ACC v1.1
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This document summarizes a medication adherence platform called Medisafe. It discusses how Medisafe addresses the major causes of non-adherence through personalized medication management. The document also provides data on medication non-adherence costs and statistics, an overview of Medisafe's features and user growth, clinical studies showing improved adherence, and strategies for expanding the platform to involve providers and payers. It analyzes the competitive landscape and outlines how Medisafe differentiates itself as the market leader in medication management.
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ACC v1.1
- 1. 1 THE PERSONALIZED MEDICATION MANAGEMENT PLATFORM The Patient & You: Aligning Interests To Increase Medication Adherence By: Jon Michaeli EVP Marketing & Business Development For:
- 3. 3 Founded August 2012 Launched Nov 2012 (alpha) May 2013 (beta) First Funding August 2013 Series A January 2015 FIRST INSPIRATION & MILESTONES
- 4. 4 PATIENT-CENTRIC PERSONALIZED MEDICATION MANAGEMENT PLATFORM ADDRESSING ALL MAJOR CAUSES OF NON-ADHERENCE: Source: Cramer JA, Spilker B, eds. Patient compliance in medical practice and clinical trials. New York: Raven Press, 1991:387-92 Forgetfulness (30%) Decision to omit doses (11%) Emotional distress / Lack of support (7%) Lack of information / Information overload (9%) Low engagement / Other reasons (27%) Other priorities / Medication costs (16%) WHAT IS MEDISAFE?
- 5. Quality of Care 5 146M Prescribed daily meds 700,000 Over/under dose emergencies Non-adherence related deaths $187B Lost sales to pharma(cies) $300B Related to non- adherence Lost RevenuesHealthcare Costs Sources: CVS research, 2012; CDC research, 2012; Congress report regarding non-adherence, 2012; CapGemini/HealthPrize research 2012 4 minEvery Statistics are yearly figures (U.S) WHAT WE’RE UP AGAINST
- 6. PharmaProvider / Payer / Employer Pharmacy Rx and Treatment Rx Transfers / Refills Targeted Education AnalyticsE-Prescription, Pt. History Pop Health, Cost Savings Med List, Rx Coverage Adherence Data & Biometrics UP TO THE CHALLENGE Doctor / Care TeamPatient / Caregiver 6 6
- 7. Dr. Appointments Social Support Patient Education - Multimedia Telemedicine Intrinsic Reward System Supportive Content Positive Reinforcement Financial Assistance DEMO / DATA DRIVEN FEED
- 9. - 500,000 1,000,000 1,500,000 2,000,000 2,500,000 2013-Qtr3 2013-Qtr4 2014-Qtr1 2014-Qtr2 2014-Qtr3 2014-Qtr4 2015-Qtr1 2015-Qtr2 2015-Qtr3 2015-Qtr4 9 2.7mm registered users 110K+ app store reviews, 4.5 stars USER GROWTH & VALIDATION
- 10. 10 DATA AT SCALE - 50,000,000 100,000,000 150,000,000 200,000,000 250,000,000 300,000,000 2013-Q3 2013-Q4 2014-Q1 2014-Q2 2014-Q3 2014-Q4 2015-Q1 2015-Q2 2015-Q3 2015-Q4* 330mm doses taken correctly 60mm user sessions / mo.
