Current Market Dynamics and Future Vision of the Care Cycle Tim Irish Analysts Meeting June 15 th, 2005
Overview Market and Customer trends The Care Cycle and Molecular Medicine 2
Healthcare is the world s largest service sector 8% 2% 13% North America Western Europe Worldwide Healthcare Expenditure: US$3,300 bln in 2002 49% Japan China/Hong Kong North America makes up 49% of the worldwide spent Rest of the World 28% Source: Medistat Healthcare Expenditures will grow from ~8% of worldwide GDP to ~10% in 2010 10% 8% 6% 4% 2% Source: WHO 0% 1950 2000 2010 3
Demographics and economic developments add to long term growth 50% % of people over 60 years, Western World 40% 30% 30% 20% 20% 12% 10% 1950 2000 2050 0% 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 Sources: United Nations, Victor R. Fuchs (Stanford University) As national economies develop, healthcare investments follow 4
Demographics and economic developments add to long term growth 50% % of people over 60 years, Western World Share of Medical Expenditure 40% 30% 30% 20% 20% 12% 10% 1950 2000 2050 0% 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 Sources: United Nations, Victor R. Fuchs (Stanford University) All other countries Top 5 countries As national economies develop, healthcare investments follow Source: Medistat 5
$1 of Healthcare creates $2.5 of economic value through better outcomes Source: Medtap report, The Value of Investment in Healthcare, 2005 6
Healthcare delivers huge benefits Benefits from increased spendings since 1980, USA: From a human perspective: 470,000 less deaths 2,300,000 less people with disabilities 206,000,000 days less spent in hospital From an economic perspective: Delivering $ 1600 bln of economic value Iron lungs during Polio epidemic in the 1950 s Source: Medtap report, The Value of Investment in Healthcare, 2005 7
Medical technology continues to transform Healthcare Imaging earlier diagnosis saves lives and reduces costs Minimally invasive surgery reducing patient trauma and costs Healthcare IT Right Information at the right time enables better treatment and lower costs Molecular Medicine Preventing disease from happening Around 70% of the survival improvement in heart attack mortality is a result of changes in technology. Cutler & McClellan, 2001 Sources: Russ Coile, Futurescan 2003, SG-2 8
Imaging is key to lower Healthcare costs and improved patient outcome Imaging is about: Better diagnosis for better treatment Earlier detection to catch disease early Minimally invasive surgery to avoid trauma and shorten procedure time McKinsey, 2004 Continued advances in Imaging modalities will transform medicine during this decade SG-2, 2004 9
Big cost savings by Imaging in large teaching hospital 6 year CAGR cost growth Hospital costs 8% Imaging costs 8% Increase in number of patients imaged Imaging costs/patient 12% -4% Beinfeld et al., Radiology, 2005; 17,200 patients, 1996 2002 $1 of imaging saved $ 3 in hospital costs 10
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Nuclear Medicine 11
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Diagnosis of blood vessels Heart, Brain, Body; skeletal trauma (e.g., broken bones), chest & lungs, gastro-intestines (digestive tract), high-resolution mammography Nuclear Medicine 12
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Nuclear Medicine Cardiology: Detection, diagnosis and treatment of heart disease, heart attack, acute stroke, vascular disease; Ob/gyn; General Body: kidneys, liver, thyroid, and blood vessels. Also being used for breast imaging 13
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Cardiac & Vascular; Neurologic Diagnosis; Pelvic/abdominal, Spine, Lungs; Accidents/trauma cases Cancer Detection; CT Angiography (CTA) Nuclear Medicine 14
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Nuclear Medicine Soft tissue, such as the brain and nervous system; Spine, skeleton, joints: bone, cartilage, ligament, tendon, and images of inside the bone; Cardiovascular/ angiography: (MRA); Functional fmri; Abdominal; Pediatric 15
Ever expanding range of clinical applications X-Ray Ultrasound CT MR Nuclear Medicine SPECT: Coronary artery disease; Bones, lungs, brain, blood, gastrointestinal organs PET: Primary cancer and metastases; Neurology stroke, Alzheimer s, Parkinson s 16
Growth in imaging procedures driven by innovations in technology & clinical applications 450 400 350 300 250 200 150 100 50 0 1963 1973 1983 1993 2003 Source: Frost & Sullivan NM CT MR US CV X-Ray General X-Ray Avg. 10- Year CAGR 15% 25% 10% 5% 6% 2% TOTAL 4% Total Excl GXR 10% 17
Procedure Volume will continue to grow. Example: USA 20000 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 2004 2014 8% 5% 7% 26% 13% MR heart CT bloodvessels CT chest MR spine CT abdomen Source: SG2, June 2005 18
