Vishuo Biomedical

Vishuo Biomedical Singapore

Business Model : Analysis and ProposalsMaria Ivona Climaco- [email protected]

Keong Wei Jiao- [email protected] Chatly- [email protected]

Liu Jia- [email protected] Xiang- [email protected]

Erwin Ernady- [email protected]

A/Prof. Jeffrey Funk LeeMT5016 | Business Models for High Technology Products

National University of Singapore

“You can easily match a bloodtransfusion to a blood type..

What if matching a cancer cureto our genetic code was just aseasy? That’s the promise ofprecision medicine. Delivering theright treatment at the right time,to the right person, every time”

-US President Barack Obama, Time Magazine

Agenda• Personalized medicine• Personal Genomics industry• Vishuo: A bioinformatics company

• iCMDBTM

• Value Propositions• Customer Segments• Methods of Value Capture• Scope of Activities• Competitive Analysis

• Vishuo vs. Main Competitors• Vishuo vs. 23andMe

• Strategic Control

• Proposed Improvements • Value Proposition• Customer Segments• Methods of Value Capture• Scope of Activities• Strategic Control

• Conclusion

The Future of Healthcare

• The future of healthcare is moving towards becomemore personalized.

• Precision/personalized medicine: Embracing geneticbased medications, will help world economies byreducing the millions of dollars spent in presentdiagnostic and treatment approaches.

• Personalized medicines will improve the quality of anindividual’s health.

Sources: -Frost & Sullivan, March 2014, Future of Personalized Genomics (Technical Insights) Impact Assessment of Business Models in DTC Genetic Testing- http://giphy.com/search/mark-j-kiel

Personalized Medicine“Modern approach to understanding health”

Source: https://www.youtube.com/watch?v=HQKFgfMO5Sw, https://www.genome.gov/Multimedia/Slides/GenomicsInMedicine2013-2014/Helman_6-7-2013.pdf

Personal genomics

Empirical diagnosisDescriptive medicine

Uniform treatment

Retrospectively diagnose disease

Acute care

Mechanism-based diagnosis/treatment

Understanding of disease mechanism

Individualized treatment

Prospectively evaluate relative disease risk

Early detection and intervention

Personal Genomics industry

Sources:The Promise of Precision Medicine. Time. April 9, 2015. https://www.youtube.com/watch?v=zkagtWSeisQFrost & Sullivan, March 2014, Future of Personalized Genomics (Technical Insights) Impact Assessment of Business Models in DTC Genetic Testing

The cost of gene sequencing hasdrastically reduced over the years

Growing need for big dataanalytics to manage complexand voluminous health data

Information regarding humangenome has rapidly increased and isstill continuing to explode.

Promising new applications of nextgeneration sequencing like oncology

Increased awareness aboutpersonalized medicine.

Government support andinitiatives.

Collaborations between IT,Pharma and DiagnosticCompanies

Key Drivers for Personal Genomics Industry

Participants in Personal Genomics industry

Reference: Frost & Sullivan, March 2014, Future of Personalized Genomics (Technical Insights) Impact Assessment of Business Models in DTC Genetic Testing

• Whole genome and exome sequencing machine manufacturers

• Diagnostic/ Pharmacogenetic/Nutrigenomics testing kits

• Conducts sequencing services and clinical trials/analysis

• Software for genetic test result, visualization, storage, analysis and annotation

• Integrates genetic tests and results into diagnostic and treatment approaches

• Researchers, scientists, patients, physicians, healthy individuals

Sequencing Technology

ManufacturersGenetic Test Developers Laboratories

Data Analytics Bioinformatics

Solutions

Hospitals and Healthcare

SystemsEnd User

*not in any particular order

Overview of Personal Genomics Industry

Sequencing Technology Manufacturers

Hospitals and Healthcare Systems

End User

Research Institutes


Solutions

Genetic Test Developers

Data Analytics Bioinformatics Solutions

Platform/Software for genetic sequencevisualization, storage, analysis, interpretation

and correlation to drug and treatment response

Bioinformatics- application of computer technology to the management of biological information.

