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Mira Medicine Final Presentation
1. MIRA Medicine
Empowering complex clinical decisions
Lean Launch Pad for the Life Sciences
UCSF – Fall 2013
Team:
PA Gourraud
Raphaelle Loren
Jason Crane
2. team
PA Gourraud - Analytics Lead
Hustler, Hacker, Biostatistician
Raphaelle Loren - Business Lead
Hustler, Product, Marketer
Jason Crane - Software Lead
Hacker, Imaging Software
4. MULTIPLE SCLEROSIS: a case study
Challenge #1
Evaluating the disease
Challenge #2
Selecting the right
treatment at the right time
Bonus challenge
Education and communication
with the patient
5. MS Economics
500,000 patients in North America
18,000 neurologists
$7.8B in drugs prescribed every year for MS
Total cost to society $28B/year
Competitive market for therapies
6.
7. BEFORE LLP: Memorable quotes
If you can show
pharmacoeconomics, payors will be
really interested
Dr. G, UCSF Neurology
This would be a great tool to monitor
individual trajectories during clinical
trials
This is a great telemedicine tool!
T.M., J&J
Head of Innovation, Sanofi
Dr. S., community MD & entrepreneur
We’d be really interested in testing a
tool like this for Alzheimer’s
8. A RICH MAN’S PROBLEM
PRODUCT OR SERVICE COMPANY?
MS OR MULTI-DISEASE FOCUS?
13. What did we learn?
LESSON #1 - Our solution elicits advice and new ideas from almost all
interviewees
LESSON # 2
Focusing on a specific set of customers at a time will
give us more insights into their needs
14. 1 step back for 3 steps forward
visualize data
personalize
guidance
quicker
assessment
facilitate
patient/clinician
collaboration
improve
outcomes
Takes pride
in art of
medicine
See more
patients
Enhance
relationship
with
patients
Slow down
MS even
more
assess
history
explain
options
MS Bioscreen
10 min saving
per consult
simplify data
access
trial and
error
# of
options
1/3 visit is
about disease
education
no
personalized
guidance
Recommend tx
+ disease
management
tools/services
keeping up with
latest research
17. Key Alpha customer: Clinical researcher
Research Lab Director & MD
• Translational focus, lots of data
• Financially independent
• Can initiate clinical trials
18. Memorable quotes from LLP interviews
I can’t wait to see our research
on here. When can we install this
in our clinic?
Prof Miravalle, University of CO
I would love to test this tool
for epilepsy
Prof Steinman, Stanford
[I see] this tool as a fundamental step
into optimizing therapies in MS and will
lead the implementation here.
Dr P, UCSF
19. What did we learn?
LESSON #1 - Our solution elicits advice and new ideas from almost all
interviewees
LESSON # 2 - Focusing on 1 specific set of customers at a time will give us
more insights
KEY TAKE AWAYS
1. Validated of initial target audience for the existing tool
2. Our Holy Grail is the predictions and treatment recommendations
1. We can create value before we get to that Holy Grail
25. 2015
Cash reserve
2014
2016
2017
Series A
Series C
Series B
Product dev
Data +
analytics
MIRA MS custom installs
IP
MIRA MS
marketable
product
MIRA MS
2nd release
Pilot studies
US Pivotal Clinical Trials
US Interim Trials
Clinical trials
Research Ctrs
EMRs
Comparative
1st gen predictive & reco
2nd gen predictive & reco
Technology
Licensing
Provisional patents
Regulatory
/ IP
Multi-disease cognitive
system platform
3rd disease
2nd disease beta
1 disease beta
2018
IDE
from
IRB
Cat III
CPT
Algos patents
FDA – Class III –
510(k) with Clinical
Trials
CPT
codes
3rd gen predictive & reco
26. Mira Medicine
Custom tools for therapeutic decision-making in complex neurological disease
•
•
•
•
•
•
EMRs?
Data analytics company
Imaging processing
partner
Data aggregation
platform?
Pilot studies partners
(Med Center)
Design firm/data viz guru
-
Algorithm development
Imaging processing
Software design and
development
UI design and development
Data curation (at later
phase for baseline)
Sales, marketing, customer
development
Development team
AI team
Designer
Provider: Multi-data type
decision-making tool
Dedicated personal assistance
Co-creation of some of the IP?
Pharma = recruit new patients
and keep them on therapy
CROs: carefully design
studies with deep experts.
Recruit patients faster
Custom solution to visualize
individual health data in
context
- Reduce overall costs
- Improve efficiency of
clinical trials
- personalized tracking
- Provide personalized
therapeutic guidance
(pilots)
•
•
•
•
•
Medical Centers
Pharmas
VA
EMRs?