- 11. 11 TOP 20 THERAPEUTIC AREAS 12% 4% 3% 0% 5% 10% 15% 20% 25% Depression / Anxiety Hypertension Vitamin Pain Diabetes Antibiotic Seizures High Cholesterol Acid reduction Hypothyroidism Anticoagulants Allergy Other mental disorders Asthma Contraceptive ADHD Cancer Epilepsy Insomnia Anti Inflammatory
- 12. 12 CLINICAL SIGNIFICANCE Independent comparative study of 100 medication management apps. Internal blood pressure study of Stage 1 and 2 hypertension patients after tracking their BP in Medisafe. Retrospective study using RX fill data to assess adherence vs. control in hyperlipidemia, hypertension and diabetes. Randomized Control Trial with Partners Healthcare and Evidation Health. Result: Medisafe ranked #1 Result: 19.3mmHg systolic decline in 30 days Result: +8 - 20% adherence for 3 – 6 months Result: Due Q4 2016
- 13. 13 • Safeguards • HIPAA compliant • Bank level security (ISO 27001) • Medication pre-population • Import via medical record for ~60% of covered lives • Streamlined UI / reduce friction • Enhanced personalization • Medication reconciliation BEYOND THE PATIENT – PHASE 1
- 14. 14 BEYOND THE PATIENT – PHASE 2 36% 36% 35% 34% 30% 57% 47% 48% 51% 41% 0% 10% 20% 30% 40% 50% 60% Has empathetic medical and admin staff Scheduling appts is quick and easy Communicates test results in timely manner Takes time to understand my opinions and needs Allows me to see the doctor I want, when I want % of consumer who believe providers are dlivering % of providers who believe they're delivering Source: Patient Experience” it’s Time to Rethink the Consumer Healthcare Journey, GE Healthcare Camden Group, March 2016
- 15. 15 Despite studies and a bevy of evidence from other investigators in the field, I still get routinely reminded, when I am out presenting on connected health, that “physicians don’t want this data.” This is a resounding theme that ranks right up there with concerns about liability and reimbursement. Dr. Joe Kvedar, MD - Center for Connected Health, Partners Healthcare Feb 25, 2016 BEYOND THE PATIENT – PHASE 2 Source: MedCity News, Feb 25, 2016
- 16. 16 BEYOND THE PATIENT – PHASE 2 48% of non-health app users would use them if recommended by doctors Source: Technology Advice, 2014
- 17. 17 BEYOND THE PATIENT – PHASE 2 150 Physicians Cardiology Endocrinology Pain medicine Psychiatry Pulmonology 200 Consumers Chronic pain Depression/Anxiety Diabetes Mellitus Gastrointestinal disorders Hyperlipidemia Hypertension Hypothyroidism
- 18. 18 How do you monitor patient adherence? Don’t monitor (21%) Monitors via email/phone (21%) Monitors via refills (40%) Patient self-reports (18%) BEYOND THE PATIENT – PHASE 2
- 19. 21% 17% 15%22% 25% Email Mobile app Patient portal Journal Memory / Office call / Other 19 Patients: How do you want to share your data? BEYOND THE PATIENT – PHASE 2 35% 65% EMR only Outside the EMR (email/mobile/fax) Doctors: How do you want to receive the data?
- 20. 20 Who is the first to ask about your meds? Doctor (18%) PA (18%) Receptionist (5%) Nurse/ NP (59%) BEYOND THE PATIENT – PHASE 2
- 21. 59% 30% 11% Strongly agree/Agree Neither agree nor disagree Strongly agree/Disagree 21 Sharing helps improve treatment BEYOND THE PATIENT – PHASE 2 40% 37% 23% Taking meds lowers long-term medical costs
- 22. 22 - 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 1 - 19 20 - 39 40 - 59 60 - 79 80 - 100 1 - 19 20 - 39 40 - 59 60 - 79 80 - 100 1 - 19 20 - 39 40 - 59 60 - 79 80 - 100 Medical Cost Drug CostAdherence % Source: Sokol et al., 2005 TotalCost($) Diabetes Hypertension Hypercholesterolemia HEALTH COSTS RELATED TO ADHERENCE
- 23. 23
- 24. 24THIS DOCUMENT IS PROPRIETARY AND CONFIDENTIAL.
