Hosp Lab Management (HLM) Service. HLM Tie-ups Cervical Screening & Diagnostics Tie-up Business Process Flow

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Bryan Lawrence
5 years ago
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1 Hosp Lab Management (HLM) Service HLM Tie-ups Cervical Screening & Diagnostics Tie-up Business Process Flow

2 Women s Healthcare: Demography

3 End of uncertainties

Actual Disease Burden: Delhi NCR: FY2012-13 80% Patients do

detected for LGTI Only 7% patients receive appropriate

4 Actual Disease Burden: Delhi NCR: FY % Patients do not receive Ca Cx screening / diagnostic tests 80% get detected for LGTI Only 7% patients receive appropriate treatment 93% patients livewith the disease and get detected for invasive ca.

5 Cost-Effectiveness and/or Cost-Benefit Analysis of Preventive Intervention In comparison to other preventive interventions and to commonly accepted cost-effectiveness benchmarks, cervical cancer screening is highly cost-effective. Introduction of screening to populations previously unexposed to screening reduces cervical cancer rates by 60% to 90% within 3 years of implementation. The relative costs and benefits of screening will vary depending on the age of patients screened and the screening interval. A study that included patient-time costs estimated that the cost-effectiveness ratio of a conventional Pap smear repeated every three years up to the age of 75 was $11,830 per quality-adjusted life year saved (in year 2000 dollars). Eichler H, Kong SX, Gerth WC, Mavros P, Jonsson B. Use of cost-effectiveness analysis in health-care resource allocation decision-making: how are cost-effectiveness threshold expected to emerge? Value Health. 2004; 7(5): Screening for squamous cervical cancer: duration of low risk after negative results of cervical cytology and its implication for screening policies. IARC Working Group on evaluation of cervical cancer screening programmes. Br Med J (Clin Res Ed). 1986;293: Mandelblatt JS et al. Benefits and costs of using HPV testing to screen for cervical cancer. JAMA. 2002; 287(18):

6 Model schematic: Premalignant states Non-Cervical Cancer Deaths HSIL Treated Wellness HPV Inf LSIL/CIN1 HSIL/CIN2+ Hysterectomy or Non-Cervical Disease Am.J. Epidemiology Vol 151, No The Cervical Cancer progression must be STOPPED at the CIN 2+ stage The clinical stages of LSIL/ CIN1 are highly subjective for prognoses Nearly 70% LSIL/ CIN1 regress v/s nearly 70% CIN2 progress to Ca Cx Most CIN2+ disease is asymptomatic Most LSIL/ CIN do not show abnormalities on Cytology/ histopathology Most CIN disease requires patients frequent hospital /pathlabs visit

Model schematic: Malignant states Undetected Ca Cx Stage I Undetected Ca Cx Stage II Undetected Ca Cx Stage III Undetected Ca Cx Stage IV Non-Cervical Cancer Death Non-Cervical Cancer Death

7 Model schematic: Malignant states Undetected Ca Cx Stage I Undetected Ca Cx Stage II Undetected Ca Cx Stage III Undetected Ca Cx Stage IV Non-Cervical Cancer Death Non-Cervical Cancer Death Non-Cervical Cancer Death Cancer Survivor Am.J. Epidemiology Vol 151, No The cost of undetected cancer and referral to cancer hospitals The cost of detected cancer and associated chemo- radiotherapy is manifolds incremental, deprives other incurable cancer patients Agony of cancer survivors very high

8 Cost Effectiveness Influencers Ideal Clinical Test performance High Sensitivity (NPV), High Specificity (PPV) High Reproducibility, High Sustainability >> OncoTect combines Cost of current diagnostic approach Increased patient visits, repeated laboratory investigations, greater clinical dilemma on disease prognosis, frustrated patient >> seeks second opinion, lost to follow up Patients loose money, hospitals loose revenue, healthcare inadequacy Reduction in diagnostic cost burden early detection facilitates affordable treatment, HSIL vs Cx Ca ie. reduce incidence (reduce viral burden I e transmission) as well as mortality A more sensitive and specific test will always COST more since it detects more disease but has longer term benefit.. A Win-Win for hospitals and patients

9 Variability in Test Performance Test A: Sensitivity 75%, Specificity 75% Standard deviation of sensitivity Test B: Sensitivity 75%, Specificity 92% Standard deviation of sensitivity Marginal incremental cost compared to Test A: 680- only Adding a test that has a high clinical specificity will cut down on the COST of disease management... Lesser referrals to cancer hospitals

10 Variability Random variability in test characteristics has potentially important economic consequences Tests with less variability have more predictable costs Systematic variability in test characteristics has important consequences for equitable distribution of benefits of screening and disease diagnostics HPV mrna testing likely to be favored over DNA testing owing to higher specificity, quantitative estimation and intact cell characteristics that allows better clinical correlation with cytology and histopathology.