CROs (for targeted
therapies)
DIRECT
Awareness: conferences,
papers, online
Eval, purchase:
Bus dev 1:1 (initially PAG +
RDL)
INDIRECT: Partners such as
McKesson? Bundled with an
EMR? CROs? OEMs
Value-driven model (high personalization of offering)
Fixed costs low (no major cap ex to get started, and some costs are proportionate
to growth, while others are reduced through economies of scale.)
Cash-flow should be watched tightly at the beginning (net 30 after submission of
first invoice, unless we can negotiate % upfront)
Platform as a Service (+ 10-20% custom work)
Fee for service: Custom software development contract
Data curation services
Subscription: Maintenance/support contract
27. Business Model Canvas: MIRA
Key Partners
Problem
Image processing
IP attorney
CPA/CFO
Med Center for
studies/validation
NMSS
Key
Solution
Activities
Algos
Unique Value
Proposition
Software design and dev
Image processing
Customer development
Validation & pilots
1. Improved patient
outcome by
identification of optimal
treatment paths
2. Saves time
3. Improves relationship
Key Activity
Key
KOLs, case studies
Patient stories,
community
Expert dedicated project
lead
Thought-leadership
Customer
Segments
MS Neurologists
MS Patients
Medical Centers
CROs
AI team
DB and mobile dev team
Designer
Product
Regulatory
Channels
Pharma
4. Increases compliance
Resources
Channels
Payors
5. Increases probability of
success of clinical trial
(patient id)
OEM/Mobile tool
provider ePocrates?
NMSS
Cost Structure
Direct sales 1:1
Revenue Streams
Core team
Dev tools
Licensing from UCSF (equity at end of Series A)
Date: 06/05/2013
Customer
Unfair
Relationships
Advantage
Version Name: v02
- Pay per use (cash or credits) (Credits are
earned for sharing data)
- Fee for custom development
- Maintenance /upgrade subscription
28. Business Model Canvas: MIRA (bold items are validated)
Key Partners
Problem
Image processing
Med Center for
studies/validation
Data generating devices
NMSS
EMR
Key
Solution
Activities
Algos
Unique Value
Proposition
Software design and dev
Image processing
Customer development
Validation & pilots
1. Improved patient
outcome by
identification of optimal
treatment paths
2. Saves time
3. Improves relationship
Key Activity
Key
Resources
AI team
DB and mobile dev team
Designer
Product
Regulatory
4. Improve patient
retention; ROI on
infrastructure; decrease
penalties (MU2)
Customer
Segments
Get: Awareness
campaign (Conferences,
KOLs, articles)
MS Neurologists
Keep & Grow: Expert
dedicated project lead
Channels
Medical Centers
Purchasing
Pharma
Payers
Clinical researchers
Channels
APIs/existing systems
5. Visualize their own
data; realize translational
promise
Cost Structure
Direct 1:1 sales
Revenue Streams
Core team
Dev tools
Licensing from UCSF (equity at end of Series A)
Date: 06/05/2013
Customer
Unfair
Relationships
Advantage
Version Name: v02
- Pay per use (cash or credits) (Credits are
earned for sharing data)
- Fee for custom development
- Maintenance /upgrade subscription
Editor's Notes
[[ SLIDE 1 TITLE ]] We Are MIRA Medicine a Spin- off from UCSF Neuroloogy and a first genetration of precision medicine application in complex diseaseWe deliver aster more precise clinical decision at low cost !
[[ SLIDE 2 Presentation ]] I am Raphy Loren Business Lead I am PA Gourraud analytics leads I am Jason Crane Software Lead
[[ SLIDE 3 STARTING POINT ]] [Raphaelle] Starting the LLP we had a rich man’s Problem ! We had developed a workingprototype, and almost each time we would demo it, our audience would come up with new opportunities – from augmenting the physician-patient relationship to We couldn’t choose between the 2 problems we were proposing to solve: helping patients with MS and solve the flood of data from modern medicine to change practiceThe problemturned into a bit of schizophrenia: are we a product company OR are we a Service company ? Offering what we did for MS as a Service for other research centers?Or build a MS-centered product to respond to the needs of community neurologists?--- [PA] “ an Application “ [Jason] OR a data analytics platform for all the complex diseases --[Raphaelle] We adopted the Steve Blanks’ s Method – Go and ask people outsdie the Lab ! And answer where is value in the platform of in the data you analysed but also when is the value ?Now with the protot or later with more than the proto . Are we a service company or a product company? [May not have to choose] A platform and an app? How do we provide value now and later? [Tiered model]What is our disease focus? [Neurological? Auto-immune conditions?
