Pharma 3.

0 and Technology

Nagesh Rajanala
Sr. Principal, CSC

 Where did I go from XIM ?

Mafatlal Textiles, Navsari, Mumbai 1995
Siemens, Mumbai, 1996
CBSI, Farmington Hills, MI, 2000

Rebranded as Covansys
Acquired by CSC, Falls Church, VA, 2008-09
Lived in CA, MI, MO, NJ

Currently Sr. Principal

Housekeeping
9:45 pm ?
US examples
Questions and perspectives any time

By the end of this session

Disruptive Nature of Technology

The Convergence of Key Technologies
Pharma 3.0

Strategic Imperatives
Focus on sustained shareholder value
Aggressively Deliver the Phase II and Phase III Portfolio
Prioritize Our Portfolio to Deliver the Most Value

Become a Top Tier Biotherapeutics Company

Be Respected by Society

Life Sciences Is a Fast-Changing Business Environment

Business Portfolio
Evolution
Patent cliff, over $100 billion $ in drug sales lost
between 09 12.
Evolution of chronic, easier-to-treat conditions
to diseases with higher medical need.
Developing orphan drugs, which have extra
patent protections and a streamlined regulatory
review in some countries.

Growing regulatory
and risk concerns
New pharmacovigilance legislation will significantly
increase data provision requirements and the burden
on regulatory operations and systems.
Weak or incomplete supply chain security is
exacerbating the spread of counterfeit drugs.
Increasing scrutiny of manufacturing processes to
ensure product safety.

#1

Market Treatment Changes

Convergence of product innovation, lifestyle
evolution, and government mandates/regulations
taking place.
Companies are leveraging new techniques to
develop improved treatments for high unmet
medical needs for increasingly informed
consumers.

Heightening demand
for managing profitability
Invent and bring to market more products to fill the
pipeline and generate comparable revenue levels.
Worldwide, payers are pushing for lower drug prices
to counter their own budget pressures to make
health care more affordable for the public.
Payers and drug regulators are demanding that
products demonstrate superior patient benefits
before granting reimbursement and marketing
approvals.

General Timeline to bring a new drug to market ... ~12 years

with 5-10,000 compounds and that the

average cost to bring a new product to
market is $1.2-1.3 billion.
5-10,000
compounds

The full cost to bring a new drug (a new chemical entity) from
discovery to approval and launch is estimated to be $1.2 1.3 billion.

1
approved

http://projects.propublica.org/graphics/bigpharma
http://online.wsj.com/news/articles/SB10001424052702304450904579369281649597054

Patent Cliff - $63B

http://www.rsc.org/chemistryworld/Issues/2009/January/PharmaRefocusesOnThePatentCliff.asp

The Affordable Care Act

WHY THE LAW WAS NEEDED
Insurance companies had discretion to deny coverage for pre-existing conditions
Premiums had more than doubled over the last decade, while insurance company profits were soaring
Tens of millions were underinsured. Insurance companies had discretion to withdraw coverage
50 million Americans had no insurance at all
Cost of healthcare was spiraling
WHAT THE LAW DID
Insurance companies cannot deny coverage for pre-existing conditions or put lifetime maximums
Preventive services became free - Cancer screenings such as mammograms & colonoscopies, Vaccinations
such as flu, mumps & measles, Blood pressure screening, Cholesterol screening, Tobacco cessation counseling
and interventions, Birth control, Depression screening
Mandated that Insurance companies overhead decrease from 40% to 20%
Mandated that all Americans have coverage

Children can stay on parent policies till they are 26

Established competitive Insurance exchanges at State and Federal level
Strengthened accountability and penalties
Introduced pay for health outcomes

What is Pharma 3.0

DRIVERS FOR CHANGE
Patent Expiration
R&D ROI
Globalization
Personalized Medicine
Rise of the Payors

DRIVERS FOR CHANGE

Healthcare Reform
Patient participation
Emerging Technologies
Pharma, Payor, Provider and other

PHARMA 1.0

PHARMA 2.0

PHARMA 3.0

BLOCKBUSTER ERA

INNOVATION &
PORTFOLIO
DIVERSIFICATION

HEALTH OUTCOMES

PERSONALIZED
MEDICINE

PATIENT PARTICIPATION
RISE OF MED DEVICES
PHARMA 4.0
FOUNDATION
GENETICS AND
INDIVIDUAL THERAPY

Payer

Physician
Patient

Patient care Eco-System

Industry in Active consolidation phase

Valeant Allergan

$54B

Abbvie Shire

$53B

Medtronic Covidien

$42B

Pfizer Wyeth

$62B

Pfizer AstraZeneca

$116B ?

