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Oncology Dynamics - IQVIA

The document outlines IQVIA's oncology data capabilities, emphasizing the importance of large real-world data sources and advanced analytics to improve healthcare and commercial performance. It details the challenges in delivering high-quality oncology data, the methodologies used for data collection, and the types of insights that can be derived from such data. The oncology dynamics survey aims to provide comprehensive, anonymized insights into patient journeys and treatment patterns across various cancers and geographies.

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© 2020. All rights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries. Reimagining Healthcare: IQVIA Real-World Data Oncology Dynamics Weronika Ficek
1 Meaningful insights based on large real-world data sources and advanced analytics. Robust evidence to support treatments. A clearer picture of the patient journey. And insights that actually lead to better commercial performance. Oncology expertise powered by real-world insights IQVIA Global Oncology Capabilities *Evaluate Pharma 2016
2 The three hurdles of high-quality oncology data delivery: 1. Identifying and accessing reliable and rich data sources 2. Finding solutions to secure, cleanse, and structure the data 3. Deriving meaningful insights and evidence from the data at hand The oncology data-to-insights ecosystem is simple to define but complex to deliver IQVIA Global Oncology Capabilities Oncology Dynamics: Survey data that provides easy access to rich, structured, multi-country, oncology anonymous patient-level insights
3 Oncology Syndicated Solutions in IQVIA • Larger sample and panel size overall • Covers all cancers • Predefined focused questionnaire • Current treatment + most recent prior treatment • Sample and projected data • Data reported from medical records • Covers specific cancer sub-type, stage or line of therapy • Predefined detailed questionnaire • Full treatment history • Sample data • Data reported from medical records • Specific questions related to cancer types, treatment, patients, outcomes, healthcare resource use, physician perception • Customized questionnaire • Sample data • Data can/cannot be reported from medical recordsAn international team dedicated to optimal study design, fieldwork, panel management, data collection, reporting Oncology Dynamics, including OD Boosts Customised Market Research & PI 2 4 3 Oncology Advantage Oncology Diagnosis Insights 1 • All cancers, all stages, all lines of therapy • Co-diagnosis related to certain supportive care treatments • Specialties identified to be involved in the active treatment • Prescription information (diseases, biomarkers, drug treatment, patient profile, prescriber) Oncology Diagnosis Insights
4 What type of questions can be answered with the aid of OncoDynamics… Interested in the up-to-date clinical and treatment information within oncology? IQVIA Global Oncology Capabilities  Market Dynamics in Breast Cancer  Patient Profiling and Treatment Patterns in Liver Cancer  Treatment Landscape in Ovarian Cancer  Treatment Patterns in Pancreatic Cancer  Biomarker Testing Rates and Impact on Treatment Decisions in NSCLC  Market Dynamics for select Supportive Therapies  Standard of care in Acute Myeloid Leukemia
5 EVALUATE Current Standard of Care UNDERSTAND Patient profiles & sub-populations EXAMINE Drug Utilization & Treatment Patterns BENCHMARK Adherence to Clinical Guidelines INFORM Study Protocols & Feasibility QUANTIFY Cost of Drug Therapies Interrogate our syndicated patient database with little lead time and effort – Oncology Dynamics Oncology cross-sectional surveys can address many RWE questions – from strategy development to post-launch IQVIA Global Oncology Capabilities
6 Key business questions How do healthcare stakeholders use oncology survey data today? IQVIA Global Oncology Capabilities Business Intelligence Team HEOR Team Pipeline & BD Team Market Access Team Brand Team Clinical Operations & Study Teams ____________________ How does the patient journey and standard of care differ across countries? ____________________ How is the testing rate for key biomarkers evolving over time? ____________________ Which patient populations are underserved with effective therapies? ____________________ How is the competitive landscape evolving? ____________________ How is my brand being used in the real-world setting? ____________________ Does my clinical study protocol reflect real-world populations and clinical practice?
7 Geographies Variables Diseases Physician specialties + Europe: France, Germany, Italy, Spain, UK, Romania. Belgium coming in Q2 2020. + Americas: Mexico, Brazil + Asia: Japan, China, South Korea, Saudi Arabia + Drug-treated cases of all cancers are collected at natural fallout and projected to treated prevalence. A selection of key cancers are available in Romania, Mexico, Brazil, and Saudi Arabia. + All drug-treating physician specialties working with oncology patients + Patient and clinical characteristics, including staging and biomarker status + Current and most recent previous drug treatments, including chemotherapy, immunotherapy, endocrine and targeted therapies + Current supportive therapy + Indication-specific parameters Features & coverage All patient data are de-identified and comply with relevant rules for patient privacy protection Oncology Dynamics is a cross-sectional survey that collects patient-level data from a representative panel of physicians