Data Analytics- science of examining raw data with the purpose of drawing conclusions about that information.

www.bioplanet.com/what-is-bioinformatics/searchdatamanagement.techtarget.com/definition/data-analytics

Challenges：

• Data analysis requires bioinformaticians, long turnaround time

• Weak or no clinical annotation available• Multiple sequencing platforms with its own software• Patient data confidentiality must be ensured

Challenges of traditional Next Generation Sequencing Workflow

Solution: Data Analysis Bioinformatics

HQ Singapore Founder Guo Dong Liang (Bioinformatician)

Established 2011

Industry Health & BioTech

Regions US, China, APAC

“Vishuo Biomedical is a Singapore basedhealthcare technology company dedicatedto establish personalized medicine fordiagnosis, prognosis and treatment. It deliversgenomic sequence analysis to researchinstitutes, health screening clinics, hospitalsand pharmaceutical industry.”

Source: http://www.vishuo.com/en/company/

Vishuo: A bioinformatics company

Core Product/Service:

iCMDBTM

(Individual Customized Medicine Database)

Data Analytics Bioinformatics Platform

What is Vishuo iCMDBTM?

iCMDBTMVishuo’s Data Analytics Bioinformatics Platform

Generates genetic annotation report

• Application to gene-based drugdiscovery and development

• Tailored for clinicians to conductpersonalized treatment for the patients

Powered by supercomputers

Stores, visualizes, analyzes and interprets

genetic sequence

With an integrated drug-gene-relation database

• Integrates drug and genetic information

• Correlates genetic sequence to drug treatment and response

Source: Vishuo

How does Vishuo iCMDBTM work?

Upload Gene Sequence

Analysis Report Generation

Vishuo iCMDBTM DatabaseCoverage: 1200+ Biomarker | Gene alterations | 200+ Diseases | Drugs | 750+ Treatment |Disease-Gene-Drug Association

External Research Data Internal Clinical Data

• High quality publicdatabase and medical& clinical researcharticles

Together the robust and co mprehensive database and algori thm give areliable analysis and accurate correlation of data for drugs, genes anddiseases.

Real Time Data• Manually curated drug-

gene corresponding data

• Historical patientsequencing data

• Multi-cancer supportdata* and treatmenteffectiveness data

• Clinical patient data iscollected on a real-timebasis from varioushospitals

*Covering top 20 cancers in China

Proprietary algorithm: Data mining, collection, classification and storing

Sources:

Process:

What are the main features ofVishuo iCMDBTM ?

Compatibility Accuracy Speed

Super computing power reduces

analysis lead-timeCompatible to all

sequencers

Clinical annotation based on high quality evidence and

manually curated database3-5days

Serve unarticulated needs

Source: Vishuo

iCMDBTM Output Report (1)Data Quality Report

Guides the user on the qualityof the genetic sequence data(obtained from the sequencinglaboratories/machines) thatwas used in the analysis

Source: Vishuo

iCMDBTM Output Report (2)Clinical Annotation Report

Provides recommendationon optimal treatment planfor the patient’sdisease/medical condition

Source: Vishuo

Value Propositions

Basisfortargeteddiagnosis

Patients Research InstitutesHospitals

Receivepersonalizedtreatments

Databaseanalysisforclinicalprojects

Value Propositions – HospitalsNo more trial and error, with life on the line!

• Seeing the unseenVishuo’s DNA analysis platform help physicians to ‘see’ beyond their diagnosis ie. symptoms.

• The genes don’t liePhysician makes fast and accurate medical treatment decisions based on the geneticpredisposition of patients.

• Treat one, treat moreThe collection of patients’ genes profiles and disease details allow matching of similarpatients and treatments.

Ultimately, by adopting an advanced technology like Vishuo’s iCMDBTM, hospitals canpotentially have an enhanced reputation from the improved success rates of treatments.

Value Propositions – PatientsThe right treatment for the right person at the right time, every time! - Obama

http://biomedvic.org.au/symposium/genomic-medicine-symposium/

• Accuracy Vishuo minimizes the ambiguity between diagnosis and effective treatment by analysing patients’ DNA profiles and annotating reports by using iCMDB.

• Reduced CostTargeted treatment reduces time and medical bills caused by inaccurate diagnosis and generic treatment.

• Prevention is better than cureEarly prediction and detection allows patient to seek the right treatment before it is too late.

Value Propositions – Research InstitutesFrom data to clinical breakthrough!

• Clinical research Research institutes use Vishuo’s database to evaluate and improve their clinical trial projects.

• Future drug discoveriesVishuo helps research institutes to learn more about the existing drugs’ functions and resistance, thus providing information as evidence to create better ones.