Creating long term growth in Imaging Market 18000 16000 14000 12000 10000 8000 6000 4000 2000 Growth of Diagnostic imaging equipment market (orders) Asia/Pac.(rest of) Japan Latin America EMEA NA 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 US$ On average by 5% per year Source: Nema, Cocir, JIRA, PMS analysis 19
Customer Dynamics Continuation of established trends Privatization of Healthcare Consumerism Pay-for-Performance programs Staffing shortages Productivity opportunities through new technology Increased New hospital construction New dynamics are becoming manifest: More large, multiyear, partnership deals with higher margins and risks Strategic partnerships 20
Hospitals and Health care systems continue to be financially challenged. Example: USA 45% 44% 42% 41% 41% 40% 41% 41% Percent of Hospitals with Positive Margins 0% Medicare Margin Percent of Hospitals with Negative Margins 56% 58% 59% 59% 60% 59% 59% 1998 1999 2000 2001 2002 2003 2004 Source: Healthcare Advisory Board 2004 21
Customers are slowly consolidating 5,194 880 870 860 5,134 Number of Community Hospitals Total number of hospitals and beds 5,057 5,015 850 4,956 4,915 4,908 4,927 840 830 820 1995 1996 1997 1998 1999 200 2001 2002 Community hospitals in the USA Similar trends in many Western countries Source: American Hospital Association, 312-422-3000, sha.org 22
Buying needs are changing towards longer term partnerships Support and Services: Biomedical service and a complete program of consulting and marketing assistance for your facility Capital Financing: Full-service financing resources include strategies for tax-free capital and variable term financing Technology Procurement: Alliance-level pricing for products and services and ongoing technology availability updates Partnership Elements Construction and Planning: Coordination of all aspects of new facility planning and implementation thru a consortium of industry experts Research: Mutually significant projects and collaborations defined with short and long-term objectives Education and Training: Philips offers a comprehensive on-line CE program to keep technologist credits up to date. New-user physician training programs provide revenue generation opportunities 23
University of Alabama, Birmingham Today Largest University Health System in Southeastern United States Complex includes 5 City Blocks 2.1 Million Square Feet 13 Major Free Standing Buildings 2010 75 City Blocks 12 Million Square Feet 17 Free Standing Buildings UAB Campus Master Plan 6th Univ. 18th 20th 24
Overview Market and Customer trends The Care Cycle and Molecular Medicine 25
Changing Care Cycle: Liver Cancer Surgery Therapy ICU Diagnostics Information & Decision support Rest in Peace Follow Up Lab Ward Symptoms 26
Changing Care Cycle: Liver Cancer Therapy Diagnostics Information & Decision support Follow Up Lab Symptoms 27
Changing Care Cycle: Stroke Rest in Peace Surgery Therapy ICU 40% Mortality today Diagnostics Information & Decision support 30% loss of independence Symptoms Follow Up Ward Ward 28
Changing Care Cycle: Stroke Therapy Diagnostics Information & Decision support Follow Up 29
The ingredients of Molecular Medicine Biomarkers In Vitro Diagnostics Image-guided Discovery In Vivo Imaging therapeutic agents Courtesy: Ciphergen Linking disease to bio-molecules Diagnosing Disease Targeted therapeutics 30
Changing Care Cycle: Preventing heart attacks Therapy Diagnostics Information & Decision support Follow Up 31
Breakthrough in Biochips for molecular biomarkers Building on Philips competences: Sensitive and compact magnetic detection techniques Magnetic nanoparticles as detection probes for bio-molecules Semiconductor technology Order of magnitude more sensitive than current technologies 32
Tomorrow s Modality: new Molecular Diagnostics platforms To fight sepsis: An estimated >1.5 mio sepsis cases (US and Europe only) every year in hospitals with an increasing rate of mortality Utilizing Philips in-house competencies in Miniaturization and Integration, to reduce diagnosis from days to hours 0,5 micron structures Philips unique Lab-on-a-chip solution Size: ~10 x12 cm 33
Tomorrow s Modality Today: Unique Molecular Imaging platform First high end SPECT-CT Unique information 34
To build the new Medical Paradigm: Molecular Medicine The Future Your own biochemistry becomes the basis for diagnosis and treatment Molecular imaging will screen people with genetically inherited & life-style risks 35
Conclusions Healthcare and medical technology add both human and economic value Very predictable growth outlook based on established growth drivers (demographics, chronic illness, technology, privatization and consumerism) Technology innovation to accelerate ever faster, ever more accurate and much earlier (more screening) The future lies in linking new technology applications to the Care Cycle Massive opportunities to increase both clinical outcomes and health economics through Care Cycle improvements 36
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