8 The Oncology Dynamics survey can be carried out in other countries Interested in new geographies? • A dedicated international fieldwork team operating in over 20 countries • A large and stable panel of oncologists and cancer treating specialists participating to multiple IQVIA studies • A global and standard methodology applied across all countries • A syndicated questionnaire applicable to most countries *Europe: 5EU, Austria, Belgium, Denmark, Ireland, Netherlands, Poland, Russia, Sweden; Americas: Brazil, Canada, Mexico; APAC: Australia, China, Japan, South Korea, Taiwan, Philippines  Over 10 years experience in conducting international syndicated & customised oncology survey based studies  Over 100 customised cancer-specific surveys conducted in last 10 years  Data collected for over 20 countries*
9 Easily access rich, structured, multi-country, oncology anonymous patient-level data Compare KPIs across tumour types, drugs, and countries through a consistent methodology Make confident decisions based on data from a stable and representative source Derive insights and understand trends in cancer care • 150,000+ patient cases collected each year • 1,500+ specialists per year • Statistically driven study design • Consistent methodology applied across all countries • Frequent updates The product enables healthcare stakeholders to… Oncology Dynamics is a syndicated survey collecting comprehensive and clinically relevant oncology patient data IQVIA Global Oncology Capabilities
10  No derived variables  No data period gap Capture & measure unobservable data (e.g. line of therapy, drug preference) Collect same data parameters from different sites Structured data Collect standardized measures Regular updates  Easy to query  Simple to analyse  Consistent comparison across healthcare settings and providers  No derived variables  Relatively free from several types of errors Structured, Easy to Access, Consistent, Up-to-date Key Features of Oncology Dynamics Data IQVIA Global Oncology Capabilities
11 Four Key Characteristics of the Oncology Dynamics Offering IQVIA Global Oncology Capabilities Fully Anonymised Patient Data Secondary Data Market Research Survey Syndicated Data are fully anonymised and no patient identifier is collected. Comply with personal data protection regulation GDPR Regulation EU 2016/679 No primary data is generated or collected. Reporting of individual Adverse events is not required (EMA Guideline on Good Pharmacovigilance Practices GVP Module VI - Management and reporting of adverse reactions to medicinal products) Information is collected to satisfy multiple clients’ needs. Hence, it is not required to follow PMR regulations. Comply with the market research code of conduct (EphMRA Code of Conduct 2017) (Regulation of the European Parliament and the Council on the Protection of individuals with regard to the processing of personal data and on the free movement of such data)
12 Patient records are collected during consultation Data are transmitted to IQVIA and processed QuestionnairePatient record Clients Physicians fill in the online questionnaire Data are delivered to clients via applications and reports Snapshots of medical records are reported by the physician through a web-based questionnaire Data collection methodology IQVIA Global Oncology Capabilities IQVIA • Large and stable panels of physicians participating in multiple IQVIA studies • Fieldwork and data collection managed by a dedicated international team Over 400 quality controls are conducted during each data production cycle
13 Physicians and cases are selected based on specific criteria IQVIA Global Oncology Capabilities *Physicians surveyed are enrolled in the IQVIA One Key & MEBOS panel (representing >80% of the universe). **Hospitals physicians in France, Italy, Spain, UK, China, South Korea, Japan. Hospital and office-based specialists in Germany. ***The consecutive order of cases collected ensures a random un-biased collection of cases. This criteria does not apply to Saudi Arabia Case selection criteria • Patients with a current diagnosis of cancer (any stage) • Patients currently receiving any cytotoxic therapy, targeted therapy, gene therapy, hormonal or immunotherapy • First consecutive cases personally treated by the surveyed physician during the reporting period (length of period depending on the country) up to a maximum defined number of cases*** Panel selection criteria* • Clinicians must have personally drug treated cancer patients during the last reporting period (length of period depending on the country)** • Targeting a maximum of 3 clinicians from the same hospital in order to avoid any cluster effect and potential duplication of patients
14 OncoDynamics captures a substantial part of the oncological patient treatment journey IQVIA Global Oncology Capabilities Time Current Disease Status ECOG, current stage/grade May 2017 Current drug treatment Regimen, line of therapy, planned duration, dosage, cycles Demographics & Clinical Characteristics Age, gender, smoking status, comorbidities Most recent prior drug treatment Regimen, duration, Cycles given, side effects Oncology Dynamics relies exclusively on the usage of secondary data and no primary data is generated or collected. As per EMA Guideline on Good Pharmacovigilance Practices (GVP) Module VI, “Management and reporting of adverse reactions to medicinal products”, the offering does not require search or reporting of individual Adverse events or any other special reporting situation Jan 2019 Surgery Initial diagnosis (histology, cancer type, stage& grade) Tests (chromosomal abnormalities, biomarkers) Current treatment start dateMost recent previous treatment start date Survey time
