Health Care and Digital in Italy. Daniela Bianco, Partner e Responsabile Health Care Unit Alessandro Viviani, Principal Expert Digital Strategy

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1 Health Care and Digital in Italy Daniela Bianco, Partner e Responsabile Health Care Unit Alessandro Viviani, Principal Expert Digital Strategy

2 Key drivers and Health Care evolution 1 2 ECONOMIC RESOURCES AND FINANCIAL ISSUES 3 DEMOGRAPHY AND CHRONIC DISEASES Health Care System TECNOLOGIES INNOVATION Source: Meridiano Sanità 2017 Report, The European House-Ambrosetti

3 In Italy, the incidence of healthcare expenditure on GDP has been decreasing in the last years and is forecasted to decline even more in the future Trend of the ratio between healthcare expenditure and GDP (%), Source: elaboration of The European House - Ambrosetti on Ministry of Economy and Finance data, 2018

4 Health Care Public Expenditure Pro capite 2017 and trend , ,0 127, ,4 Germania Francia EU-14 Regno Unito Italia = 100 Fonte: Elaborazione The European House - Ambrosetti su dati OECD, 2018 Francia Germania Italia Regno Unito

5 Changes in demographic structure Individuals over 65 in Italy (millions), 2018, 2038 and 2058 Individuals in active age (15-64 years) in Italy (millions), 2018, 2038 and 2058 % of total population 23% 31% 34% 64% 57% 54% Source: elaboration of The European House Ambrosetti on Istat data, 2018

6 In Italy, the life expectancy is among the highest in Europe, but Life expectancy at birth in Europe (years), 2016 Life expectancy in Italy (years), 2006 and 2016 Source: The European House Ambrosetti on Eurostat data, 2018

7 Ageing population is typically accompanied by an increase of chronic diseases and by a greater pressure on healthcare systems and social-health assistance Presence of at least one chronic disease by age-group (%), 2015 Curve of healthcare costs by gender and age-group Source: elaboration of The European House - Ambrosetti on Istat and Ragioneria Generale dello Stato data, 2018

8 Technologies and Innovation: impacts on health Standardized Mortality Rate (per 100,000 inhabitants), Standardized prevalences for diseases (per 100,000 inhabitants), ,7% Malattie cardiovascolari 671,6 243,7 Malattie cardiovascolari ,7% -16,9% Neoplasie 244,8 203,5 Neoplasie ,1% -47,1% Malattie respiratorie 93,2 49,3 Malattie respiratorie ,9% -63,2% Malattie endocrine e metaboliche 28,6 30,9 Malattie endocrine e metaboliche ,2% Source: The European House Ambrosetti su dati Eurostat, Istat e ISS, 2018

9 Digital and Healthcare: a patient-centered vision Personalized medicine Evidence based medicine Electronic health records DIGITAL HEALTH Efficiency improvement e-prescription e-booking Big data analytics Data center Cloud Telemedicine Homecare Mobile Integration and personalization of care Source: The European House Ambrosetti, Meridiano Sanità Patient-centered vision Improved access and security/quality of carer

10 A new opportunity era is upcoming NEW APPROACH TO BAU GROWTH Development of activities of real utility for the S.S. and capable of enabling medium and long-term growth strategies for the most innovative and performing pharmaceutical and healthcare companies based on objective parameters that are more easily measurable with digital NEW BUSINESS MODELS Ideas of new business and service models thanks to mashing products and technologies Use of development and servitization platforms Today BAU BAU growth New business Tomorrow

11 Disruption in industry innovation models > 1,000 exponential technologies developed in parallel THINGS THAT CAN KILL YOU THINGS THAT CAN KILL YOU Technology cost drop Ecosystem models New business models

12 Health, pharma and digital industries convergences Everywhere Anytime Wearable device Blockchain Augmented reality IoT & Big data Biometrics Artificial Intelligenc e New technologies are transforming the healthcare industry in the same way that they have already transformed other sectors, leading to a convergence of health, pharmaceutical and digital services Patient centricity Long-term projects (customer total solution) Digital ecosystem Benefits fo PAYERS and all STAKEHOLDERS

13 Biotechnology in our daily life not only wearable > 275 M$ founding raised

14 Digitalizing human being > 300 M$ founding raised > 200 M$ founding raised

15 New straightway business opportunities AVAILABLE DIGITAL HEALTH TECHNOLOGIES TRIALS MANAGEMENT Digital platforms Analytics Personal device CONNECTED PATIENTS Continuous monitoring Alert system Implanted monitoring Fitness Diets Life style CUSTOMIZED THERAPIES DECISIONAL SUPPORT Big data Analytics Artificial Intelligence NEW BUSINESS OPPORTUNITIES PERSONAL WELLNESS ENTERPRISE WELLNESS ELDERLY AND ISOLATED POPULATION CHRONIC DISEASES (CHF, COPD, diabete, ecc.) MENTAL HEALTH

16 HOW TO INTEGRATE ALL OF THESE DECOUPLED DATASETS TO CREATE THE MAXIMUM VALUE FOR BUSINESSES AND CITIZEN?

17 New technology approach to data management NOT EXHAUSTIVE * BLOCKCHAIN It allows creating relationship environments through which to develop new business models able to leverage new digital technologies TOKEN People, devices, services WEREABLE BIG DATA & CLOUD ARTIFICIAL INTELLIGENCE NEW BUSINESS MODELS * Major pharmaceutical conglomerates Pfizer and Genentech, together constituting a market cap greater than $300 billion, recently announced the MediLedger blockchain platform, powered by JP Morgan's enterprise-focused, Ethereum-based Quorum, designed to keep counterfeit goods out of medical supply chains

18 Which role for Public Health System From the point of view of the Public Health System, it is necessary to address actions aimed at starting an innovation drive that guarantees efficiency for the public system and avoids the proliferation of diversified, untested and potentially unsafe digital environments for the citizen! It is therefore necessary to harmonize the models for the application of digital technology in healthcare, in order to enable the transition from an experimental logic to a structured logic of widespread use of new digital health services.

19 Guidelines for the Public Health System 1 2 DEFINITION OF NEW FRAMEWORK FOR THE TESTING AND USE OF SOFTWARE AND DEVICES IN IMPLEMENTATION BY HEALTH CONVENTIONAL HEALTH FACILITIES STRUCTURES OF NEW E-HEALTH THERAPEUTIC PATHWAYS 3 OPEN ECOSYSTEM APPROAHCES AND PROMOTION OF CENTRE OF EXCELLENCE IN E-HEALTH 4 INTEGRATION OF NEW DATA WITHIN CURRENT SYSTEM

20 New IoT ecosystem in healthcare OBJECTIVES Facilitate the exchange of information between patients and the various health service operators Ensure integration with the FSE on SISS Ensure autonomy of development by individual health structures and centers of excellence Enable the "agile" experimentation and the creation of new services Enhance appropriate partnerships with the technology suppliers Create an environment conducive to innovation in which to experiment in an "agile" way new proposals coming from the Health System, from industry players or from innovation environments

21 Thank you for your attention Daniela Bianco, Partner e Responsabile Health Care Unit daniela.bianco@ambrosetti.eu Alessandro Viviani, Principal Expert Digital Strategy alessandro.viviani@ambrosetti.eu

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