Zayna Khayat, PhD., MaRS, Canada
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1 Zayna Khayat, PhD., MaRS, Canada MaRSMission: improve public health & Improve health system performance, & drive the new health economy Senior Advisor, Director of EXCITE program pre-market health technology evaluation Adjunct professor, Health strategy, RotmanSchool of Management, U. of Toronto Health and Life Science consulting - Boston Consulting Group & KPMG
2 Developing talent Growing ventures Opening markets Ensuringwide scale adoption of precision medicine technologies Zayna SEPTEMBER 19, 2015 Visit us at marsdd.com
3 Health Energy & Environment Finance & Commerce Work & Learning 9/26/2016
4 The Future of Health 1. Timing Today: System Reactive, delayed, sick care Future: Citizen Anticipatory, predictive 2. Tailoring 3. Modality 1 size fits all [none] Institution-centred Individualized,configurable,precise Dephysicalized, Digi-cal 4. Duration 5. Power 6. Biz Model Episodic, intermittent, silo d Provider Volume-based Continuous, team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 4
5 Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Visit us at marsdd.com Innovation capacity Outdated regul n Today: System Push vs. pull Infrastructure Procurement/diffusion Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 5 Developing talent Growing ventures Opening markets
6 Invention + Adoption = Innovation Invention Adoption
7 Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Visit us at marsdd.com Innovation capacity Innovation capacity Outdated regul n Procurement Push instead of pull Infrastructure Procurement Push instead of / diffusion pull Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 7 Developing talent Growing ventures Opening markets
8 Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Innovation capacity 1. Innovation capacity Outdated regul n Procurement Infrastructure Push instead of pull Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 8
9 9/26/2016
10 The problem:incumbent institutions largely designed to stifle innovation Zayna Khayat MaRS Discovery District (2016) 10
11 Corporate vs. Startup A permanent organization designed to execute a repeatable and scalable business model A temporary organization designed to search for a repeatable and scalable business model Source: Steve Blank Zayna Khayat MaRS Discovery District (2016) 11
12 MaRS Corporate Innovation Platform Roland Harwood, Open Innovation (2014) (Reproduced) Zayna Khayat MaRS Discovery District (2016) 12
13 Corporate Innovation Partners
14 Health Innovation Centre Meetup (Hosted by MaRS)
15 40,000 square MaRS health startups incubated Rx + med tech + digital health + consumer Access to J&J global networks No strings attached model
16 Outdated regul n Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Innovation capacity Procurement 2. Push instead of pull Infrastructure Push instead of pull Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 16
17 Hurdles to full value capture from med tech Patients accessing technology (+ Obsolescence of old) Developing talent Growing ventures Opening markets 1. Evidence 6. Adoption 2. Licensing 3. HTA, Coverage decision 4. Funding, fee codes 5. Procurement Time Visit us at marsdd.com
18 Pull model for innovation U Pre-Market Post-Market Diffusion E f f e c t i v Effectiveness e n e s s Systematic review Systematic review Cost Effectiveness Cost Effectiveness (CE) Obsolescence Efficacy Safety Value (CE) Affordability Ethical & societal Post-market conditions Efficacy Safety Value (CE) Affordability Ethical & societal Post-market conditions Yes Unconditional No TIME Regulation Reimbursement Zayna Khayat MaRS Discovery District (2016) 18
19 EXCELLENCE IN CLINICAL INNOVATION & TECHNOLOGY EVALUATION Health System Regulators + 24 research hospitals + >30 community health orgs Academic HTA + 15 others Industry Zayna Khayat MaRS Discovery District (2016) 19
20 P R E L I M I N A R Y EXCITE International: Extending the model globally International Board International Scientific Collaboration Develop accepted frameworks to assist EXCITE International affiliates in their work EXCITE INTERNATIONAL SECRETARIAT International Leadership Centres Coordinates multinational evaluations for MNEs and SMEs Facilitates MC quality frameworks Advises/assists members in setting up local EXCITE like operations EXCITE International Affiliates CANADA(MARS) US UK NL NZ Others
21 Outdated regul n Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Visit us at marsdd.com Innovation capacity Procurement Infrastructure 3. Push Procurement instead of / pull diffusion Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 21 Developing talent Growing ventures Opening markets
22 Exponential tech. Linear health system Time to reach 50 M users 17 yrs Average time from evidence to practice in medicine: 17 years Vala Afshar; Citi Digital Strategy Team; Michael Felton, The New York Times (in HBR.org) 22
23 REACH: Outcomes-based procurement Resources for Evaluating, Adopting and Capitalizing on Innovative Healthcare Technology A program to help Ontario healthcare providers use new ways to evaluate, buy and more rapidly adopt beneficial medical technologies addressing highpriority health system problems. REACH will provide a pathway for innovative technologies to earn access to the Ontario market. Zayna Khayat MaRS Discovery District (2016) 23
24 Procurement by Co-Design Program $50K to help health organizations buy innovative med tech INITIATION DESIGN & PROTOTYPE 10 weeks 32 weeks Provider Challenge Briefs Design Discovery Vendor Innovator Briefs Vendor Selection Prototype $25K PROCURE Procurement voucher $25K Evaluate Final evaluation Zayna Khayat MaRS Discovery District (2016) 24
25 Outdated regul n Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Innovation capacity Procurement Infrastructure Push instead of pull Consumer User Payer Outdated delivery models 4. Information asymmetry Fragmentation / lack of scale Incentives/payment schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 25
26 Information Asymmetry Source: Lucien Engelen, Radboud Medical University Centre (Netherlands) Zayna Khayat MaRS Discovery District (2016) 26
27 Data Everywhere Developing talent Growing ventures Opening markets Medical record = Phenome Visit us at marsdd.com Source: Exponential Medicine 2015 Zayna Khayat MaRS Discovery District (2016) 27
28 MyHealth: Data flows to/thru Patient Zayna Khayat MaRS Discovery District (2016) Source: Lucien Engelen, Radboud Medical University Centre (Netherlands) 28
![Outdated regul n Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Innovation capacity Procurement Infrastructure Push](/docs-images/95/124897667/images/29-0.jpg "instead of pull Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale 5.")
29 Outdated regul n Today: System Reactive, sick care 1 size fits all [none] Institution-centred Episodic, intermittent, silo d Provider Volume-based Innovation capacity Procurement Infrastructure Push instead of pull Consumer User Payer Outdated delivery models Information asymmetry Fragmentation / lack of scale 5. Incentives/payment schemes schemes Future: Citizen Anticipatory, proactive, predictive Individualized,precise Dephysicalized, Digi-cal Continuous team People-powered Outcomes-based Zayna Khayat MaRS Discovery District (2016) 29
30 HowGoogleWorks.Net Zayna Khayat MaRS Discovery District (2016) 30
31 Buying outcomes, not products Value = Outcomes Costs All or some portion of payment made to a product or service provider is contingent on meeting a set of results Zayna Khayat MaRS Discovery District (2016) 31
32 New outcomes financing vehicles Social impact bond in hypertension Intermediary Investor(s) Success payments Capital investment Service provider Success payments Outcomes payer Health intervention Target population Outcome measures Evaluator
33 Developing talent Growing ventures Opening markets Invention + Adoption = Innovation Visit us at marsdd.com
34 KEEP CALM & KEEP INNOVATING Developing talent Growing ventures Opening markets Zayna Khayat, Ph.D. MaRS INNOVATION B ECAUSE THE FUTURE MAT TERS Visit us at marsdd.com Zayna Khayat MaRS Discovery District (2016) 34
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