The INVERSION Debate

End User / Consumer Behavior

As patients,
We take what the doctor prescribes
We rarely look at who made the drug
We rarely research the literature around the drug
We almost never try to find out what experiences other users have had

We pay for the service not for the outcome

The Trust Issue

A Deloitte survey of general population in 2012: Respondents Trust:
Doctors and academic centers most
Companies like WebMD Next
Google search results next
At the bottom of the list is pharma and payor companies.
A more recent study, by Makovsky Health:

Found that only around 35 percent of consumers would trust a disease website
sponsored by a pharmaceutical company,
and 16 percent said they would never visit a disease website sponsored by a
pharma company.
http://mobihealthnews.com/32728/in-depth-pharmas-digital-health-opportunities/

Strategic Imperatives
Focus on sustained shareholder value
Aggressively Deliver the Phase II and Phase III Portfolio
Prioritize Our Portfolio to Deliver the Most Value

Become a Top Tier Biotherapeutics Company

Be Respected by Society

The Disruptive Power of Technology

http://scoop.intel.com/files/2012/03/infographic_1080_logo.jpg

My plane was 50 mins away from landing in Minneapolis for AGT auditions today, when it turned round and is now heading BACK to NY.
Can someone explain to me, perhaps from Delta, what the **** is going on as none of your crew seem to have the foggiest?
I will now be landing back in New York an hour before Im supposed to start judging AGT auditions in Minneapolis. Thanks Delta.
Someone told me DELTA stands for Dont Ever Leave The Airport. Not correct. They leave, then come back again. #utterfarce
Pilot: Good news is well be on the ground in about 25 mins. Yes, but its the wrong ground, isnt it my friend? The WRONG BLOODY GROUND.

Still on tarmac. Not moving. Ominous.

Flight attendant just smiled, then whispered to me: Not looking good. #mixedmessageWe are de-planing everyone off. What an absolute bloody joke. Be
ashamed Delta. This is shocking even by your standards.
And you can all relax at Delta now because the gates of Hades will freezeth over before I darken your pitifully incomptent doors again.
So sorry to AGT audience for not being there today. Never missed a show in six years. Will be there tomorrow if I have to yomp there.
Admit it, even if you hate my guts, youre pulling for me now in Operation Get Morgan To Minneapolis right?
This is at about 9 p.m. last night:
Engines on. De-icing finished. I see a flicker of light at the end of this long dark tunnel.
Taking off! Minneapolis, here I come. #notgoodnewsfordodgycontestants
At midnight today Touchdown. Im in Minneapolis. Thank you Tim Mapes the man who single-handedly, and against all odds, restored my faith in Delta.
To deploy, and slightly amendm, the vernacular of @charliesheen its been a day of quite spectacular whining, duh Apologies.
Morgan will be in Atlanta April 12 to 14 for Americas Got Talent auditions at Fox Theatre. Will he use Delta then?