15 Many of the key cancer-specific variables are collected in Oncology Dynamics Current drug therapy – Molecule & regimen – Line of therapy – Planned duration and dosing Most recent prior drug therapy – Molecule & regimen – Line of therapy – Duration – Side effects – Reason for discontinuation Non-drug therapy – Surgery – Radiotherapy – Stem cell transplant Supportive therapy – Anti-emetics – Growth factors – Erythropoietins – Bone-targeted agents Core information – Cancer type – Histology – Stage/grade at diagnosis – Stage/grade at current treatment – Relapse/progression – Date of diagnosis – Gender – Age – Smoking status – Clinical trial enrolment – ECOG status & comorbidities Tumour-specific attributes – Hormone refractory status (prostate) – PSA level (prostate) – Platinum status (ovarian) Tumour-specific biomarkers & tests – Time of test (e.g. at diagnosis) Therapy initiator specialty Treatment perception – Overall therapy satisfaction – Treatment alternatives considered by the physician Measure AttributesTHERAPY ASPECTS PATIENT PROFILE PHYSICIAN ATTRIBUTES
16 Robust sample size for most key cancers across all countries Global Cancer Coverage in Oncology Dynamics IQVIA Global Oncology Capabilities *MAT Q3 sample counts provided where possible, estimates provided otherwise **Italy: sub-regional data collection requiring larger sample than other countries ***Semesterly collection Country Hem. Cancers M. Myeloma Breast NSCLC Prostate CRC Bladder Kidney Stomach Pancreas Ovarian Liver Melanoma Head & Neck SCLC Other Cancers Annual count* France 2,950 890 3,399 2,252 2,282 1,497 824 1,056 222 763 495 487 413 802 118 2,036 20,486 Germany 3,369 810 3,195 2,438 4,778 1,827 2,024 1,626 473 981 696 340 1,135 305 458 2,580 27,035 Italy 7,162 1,549 3,725 4,103 3,304 3,153 2,231 1,359 674 1,112 1,409 650 929 778 619 2,895 35,652** Spain 4,663 1,228 2,452 1,875 2,163 1,650 1,212 945 260 604 403 228 520 590 264 2,895 21,952 UK 3,142 756 2,730 2,311 2,621 1,383 1,296 1,047 298 634 496 306 818 551 345 3,018 21,752 China 1,567 367 2,150 3,588 530 2,616 465 266 1,280 407 651 943 31 683 504 1,950 17,998 Japan 946 195 1,352 2,330 1,463 1,468 174 402 1,449 730 299 778 238 214 157 1,018 13,213 South Korea 822 159 696 756 467 769 54 85 637 150 313 536 22 66 104 634 6,270 Mexico 1,072 ALL, CML, CLL, NHL 196 1,924 359 1,236 641 277 476 — 205 416 — 131 — — — 6,933 Saudi Arabia*** Yes (NHL) New 2019 Yes Yes — Yes — RCC New 2019 — — — — — — Yes — ~2,060 Romania — Yes Yes Yes Yes Yes — — — — Yes — Yes — — — ~4,300 Brazil CML, NHL, AML, CLL Yes Yes Yes Yes Yes Yes Yes — Yes Yes — Yes — — — ~6,180
17 Cancer-specific diagnostic and prognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Bladder Brain Breast Bronchus & Lung Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver ALK 2016 l BRAF 2016 l BRCA1/2 2016 l BRCA origin Q1 17 l BRCA1/2 test performed Q1 2018 l Circulating Tumour Cells 2016 l l l C-KIT 2016 l C-MET 2016 l l l l l Current PSA 2016 EGFR 2016 (GBM Q1 17) l l l EGFR test performed Q1 2018 l l FGFR 2016 l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above *NEW indication l Mutation KEY l Over expression / elevated / gene amplification l Other
18 Cancer-specific diagnostic and prognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Bladder Brain Breast Bronchus & Lung Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver HER2 status 2016 l Hormone receptors ( ER and PR) 2016 l TNBC 2016 l Ki-67 antigen level 2016 l l K-RAS 2016 l l Microsatellite instability All tumours from Q3 17 l l l l l l l l l l l Mitotic index 2016 l l N-RAS 2016 l PD1/ PD-L1/PD-L2 Q4 2016 all tumours collected from Q1 18 l l l l l l l l l l l PIK3CA Q1 2019 l l Platinum status 2016 l RET rearrangement Q3 17 l ROS-1 gene alteration Q3 17 l tp53 mutation Q3 2019 TRK expression Q2 2019 l l l l l l l l l l l Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above *NEW indication l Mutation KEY l Over expression / elevated / gene amplification l Other
19 Cancer-specific diagnostic and prognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid ALK 2016 l l BRAF 2016 (NSCLC Q4 16 ) l l BRCA1/2 2016 l l BRCA origin Q1 17 l BRCA1/2 test performed Q1 2018 l Castration-resistant 2016 l C-KIT 2016 l l C-MET 2016 l l l l l l Current PSA level 2016 l Circulating Tumour Cells 2016 l l l EGFR 2016 (GBM Q1 17) l l EGFR Type of mutations (Exon19Del, L858R, T790M Q2/Q3 17 l NOTE: Not all biomarkers are collected in Italy for the cancers listed above l Mutation KEY l Over expression / elevated / gene amplification l Other
20 Cancer-specific diagnostic and prognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid FGFR 2016 l l l Gleason Score 2016 l HER2 status 2016 l Ki-67 antigen level 2016 K-RAS 2016 l l l Microsatellite instability from Q3 17 all solid tumours l l l l l l l l l l Mitotic index 2016 N-RAS 2016 l PD1/ PD-L1/PD-L2 Q4 2016 all tumors collected from Q1 18 l l l l l l l l l l Platinum Status 2016 l RET rearrangement 2016 l l ROS-1 gene alteration 2016 l l tp53 mutation Q3 2019 l TRK expression Q2 2019 l l l l l l l l l l Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above l Mutation KEY l Over expression / elevated / gene amplification l Other
21 Indications added in Q1 2018 Cancer-specific diagnostic and prognostic biomarkers are collected IQVIA Global Oncology Capabilities Cancers Available from Connective & Soft Tissue Gall Bladder GIST Mesothelioma NETs Myelodysplastic Syndromes C-KIT Q1 2018 l Ki-67 antigen level Q1 2018 l l Microsatellite instability Q1 2018 l l l l l Minimum residual disease Q2 2019 l Mitotic index Q1 2018 l l l PD1/ PD-L1/PD-L2 % expression Q1 2018 l l l l l l TRK expression Q2 2019 l l l l l Tumour Mutational Burden (TMB) Q1 2019 l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above While we might have back data for these indications , we will not have all biomarkers in these indications – these have been created as new indications in Q1 2018 so biomarkers will be aligned from then. l Mutation KEY l Over expression / elevated / gene amplification l Other
