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© 2013. inVentiv Health. All rights reserved. European digital healthcare trends 2013 Our world, our industry, our opportunity.

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At the start of each year our US colleagues take a look at the key trends in the digital landscape and the opportunities they present in healthcare. For 2013, we’ve looked at how these may apply to Europe – highlighting emerging customer behaviours and expectations, the drivers behind these, and the role that innovation can play in meeting the challenges they present.

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Page 1: inVentiv Digital - European Healthcare Trends

© 2013. inVentiv Health. All rights reserved.

European digital healthcare trends 2013

Our world, our industry, our opportunity.

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2 © 2013. inVentiv Health. All rights reserved.

Digital in context: four key business trends

In the last decade, our industry

brought 300 new drugs to market,

created new categories of care, and

served millions with a single

compound. The years ahead will look

very different, driven by four key

trends:

1. Commoditization: Increasingly,

we’ll see drugs that are 5th, 6th, 7th

to market with small feature

differentiation and limited impact.

Generic erosion and off-label writing

will further muddy crowded

categories.

2. Biologic innovation: Biologics are

filling pipelines with the next

generation of "blockbusters.” These

more expensive drugs serve smaller

patient populations and will demand

both improved payer partnerships and

new levels of patient service.

3. Fewer Human Connections: The

explosion of specialty pharma, payer

interventions, and digital consultations

will continue to make medicine more

remote and disconnected from the

core human interactions that once

drove experience.

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Digital in context: four key business trends

A 2012 survey highlighted that more than half of senior European pharma

marketing executives intended to increase spending across key digital channels

including eDetailing, mobile and HCP social media throughout the year.

In 2013, digital will play an even stronger role in the industry’s marketing mix.

As such, this presentation looks more closely at how digital continues to

transform customer experiences and behaviours.

booz&co: pharmaceutical marketing trends

4. Digital takes the lead in the marketing suite

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© 2013. inVentiv Health. All rights reserved.

Our world Trends impacting how we live and work

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FULL MOBILITY

“KNOW ME” EXPECTATION

COMMON INTEREST

QUANTIFIED IMPACT

DIVIDED ATTENTION

1 2 3

4 5

Overview

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Full mobility

In 2013, mobile phones will

overtake PCs as the most common

way to access the web.

Across the main European markets,

smartphone ownership hit 55% in

2012, with 15.5% of these adopters

also owning a tablet.

1

Gartner, Comscore

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inVentiv Insight: full mobility

A recent Google survey highlights that the large majority of interactive

tasks are started on one device – typically a smartphone – and

completed through another. So mobility isn’t about the replacement of

the PC by the mobile device, rather a new paradigm where activities

are no longer tied to a single device.

Making this possible is the rise of the personal cloud – all your data, all

your contacts and all of your preference stored in one place and

served up how and when you require it.

Your customers are mobile, your services need to be mobile too.

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MY PERSONAL CLOUD After all the technical hub-bub about 2012 being the year of the enterprise cloud, 2013 is set to make the cloud easy and personal. These personal clouds from major players including Apple, Google and Microsoft will be the single biggest enabler of mobility.

The number of personal cloud subscriptions worldwide topped 375 million in the first half of 2012. They’re expected to more than double in 2013.

IHS iSuppli 2012

Mobile access

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A TABLET UNDER EVERY TREE 17.4 million new smartphones and tablets were activated on Christmas Day 2012

Apple’s iPad and iOS software (boosted by the new iPad mini) held the lead over the holiday season, but by mid 2013, we expect the Android platform to own a critical 50%+ of the market.

Flurry Analytics

Mobile adoption

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More European seniors than teens own tablets. Texting and growing smartphone adoption are adding to the mobility of people ages 55+

18% Of people 55+ own smartphones

Compare to:

55% of all adults

15% of 45-55 year olds

17% Of people 55+ own tablets

Compare to:

8% of 13–17 year olds

13% of 45-55 year olds

eConsultancy, Comscore MobiLens

Mobile adoption

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Online consumers expect companies to

use what they know about them in order

to tailor digital experiences to their needs.