- 25. 25
- 26. 26THIS DOCUMENT IS PROPRIETARY AND CONFIDENTIAL. PROPS
- 27. 27 Capital Raised To Date $7 Million Last Funding Series A, $6 Million, Jan. 2015 Timeframe Until Next Raise 6 Months Notable Investors: INVESTORS
- 28. 28THIS DOCUMENT IS PROPRIETARY AND CONFIDENTIAL. DAYS OF USE BY CONDITION TYPE 0 20 40 60 80 100 Acute Hybrid Chronic
- 29. In the US, medication nonadherence costs more than $100 billion annually. Medication adherence applications (apps) are a new resource to help patients manage their medication regimens and potentially improve adherence. However, there are hundreds of medication adherence apps making it difficult for patients and providers to identify quality apps. In 2012, an initial study found 160 medication adherence apps available to consumers. • The medication adherence app market has more than doubled in the past two years and continues to offer apps with high variability in terms of app quality • No app possessed all desirable author-identified features; however, several apps were highly rated across all four domains • Sharing this information with healthcare providers and consumers could enable them to find a quality app that may improve their medication adherence • 461 medication adherence apps were initially identified across the three marketplaces • 367 apps were available for evaluation after removing Lite/Trial versions and apps that were specific to a single medication or disease state • The mean initial score based on the product description was 26.7 and ranged from 23-47 (max of 68) • Of the 100 apps eligible for testing, 19 were excluded because they failed to produce medication reminders or could not be installed by at least one author, which included all of the Blackberry apps, leaving 81 apps for testing • The mean user-tested score was 27 and ranged from 13-50 (max of 68) • Compared to the initial scores, 39 (48%) user-tested scores increased, 35 (43%) user-tested scores decreased, and 7 (9%) user- tested scores were unchanged Navigating the Flooded Adherence App Marketplace: Rating the Quality of Medication Adherence Apps Catherine Renna, Rebecca Shilling, Seth Heldenbrand, PharmD, Lindsey Dayer, PharmD, BCACP, Bradley C. Martin PharmD, PhD • Online marketplaces (iTunes, Google Play, and Blackberry App World) were searched for medication adherence apps during June of 2014 • Inclusion criteria: English language apps capable of generating medication reminders • Apps limited to a single disease state or medication were excluded • 28 author-identified desirable app features were divided into four domains and assessed from developer descriptions • Each feature was assigned a score based on their importance in their respective domain (1-modest; 2-moderate; 3-high) • Apps with Lite/Trial versions were treated as one product • The 100 highest scoring apps were eligible for testing and were evaluated by two authors against developer claims • Each app was evaluated over a four day period using a standardized six drug regimen: vitamin E once daily, diltiazem twice daily, simvastatin once daily at bedtime, azithromycin once daily for three days, prednisone three day taper, and alendronate once weekly • Apps were then re-ranked based on user-tested score CONCLUSIONS • Development of a searchable adherence app website in order to alleviate the frustrations of identifying quality apps in the online marketplaces • App effectiveness could be diminished if designed without health literacy in mind; therefore, the addition of a health literacy domain could help in identifying apps with the highest patient usability • To assess the smartphone medication adherence app market by evaluating available apps based on descriptions in the marketplace and testing the performance of the highest-scoring apps against developer claims • Dayer L, Heldenbrand S, et al. Smartphone medication adherence apps: potential benefits to patients and providers. J Am Pharm Assoc. 2013; 53( 2): 172– 81 RESULTSBACKGROUND OBJECTIVES METHODS FUTURE DIRECTIONS REFERENCE #1 OF 100 APPS REVIEWED 29
- 30. 55% 47% 42% 39% 30% 44% 39% 36% 30% 27%26% 18% 20% 21% 16% 0% 10% 20% 30% 40% 50% 60% 1 - 19 20 - 39 40 - 59 60 - 79 80 - 100 Diabetes Hypertension Hypercholesterolemia 30 Adherence % HospitalizationRisk Source: Sokol et al., 2005 HOSPITALIZATIONS RELATED TO NON-ADHERENCE
- 31. 31 • Difference between test and control is significant at the 95% level Patient Cohort Timeframe Test Control Absolute Lift Relative Lift Hyperlipidemia (n=150) 6 Months 65.3% 54.7% +10.7%* +19.5% Hypertension (n=406) 6 Months 69.7% 64.3% +5.4%* +8.4% Diabetes (n=143) 3 Months 84.6% 76.9% +7.7%* +10.0% IMS RETROSPECTIVE STUDY RESULTS
- 32. 32 Change in Systolic BP for Medisafe Stage 1 and Stage 2 Hypertensives Avg. Improvement of 19.3 mmHg in 30 days, persists for at least 60 days HYPERTENSION STUDY RESULTS
- 33. 33 56% from Stage 1 reduced their risk category 86% from Stage 2 reduced their risk category Normal Pre- Stage 1 Stage 2 HYPERTENSION STUDY RESULTS
- 35. 35 Category Leaders Traction Advantages Disadvantages Reminder Apps Varies Address most prevalent factor Commoditized Pharma(cy) Apps Huge customer base Deep pockets, direct tie in to core business Fragments the market Med / Health Mgmt Platforms Some early market traction (000,000) Well funded Unfocused, relying on extrinsic rewards Health Ed / News Leaders in web traffic Audience of consumers and providers DNA is in media and content, not tech Pillboxes, Sorting Limited in consumer / retail Organization, reporting Low scalability, Limited interactivity Market Leader (med mgmt) Addresses all major causes Agnostic 3rd party Patient centric Caregiver / care coordination Adherence focus Medisafe Differentiation COMPETITION THIS DOCUMENT IS PROPRIETARY AND CONFIDENTIAL.