22 The sample can be boosted for a tumor, subpopulation, and lines of therapy of choice Additional ovarian cancer and melanoma patients are collected each quarter to ensure a robust sample in later lines of therapy IQVIA Global Oncology Capabilities Custom OD Boost • Population of interest • Select lines of therapy Running Boost: Melanoma • Advanced or metastatic stage • 2nd and 3rd+ lines of therapy • EU5: since Q1 2019 and running Running Boost: Ovarian cancer • Advanced or metastatic stage • 2nd and 3rd+ lines of therapy • EU5: since Q2 2018 and running Oncology Dynamics
23 Drug-treating specialties contributing to the Oncology Dynamics survey Global Panel Coverage in Oncology Dynamics IQVIA Global Oncology Capabilities Specialties* France Germany Italy Spain UK Japan China South Korea Mexico Saudi Arabia Romania New for 2019 Brazil New for 2019 Dermatology ENT GI medicine Gynecology Hematology Hepatology Oncology Pulmonology Radiotherapy Urology Surgery Total** 231 246 475*** 222 221 418 750 130 102 45 76-81 73-91† *Specialty distribution design derived from findings of a large IQVIA survey conducted in 2015 & 2017 **Quarterly targets for 2019 ***Large panel due to sub-regional offering available in Italy †Q2–Q3 2019 range
24 Oncology Dynamics data are projected based on a robust projection methodology IQVIA Global Oncology Capabilities Sample patients are projected to an aggregated annual treated prevalence figure at the key cancer and specialty level within country. Physicians Patient Prevalence Physician Universe Treated Prevalence The number of physicians in the panel is projected to the universe for that specialty The number of patients treated by the physicians in each specialty is projected to the universe to provide national prevalence in each cancer and country *A large study conducted in 2015 & 2017. Data from a large sample of nearly 5,000 physicians across all specialties were collected to evaluate the prevalent treated population and the specialties treating cancer patients. The study was conducted in France, Germany, Italy, Spain and the UK. • The IQVIA Physician Universe Study* is used to define the right mix and weighting of specialties which allows more accurate projections to market level • The projection methodology takes into account varying workload levels of participating physicians OD Physician Panel OD Physician Workload
25 Type of Facility by Country G5 EU Sample Base: 891 Facilities 72% 29% 90% 85% 97% 15% 13% 8% 10% 15% 3% 63% 155 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. PUBLIC PRIVATE NO PROFIT PRIVATE OFFICE BASED PRACTITIONER
26 Status of Facility by Country G5 EU Sample Base: 891 Facilities 65% 22% 82% 34% 36% 35% 14% 18% 66% 64%63% 155 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. Non University University Office Based Practitioner
27 Facilities by Bed Range G5 EU Sample Base: 763 Facilities 25% 39% 40% 25% 20% 25% 14% 29% 30% 25% 50% 47% 30% 45% 55% 155 74 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. < 250 250 - 500 500 >
28 Facilities by Country G4 EU Sample Base: 736 Facilities 12% 7% 8% 11% 23% 63% 88% 61% 1% 30% 4% 28% 63% 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Germany Italy Spain U.K. CANCER HOSPITAL MAIN CANCER UNIT NO CANCER UNIT OFFICE BASED PRACTITIONER
29 249 273 572 265 286 169 230 298 158 154 20486 27035 35652 21952 21752 FRANCE GERMANY ITALY SPAIN U.K. 0 5000 10000 15000 20000 25000 30000 35000 40000 No.Patients No. Facilities No. Respondents Sample Summary MAT Q3 2019 Patient, Facilities and respondent sample size
30 Exemplars?
31 While oncologists are the main therapy initiations for gastroenteropancreatic neuroendocrine tumors treatment in EU5, surgeons take the lead in Benelux -10 -5 0 5 10 15 20 25 30 35 40 45 50 55 60 65 -10 -5 0 5 10 15 20 30 35 40 45 50 55 60 65 Benelux Oncologist Surgeon EU5 Endocrinologist Gastroenetrologist Illustrative (dummy data)
32 Therapy initiators for Somatuline by ICD-10 indication in the UK&I C7A.020 C25.8 C26.9 OncologistsPulmonologists Onco-Haematologists Radiotherapists Dermatologists Endocrinologists Illustrative (dummy data)
33 Interesting findings published in the medical domain using Oncology Dynamics data IQVIA Global Oncology Capabilities NSCLC pts with brain metastases are not treated as expected (lack of guidelines, no clinical trial data available). Abstract accepted at American Oncology conference 2018 Unexpected immune related side effects for innovative targeted therapies. Presented at European Oncology Conference 2017
34 Deliverables IQVIA Global Oncology Capabilities • Dataview database – Allows advanced data manipulation and groupings • OD Easy Access: Web-based Microstrategy® application. – Core application with pre-defined reports Syndicated • Customised reports – Developed to meet specific clients’ needs: Excel, PowerPoint, customized dashboards that can be built using the Microstrategy Visual Insights solution • OD Custom View: – Customised analyses based on parameters not included in Dataview or in the web-based application e.g. time gap analysis, treatment duration, dosing, multi-variables patient profiling analysis, volume use by indication, more… Customised
35 For further information, please contact: Weronika Ficek Business Development Specialist, Secondary Care Solutions +44 7880 378081 Weronika.Ficek@iqvia.com Thank you

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Oncology Dynamics - IQVIA

  • 1.
    © 2020. Allrights reserved. IQVIA® is a registered trademark of IQVIA Inc. in the United States, the European Union, and various other countries. Reimagining Healthcare: IQVIA Real-World Data Oncology Dynamics Weronika Ficek
  • 2.
    1 Meaningful insights basedon large real-world data sources and advanced analytics. Robust evidence to support treatments. A clearer picture of the patient journey. And insights that actually lead to better commercial performance. Oncology expertise powered by real-world insights IQVIA Global Oncology Capabilities *Evaluate Pharma 2016
  • 3.
