Arnfin Bergmann, CEO at NeuroTransData GmbH, on the topic of 'DESTINY – An Innovative Platform for Personalized Medicine from Doctors for Doctors & Patients' at IFAH held at Le Meridien, Dubai on 16th - 18th December, 2019.

1. DESTINY – an innovative platform for personalized
medicine from doctors for doctors & patients
Dubai, 16.12.2019

2. • Foundedin2008
• Network of 136 Neurologists/ Psychiatrists specialistsacross72
practices
• Distributed acrossGermany in 4 districts (North-East,North-West,
South-East, South-West)
• Standardised, fully digital, and ISO-certified office-based EMR
systemwith centralised cloud-based database - updated daily
• ~600,000 patients with neurological or psychiatric diseases**;
~25,000 MSpatients acrossdiseasesubtypes with back-data to
2008
• Cooperation with several universitiesin Germany and abroad
(Munich,Essen,Nuremberg, Basel,Zurich, Stanford)
• Approval by EthicsCommitteeof the Bavarian Medical Board as
well asEthicsCommitteeof the Medical BoardNorth-Rhine
NeuroTransData
Physiciannetworkneurology/psychiatry
2 NeuroTransData GmbH / NeuroTransConcept GmbH

3. Indication
3 NeuroTransData GmbH / NeuroTransConcept GmbH
Patientsin the network
Multiple Sclerosis 25,681
Dementia 33,146
Epilepsy 23,166
Depression 69,594
Schizophrenia 8,430
Parkinsonand motordisorders 20,972
Migraine 24,704
Indications & populations in the NTD network

4. 4 NeuroTransData GmbH / NeuroTransConcept GmbH

5. Hard criteria (must-have)
5 NeuroTransData GmbH / NeuroTransConcept GmbH
• Certified according to ISO-Standard
• Authorization for post-graduate medical education in subject area
• Integrated standardised continuoustraining (e.g. via Virtual Classrooms)
for physicians and assistants(e.g. GCP,E-Diagnostics,Coaching)
• Utilisation of the NTD-Database
• Complete modern equipment, at least consistingof EEG,EMG/NCS,
CCDS(extracranial and evoked potentials)

6. Hard criteria (must-have)
6 NeuroTransData GmbH / NeuroTransConcept GmbH
• Fully digitalised practice with modern meansof communication(at least
T-DSLor the like)
• Consistentutilisation of theinternet
• Sufficient numberof physicians and medical personnel / healthcare
professionals
• Handicapped-suited accessand facilities

7. Furthercriteria (should-have)
7 NeuroTransData GmbH / NeuroTransConcept GmbH
• Neurologists at least
Nervenärzte at least
Psychiatristsatleast
900 panel patients/quarter/panel doctor
750 panel patients/quarter/panel doctor
450 panel patients/quarter/panel doctor
• Utilisation of a „positive list“ (medications)aswell asdiagnostics and therapy
conceptsin pre-defined indications
• Mustbe able to perform
• Lumbar puncture
• Infusion
• Observation room
• Conduct of clinical trials

8. Furthercriteria (should-have)
8 NeuroTransData GmbH / NeuroTransConcept GmbH
• Possibility to perform an MRTwithin 1-2 days (cooperation with a
radiologist or hospital), aswell asan on-site laboratory to assess
relevant parameters (e.g. CSF)or cooperation with a laboratory /
hospital
• Location, public transport, parking
• Publicrelations and development of a „Corporate Identity“ (outward
and inward)

9. DESTINY
DatabasE-assiStedTherapy decIsioN support sYstem

10. 10
Theidea
Personalized medicine
‘Intuitive’ decisionby
physician
Studyresultsusedasbasis
Evidencebased
therapy
recommendation
Consideringindividual
patient characteristics
Currently, therapy decisionisbased mainlyonexperience ongut instinctfromdoctors.
Patientshave a desiretoget a second opinion onwhat therapy could work bestfor themselvesbased onthe experience from other patients with thesamedisease.
“Trial and error” iscostintensive.
‘Shotgun blast’ ‘Marksman’s shot’
NeuroTransData GmbH / NeuroTransConcept GmbH