Complex, life-long diseases are very difficult to assess, predict, and treat efficiently.Multitude of factors to assess diseaseDeluge of data on each factorLack of visibility in disease progression at individual level and trends at population levelLow-reproducibility of assessment (primary score is aggregate)Frustrating and costly trial and error (increasing number of DMTs)Knowledgegap between specialty centers and community providers
average lifetime cost of treatment $1.2M+ trends from other industries (patients and physicians benefit from visualizations in other fields : travel, finance, education, real estate)
[[ SLIDE 3 STARTING POINT ]] [Raphaelle] Starting the LLP we had a rich man’s Problem ! We had developed a workingprototype, and almost each time we would demo it, our audience would come up with new opportunities – from augmenting the physician-patient relationship to We couldn’t choose between the 2 problems we were proposing to solve: helping patients with MS and solve the flood of data from modern medicine to change practiceThe problemturned into a bit of schizophrenia: are we a product company OR are we a Service company ? Offering what we did for MS as a Service for other research centers?Or build a MS-centered product to respond to the needs of community neurologists?--- [PA] “ an Application “ [Jason] OR a data analytics platform for all the complex diseases --[Raphaelle] We adopted the Steve Blanks’ s Method – Go and ask people outsdie the Lab ! And answer where is value in the platform of in the data you analysed but also when is the value ?Now with the protot or later with more than the proto . Are we a service company or a product company? [May not have to choose] A platform and an app? How do we provide value now and later? [Tiered model]What is our disease focus? [Neurological? Auto-immune conditions?
[[SLIDE 6]] We wanted to develop this great know-how for everyone TOO MANY VALUE PROP for TOO MANY CUSTOMER SEGMENTS So what did we learn from our interviews ? Pharmas, Clinicians. Researchers etcetc
Prisoners of our own solution:this existing solution was constraining us in finding needsToo many directions! Our BMC is a mess! Let’s narrow down to who has the biggest pain points and can pay for our offering, whether it’s a product or a service
Let’s narrow down to who has the biggest pain points and can pay for our offering, whether it’s a product or a servicewe refined the Value Proposition and Started chopping out the Customer Segments We excluded the MS patients, not because there is not demand but because we did not want to become a 23 and me for MS patients, too many regulatory problems.
Identify the best match between the Value Propositions and the multiple customer segments in order to find the easiest customer relations and channelsFeeling better Categorize interest and started to clarify it
We need validation!
PresentMIRA Spin off from UCSF NeurologyFirst product MIRA MS is the extension of the research tool MS BioscreenMarket: research centers, medical centers, and ACOs for MSVision for the future. Product vision MS: Augment the MS DB by 20x in 2 years Develop analytics for comparison and prediction Other diseases: Port model to Parkinson’s, RA, Alzheimer’s, Cognitive system platform for complex diseases by 2018
[[SLIDE 5 Our MARKET ]] [Raphaelle] With this Prototype we have a pretty clear MARKET POSITIONNING. “ Our offering places MIRA at the convergence of precision medicine, bioinformatics (knowledge management tools), and clinical care markets – each poised for exponential growth. The healthcare decision support market represented $202 million in 2012 and rapidly growing, thanks to mutually reinforcing factors, including: the dramatic reductions in costs of human genome sequencing; innovation and dramatic cost reductions in cloud-based data storage and parallel computing; new regulations such as the HIGHTECH Act of 2009, specifically the Meaningful Use incentives and requirements, are powerful drivers for adoption and use of Electronic Medical Records systems; consumer expectations of access to information and demand for quality of care; new reimbursement models based on quality of care and outcome, including Accountable Care Organizations. The nascent Clinical Care market is focused on providing tools that can be used by physicians at the point of care to amplify their expertise by complex, data-driven analyses, and is estimated at $100M in 2015. MIRA’s initial focus is on Multiple Sclerosis which has an incidence of 500,000 patients in the United States and 20,000 new cases identified every year. A life-long disease, Multiple Sclerosis has no cure, and currently approved Disease Modifying Therapies (DMTs) cost between $20-60,000 per patient per year. The MS therapeutics market, where 9 currently approved and 5 additional DMTs seeking FDA clearance are competing, is worth $7B per year in the US alone.If MIRA were to focus exclusively on MS, we would estimate our market size to 15-25M. By expanding to additional complex diseases and offering a platform, we estimate our market size at $100-200M.
…- It is already happening We are coached by a VC We have a research parternwho just got 900,000 awarded …
[[ SLIDE 1 TITLE ]] We Are MIRA Medicine a Spin- off from UCSF Neuroloogy and a first genetration of precision medicine application in complex diseaseWe deliver aster more precise clinical decision at low cost !
Value prop for physicians/cliniciansData-driven, personalized view supports patient education and communication (data-driven and visual) and shared decision makingVisual cues leads to better information retentionBetter retention and shared decision making lead to better adherence and hence efficacy and outcome.
Value prop for physicians/cliniciansData-driven, personalized view supports patient education and communication (data-driven and visual) and shared decision makingVisual cues leads to better information retentionBetter retention and shared decision making lead to better adherence and hence efficacy and outcome.