About us: Leading HPV Diagnostics Pioneers in the field of Cervical Cancer screening & diagnostics First to introduce LBC test in India (Currently every big/ medium/ small

11 About us: Leading HPV Diagnostics Pioneers in the field of Cervical Cancer screening & diagnostics First to introduce LBC test in India (Currently every big/ medium/ small hospital uses LBC) First to introduce HPV molecular testing by Hybrid Capture (Further replicated by all Labs & research institutes in India) Nearly 15 years of experience

12 Our Service A to Z Diagnostic solution for Cervical Cancer screening & diagnostics Most advanced quantitative oncogenic activity test HPV mrna Test Molecular co-testing HPV DNA HR, HPV DNA LR, HPV PCR Genotyping Liquid based Cytology (LBC) with dual filtartion technology first time in India.. Histopathology Cervical biopsy Diagnosis of STI (Sexually transmitted infections)

13 Hospital Lab Management (HLM) - Process Flow Signing of Agreement with the hospital labs Incorporation of Test name & rates in Hospital/ Lab system Service branding as exclusive hospital service to enhance awareness and acceptance of screening & diagnostics CMEs & Colposcopy Workshops One-to-One meeting with hospital doctors Service Identity for the Hospital Specimen collection by well trained staff Patient to pay at the Hospital Provide clinically validated & sterile sampling kits

14 CME Conference by National/International Experts

15 Hospital Service Branding for increasing patient base & footfall by spread of cancer prevention Standees Wall Poster for clinics Patient awareness booklets (FAQs) Patient awareness camps with Cancer NGOs Innovative Tools

International Technology Support OncoTect 3Dx-M Established in technical

the 2012 North American Product Leadership Award in the Molecular Diagnostics

Sullivan cited IncellDx s newly available cervical cancer testing methodology,

16 International Technology Support OncoTect 3Dx-M Established in technical collaboration with IncellDx, a California based MDx company IncellDx received the 2012 North American Product Leadership Award in the Molecular Diagnostics Market from Frost & Sullivan A zealous mission in women s health Frost & Sullivan cited IncellDx s newly available cervical cancer testing methodology, HPV OncoTect, as the company s greatest contribution and the gold standard for gynecological care.

17 Successful Tie-ups so far National.. International.. AND THERE IS A ROOM FOR YOU, TOO

18 Advantages to the Hospital: Total Solution State-of-the-modern-care procedures under one umbrella One-point Lab for all Cervical Cancer diagnostic solutions Partnership with Experts of the Field Additional Revenue generation to the Hospital on test outsource Regular CME/Conference every 6 months by experts of the Field Co-Branded literature on cervical cancer awareness for patients at hospital premise Co-Branded wall posters & standees for encouraging more people to go for Cervical Cancer screening Increase in number of follow-up patients with better diagnosis Increase in number of patients for further treatment

About the Test HPV OncoTect is a screening & diagnostic test for cervical precursor lesions (CIN2+). It identifies the oncogenic activity of HPV in infected cervical cells.

19 About the Test HPV OncoTect is a screening & diagnostic test for cervical precursor lesions (CIN2+). It identifies the oncogenic activity of HPV in infected cervical cells. This method is widely used in U.S.A, Canada, Asia, South America and Europe A flow cytometry based in situ hybridization test for quantitative detection of CIN2+ Takes advantage of the fact that oncogenic genotypes of HPV over-express E6 and E7 mrna following integration of HPV into genomic DNA. The presence of high levels of HPV E6, E7 mrna indicates that these cells are undergoing the molecular changes of cellular transformation that are the early stages of high grade CIN. Advantages of test as compared to current Diagnosis : Detects active progression towards invasive cancer rather than if women is at risk of getting a lesion. It Increases PPV of cervical cancer screening up to 90 % as compared to HPV DNA alone resulting in to less stress on the patient due to fewer false positives by significantly reduces unnecessary colposcopy or biopsies. Detects lesions earlier because molecular changes occur well before morphological changes.

Additional Revenue Generation to the Hospital We provide tempting margin to the Hospital on test outsourced to us Our technology offers higher specificity as compared to current testing - Regaining

20 Additional Revenue Generation to the Hospital We provide tempting margin to the Hospital on test outsourced to us Our technology offers higher specificity as compared to current testing - Regaining of Lost patient by 20 % 20 % more patient to the Hospital for long term follow up Our patient awareness activity to go for Cervical Cancer screening will help to increase 10 % more patients to go for Cervical Cancer diagnosis Considering 1 out of Every 7 women getting affected with Cervical cancer in India Additional diagnosis will provide additional patient to the hospital for treatment

Diagnostics: The Effect on Evidence Based Clinical Pathways. DNA vs Disease. Bruce K. Pa+erson MD CEO and President, IncellDx, Inc.

Diagnostics: The Effect on Evidence Based Clinical Pathways DNA vs Disease Bruce K. Pa+erson MD CEO and President, IncellDx, Inc. Who Who are we? We Are Cancer First platform to combine proteomic and genomic