11. DESTINY®– the patient-centered benefit model
DatabasE-assiSted Therapy decIsioN support sYstem
NTD Registry Database
External Registries/
Databases
Doctor Nurse
Patient Patient and doctor portal
My NTC Health Guide
PCTablet
Wearable App
External clinics, doctors
and healthcareproviders
Bidirectional
data transfer
Data entry & upload
Visualization and
eHealth application
Automatic MRI
evaluation & report
(via service provider)
Medication chart
Allergies and
intolerances
Findings and lab values
Vaccination and
vaccination plan
MRI images
Diagnosis and
clinical documentation
Treatment information
and implants
Medical reports
Modules for
therapy decisionsupport
PHREND
Therapy
optimization
Safety-Management
Tool
Biomarker
ELISPOT-test
Automated
Cognitive Platform
Drug Interactions
PGXperts
External systems
e.g.
powered by
“Fromdoctorsfor doctors& patients”
Upload

12. Module PHREND®
Predictive Healthcare with RealWorld Evidencefor Neurological Disorders
App providing personalized
comparisonsof treatment
effectiveness usingreal world
evidencedata (RWE)
Rollout to German doctor’s
offices starting early 2018
Pilot in NTDoffices launched
August 2017
Machinelearning and
statistical modelapplied for
clinical outcomes
Web-based tool providing
personalized comparisonsof
treatmenteffectivenessusingreal
world evidence (RWE)
Machinelearning / statistical
model used
RWEprovided by NTDcovering
20% of GermanMS patients
Currently 12 easy-to-enter input
variables for the doctor
Publishedinacademicliterature
(BMCMedical Research
Methodology)
CEcertified asmedical device
(classIapproved, classIIa in
progress)
12

13. Reasonsfor Prediction (doctor´s view)
13

14. Ethics committee
approvals
Quality Management
& RiskManagement
CECertification
(PHREND)
Privacy according to
EU-GDPRand German
PrivacyLaw
Quality standards & certifications
14 NeuroTransData GmbH | NeuroTransConceptGmbH
ISO 9001
ISO 14971

15. Awards
15 NeuroTransData GmbH | NeuroTransConceptGmbH

16. DESTINYfor doctors
16 NeuroTransData GmbH / NeuroTransConcept GmbH

17. 17 Gesellschafterversammlung, Stuttgart28.09.2019

18. 18 Gesellschafterversammlung, Stuttgart28.09.2019

19. Progress of
RWE data analytics
New
RWE Data use cases

20. • Propensity score:
• Theprobability of a patient
receiving thetreatment being tested
• Ina real world analysis, this
probability isunknownand ishence
estimated usinga logistic regression
model
Indication bias
DMT,diseasemodifying therapy; EDSS,expanded disability statusscore;MS,multiple sclerosis.Adapted from Kalincik TandButzkuevenH.Mult Scler. 2016;22:1642–8.
Covariates
characteristics that
predict subsequent
treatment success
Propensity score:0 1
TreatmentA TreatmentB
RecentMSactivity
(relapse / progression)
Previousimmunosuppressive treatment
Relapses(over last 12 months)
Numberof previous DMTs
Treatingcentre/ country
Disease duration
EDSS
Gender
Age
Multivariate
logistic regression
model
0.41

21. 0.82
0.82
0.87
0.87
0.15
0.91
0.74
0.79
0.74
Propensity score matching
Mimics randomisation
in observationalstudies
Compares individuals who had a similar probability
(propensity score) of receiving the same treatment
but actually received differenttreatments
RWE data analytics: Indication bias

22. Propensity Score Matching (PSM) schafft vergleichbare
Patientenpopulationen (Reduktion des “Indication Bias”)
0.39398
0.82922 0.15441
0.79748
0.39758
0.79743
0.67654
0.75222 0.98011
0.91542
0.24591
0.33322
0.81951
0.48123
0.35998
0.22123
0.76720
0.39221
0.07739
0.00233
0.91924
0.28007
0.69792
0.74700
0.33386
0.42549
Patienten Therapie A Patienten Therapie B
Matching
nach
PSM score
10 0.5
▸Der Propensity Score (PS) gibt die Wahrscheinlichkeit an, mit der ein Patient die Therapie A erhält.
Er wird aus einem Set an Baseline-Charakteristiken berechnet.
VOR MATCHING NACH MATCHING
Extrahierte Paare
nach dem Matching
0.69792 0.67654 0.33386 0.33322
0.91542 0.91924 0.7607.75222
20
0.81951 0.82922 0.39758 0.39398
0.35998 0.22123 0.48123
0.28007 0.39221 0.79748
0.00233 0.07739 0.15441
Patienten
ohne Match
Patienten
ohne Match
Patienten Therapie A
Patienten Therapie B
10 0.5
0.98011
0.7974
3
0.74591