“Know me” expectation 2

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12 © 2013. inVentiv Health. All rights reserved.

inVentiv Insight: “know me” expectation

All of our digital interactions now have a virtual data shadow. When

aggregated and analysed and even merged with other people’s, this

data delivers a rich view of preference and can also point predictively

to what we may want, need or appreciate in the future.

While there are obviously issues around how data is collected and how

it gets put to use, the right balance of personalised content and

promotion is one welcomed by most users .

If yours is an organisation with ambitions to be customer-centred but

you’re not using data in this way then you’re missing a vital trick.

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SoLoMo

When someone visits a website, we immediately know three things: what device they’re using, where they’re located and what time of day it is. If they’re logged in, we can add yet another dimension: who they’re connected to.

SoLoMo stands for Social-Local-Mobile.

It’s an emerging new standard for apps, search and experience – one focused on using what we know about people to deliver them highly-targeted, immediately actionable context-rich communications.

The new decision set

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IDENTITY AS CURRENCY There’s one thing you can’t buy online: Privacy. Instead, people trade it – sharing personal identity for access and free services, while constantly re-negotiating what they’ll share and for how much.

Universal login options – like “sign in with Facebook” – simplify sign-up, but raise a key question about identity and access:

“Just how much do you need to know about me to sign me up for a simple email alert? What’s a fair value exchange for my data?”

A fair trade

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15 © 2013. inVentiv Health. All rights reserved.

COOL OR CREEPY? People expect apps and websites to be customised based on their preferences and behavior, but not too customised … 47% of UK social media users recently declared their distaste for ads targeted to their profiles.

Luckily, this level of customisation tends to be possible only for major players in search, social and retail and a June 2012 survey of European marketers highlighted that less than a third believed that their current content management systems were useful enablers of personalisation.

YouGov, eConsultancy

A new thin line

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16 © 2013. inVentiv Health. All rights reserved.

Smaller social communities connect

people around common interests or

geographies.

“Common interest communities 3

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17 © 2013. inVentiv Health. All rights reserved.

inVentiv insight: common interest communities

In 1992, anthropologist Robin Dunbar proposed a number for the

amount of people that any of us can maintain a stable social

relationship with. He set this at 150.Then 25 years later, Facebook

came along and broke Dunbar’s number.

Now, the definition of ‘friend’ has changed, and Facebook now

provides more entertainment and distraction than it does meaningful

connections.

As a result, we’re starting to see a rise of niche communities where

people rediscover the benefits of deep conversation with properly

close friends and contacts. Facebook is by no means dead, but for

more intimate connection it’s probably not the best game in town.

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TO PIN OR FILTER? The current darlings of interest-based social media appeal to users’ creativity. With Instagram (now owned by Facebook), users apply filters to upgrade digital photos. On Pinterest, they amass visual collections of inspiration. Through Spotify, they can share best-ever playlists. What social network got to 10 million users the fastest? Not Facebook, Pinterest.

Powerful photos

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WANT TO CHATTER?

A growing number of companies (including ourselves at inVentiv) are seeing the results of using internal social networks to encourage employees to share their thoughts, opinions and ideas with their colleagues. Nearly 100,000 companies use the industry-leading solution, Chatter, by Salesforce.com, while its competitor Yammer is starting to be folded into Microsoft’s enterprise collaboration toolset. Even Google’s getting in on the action with new enterprise features for Google+.

Connected corporations

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From calorie-counting to logging runs and

other exercise, self-tracking behaviours

are increasingly common (and addictive!)

Quantified impact 4

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inVentiv insight: quantified impact

Committed evangelists call it ‘body hacking’, but to most of us it’s

known as the ‘quantified self’ movement – using technology to monitor

and report on our daily lives: our exercise, sleep patterns, calories

taken and even our moods.

Once the province only of a committed few, it’s a behaviour that’s now

moving mainstream as a new generation of devices and platforms

makes the technology increasingly portable, wearable and capable of

handling even more inputs.

