Asthma In the US 10M CHILDREN 50% PREVENTABLE $15B IN COSTS
Main Existing Barriers Adherence < 40%
Respiratory Diseases: Market Opportunity WORLDWIDE 300M People With Respiratory Diseases* US Total Asthma + COPD 40M People $100B US Children’s Asthma 10M Children $15B * Additional 100M people with asthma worldwide by 2025
The Adherence Problem = $317B in US ADHD Anemia Cancer Dermatology Diabetes IBD Mental Health US CHRONIC PEDI MEDICATION * Express Scripts: “$317B in excess health costs, 69% due to procrastination and forgetfulness”
Evolution of a m.Health startup in 2013: The Beginning • Gamification as a way to motivate people • How to be the best asthma consumer product • Design, UX, and UI • Who is our real customer? • ACO, a “great opportunity” for connected device coverage?
How to be the best asthma consumer product (and stay away from healthcare)
Who is our real customer? Parents of other kids with G.C. Other kids with G.C. Other Caregivers Kids (users & beneficiaries) Parents (users & beneficiaries) Friends Pharmacy/PBM (sellers) Doctors (“trail guides”) Pharma (inhaler providers) Data customers1
ACO, a “great opportunity” for connected device reimbursement?
Evolution of a m.Health Startup in 2013:This is what bothers us NOW • Clinically proven mobile products? • What is the meaning of meaningful use of data? • FDA / HIPPA / Privacy? • What do risk holders want? • Reimbursement process and CMS Coding for apps and mobile devices?
Clinically Proven, Self Managed • Grants for non-regulated mobile apps • RCT for mobile products • Hard to measure: what are the expected outcomes? • What is our place in the clinical workflow?
Meaningful Use of Data • How do you show more than just what you measure? • What will make a difference? • How do you make the UX “one” with the user’s lifestyle?
FDA, FCC, CMS, ONC OLD regulations for NEW Solutions • FDA regulations for mobile applications • Privacy: who handles all the healthcare data in the cloud? • Vs
What Do Risk Holders Want? • Payers? PBMS? Drug manufacturers? • How should we prove ROI, show clinical evidence, reduce costs? • What can we sell? Hardware, Software, Data? • Who will pay: Pharma, PBMs Payers, Providers Consumers
HSPCS, NDC, UDI, CPT, DRG, &%$# New Solutions – Old Payment Systems • Reimbursement process and Coding • CMS Accountable Care payment system?