    2 The three hurdlesof high-quality oncology data delivery: 1. Identifying and accessing reliable and rich data sources 2. Finding solutions to secure, cleanse, and structure the data 3. Deriving meaningful insights and evidence from the data at hand The oncology data-to-insights ecosystem is simple to define but complex to deliver IQVIA Global Oncology Capabilities Oncology Dynamics: Survey data that provides easy access to rich, structured, multi-country, oncology anonymous patient-level insights
  • 4.
    3 Oncology Syndicated Solutionsin IQVIA • Larger sample and panel size overall • Covers all cancers • Predefined focused questionnaire • Current treatment + most recent prior treatment • Sample and projected data • Data reported from medical records • Covers specific cancer sub-type, stage or line of therapy • Predefined detailed questionnaire • Full treatment history • Sample data • Data reported from medical records • Specific questions related to cancer types, treatment, patients, outcomes, healthcare resource use, physician perception • Customized questionnaire • Sample data • Data can/cannot be reported from medical recordsAn international team dedicated to optimal study design, fieldwork, panel management, data collection, reporting Oncology Dynamics, including OD Boosts Customised Market Research & PI 2 4 3 Oncology Advantage Oncology Diagnosis Insights 1 • All cancers, all stages, all lines of therapy • Co-diagnosis related to certain supportive care treatments • Specialties identified to be involved in the active treatment • Prescription information (diseases, biomarkers, drug treatment, patient profile, prescriber) Oncology Diagnosis Insights
  • 5.
    4 What type ofquestions can be answered with the aid of OncoDynamics… Interested in the up-to-date clinical and treatment information within oncology? IQVIA Global Oncology Capabilities  Market Dynamics in Breast Cancer  Patient Profiling and Treatment Patterns in Liver Cancer  Treatment Landscape in Ovarian Cancer  Treatment Patterns in Pancreatic Cancer  Biomarker Testing Rates and Impact on Treatment Decisions in NSCLC  Market Dynamics for select Supportive Therapies  Standard of care in Acute Myeloid Leukemia
  • 6.
    5 EVALUATE Current Standard of Care UNDERSTAND Patientprofiles & sub-populations EXAMINE Drug Utilization & Treatment Patterns BENCHMARK Adherence to Clinical Guidelines INFORM Study Protocols & Feasibility QUANTIFY Cost of Drug Therapies Interrogate our syndicated patient database with little lead time and effort – Oncology Dynamics Oncology cross-sectional surveys can address many RWE questions – from strategy development to post-launch IQVIA Global Oncology Capabilities
  • 7.
    6 Key business questions Howdo healthcare stakeholders use oncology survey data today? IQVIA Global Oncology Capabilities Business Intelligence Team HEOR Team Pipeline & BD Team Market Access Team Brand Team Clinical Operations & Study Teams ____________________ How does the patient journey and standard of care differ across countries? ____________________ How is the testing rate for key biomarkers evolving over time? ____________________ Which patient populations are underserved with effective therapies? ____________________ How is the competitive landscape evolving? ____________________ How is my brand being used in the real-world setting? ____________________ Does my clinical study protocol reflect real-world populations and clinical practice?
  • 8.
    7 Geographies Variables Diseases Physician specialties + Europe: France,Germany, Italy, Spain, UK, Romania. Belgium coming in Q2 2020. + Americas: Mexico, Brazil + Asia: Japan, China, South Korea, Saudi Arabia + Drug-treated cases of all cancers are collected at natural fallout and projected to treated prevalence. A selection of key cancers are available in Romania, Mexico, Brazil, and Saudi Arabia. + All drug-treating physician specialties working with oncology patients + Patient and clinical characteristics, including staging and biomarker status + Current and most recent previous drug treatments, including chemotherapy, immunotherapy, endocrine and targeted therapies + Current supportive therapy + Indication-specific parameters Features & coverage All patient data are de-identified and comply with relevant rules for patient privacy protection Oncology Dynamics is a cross-sectional survey that collects patient-level data from a representative panel of physicians
  • 9.
    8 The Oncology Dynamicssurvey can be carried out in other countries Interested in new geographies? • A dedicated international fieldwork team operating in over 20 countries • A large and stable panel of oncologists and cancer treating specialists participating to multiple IQVIA studies • A global and standard methodology applied across all countries • A syndicated questionnaire applicable to most countries *Europe: 5EU, Austria, Belgium, Denmark, Ireland, Netherlands, Poland, Russia, Sweden; Americas: Brazil, Canada, Mexico; APAC: Australia, China, Japan, South Korea, Taiwan, Philippines  Over 10 years experience in conducting international syndicated & customised oncology survey based studies  Over 100 customised cancer-specific surveys conducted in last 10 years  Data collected for over 20 countries*
  • 10.
    9 Easily access rich,structured, multi-country, oncology anonymous patient-level data Compare KPIs across tumour types, drugs, and countries through a consistent methodology Make confident decisions based on data from a stable and representative source Derive insights and understand trends in cancer care • 150,000+ patient cases collected each year • 1,500+ specialists per year • Statistically driven study design • Consistent methodology applied across all countries • Frequent updates The product enables healthcare stakeholders to… Oncology Dynamics is a syndicated survey collecting comprehensive and clinically relevant oncology patient data IQVIA Global Oncology Capabilities
  • 11.
    10  No derived variables No data period gap Capture & measure unobservable data (e.g. line of therapy, drug preference) Collect same data parameters from different sites Structured data Collect standardized measures Regular updates  Easy to query  Simple to analyse  Consistent comparison across healthcare settings and providers  No derived variables  Relatively free from several types of errors Structured, Easy to Access, Consistent, Up-to-date Key Features of Oncology Dynamics Data IQVIA Global Oncology Capabilities
  • 12.