More interesting still is the trend in sharing this data – creating new

social objects to spur motivation, commitment and competition around

the way we live our lives both individually and as part of wider groups.

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EVERY WORKOUT IS BRAGGING RIGHTS Wearable self-trackers like the Fitbit and Nike’s FuelBand add a competitive element to tracking by recording distance, pace, time, and calories burned.

When those numbers are posted in dedicated communities or to public social networks, the competition (and the swagger) are even greater.

Built-in competition

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TRACKING CAN BE ONE NUMBER OR A PERSONAL DASHBOARD Today’s personal trackers allow users to evaluate multiple, interconnected parts of their lives. They can track vitals, sleep, eating, exercise and more to help drive understanding of what inputs create a better day and what ones just aren’t working.

Others, and let’s face it – this means most of us – use a far simpler tracker: still being able to get into (or not) a favourite pair of jeans.

A matter of degree

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The new multi-tasking norm means

real attention is really valuable.

The divided attention economy 5

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inVentiv insight: the divided attention economy

We used to talk about multi-tasking to refer to office workers taking

advantage of their PCs to work on multiple documents at once, now –

as pervasive always-on connections follow us from the office to home

via the streets, public transport and bars – the buzz word is ‘hyper-

tasking’, with smartphones as the ultimate enabling tool.

Think about the interactions you’re seeking to have with your

customers, then think about the time it might take to currently complete

these.

In the divided attention economy you need to think about how you can

deliver your content and services quicker, with greater impact and in a

way that doesn’t require the customer to block out 15 minutes of their

time, let alone 15 minutes at a desk in front of a computer.

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TV VIEWING CHANGED FOREVER Video content consumption used to be linear, scheduled and only on TV. Now video is available on the go, on-demand, and on multiple screens. What’s more, an increasing percentage of Europeans are now comfortable with using multiple screens at the same time – watching TV while also using a laptop or mobile device. Not all markets are equal here, however, and Italy and Spain lag behind the rest of Europe with less than 6% of consumer viewing time expected to be timeshifted by 2015.

Nielsen, Google

Multi-layer entertainment

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FOCUS IS LOVE Keeping all that multitasking from interfering with real life isn’t easy. At work, at home, and on the go, people have created new rituals designed to give them time to focus. Some companies have banned internal emails at least one day / week, families have strictly limited total screen time (not just TV or phone), and now friends around the world have started stacking their phones at dinner.

Phone stack: When friends and family are together for a meal, everyone stacks their phones in the middle of the table. First to pick up their phone, pays the bill for all.

New rituals

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© 2013. inVentiv Health. All rights reserved.

Our industry Trends changing healthcare communications

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MOBILE FOCUS

SHARING SCREENS

RETAIL SELF- CARE

1 2 3

4 5

CONTENT

CONNECTION

RECLAIMING

DATA

Overview

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30 © 2013. inVentiv Health. All rights reserved.

Pharma is embracing mobile, creating

new kinds of tools and support systems to

support enduring connections.

Mobile focus 1

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inVentiv insight: mobile focus

If you’re not designing ‘mobile first’ then you’re already failing your

customers.

Data from Google and Manhattan Research suggests that more than

60% of Healthcare Professionals will immediately leave a non-

optimised website accessed on a smartphone or tablet, yet within

Europe only a handful of firms are designing sites this way, and then

typically only corporate sites.

Because your audiences are mobile, so are our online services – built

to responsive design principles to ensure that the customer and their

needs – rather than the constraints of any technical platforms – are

always at the heart of our strategy and creative approaches.

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SMS AT THE CORE OF MOBILE HEALTH From supporting pregnant women to helping people quit smoking to dealing with cancer pain, simple text messages have proven to be a powerful tool in supporting better outcomes.

One European example: a trial with 5,800 smokers saw half of these randomly allocated to a text message cessation program offering motivational messaging and behavioural change support. Bio-chemically varied abstinence at six months was more than twice as high in this group vs. the control.

