial analysis for pharmaceutical markets was developed using case studies and market analysis tools. The tutoring for the workshops was provided by an experienced market research for the country or local group Business solution of countries. The tutors were trained in a series of regional workshop. Using local tutors also made it possible to address issues of local language and issues relating to local sources of data. Product managers from 45 countries in Asia, Eastern Europe and the Middle East covering seven different therapy areas. Project scope Tools Skills Key Optimi Market analysis tool including market sizing, market E-learning modules on market research and financial analysis dynamics, segmentation and forecasting techniques for the pharmaceutical industry. Case study examples. capabilities used Workshop for course tutors Improved use of the data that was available in each country. Business benefits Better identification of situations in which additional research was required Better briefing of agencies and improved design of internally conducted work Better interpretation and use of the results of research A low cost but high impact programme © Optimi Systems Limited 2010
  • 20. The life science market model in Optimi © Optimi Systems Limited 2010
  • 21. The healthcare market The Optimi process enables sales and marketing teams to understand the issues in their markets and choices that they can make. The Optimi tools put data into a context and structure that gives an accurate understanding of their market. This model is built around the features that are unique to life science companies and the healthcare market. These unique features are: •  The involuntary nature of demand •  The complex and regulated purchasing process •  Influence chains outside of the control of the industry determine product usage To accommodate these special features Optimi organises data around four major themes: •  The clinical pathway •  Treatment delivery and funding •  Opinion formation and communication •  Company organisation, planning, investment and implementation processes © Optimi Systems Limited 2010
  • 22. Healthcare decision processes Optimi provides the skills and tools to analyse Clinical pathways •  The disease, diagnosis, severity, incidence by Buying decision demographics, and patient numbers by disease state. •  The needs of patients for relief from disease and symptoms and the tolerability of The demand for healthcare is driven by the treatment incidence of illness or actions to avoid illness •  The needs of prescribers and healthcare providers for efficacy of treatment and the management of patients The amount and location of total demand is largely outside the control of life science •  The classes of treatment and products companies available, and the extent to which they meet the needs of patients, prescribers and providers •  The regulatory processes over the provision of clinical services and the licensing of medical products Optimi map’s the incidence and impact of disease and alternative treatments so that planners can identify where demand may be available to them © Optimi Systems Limited 2010
  • 23. The clinical pathway Define key Identify key Identify product Quantify patent performance characteristics clinical needs numbers against needs and build clinical map How does each class of treatment perform • Disease definitions What are the needs of against each need How many patients are and stages • Prescribers there in each branch • Patient types • Patients How does the product of the clinical map. • Classes of treatment • Healthcare providers under consideration • Treatment outcomes • Funders perform against each What proportion of • Disease progression patients get each type need. How important is of treatment Select the each need, where In what areas does the characteristics and are there similarity product meet needs What are the cure choices specific to of needs, and where rates, remission and not currently met by therapy area do needs conflict. other treatments. relapse rates How are such Map the conflicts resolved. What non-product combinations that (service) features can best describe the meet needs. clinical processes © Optimi Systems Limited 2010
  • 24. Healthcare decision processes Optimi provides the skills and tools to analyse Managed Prescribing Treatment delivery and funding care Hospitals doctors •  The organisation for diagnosis and the delivery of treatment and the people and organisations involved in the clinical decision making process Buying •  The organisation for funding treatment and decision facilities and the economic decision making process Life science companies rarely sell directly to the •  The regulatory processes over the pricing and person requiring the treatment reimbursement of healthcare costs •  The financial and service requirements of The organisation and funding of the delivery of prescribers, treatment providers and funders, treatment is complex, and varies from country to and the extent to which they are met by life country science companies and their products Optimi map’s complex treatment delivery and funding processes and matches them to the disease and treatment information to identify how products are purchased and used. © Optimi Systems Limited 2010