    11 Four Key Characteristicsof the Oncology Dynamics Offering IQVIA Global Oncology Capabilities Fully Anonymised Patient Data Secondary Data Market Research Survey Syndicated Data are fully anonymised and no patient identifier is collected. Comply with personal data protection regulation GDPR Regulation EU 2016/679 No primary data is generated or collected. Reporting of individual Adverse events is not required (EMA Guideline on Good Pharmacovigilance Practices GVP Module VI - Management and reporting of adverse reactions to medicinal products) Information is collected to satisfy multiple clients’ needs. Hence, it is not required to follow PMR regulations. Comply with the market research code of conduct (EphMRA Code of Conduct 2017) (Regulation of the European Parliament and the Council on the Protection of individuals with regard to the processing of personal data and on the free movement of such data)
  • 13.
    12 Patient records are collectedduring consultation Data are transmitted to IQVIA and processed QuestionnairePatient record Clients Physicians fill in the online questionnaire Data are delivered to clients via applications and reports Snapshots of medical records are reported by the physician through a web-based questionnaire Data collection methodology IQVIA Global Oncology Capabilities IQVIA • Large and stable panels of physicians participating in multiple IQVIA studies • Fieldwork and data collection managed by a dedicated international team Over 400 quality controls are conducted during each data production cycle
  • 14.
    13 Physicians and casesare selected based on specific criteria IQVIA Global Oncology Capabilities *Physicians surveyed are enrolled in the IQVIA One Key & MEBOS panel (representing >80% of the universe). **Hospitals physicians in France, Italy, Spain, UK, China, South Korea, Japan. Hospital and office-based specialists in Germany. ***The consecutive order of cases collected ensures a random un-biased collection of cases. This criteria does not apply to Saudi Arabia Case selection criteria • Patients with a current diagnosis of cancer (any stage) • Patients currently receiving any cytotoxic therapy, targeted therapy, gene therapy, hormonal or immunotherapy • First consecutive cases personally treated by the surveyed physician during the reporting period (length of period depending on the country) up to a maximum defined number of cases*** Panel selection criteria* • Clinicians must have personally drug treated cancer patients during the last reporting period (length of period depending on the country)** • Targeting a maximum of 3 clinicians from the same hospital in order to avoid any cluster effect and potential duplication of patients
  • 15.
    14 OncoDynamics captures asubstantial part of the oncological patient treatment journey IQVIA Global Oncology Capabilities Time Current Disease Status ECOG, current stage/grade May 2017 Current drug treatment Regimen, line of therapy, planned duration, dosage, cycles Demographics & Clinical Characteristics Age, gender, smoking status, comorbidities Most recent prior drug treatment Regimen, duration, Cycles given, side effects Oncology Dynamics relies exclusively on the usage of secondary data and no primary data is generated or collected. As per EMA Guideline on Good Pharmacovigilance Practices (GVP) Module VI, “Management and reporting of adverse reactions to medicinal products”, the offering does not require search or reporting of individual Adverse events or any other special reporting situation Jan 2019 Surgery Initial diagnosis (histology, cancer type, stage& grade) Tests (chromosomal abnormalities, biomarkers) Current treatment start dateMost recent previous treatment start date Survey time
  • 16.
    15 Many of thekey cancer-specific variables are collected in Oncology Dynamics Current drug therapy – Molecule & regimen – Line of therapy – Planned duration and dosing Most recent prior drug therapy – Molecule & regimen – Line of therapy – Duration – Side effects – Reason for discontinuation Non-drug therapy – Surgery – Radiotherapy – Stem cell transplant Supportive therapy – Anti-emetics – Growth factors – Erythropoietins – Bone-targeted agents Core information – Cancer type – Histology – Stage/grade at diagnosis – Stage/grade at current treatment – Relapse/progression – Date of diagnosis – Gender – Age – Smoking status – Clinical trial enrolment – ECOG status & comorbidities Tumour-specific attributes – Hormone refractory status (prostate) – PSA level (prostate) – Platinum status (ovarian) Tumour-specific biomarkers & tests – Time of test (e.g. at diagnosis) Therapy initiator specialty Treatment perception – Overall therapy satisfaction – Treatment alternatives considered by the physician Measure AttributesTHERAPY ASPECTS PATIENT PROFILE PHYSICIAN ATTRIBUTES
  • 17.
    16 Robust sample sizefor most key cancers across all countries Global Cancer Coverage in Oncology Dynamics IQVIA Global Oncology Capabilities *MAT Q3 sample counts provided where possible, estimates provided otherwise **Italy: sub-regional data collection requiring larger sample than other countries ***Semesterly collection Country Hem. Cancers M. Myeloma Breast NSCLC Prostate CRC Bladder Kidney Stomach Pancreas Ovarian Liver Melanoma Head & Neck SCLC Other Cancers Annual count* France 2,950 890 3,399 2,252 2,282 1,497 824 1,056 222 763 495 487 413 802 118 2,036 20,486 Germany 3,369 810 3,195 2,438 4,778 1,827 2,024 1,626 473 981 696 340 1,135 305 458 2,580 27,035 Italy 7,162 1,549 3,725 4,103 3,304 3,153 2,231 1,359 674 1,112 1,409 650 929 778 619 2,895 35,652** Spain 4,663 1,228 2,452 1,875 2,163 1,650 1,212 945 260 604 403 228 520 590 264 2,895 21,952 UK 3,142 756 2,730 2,311 2,621 1,383 1,296 1,047 298 634 496 306 818 551 345 3,018 21,752 China 1,567 367 2,150 3,588 530 2,616 465 266 1,280 407 651 943 31 683 504 1,950 17,998 Japan 946 195 1,352 2,330 1,463 1,468 174 402 1,449 730 299 778 238 214 157 1,018 13,213 South Korea 822 159 696 756 467 769 54 85 637 150 313 536 22 66 104 634 6,270 Mexico 1,072 ALL, CML, CLL, NHL 196 1,924 359 1,236 641 277 476 — 205 416 — 131 — — — 6,933 Saudi Arabia*** Yes (NHL) New 2019 Yes Yes — Yes — RCC New 2019 — — — — — — Yes — ~2,060 Romania — Yes Yes Yes Yes Yes — — — — Yes — Yes — — — ~4,300 Brazil CML, NHL, AML, CLL Yes Yes Yes Yes Yes Yes Yes — Yes Yes — Yes — — — ~6,180
  • 18.