23. DMF,delayed-release dimethyl fumarate; NTD,NeuroTransData.
Matching NTD populations: DMF vs fingolimod
0.0
0.5
1.5
2.0
Density 1.0
0.00 0.25 0.75 1.000.50
Propensityscore
BEFORE 1:1 MATCHING
0.0
0.5
1.0
1.5
2.0
Density
0.00 0.25 0.75 1.000.50
Propensityscore
AFTER 1:1 MATCHING
Fingolimod
DMF

24. Resultsof prediction PHREND®vs.CONFIRM,DEFINE,REGARD,
TRANSFORMS(all outcomes)
24 NeuroTransData GmbH / NeuroTransConcept GmbH

25. DESTINYfor patients
25 NeuroTransData GmbH / NeuroTransConcept GmbH

26. Therapieplan.Plus
With individualized information, instructionsand medication schedulefor patients
Therapy plan Individual information Patient diary Medication schedule
26 NeuroTransData GmbH / NeuroTransConcept GmbH

27. Individualized information channelfor patients
Theright information for the
right patient at the right time.
27
• General information about disease&
treatmentoptions
• Information about therapy support
programs and services
• Product-specificinformation
• Special instructionsfor medication intake

28. Connectingall actors in the healthcare system
28 NeuroTransData GmbH / NeuroTransConcept GmbH

29. Individual Therapy Management
29 NeuroTransData GmbH / NeuroTransConcept GmbH

30. sConceptGmbH
Benefits for patients & doctors
Advantages for patients
• Platform tailored to individualpatient
characteristics
• Interaction with treating physician outside
of office hours, enhancement of
communication between doctor and
patient
• Bidirectional data exchange patient/doctor
• Visualization of clinical data, active
involvement of patients in treatment
process
• Improved control and coping with disease,
higher treatment success
• Information about new developments,
supportive measurements and services
Advantages for doctors
• Optimization of interaction between
doctor and patient
• Enhancement of patients‘ loyalty
• Improved therapy control
• Higher adherence, compliance and
treatment success
• Reputation as modern, state-of-the-art
practice
• Support of doctor and medical personnel
in daily practice
“New waysto improveyour health.”
30 NeuroTransData GmbH / NeuroTran

31. Futuremodel – value-based payment for healthcare systems
31 NeuroTransData GmbH / NeuroTransConcept GmbH

32. Leverage PwCand NTDexpertise to scaleDESTINYto other disease areas
Destiny
Other Disease Areas
32 NeuroTransData GmbH / NeuroTransConcept GmbH

33. DESTINY®– the patient-centered benefit model
DatabasE-assiSted Therapy decIsioN support sYstem
NTD Registry Database
External Registries/
Databases
Doctor Nurse
Patient Patient and doctor portal
My NTC Health Guide
PCTablet
External clinics, doctors
and healthcareproviders
Bidirectional
data transfer
Data entry & upload
Visualization and
eHealth application
Automatic MRI
evaluation & report
(via service provider)
Medication chart
Allergies and
intolerances
Findings and lab values
Vaccination and
vaccination plan
MRI images
Diagnosis and
clinical documentation
Treatment information
and implants
Medical reportsTherapy
optimization
Biomarker
ELISPOT-test
Drug Interactions
PGXperts
Modules for
therapy decisionsupport
PHREND
Automated
Cognitive Platform
Safety-
Management Tool
External systems
e.g.
powered by
Upload Wearable App
NeuroTransData GmbH / NeuroTransConcept GmbH

34. 34 NeuroTransData GmbH / NeuroTransConcept GmbH