This document discusses transforming Canada's healthcare system to focus on value-based outcomes. It notes rising costs and an aging population are putting pressure on the system. It advocates adopting a value-based healthcare approach that prioritizes improving outcomes over costs by standardizing outcome measurements, modifying incentives, and rewarding collaborative solutions. Amgen expresses commitment to demonstrating the outcomes and value of its medications beyond just costs and helping enable more efficient, sustainable healthcare.

1. MARCH 2017
AMGEN CANADA
TRANSFORMING OUR
HEALTH SYSTEM TOGETHER

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WHAT ARE TODAY’S CONCERNS?
↓ ECONOMIC
GROWTH
↑ AGEING
POPULATIONS
↑ FOCUS ON DRUGS
AND PRICING
Express Scripts Says Costly
New Cholesterol Drugs
Could “Wreak Havoc”

3. Societies face a costly and growing burden of
serious disease … this is “the enemy”

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First, let’s take a look at the current fiscal pressures
As a participant in the Canadian healthcare system, Amgen
understands the fiscal challenges that federal/provincial
and territorial governments face
We also believe that we can help improve the system

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NATIONAL BREAKDOWN OF HEALTHCARE EXPENDITURE
Where is most
of the money
being spent
in 2015?
Source: CIHI, National Health Expenditure Database, October 2015.

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Benefits of a focus on outcomes: improved patient outcomes,
reduced variation, reduced medical cost, continuous improvement
THE VALUE‐BASED HEALTHCARE SOLUTION
The goal of value-
based healthcare
(VBHC) is to
improve quality
and outcomes
at the same or
lower cost...
Holistic approach ...relying on quality outcome data as
starting point to improve care cycle

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ICHOM
The International Consortium for Health Outcome Measurement
STANDARDIZED OUTCOMES WE CAN ALL AGREE ON
• Standardize, meaningful, relevant, patient centered outcomes
• Aspiration: By 2017, we aim to have published Standard Sets covering more than
50 percent of the global disease burden
• 21 set of standards completed as of today
• In Canada, The Montreal Jewish General and Sick Kids have participated in the
elaboration of sets of standards in addition to a number of academics.
www.ichom.org

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Parameter Improvement Opportunity
Mindset
Recognize value of key stakeholder input; need to collaborate across siloes
Partnerships
Collaborative partnerships across sectors
Data
Capture, analyze & share outcomes and financial data; standard definitions
of outcomes
Policy Multi-year political commitment to enact value and outcome-based policies
Payment
Value-based payment models – override budget silo and annual
budget constraints
WE NEED TO MAKE FUNDAMENTAL SHIFTS TO MOVE
TOWARDS VALUE‐BASED HEALTHCARE IN CANADA

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Amgen’s medications target unmet needs and grievous illnesses and we believe they transform patients’
lives. Measuring the health impact of our products in patients is a challenge we are willing to take on
SOLVING THE CHALLENGE TOGETHER
• Adopt VBHC concepts to
move beyond cost measures
only to patient outcomes and
system value
• Agree on measurable outcomes,
modify the financial incentives
from volume to outcomes and
value, ensure the health
technology assessment (HTA)
process includes stronger VBHC
considerations, pan-Canadian
Pharmaceutical Alliance (pCPA)
evolves to negotiate innovative
Product Listing Agreements
• Reward players that implement
integrated system solutions that
promote value
• Ensure that outcomes
measurement is part of every
aspect of healthcare
interventions
Develop Innovative
Solutions
Deliver Value
and Outcomes
Improve
Efficiency

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We’ve started on this journey and can do more together to serve patients
AMGEN’S COMMITMENT
Our medications are improving patient outcomes for serious
illnesses and contributing value beyond costs
Our programming is focused on enabling system change
We are keen to help deliver outcomes-driven sustainable
healthcare solutions
• Helping payers manage risk
• Identifying ways to use healthcare dollars efficiently
through process improvement
• Supporting quality measures through appropriate indicators

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QUESTIONS