    17 Cancer-specific diagnostic andprognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Bladder Brain Breast Bronchus & Lung Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver ALK 2016 l BRAF 2016 l BRCA1/2 2016 l BRCA origin Q1 17 l BRCA1/2 test performed Q1 2018 l Circulating Tumour Cells 2016 l l l C-KIT 2016 l C-MET 2016 l l l l l Current PSA 2016 EGFR 2016 (GBM Q1 17) l l l EGFR test performed Q1 2018 l l FGFR 2016 l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above *NEW indication l Mutation KEY l Over expression / elevated / gene amplification l Other
  • 19.
    18 Cancer-specific diagnostic andprognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Bladder Brain Breast Bronchus & Lung Cervix Uteri Colorectal Corpus Uteri GIST* Head & Neck Kidney Liver HER2 status 2016 l Hormone receptors ( ER and PR) 2016 l TNBC 2016 l Ki-67 antigen level 2016 l l K-RAS 2016 l l Microsatellite instability All tumours from Q3 17 l l l l l l l l l l l Mitotic index 2016 l l N-RAS 2016 l PD1/ PD-L1/PD-L2 Q4 2016 all tumours collected from Q1 18 l l l l l l l l l l l PIK3CA Q1 2019 l l Platinum status 2016 l RET rearrangement Q3 17 l ROS-1 gene alteration Q3 17 l tp53 mutation Q3 2019 TRK expression Q2 2019 l l l l l l l l l l l Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above *NEW indication l Mutation KEY l Over expression / elevated / gene amplification l Other
  • 20.
    19 Cancer-specific diagnostic andprognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid ALK 2016 l l BRAF 2016 (NSCLC Q4 16 ) l l BRCA1/2 2016 l l BRCA origin Q1 17 l BRCA1/2 test performed Q1 2018 l Castration-resistant 2016 l C-KIT 2016 l l C-MET 2016 l l l l l l Current PSA level 2016 l Circulating Tumour Cells 2016 l l l EGFR 2016 (GBM Q1 17) l l EGFR Type of mutations (Exon19Del, L858R, T790M Q2/Q3 17 l NOTE: Not all biomarkers are collected in Italy for the cancers listed above l Mutation KEY l Over expression / elevated / gene amplification l Other
  • 21.
    20 Cancer-specific diagnostic andprognostic biomarkers are collected for solid cancers IQVIA Global Oncology Capabilities Solid tumours Available from Melanoma NSCLC Oesophagus Ovarian Pancreas Prostate SCLC Stomach Testis Thyroid FGFR 2016 l l l Gleason Score 2016 l HER2 status 2016 l Ki-67 antigen level 2016 K-RAS 2016 l l l Microsatellite instability from Q3 17 all solid tumours l l l l l l l l l l Mitotic index 2016 N-RAS 2016 l PD1/ PD-L1/PD-L2 Q4 2016 all tumors collected from Q1 18 l l l l l l l l l l Platinum Status 2016 l RET rearrangement 2016 l l ROS-1 gene alteration 2016 l l tp53 mutation Q3 2019 l TRK expression Q2 2019 l l l l l l l l l l Tumour Mutation Burden (TMB) Q1 2019 l l l l l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above l Mutation KEY l Over expression / elevated / gene amplification l Other
  • 22.
    21 Indications added inQ1 2018 Cancer-specific diagnostic and prognostic biomarkers are collected IQVIA Global Oncology Capabilities Cancers Available from Connective & Soft Tissue Gall Bladder GIST Mesothelioma NETs Myelodysplastic Syndromes C-KIT Q1 2018 l Ki-67 antigen level Q1 2018 l l Microsatellite instability Q1 2018 l l l l l Minimum residual disease Q2 2019 l Mitotic index Q1 2018 l l l PD1/ PD-L1/PD-L2 % expression Q1 2018 l l l l l l TRK expression Q2 2019 l l l l l Tumour Mutational Burden (TMB) Q1 2019 l l l l l l NOTE: Not all biomarkers are collected in Italy for the cancers listed above While we might have back data for these indications , we will not have all biomarkers in these indications – these have been created as new indications in Q1 2018 so biomarkers will be aligned from then. l Mutation KEY l Over expression / elevated / gene amplification l Other
  • 23.
    22 The sample canbe boosted for a tumor, subpopulation, and lines of therapy of choice Additional ovarian cancer and melanoma patients are collected each quarter to ensure a robust sample in later lines of therapy IQVIA Global Oncology Capabilities Custom OD Boost • Population of interest • Select lines of therapy Running Boost: Melanoma • Advanced or metastatic stage • 2nd and 3rd+ lines of therapy • EU5: since Q1 2019 and running Running Boost: Ovarian cancer • Advanced or metastatic stage • 2nd and 3rd+ lines of therapy • EU5: since Q2 2018 and running Oncology Dynamics
  • 24.