The Lancet, 2012

Proven platform

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RESPONSIVE RX

While mobile app development was common across Europe’s major pharma and healthcare players in 2012, successful optimisation of websites for mobile devices was rare. Rarer still were sites built according to the principles of responsive design – e.g. designing a website/app that will work on any screen size by responding and adapting to it. Throughout 2013, we expect to see responsive design practices replace single designs for each and every one of a user’s multiple screens.

Trending approach

Astellas.eu – a leading light of pharma

responsive site design in Europe.

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PHARMA TAKES MHEALTH BEYOND MARKETING Pharma leaders are increasingly turning toward integrated teams to develop mobile initiatives that go beyond the scope of individual departments. They’re incorporating the efforts of marketing, medical affairs and IT within new mobile health teams and task forces.

Cutting Edge Info, Pharmaceutical Mobile Health, 2012

New teams

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Looking at a screen is increasingly a

collaborative experience, one that earns

attention and promotes understanding.

Sharing screens 2

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inVentiv insight: sharing screens

Given that the iPad experience is – above all – interactive, treating it

like a screen solely for presentation seems perverse, yet many

companies still do this and simply put their existing detail aids behind

glass.

Talk to your customers and you’ll quickly find out that they’re not

interested in just watching another presentation, rather they want to be

part of a real conversation – interacting with data, trying out formulas,

and choosing their own path through information.

It’s how an increasing number of them have experienced their

professional education and learning, and it’s an insight that informs

everything about the way we approach developing for the screen.

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AN PAD FOR YOUR POCKET

47% of European physicians already owned an iPad (or another tablet) by the end of 2012. If European trends in medical mobile usage continue to follow the US, not only will this figure grow rapidly over 2013, but as many as 1/3 of existing owners will buy a new iPad mini. Their #1 reason? A pocket-sized tablet is easier to carry with them on rounds.

Manhattan Research, EPG

Easier access

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NEW TOOLS FOR POINT OF CARE

Manhattan research

57% of European HCPs are interested in sharing educational material with patients during consultations, and a quarter of them already use tablets for this purpose. There is a strong rationale for pharma to invest in tablet-ready point of care tools and educational content to service this demand.

Teaching moments

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Great new health tools that actually fit in

our lives are bringing healthcare home.

Retail self care 3

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inVentiv insight: retail self-care

If you’re looking at projects at the intersection of healthcare, motivation

and design but you haven’t personally experienced a device such as the

Fitbit One or Nike FuelBand then you probably have no idea of the

reality behind the rhetoric of the quantified self movement and are

missing out on the opportunities to be explored as a grass-roots

movement goes mainstream (how long from “Facebook Places” logging

location to “Facebook Paces” logging exercise we wonder?)

Likewise, seeing the smartphone opportunity as simply app-based is

missing the point. The power of Bluetooth and Wi-Fi to connect sensors,

peripherals and actionable data is set to drive a revolution in self-care

and 99% of pharma apps simply scrape the surface of this potential.

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HEALTH DEVICES THAT WORK WITH OUR DEVICES When you walk into the Apple store today, you’ll see the newest Macbooks, iPhone 5s, and a growing selection of health related devices including Nike’s FuelBand and Withings’ weighing scales and blood pressure cuff. These new devices are designed with simple, consumer interfaces and plug easily into our favorites devices for self tracking or monitoring.

Finally…

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DRIVE TO WEARABLES

The latest industry models point to a doubling of the wearables market by 2014 – with parity between the fitness and health markets by 2017. These body monitoring sensors – like Nike’s FuelBand – were born of the retail, exercise marketplace, but are quickly finding a foothold in healthcare.

Early predictions are that smart clothing designed to track nutrition and continuous glucose monitors will be the first to dominate the wearable health market.

Juniper, IMS 2012

Quantified health

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TELECOMS BRING REMOTE MONITORING TO MASSES Early remote monitoring studies heralded fantastic results – improving everything from compliance to safety to outcomes. Now, it’s traditional telecom companies trying to grow big new markets around the promising technology.

