Presentation on eHealth program at BioIT World 2011.

1. eHealth Chris L. Waller, Ph.D. 1

2. The global health and life sciences market is a large, complex and highly fragmented. While “data” is flowing freely through the system unabated, an “information” gap has formed. Providers Payers Regulators Policy Makers Accreditation Entities Govt. Programs Diagnostic Services/ GCRCs Employers Regulations Applications and Approvals Licenses Licensed Health Prof’nals Consumers/ Patients $ Coverage Health Plans/ Care Premium $ Health Delivery Systems/ Facilities $ $ $ Carve Outs (PBMs, others) “orders” Products Pharmacies Pharma. (including Biotech) Medical Products Contract Services Nursing and Home Health Global Insurers Distributors Info Companies Generic Mfgs. Products The Worldwide Healthcare Ecosystem

3. What is Happening in HIT: Growing HIT Momentum in the US Selected Critical Developments Projected Timeline 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 MMA mandates federal eRx standards by 2009 Healthcare Reform Enacted. $35B alloc. to HIT Pressure to Accelerate June 2005 AHIC & RFPs Announced Pressure to Accelerate Mar 2001 Landmark IOM study “Crossing the Quality Chasm” identifies rampant errors and urges HIT Dec 2003 MMA becomes law. Pfizer leads successful effort to block federal eRx mandate, but timetable is set to drive eRx standards process Jul 2004ONCHIT releases strategic framework for NHII ARRA: majority of Americans use EMRs by 2015 Kerry Pledge: 100% EHR use by 2008 Pressure to Accelerate June 2004 RAND study estimates that Americans receive only 55% of recommended care and proposes HIT- based solutions Apr 2004 Presidential Executive Order sets EHR adoption goal, and appoints Dr. David Brailer to lead the Office of the National HIT Coordinator (ONCHIT) Note: ONCHIT = Office of the National Health Information Technology Coordinator NHII = National Health Information Infrastructure MMA = Medicare Modernization Act

4. HITECH The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. DIVISION A: TITLE XIII—HEALTH INFORMATION TECHNOLOGY Subtitle A—Promotion of Health Information Technology PART 1—IMPROVING HEALTH CARE QUALITY, SAFETY, AND EFFICIENCY PART 2—Application and use of adopted health information technology standards; Reports Subtitle B—Testing of Health Information Technology Subtitle C—Grants and Loans Funding Subtitle D—Privacy PART 1—IMPROVED PRIVACY PROVISIONS AND SECURITY PROVISIONS PART 2—RELATIONSHIP TO OTHER LAWS; REGULATORY REFERENCES; EFFECTIVE DATE; REPORTS DIVISION B: TITLE IV—MEDICARE AND MEDICAID HEALTH INFORMATION TECHNOLOGY; MISCELLANEOUS MEDICARE PROVISIONS Subtitle A—Medicare Incentives Subtitle B—Medicaid Incentives Subtitle C—Miscellaneous Medicare Provisions

5. eHealth at Pfizer (2010) We developed a capability called eHealth, which is a group that focuses on thinking about the convergence of healthcare and information technology. Over the last nine months, we’ve made three investments in companies that are in the e-Health space: Private Access, Keas, and Acacia Living. All three are focused on driving consumer outcomes-based healthcare. They’re in the vein of personalizing medical treatment, health and wellness; and they’re in the vein of decentralizing health and wellness so that consumers are more responsible and more engaged, as well as their communities and caregivers. Another capability is looking at complex partnerships between large players effecting healthcare to solve very complex problems requiring multi-player solutions. So, we’ve been building the capability to think about multiple-player collaboration and business models. One of the investments that we made in the last nine months is Private Access. It is enabling a collaborative model, which addresses clinical trial improvement through building an eco-system across the industry, bringing multiple stakeholders, government, private sector, and society together in a coherent and consolidated way. From an interview with Usama Malik. http://www.innovate1st.com/newsletter/october%202010/TheInnovators.html

6. eHealth Steering Committee WWS&I WWBD WW BT WW Policy Technology Strategy Strategy Setting Search & Evaluation US Policy Strategy Technology Standards Program Management Due Diligence US Advocacy Technology Evaluation Business Architecture Deal Negotiation Intl. Policy Strategy Technology Architecture Alliance Management Investment Management Intl. Advocacy Technology Delivery

7. eHealth: Convergence of Healthcare and Technology Patient-centric Provider-centric Care provision augmentation Health & Wellness Consumer Electronics Business Diversification beyond Pharma New Product and Services Health & Wellness Self-Management Services Clinical Decision Support Aids Uses of Clinical Data for R&D Adverse Event Reporting Utility Health Economics Analytics Business Innovation within Pharma Clinical Data Flow and Uses 7

9. Cost effective

10. Drug safety

11. Epidemiology

13. Establish a sustainable business framework and exchange where are all stakeholders realize economic benefit

14. Identify regulatory and legal issues, implications for business models, and data and systems necessary for success

16. Keas Mission:consumersto take charge of their www.keas.com Keas: Empower Consumers

18. Track own progress compared to others,

19. Challenge others

21. Contact coach proactively to get persolized support7 6 D. Wellness coach

23. Inspiration/reminders for quitting

24. Distractions for overcoming urges

25. Communities for support

26. Quitting advice dispensed on-demand

27. Financial and health incentive trackers

28. Progress tracking

29. Select employer partner to participate in the experiment

30. Demonstrate value of program to other employers to support reimbursementiPhone Our Goal: - Demonstrate Behavior Modification - Improved Medication Adherence, Persistence, and Quit Rates

31. Mobile Apps http://appadvice.com/appnn/2011/03/ipad-cornerstone-medical-care

32. eHealth Strategic Plan

33. Summary of Pfizer’s HIT Efforts Support and Transform Medical Practice Adverse Drug Event Spontaneous Electronic Reporting (ASTER) 217 reports in 5 mons. vs. 0 (25% “serious”) 7x as much (structured) data as normal report Support Patient-Centric Healthcare Keas Text4Baby Nutrition, flu prevention, immunization, etc. Free, 100,000 subscribers G.C. Simon, AJMC-2010-08-0217

34. Summary of Pfizer’s HIT Efforts Improve Clinical Trials Private Access PACeR Clinical Trial Atlas Partnership with National Minority Quality Forum to collect and map trial data to demographics Expedite Research Connecting for Drug Safety Collaboration of the eHealthInitative Safety Surveillance in electronic healthcare data Observational Medical Outcomes Partnership (OMOP) 2 year pilot to develop methods to query databases to assess safety of drugs on market G.C. Simon, AJMC-2010-08-0217

35. Recommendations Embrace and Fully Fund Public-Private Partnerships Development of a National Clinical Trials Infrastructure Development of Systems that Provide Selective Sharing of Electronic Health Data Development of HIT Platforms that Allow Physicians Access to All Approved Options to Inform Decisions for Patients’ Health Implement an Incentive Model that Encourages Sustained Investment in HIT G.C. Simon, AJMC-2010-08-0217

36. eHealth at Pfizer (2011) Connected Health Contact Usama Malik for more information

37. Acknowledgements David Leventhal Chris Waller Shaf Madina Ben Bandaru Mark Brincat

38. Thanks