The Internet of Things

+
Vehicle, Asset, Person & Pet
Monitoring & Controlling

Agriculture
Automation

Security & Surveillance

Building
Management

50 BILLION DEVICES INTERNET CONNECTED BY 2020

Embedded
Mobile

Everyday
Things

Smart Homes
& Cities

Telemedicine
& Healthcare

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY
21

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY
22

50% of Americans who had a credit card were impacted

Malware attacks on Yahoo! (January, 2014)
Top 10 healthcare
breaches
for 2012
December
19, 2013
- Target
Syrian Electronic Army Hacks Skype's Platforms
announcesofdata
breach.
40-70
million
Utah
Department
Health
780,000
records
(January, 2014)
records initially reported lost.
Snapchat
Hacked
in Dec 2013-Jan
Emory
Healthcare
- 315,000
records 2014 - 4.6
millionJanuary
accounts22,
safe
2014hack
- Neiman Marcus
S.C. Dept. of Health and Human Services - 228,435
releases
a statement
about
discovering
Adobe
Hacking
- 38 Million
Accounts
Affected
records
(Oct 2013) stolen payment data.
Alere
Monitoring,
Inc.Explosions'
- 116,506 records
FakeHome
Tweet
on 'Obama,
Causes
January
26, 2014
- Michaels
Market announces
Panic
Memorial
Healthcare System,
- 102,153
possibleFla.
data
breach,records
Burger
King Hacking
(US)and
(Feboffering
2013) credit
alerting
customers
Howard University Hospital - 66,601 records
Saudi Arabia Hackers
Breach
400,000 Israeli
monitoring
services.
Apria
Healthcare
- 65,700
Credit
Cards (Jan
2012) records
February 19, 2014 - University of
Sony
Pictures
and- 64,846
Playstation
3.0 Hacking (June
University of Miami
records
Maryland announces data breach.
2011) 1 Million accounts
Safe Ride Services - 42,000 records
300,000 million records initially
reported Puerto
lost. Rico - 36,609
Medical Integration Services,
records

Nortel Networks had a market cap of $398B in Sept 2000.

The stock represented 36% of the entire Toronto Stock Exchange
In Aug 2002, the Market Cap was less than $5B
Stock price went from $124 to $0.47

There were many business reasons for the collapse.

Hacking was one of them: The passwords of seven top executives were
stolen and used to copy internal R&D reports, design, code etc to create
cheap knockoffs that flooded the market.

Code Spaces : Is Down!

Dear Customers,
On Tuesday the 17th of June 2014 we received a well orchestrated DDOS against our servers, this happens quite often and we
normally overcome them in a way that is transparent to the Code Spaces community. On this occasion however the DDOS was
just the start.
An unauthorised person who at this point who is still unknown (All we can say is that we have no reason to think its anyone who
is or was employed with Code Spaces) had gained access to our Amazon EC2 control panel and had left a number of messages
for us to contact them using a hotmail address
Reaching out to the address started a chain of events that revolved around the person trying to extort a large fee in order to
resolve the DDOS.
Upon realisation that somebody had access to our control panel we started to investigate how access had been gained and what
access that person had to the data in our systems, it became clear that so far no machine access had been achieved due to the
intruder not having our Private Keys.
At this point we took action to take control back of our panel by changing passwords, however the intruder had prepared for this
and had already created a number of backup logins to the panel and upon seeing us make the attempted recovery of the
account he proceeded to randomly delete artifacts from the panel. We finally managed to get our panel access back but not
before he had removed all EBS snapshots, S3 buckets, all AMI's, some EBS instances and several machine instances.
In summary, most of our data, backups, machine configurations and offsite backups were either partially or completely
deleted.
This took place over a 12 hour period which I have condensed into this very brief explanation, which I will elaborate on more
once we have managed our customers needs.

The gains from a networked world is matched by the pains

A 2012 study revealed that the median # days before a compromise

is detected is 416 days
94% of data breaches were discovered by an external entity
2013 Data Breach cost by industry, per lost record: Healthcare
($233), Financial ($215), Pharmaceuticals ($207)

26

Barnaby Jack Could Hack Your Pacemaker and stop the heart

http://www.vice.com/read/i-worked-out-how-to-remotely-weaponise-a-pacemaker
implantable cardioverter defibrillator

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY
28

Moving Business Analytics to the Next Level

Integrating M2M, Data Services and Open Source Data Drilling

In Memory BIG DATA Repository & Replication Services

Data Services & Open

Source Data

Enterprise
Systems
Volunteered Social
Data

BI
Cubes
Machine-to-machine
Data

EDW
EDW
EDW
Transactional Systems

When You Connect the Right Dots, the Ocean of Data Becomes Meaningful
Orphan Drugs
Regulatory Review