Customer segments

Vishuo iCMDBTM

Database and Platform Provider Customers Indirect customers

Hospitals

Research Institutes

Customers are the ones paying for the service

Patient

Indirect customers interacts with the direct

customers

Customer Segments (By needs)

HospitalsPatient

Research Institutes

“My patient has a cancer. He hasbeen undergoing chemotherapy forsome time but has not shown anypositive response. What otheralternative treatments can I proposefor him?” – Dr. Jeff

I want to find more appropriate treatment for him.

“My clinical research has beenpuzzling. I may need to study thebiomarkers (biological parameters)to understand a drug’s efficacy andtoxicity. Where can I find acomprehensive database reflectingactual clinical situation?” – Dr. Funk,PhD

I want data for evaluation.

“This is my sixth visit to the doctorsince I was diagnosed with breastcancer. I have tried all kinds oftreatments such as radiotherapyand chemotherapy. Are thesetherapies really working on me?Do I have better options?” – Ms. Li

I want the right treatment.

Targeted Customer Segments

HospitalsPatient

Research Institutes

Research Institutes which are actively involved in clinical and drug

analysis

Patients with genetic related diseases ie. cancer

All types of hospitals

Hospitals have high visits from

patients

TARGETSpecializes in

treating genetic-related

diseases ie. cancer

• Beijing PLA 307 Hospital• Beijing Cancer Hospital• General Hospital of Armed Police Forces• PLA General Hospital• Peking University People’s Hospital• West China Hospital• China Academy of Medical Science XiYuan Hospital

• Mount Sinai Hospital

• Tan Tock Seng Hospital• National University Hospital• Singapore General Hospital

Current CustomersSince the launch of iCMDB in 2013, Vishuo has successfully engaged reputable hospitals as their customers.Vishuo has continuously expand its customer base and currently has existing customers located acrossChina, Singapore, US and Thailand. Besides hospitals, Vishuo has also attracted the attention of researchinstitutes such as A*STAR in Singapore.

• Ramathibodi Hospital

How does Vishuo serve its customers?

Patient Hospitals

Reports

Vishuo’s iCMDB

1. Patient visits doctor for diagnosis 2. Pathologist uploads patient’s gene profile into iCMDB Patient’s

DNA

5. Doctor prescribes suitable treatment based on the report

3. iCMDB analyses patient’s gene profile

and automatically generates reports

4. Doctor analyses and verifies report outcomes

Research Institutes

1. Research Institute uses iCMDBTM

database for analysis

Revenue Models

• Subscription• Annual subscription for iCMDBTM

• Commission• Annotation fee

• Fee for Service• Project based payment

Methods of Value Capture

HospitalsVISHUO iCMDBTM

Subscription fee

and

Annotation fee

Clinical Annotation

report

Research Institutes

Fee for service

Research support

Data

Patient

Service Fee

Service

Scope of Activities

Sequencing Technology Manufacturers Hospitals Patient

Research Institutes

supplier

Service provider

Medical Journals (e.g. Nature,

Science)

suppliers Service provider

Super Computers and Network provider

Participants in Personal Genomics industry (recap)

Reference: Frost & Sullivan, March 2014, Future of Personalized Genomics (Technical Insights) Impact Assessment of Business Models in DTC Genetic Testing

• Whole genome and exome sequencing machine manufacturers

• Diagnostic/ Pharmacogenetic/Nutrigenomics testing kits

• Conducts sequencing services and clinical trials/analysis

• Software for genetic test result, visualization, storage, analysis and annotation

• Integrates genetic tests and results into diagnostic and treatment approaches

• Researchers, scientists, patients, physicians, healthy individuals

Sequencing Technology

ManufacturersGenetic Test Developers Laboratories


Solutions

Hospitals and Healthcare

SystemsEnd User

*not in any particular order

Market Competitors

Data Analytics Bioinformatics Solutions


Genetic Test Developers

Potential Competitors

Direct Competitors

Vishuo vs. Main Direct Competitors

Foundation Medicine & PierianDX workflow

Order Test Specimen Collection & Preparation

Gene Sequencing


Vishuo workflow

Upload Gene Sequence


What makes Vishuo better?

Better value proposition:Hospitals and Research Institute• First in Asia• Better report quality• Protected privacy and confidentiality (data is not

stored/analyzed in the cloud)

Patients• Cheaper annotation fee• Comprehensive Asian gene database• Protected identity

Hospital does sequencing

Better analysis and reportquality.- Proprietaryalgorithm- Manually curated database

i.e. High Quality Referencesonly

Valuable for physician’sin making decisions onmedical conditions oftheir patients.

