Mckesson Corporation · NYSE:MCK
Mckesson — Executive Performance Webinar Series: Clinical Leadership Education Sessions (March 2009)
26 slides from Mckesson's conference presentation, Mar 26, 2009
Slide 1: Personalized Medicine: Practical Applications, Future Implications
Personalized Medicine: Practical Applications, Future Implications Clinical Leadership Education Sessions 1 Executive Performance Webinar Series
Slide 2: Personalized Medicine: Practical Applications, Future Implications
Personalized Medicine: Practical Applications, Future Implications Frederick S. Lee, MD, MPH Surya Singh, MD Product Manager, Personalized Medicine Chief Medical Officer McKesson Corporation Proventys [email protected] [email protected] March 26, 2009 Executive Performance Webinar S
Slide 3: What you will learn
What you will learn The definition and key concepts of personalized medicine The trends and opportunities arising from advances in the biologic sciences The trends and opportunities arising from advances in healthcare IT Executive Performance Webinar Series: Clinical Leadership Education Sessi
Slide 4: Agenda
Agenda The definition and key concepts of personalized medicine The trends and opportunities arising from advances in the biologic sciences The trends and opportunities arising from advances in healthcare IT Executive Performance Webinar Series: Clinical Leadership Education Sessions 4
Slide 5: What is Personalized Medicine?
What is Personalized Medicine? “…personalized medicine uses new methods of molecular analysis [and predictive modeling] to better manage a patient’s disease or predisposition toward a disease. It aims to achieve optimal medical outcomes by helping physicians and patients choose the disease managem
Slide 6: Moving Beyond Population-Based Care
Moving Beyond Population-Based Care Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 7: Medical Decision Making
Medical Decision Making Today, at best … – Population based-evidence combined with individual clinician experience – Calculators, nomograms and criteria to risk stratify individuals Tomorrow, decision making will be … – Phenotype, environmental, clinical, and genomic factors in a “black box” ris
Slide 8: The Foundation of Personalized Medicine
The Foundation of Personalized Medicine Personalized Medicine Biologic Informatics Molecular Sciences & HCIT Diagnostics Novel Therapies EHR Disease Clinical Subtypes Adoption Databases Genomics Epigenomics Molecular Biostat Proteomics Basis of Disease Modeling Executive Performance Webinar Series:
Slide 9: Profound Transformation in Care Delivery
Profound Transformation in Care Delivery Enhanced ability to detect disease Disease Diagnosis Optimized therapies that increase efficacy Pharmacogenomics Personalized Medicine Deeper understanding of Risk & Disease disease subtypes & Classification risk predisposition Longitudinal management of an i
Slide 10: Today's Real World Examples
Today’s Real World Examples Warfarin: Genetically linked variability in patient response Prescribed to >2 million patients/year Common reasons for inpatient Rx: diagnosed clots (DVT or PE), clot prevention after heart attack 21% of patients (400,000/year) experience adverse bleeding events dur
Slide 11: Tomorrow's Examples
Tomorrow’s Examples Breast Cancer Testing Available Summer 2009 Executive Performance Webinar Series: Clinical Leadership Education Sessions 11
Slide 12: Delivery Challenges
Delivery Challenges General Preparedness Workflow Ambiguity HCIT Design Challenges Lab & Pharma Guidelines & Evidence Standards & Payors & Regulators Terminologies Rapid turnover of evidence base External Evidence Base Clinical Workforce Knowledge Delivery system capabilities Representation ~2300 ge
Slide 13: Agenda
Agenda The definition and key concepts of personalized medicine The trends and opportunities arising from advances in the biologic sciences The trends and opportunities arising from advances in healthcare IT Executive Performance Webinar Series: Clinical Leadership Education Sessions 13
Slide 14: Emerging Trends
Emerging Trends PREDICTION PROOF OPPORTUNITIES Diagnostics Whole genome Enhanced LIS will increase in sequencing importance becoming reality Molecular basis of Enhanced EHR Need for disease being interpretative elucidated support will outstrip current Pharmacogenomics Electronic syst
Slide 15: Toward the $1,000 Genome
Toward the $1,000 Genome 1999 2003 2007 2009 Volume in base pairs 70k bp/run 100M bp/run 2B bp/run 10B bp/run run Cost per run $3B $30M $300k $100k Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 16: Toward the $1,000 Genome Today
Toward the $1,000 Genome Today Next generation sequencer available for $150k Announced expected $4k genome in 2009* *http://www.bio-itworld.com/issues/2008/nov-dec/complete-genomics.html Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 17: Executive Performance Webinar Series: Clinical Leadership Education Sessions
Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 18: Agenda
Agenda The definition and key concepts of personalized medicine The trends and opportunities arising from advances in the biologic sciences The trends and opportunities arising from advances in healthcare IT Executive Performance Webinar Series: Clinical Leadership Education Sessions 18
Slide 19: Evolution of computer assisted decision making
Seeing the Present Predicting the Future Full FUNCTIONALITY Minimal Our Past Today: 2009 Our Future: 2012+ Evolution of computer assisted decision making and knowledge management Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 20: Emerging Trends
Emerging Trends PREDICTION IMPLICATIONS OPPORTUNITIES HCIT will play a “Data tsunami” Industry source of critical role in new interpretation Increased focus care paradigm content on integration into Physicians need and the clinical Predictive will embrace models workflow algorithm that a
Slide 21: Need for Patient-Specific Decision Support Assistance
Need for Patient-Specific Decision Support Assistance Source: Bill Stead, Vanderbilt University Executive Performance Webinar Series: Clinical Leadership Education Sessions
Slide 22: Proliferation of Testing
Proliferation of Testing Genetic Testing 1,200 + genetic tests now commercially available; volume growing by >10% annually Expenditure of genetic testing is growing 40-50% annually; current overall spend ≈ $2 B Useful for 2% of the population today; projected to increase to 60% within ten ye
Slide 23: Personalizing Care with Today's Data
Personalizing Care with Today’s Data Most currently utilized predictive models use non- “omic” data (genomic, proteomic, metabolomic) PORT/PSI score CHADS2, GRACE, Wells criteria Additional opportunities for model development through use of currently available/generated clinical data Criti
Slide 24: Predictive Model Development
Predictive Model Development DATA DEMOGRAPHIC CLINICAL BIOMARKER GENETIC PREDICTIVE MODELS STATISTICAL VALIDATION BASELINE RISK DISEASE PROGRESSION EVENT PREDICTION y = f (x1, x2,…xn ) THERAPY RESPONSE PREDICTIVE MODEL PREDICTIVE MODELER PATIENT’S DATA ADDITIONAL DATA; NEW BIOMARKERS PATIENT PHYSICI
Slide 25: In Conclusion – Key Takeaways
In Conclusion – Key Takeaways Advances in molecular biology and computational informatics are powering personalized medicine Personalized medicine presents real opportunities and real challenges to the existing model of care provision Personalized medicine includes genomics, but is more than g
Slide 26: Questions?
Questions? Executive Performance Webinar Series: Clinical Leadership Education Sessions 26