Regulatory

Payers

Chronic Diseases

Quicker
Approvals

More Products

Patients

Treatment Options

Discharge
Geography
Letters
Patient
Patient Satisfaction Medication
Risk Profile
Medical
ICD Codes
Age, Gender
History
Health Plans
Quality Reports
Treatment Plans
Claims Data
Result
Reports
Diagnoses Lab Results

Pharma

Suppliers

Clinical Trials
Improved Treatments
Superior Patient
Outcomes

Improved Clinical
Trials

Scientific data

Personalized
Medicine

Exposure data

Refined Risk
Management

How Target Figured Out A Teen Girl Was Pregnant Before Her Father Did

Target grew from $44 billion in 2002 $67 billion in 2010 primarily due to
huge success in tapping into the baby product market

Through Data Mining of birth registry data, Target identified about 25

products that, when analyzed together, allowed them to assign each
shopper a pregnancy prediction score.
Apart from the score, they could also estimate a shoppers due date
to within a small window, so Target could send coupons timed to very
specific stages of the pregnancy.
Would it spook customers if stores knew about their pregnancy?
http://www.forbes.com/sites/kashmirhill/2012/02/16/how-target-figured-out-a-teen-girl-was-pregnant-before-her-father-did/

PRIVACY & ETHICS

WHOSE DATA IS IT ANYWAY ?

Right to be Forgotten online

639800 G Data moved each second
The use of Sensors will increase data multi-fold
Consumer behavior varied
Government regulations not uniform

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY

THE CONVERGENCE
33

SaaS-BASED
VERTICAL
APPLICATIONS

BUSINESS PROCESS MANAGEMENT SYSTEMS

MID RANGE
APPLICATIONS
MAINFRAME
APPLICATIONS

ENTERPRISE APPLICATION INTEGRATION MESH

EXISTING
APPLICATIONS

SaaS-BASED
HORIZONTAL
APPLICATIONS

TRADITIONAL
APPLICATIONS

SaaS
DEPLOYMENT

CLOUDIFICATION
THROUGH MODERNIZATION

PVT Cloud

DATA SERVICES

SECURITY

INNOVATION QUOTIENT

CONSUMER
APPLICATIONS

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY
35

Mobile use exceeds PC in 2014

Applications across industries

DESIGN / DEVELOPMENT / TESTING / SECURITY

http://internetmedicine.com/2012/12/14/top-ten-medical-uses-of-the-iphone/

Google Novartis: Contact lens that can measure Sugar level

Proteus Digital Health

Medical Apps in the Pharma 3.0 Era

- Non-medical apps critical for health care providers
- Drug Reference
- Medical Literature Curation apps
- Medical Calculators
- Medical Language translators

- General Reference
- Patient Education
- Specialty Education

- Continuing Medical Education (CME)

- Social Networks

http://mobihealthnews.com/32728/in-depth-pharmas-digital-health-opportunities/

Janssen Healthcare Innovation

Cost of Human Gene Mapped for the first time in 2003: $1 B spent

Cost of Human Gene Mapping in 2013: $10,000

Cost of Human Gene Mapping in 2014: $1,000
Cost of Human Gene Mapping in 2015-16: $100
You will have your Gene Map on your smart device

GOOGLE X PROJECT BASELINE

http://www.theverge.com/2014/7/25/5935413/google-project-baseline-collect-medical-data-for-human-health

3D printers for medical purposes

In 2013, scientists in China used a 3D printer to successfully produce a
functioning kidney.
In February 2014, a surgeon in England created and implanted a pelvis
from a 3D printer to help a cancer patient walk again.
But where does 3D printing of body parts stop? And should it stop?

APPLICATIONS
MOBILITY
CLOUD
BIG DATA
CYBER SECURITY
43

Trends CIOs View

Lowering IT costs (64%), streamlining operations (59%), and sharpening competitiveness (27%) top the list as the three most
important reasons for enterprise organizations to modernize applications.
Lower IT costs

64%

Streamline operations

59%

Sharpen competitiveness

27%

Grow the business

25%

Increase mobility

21%

Enhance customer loyalty

13%

Get greener

11%

Move to the Cloud

11%

Other

21%
0%

10%

20%

30%

40%

50%

Q3: What are your organizations top three reasons for modernizing your applications? (Please check only top three.)
Base: 92 qualified respondents that have modernized or plan to modernize applications

http://www.enterprisecioforum.com/en/benchmark/application-modernization-benchmark-tool