    23 Drug-treating specialties contributingto the Oncology Dynamics survey Global Panel Coverage in Oncology Dynamics IQVIA Global Oncology Capabilities Specialties* France Germany Italy Spain UK Japan China South Korea Mexico Saudi Arabia Romania New for 2019 Brazil New for 2019 Dermatology ENT GI medicine Gynecology Hematology Hepatology Oncology Pulmonology Radiotherapy Urology Surgery Total** 231 246 475*** 222 221 418 750 130 102 45 76-81 73-91† *Specialty distribution design derived from findings of a large IQVIA survey conducted in 2015 & 2017 **Quarterly targets for 2019 ***Large panel due to sub-regional offering available in Italy †Q2–Q3 2019 range
  • 25.
    24 Oncology Dynamics dataare projected based on a robust projection methodology IQVIA Global Oncology Capabilities Sample patients are projected to an aggregated annual treated prevalence figure at the key cancer and specialty level within country. Physicians Patient Prevalence Physician Universe Treated Prevalence The number of physicians in the panel is projected to the universe for that specialty The number of patients treated by the physicians in each specialty is projected to the universe to provide national prevalence in each cancer and country *A large study conducted in 2015 & 2017. Data from a large sample of nearly 5,000 physicians across all specialties were collected to evaluate the prevalent treated population and the specialties treating cancer patients. The study was conducted in France, Germany, Italy, Spain and the UK. • The IQVIA Physician Universe Study* is used to define the right mix and weighting of specialties which allows more accurate projections to market level • The projection methodology takes into account varying workload levels of participating physicians OD Physician Panel OD Physician Workload
  • 26.
    25 Type of Facilityby Country G5 EU Sample Base: 891 Facilities 72% 29% 90% 85% 97% 15% 13% 8% 10% 15% 3% 63% 155 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. PUBLIC PRIVATE NO PROFIT PRIVATE OFFICE BASED PRACTITIONER
  • 27.
    26 Status of Facilityby Country G5 EU Sample Base: 891 Facilities 65% 22% 82% 34% 36% 35% 14% 18% 66% 64%63% 155 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. Non University University Office Based Practitioner
  • 28.
    27 Facilities by BedRange G5 EU Sample Base: 763 Facilities 25% 39% 40% 25% 20% 25% 14% 29% 30% 25% 50% 47% 30% 45% 55% 155 74 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% France Germany Italy Spain U.K. < 250 250 - 500 500 >
  • 29.
    28 Facilities by Country G4EU Sample Base: 736 Facilities 12% 7% 8% 11% 23% 63% 88% 61% 1% 30% 4% 28% 63% 202 263 143 128 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Germany Italy Spain U.K. CANCER HOSPITAL MAIN CANCER UNIT NO CANCER UNIT OFFICE BASED PRACTITIONER
  • 30.
    29 249 273 572 265 286 169 230 298 158 154 20486 27035 35652 21952 21752 FRANCE GERMANY ITALY SPAIN U.K. 0 5000 1000015000 20000 25000 30000 35000 40000 No.Patients No. Facilities No. Respondents Sample Summary MAT Q3 2019 Patient, Facilities and respondent sample size
  • 31.
  • 32.
    31 While oncologists arethe main therapy initiations for gastroenteropancreatic neuroendocrine tumors treatment in EU5, surgeons take the lead in Benelux -10 -5 0 5 10 15 20 25 30 35 40 45 50 55 60 65 -10 -5 0 5 10 15 20 30 35 40 45 50 55 60 65 Benelux Oncologist Surgeon EU5 Endocrinologist Gastroenetrologist Illustrative (dummy data)
  • 33.
    32 Therapy initiators forSomatuline by ICD-10 indication in the UK&I C7A.020 C25.8 C26.9 OncologistsPulmonologists Onco-Haematologists Radiotherapists Dermatologists Endocrinologists Illustrative (dummy data)
  • 34.
    33 Interesting findings publishedin the medical domain using Oncology Dynamics data IQVIA Global Oncology Capabilities NSCLC pts with brain metastases are not treated as expected (lack of guidelines, no clinical trial data available). Abstract accepted at American Oncology conference 2018 Unexpected immune related side effects for innovative targeted therapies. Presented at European Oncology Conference 2017
  • 35.
    34 Deliverables IQVIA Global OncologyCapabilities • Dataview database – Allows advanced data manipulation and groupings • OD Easy Access: Web-based Microstrategy® application. – Core application with pre-defined reports Syndicated • Customised reports – Developed to meet specific clients’ needs: Excel, PowerPoint, customized dashboards that can be built using the Microstrategy Visual Insights solution • OD Custom View: – Customised analyses based on parameters not included in Dataview or in the web-based application e.g. time gap analysis, treatment duration, dosing, multi-variables patient profiling analysis, volume use by indication, more… Customised
  • 36.
    35 For further information,please contact: Weronika Ficek Business Development Specialist, Secondary Care Solutions +44 7880 378081 Weronika.Ficek@iqvia.com Thank you

Editor's Notes

  • #33 5 min analysis, 30 min formatting
  • #34 5 min analysis, 30 min formatting
  • #35 Data Used: Diagnosis Insights, December 2015 Analysis: Chart data included for New, Switch , Repeat bar chart, person indicated in sections Contact: Claude Herinckx, Dir, Offering Development, RWES Best Practice Recommend: Product positioning is about patients first. Analysis of market dynamics and future market potential allows companies to size the addressable market, identify opportunities and understand the potential place for an agent, new or existing, in the patient journey.