In Europe, Spain’s Telefonica is a leader in telehealth, with trials showing 45% reductions in mortality rates and 20% fewer emergency admissions.

In the UK, the government’s 3 Million Lives initiative highlights the societal importance of technologies rapidly moving from ‘nice to have’ to ‘must have.’

Telefonica, 3 Million Lives

From pilot to proof

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For curious spiders and curious people,

the most effective marketing starts with

content.

Connection through content 4

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inVentiv insight: connection through content

When the web was young and Yahoo ruled the world, users found

content through browsing a catalogue of links. Then came the age of

Google, and the dominant paradigm for information discovery moved

from browsing to search and an entire industry developed around the

optimisation of content and keeping up with the PageRank algorithm.

Now, the paradigm for information discovery has changed again – from

search to sharing: we follow the links shared and curated by our

networks, across Facebook, LinkedIn and Twitter.

In this age, it’s not the most findable content that will win – it’s the most

compelling and desirable. Answer questions; tell stories; be relevant.

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PHARMA PARTNERS TO CREATE ENTERTAINING MEDIA Europe lags behind the US in terms of content based media strategies (for example, Lilly’s collaboration with Disney around books for families dealing with diabetes), but the industry is starting to move towards innovative content and engagement approaches. The launch of Boehringer’s much discussed Syrum game (regardless of its success against its declared objectives) will surely be looked back upon as a key moment for an industry transitioning towards more creative approaches to engaging with its audiences.

Original programming

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AUTHOR AUTHORITY AND GOOGLE Content alone has ceased to be king. The new opportunity is content + thought leadership. That means you’ll see a growing number of pharma companies cultivating the online personas of their most talented employees.

The impetus is an algorithm. Google now allows individual content creators to “claim” the content they author through placement of a HTML attribute, rel=author. This tag is tied to author profiles on Google+, the social network which has quietly become the platform of choice for HCP professional social networking in much of Europe.

Google, Manhattan Research

The new KOLs

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PHARMA FINDS THE “BEST OF”

With almost 200 million websites and over half a million apps to choose from, many of today’s searchers are overwhelmed. They don’t want more opinions, they want a clear path to the most relevant, credible ones. That’s led leaders like Boehringer Ingelheim and Genentech to rethink their content investment: from creation to curation. They bring together the information people are looking for in one, easy-to-navigate space. iTunes is doing a little of its own curation for health by serving up the very best apps for HCPs.

Curation nation

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The work that breaks through isn’t just creative or

even cutting edge, it’s connected. That kind of work

starts with just one thing: data

Reclaiming data 5

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inVentiv insight: reclaiming data

We know a lot more than we let on. Pharma’s databases are rich with

insight – what people want, what they use, where they go, and what

they share.

For years, we’ve let that information go unused – considering it in

aggregate, but not putting it to work. This year, that changes in a big

way.

In 2013 pharma will put data to work, for both physicians and patients.

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OPTIMISATION STARTS WITH BETTER KPIs

Metrics don’t end the discussion in pharma today – they start it. The favorite two questions: What do we want to accomplish and how will we measure success?

Look to 2013 plans to include benchmarked KPIs, live dashboards, and triggers for optimisation and improvement.

Live view

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A NEW FOCUS ON CRM

In the last few years, pharma has focused on triggered marketing to create a sense of relevance. A series of standardized messages would start when a particular event happened – like joining a program or starting an Rx. In 2013, pharma will start a new era of CRM – one that looks much more like consumer marketing with personalized content, retrigger strategies, and multichannel integration. Look for individual data to drive both the content and the results.

Personal connection

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Our opportunity

www.inventivdigital.eu

To find out more about what these trends might mean

for you, your business and how you can continue to

deliver against changing customer expectations, don’t

hesitate to get in touch. Ritesh Patel – [email protected]

Nick Bartlett – [email protected]

Duncan Arbour – [email protected]

With thanks to Leigh Householder and the IQ Lab team in US, and all the contributors and reviewers from our EU

digital team, our partners and of course our client base.