60%

70%

Trends CIOs View Cont

Levels of legacy apps at enterprise organizations are mixed.
One-quarter (25%) of the respondents indicate that 50% or more of their enterprise applications are legacy applications. An additional
quarter (27%) estimate that between 25%-49% of their enterprise apps are legacy apps, while another 25% report that 10%-24% are
legacy apps. Just under one-quarter (23%) reveal that less than ten percent are legacy apps , with 6% of those reporting that none of
their enterprise apps are legacy apps.
7%

75% or more

18%

50%-74%

27%

25%-49%

25%

10%-24%

17%

Less than 10%

None

6%

Q4. Approximately what percentage of the enterprise applications at your organization are legacy applications?
Base: 102 qualified respondents

Trends CIOs View Cont.

Over half of respondents report that implementation costs (55%) and a lack of resources (53%) are the greatest challenges to
application modernization in their organization.
55%

Implementation costs
53%

Lack of resources
36%

Downtime

35%

Risk/liability
28%

Hard to build an ROI case

Compliance/regulatory requirement

27%

Lack of skill sets

27%
25%

Lack of integrated planning between IT and business

24%

Security concerns
21%

TCO

20%

No internal strategy developed

15%

Absence of proven technology

Possible loss of customers

8%

Other

8%
0%

10%

20%

30%

40%

Q6. What are the top challenges to application modernization in your organization? (Please check all that apply.)
Base: 102 qualified respondents

50%

60%

SaaS-BASED
VERTICAL
APPLICATIONS

BUSINESS PROCESS MANAGEMENT SYSTEMS

MID RANGE
APPLICATIONS
MAINFRAME
APPLICATIONS

ENTERPRISE APPLICATION INTEGRATION MESH

EXISTING
APPLICATIONS

SaaS-BASED
HORIZONTAL
APPLICATIONS

TRADITIONAL
APPLICATIONS

SaaS
DEPLOYMENT

CLOUDIFICATION
THROUGH MODERNIZATION

PVT Cloud

DATA SERVICES

SECURITY

CONSUMER
APPLICATIONS

CSC: WHO WE ARE

CSC
A GLOBAL IT
POWERHOUSE

83,000

EMPLOYEES OPERATING
IN 70 COUNTRIES

#162

RANKING ON THE
FORTUNE 500 FOR 2012

$15.5B

GLOBAL IT
SERVICES POWERHOUSE

50+

YEARS OF INNOVATION

100+

Computer Sciences Corporation

GLOBAL ALLIANCES
WITH BEST-IN-BREED
PARTNERS

CSC: WHAT WE DO

Leading Next-Gen Technology and Business

Solutions
Industries

Energy
and Natural
Resources

Financial
Services

Healthcare &
Life-sciences

Manufacturing

Public
Sector

Communications
and
High-Tech

Travel
and
Transportation

INDUSTRY EXPERTISE

Solutions
Cloud

Applications
Services

Business Process
Services and
Outsourcing

Big Data &

Analytics

Cybersecurity

Consulting

Infrastructure
Services

Software
and IP

Consumer
and
Retail

CSC:
Serving Enterprises and Governments Worldwide*
Financial Services

Healthcare and Life Sciences

Sirirai Hospital, Thailand

Manufacturing

Energy/Natural Resources
Tech/Consumer
Transportation

Public Sector
Ministry of Health, Malaysia

*Representative client list

Moving Business Analytics to the Next Level

Integrating M2M, Data Services and Open Source Data Drilling

In Memory BIG DATA Repository & Replication Services

Data Services & Open

Source Data

Enterprise
Systems
Volunteered Social
Data

BI
Cubes
Machine-to-machine
Data

EDW
EDW
EDW
Transactional Systems

http://www.informationweek.com/big-data/big-data-analytics/16-top-big-data-analyticsplatforms/d/d-id/1113609?piddl_msgorder=asc&image_number=3
http://www.bigdata-startups.com/open-source-tools/#!prettyPhoto

eGain

eGain