FDA’s role within Precision Medicine Initiative:

Ensure the Accuracy of Tests

Source: http://www.fda.gov/ScienceResearch/SpecialTopics/PrecisionMedicine/default.htmhttp://www.forbes.com/sites/matthewherper/2014/07/31/fda-to-regulate-thousands-of-cancer-genetic-and-other-diagnostics/#44b189465698

Regulations in the USFDA’s Role in the Precision Medicine

What is FDA Doing Right Now?

• Laboratory diagnostics tonotify FDA about their test.

• Only FDA approved testscan be sold

Create a regulatoryplatform to encourageinnovation and ensuingaccuracy

Case: 23andMeFDA Issues with 23&Me

- Specific tips and guidance onreducing health risk

- Report does not needphysician’s approval (sent toconsumer directly) Surety on 23&Me

result interpretation

Too much confidence may result in bad medical

decision

Predicting nature of the report

FDA’s Concerns:

Source: http://gizmodo.com/23andme-is-back-in-the-genetic-testing-business-with-fd-1737917276

Service offerings Offers diagnosis and therapeutic recommendations Only provide diagnosis

Drug-genetics correlation data Provides personalized recommendation on drug and treatments No recommendations of drugs & treatments;

Data confidentiality Server is localized in the hospital Data is stored in the cloud

Customer privacy Only collects gene information, notcustomer’s identification Collects customer identification

Involvement of clinical experts Doctors receives and interprets the report for the patient Customers directly reads the report

Sampling Blood; more reliable, done in accredited clinics/hospitals Saliva; self-sampling

Ease of sampling Traditional sampling Sampling kit

References Strong scientific bases; manually curated database and high quality references

Relies on text mining and data analytics (might include low quality information)

Gene database More comprehensive Asian database Mainly Caucasian database

Scope of of services More comprehensive: gene-related diseases (i.e. cancer) More on health and ancestry reports

Value of application Serious medical conditions Personal interest

Vishuo vs. 23andMe

Physicians need to asses the Reports

Physicians make recommendation

based on their knowledge too

Only high quality data are included. (Tests at clinical trial level are not primarily recommended )

Vishuo does not predict but

understands why is it happening

Regulations in the USFDA’s Role in the Precision Medicine: Vishuo

FDA’s concerns less likely for Vishuo

Strategic Control

• For Vishuo to:

- Sustain Profitability- Ensure Survival- Foster Innovation- Be Responsive to Customers- Maintain Focus on Quality

Barrier to Entry: Intellectual Property

Network Effects

Complementary Assets

First Mover Advantage in Asia

Strategic Control

Distribution Channel: Present in Australia, Thailand, Malaysia, China

Marketing Channel: Medical Conferences & Exhibitions

Strategic Partner Life Technologies & Qiagen

Patents: 6 Patents in China

Trademarks: Company Name, iCMDB database

Intellectual Property

Complementary Asset

Tacit Knowledge Proprietary algorithm Patient database

Proposed Improvements

https://www.youtube.com/watch?v=HQKFgfMO5Sw

As the knowledge network grows we canensure that every patient can get the righttreatment with the right dose at the right time.

Proposed ImprovementsValue Proposition

Data Analytics is the Future of Healthcare and the Future of Vishuo

By building up database on each specificgeographical region, more appropriatetreatments can be provided for a particulardemographic group.

The more information we collect and connect, the better the scientists will understand health.

Proposed Improvements Value Propositions

Deliver better healthcare

services

Patients +

Healthy Individuals

Research Institutes

+ Pharmaceutical

Companies

Hospitals

Use data as key business

driver

Increased quality of

life

Government

Improve public health


Hospitals

Further improve (iCMDBTM) :expand into new applications

(i.e. prenatal test, nutrigenomic tests and analysis)

Healthy Individuals

introduce new services for health-consious/curious individuals:

(i.e. lifestyle, nutrition and ancestry analysis)

Benefit to Hospital: Deliver better healthcare services

Benefit to Individual: Improved quality of life


Formation of strategic partnership for mutual benefits

Pharmaceutical Companies

Benefits for Vishuo:1. New source of revenue:

• Provide data• Develop new platforms for pharma application

2. New treatment options

Benefits for Pharma: 1. Create breakthroughs in drug resistance clinical studies 2. Develop better/new drugs 3. Identify drugs suitable to specific race and disease


Formation of strategic partnership for mutual benefits

GovernmentBenefits for Vishuo:1. Government support:

• To help increase awareness about genome testing and precision medicine

• Enhanced reputation for Vishuo• Possibility of participating in developing legislations