  • 25. Treatment delivery and funding pathways Where is treatment delivered Specialist out- Hospital inpatient Specialist centre patient treatment treatment treatment Point of initial diagnosis Community Community based Step-down treatment support services treatment centre How is treatment paid for Provision of funds Disbursement of funds •  Patient self-pay •  Patient self-pay •  Patient co-payment •  Patient co-payment •  Risk base insurance •  Reimbursement of patient paid fees •  Income based insurance •  Health maintenance capitation fee •  General taxation •  Block budget (hospital or community) •  Fee for service (full cost based) •  Fee for service (fixed tariff) •  Fee for service (tariff plus selected costs) © Optimi Systems Limited 2010
  • 26. Healthcare decision processes Opinion formation Life science products require Optimi provides the skills and tools to understand and communication a large number of clinical and Clinical Economic Patients commercial approvals before •  Key organisations that control or influence clinical they can be used and economic regulatory access to markets, medical education, and treatment and purchasing Much of the information used processes in these processes is •  The approval and decision making processes generated by or required to enable the product to be purchased communicated outside of the and used Managed Hospitals Prescribing direct control of the care doctors companies •  The individuals within these organisations that have a significant role in the decision making process •  The relationships between the people in the Buying decision making processes decision •  The strength and nature of all the relationships that the company has with decision makers Optimi shows the connections, motivations and procedures of the people taking and influencing key decisions © Optimi Systems Limited 2010
  • 27. Influencing opinion and actions Political processes Research Medical Healthcare Healthcare Patient science and professional funders policymakers organisations clinicians bodies “This can be done” “This is what we can afford” “This is what we want” Community Medical Senior Hospital medicine journals doctors management management “This is best practice” “This is what its worth” Health Medical Clinical economic meetings protocols assessments Medical Formularies Medical Public professional and buying Schools Internet internet “This is what you can do” practices Prescribing Patient doctor Pharmacist © Optimi Systems Limited 2010
  • 28. Healthcare decision processes Product Communications and account Relationships Optimi tools provide the facilities to plans +/- 10 products •  Record assumptions, decisions and action plans 100 countries 100,000 institutions 2,000,000 doctors •  Track plan development, reviews and approvals Service and pricing •  Provide controlled access on a global basis Product Life science companies need to performance coordinate activities for 10-20 •  To provide action plans by team / individual products in 100+ countries across •  Forecast the financial consequences of actions numerous business functions •  Enable the aggregation of plans and forecasts Actions taken can have long term impacts and be hard to reverse •  Retain the history of plans for future reference Actions taken in one country have •  Enable updates and revisions as new information impacts in many others is available Optimi provides a consistent repository for market information, and record of analysis, decisions, and planned actions to enhance teamwork and effective management review. © Optimi Systems Limited 2010
  • 29. Healthcare decision processes Product Opinion formation Communications and and communication account Relationships Clinical Economic Patients plans +/- 10 products 100 countries 100,000 institutions 2,000,000 doctors Service and pricing Managed Prescribing Product Treatment delivery and funding care Hospitals doctors performance Clinical pathways Buying decision © Optimi Systems Limited 2010
  • 30. Clinical and funding interaction – 6 basic models Prescriber is a relatively independent agent paid on a fee for service or capitation basis that excludes drug costs. Drugs funded by patient self pay, full cost of drug reimbursement Individual insurance, or relatively unconstrained block budget for drugs. Prescriber typically works in community medicine or as an independent specialist. Drugs are supplied through the retail chain. Prescriber is normally contracted to funder. Prescriber is paid on a fee for service or capitation basis that either includes drug costs or drug costs are funded when prescribing is Managed care compliant with funder protocols and formulary. Drugs are supplied through the retail chain. Prescriber is either an employee of, or contracted to, the institution and works within the medical protocols and formulary established by the institution and / or its funders. Funding Institutional is typically through a fee for treatment or procedure or block budget basis. Drugs are usually purchased directly by the institution. Purchase or leasing of capital equipment and related supplies and services by institutions and individual prescribers. Funding is either by way of direct capital budget, allocation of Capital block budgets, or built into fee for treatment pricing. Operates within the individual, Self selected and managed care and institutional areas paid for by patient mainly through influencing the Consumer with little or no Generic protocols and formularies of funders medical inputs and institutions, or through the supply chain. © Optimi Systems Limited 2010