Benefits for Government:

1. Be at the forefront of healthcare advancement2. Better understanding of public health and thereby

implement more appropriate healthcare programs

Proposed ImprovementsCustomer Segments

Proposed improvements

Legend:

Vishuo iCMDBTM

Hospitals

Research Institutes

Patient

Pharma Companies

Direct customers

Direct customerindirect customers

(benefactor)

Healthy Indivduals

Government

Proposed ImprovementsMethods of Value Capture

Revenue Models

• Subscription• Annual subscription for iCMDBTM

• Commission• Annotation fee

• Fee for Service• Project based payment

HospitalsVISHUO

iCMDBTM

Subscription fee

and

Annotation fee

Clinical Annotation

report

Research Institutes

Fee for service

Research support Data

Patient

Service Fee

Service


Legend:

PharmaCompanies

Fee for service

Research supportData

Softwarewith new algorithm

Subscription fee

Healthy Individuals

Service Fee

ServiceReport

Government

Exposure

Reputation

Service

Data


Proposed ImprovementsScope of Activities

Vishuo HospitalsPatient and Healthy Individuals

Research Institutes

supplier

Service provider

Super Computers and Network provider

Medical Journals

(e.g. Nature, Science)

suppliers

Service provider

supplier

Service provider

Pharma CompaniesService provider

Provider of drugs/ medicine


Legend:

Vishuo should develop new algorithms/ softwares suitable for Pharma applications

Government

Vishuo should have clinics (with in-house doctors/ dieticians/nutritionists) equipped with laboratories facilities and sequencing machines

Vishuo should partner withgovern men t in some p rojectlike govern men t subsidizedhealthcare studies andinsurance service.

Proposed ImprovementsStrategic Control: Strengthen IP protection

Trad

emar

k

Aggressively apply for trademarks related to products, processes,

algorithms, etc.

To aid in:-Accelerating Brand

Recognition

Pate

nts

Continually file patents(build patent portfolio in

various countries)

A strong patent portfolio:- Reflects that Vishuo is actively participating in recent advancements in healthcare- Can be deployed for future strategic alliance - May be licensed out for additional revenue

Taci

t Kno

wle

dge

Protect and strengthen existing knowledge base

Will be a source of competitive advantage

Proposed ImprovementsStrategic Control: Leverage from Network Effects

More Physicians

More Patients

Development of Data

Better Quality of ReportsMore Business

Opportunities

More Comprehensive

Database

Proposed ImprovementsStrategic Control: Build Complementary Assets

ECOSYSTEM

Build awider

ecosystem

Have stronger presence in the industry

Continuous R&D efforts

Provide high caliber offerings and enhance

reputation

Strengthen strategic alliancesin different regions

Increase market penetration

Active Marketing

Improve consumer awareness

Conclusions & Recommendations

Conclusions and Recommendations (1)

At present, Vishuo’s strongest competency is on genome analysis for medical gradeapplication.

Their analysis is built and developed on robust and strong scientific (manuallycurated database and high quality references) and technology (proprietaryalgorithm) validation.

Currently, Vishuo’s biggest value proposition is helping physicians in makinginformed critical medical decisions for their patients.

Vishuo does not conduct the genome testing itself but provide intelligentanalysis and interpretation of the data towards gaining more knowledge aboutthe genome.

There is a vast opportunity for Vishuo toimprove its current business model.

Today, the revenue stream is mainly fromanalyzing the genome data. In the future,the large amount of data accumulatedcan enable Vishuo to embark on newservices. By doing so, Vishuo can cater toan even wider range of customer andhave a bigger contribution in providingpersonalized healthcare to the community.

The Business Times September 2, 2015

Vishuo databases aim at targeted medical treatments


Conclusions and Recommendations (3)To maintain and enhance reliability andcredibility, Vishuo will have to collaborate withmany stakeholders (i.e. government, researchinstitutes, hospitals and pharmaceuticalcompanies) to build appropriate standardprocedures and legislation and prevent unrestin terms of ethical dilemmas and other privacyissues.

These partnerships can also help to increaseawareness and adoption of Vishuo’s productsand services and thereby be more profitableand sustainable.

The future of Vishuo is promising speciallysince the world is increasingly leaningtowards leveraging technology to improvehuman life.

Undoubtedly, today’s tech-savvygeneration would like to use technology toaccess more efficient and effective healthtreatments, diagnosis and services in thenear future.


Thank you!