Consumer Point-of-Care: What’s New in 2015

− 2 − © 2015 ZS Associates | CONFIDENTIAL The 2014 ZS study presented at the POC Summit last year estimated the consumer POC market at $400 million Defined the three primary POC venues Estimated the industry’s size and historic growth Uncovered the key trends influencing POC

− 3 − © 2015 ZS Associates | CONFIDENTIAL Point of Care noun Sponsored health and wellness education and marketing communications provided in venues where consumers receive healthcare—doctors’ offices, hospitals, pharmacies.

− 4 − © 2015 ZS Associates | CONFIDENTIAL 87 % of market spend is from pharma companies MARKET SEGMENTATION We did not see any significant deviation from the historic CAGR of 10%, and estimate the industry size at $440 million *ZS estimates, based on interviews and secondary research. Sources: ZS estimates based on Interviews and secondary research. Nielsen DTC Spend Data. POC SPENDING* 2010 – 2015 : THE NUMBERS 2010 $266 MILLION 2015 $440 MILLION GROWTH 10% CAGR BY SPEND

− 5 − © 2015 ZS Associates | CONFIDENTIAL 8%, 10%, AND 15% $0.5 BILLION AGING BABY BOOMERS CHANGING HEALTH- CARE (ACO, ACA) LESS HCP ACCESS FOR SALES FORCE SPECIALTY AND TARGETED INCREASING VENDOR REACH TECHNOLOGY ACCESS POC GROWTH DRIVERS We would anticipate that the industry will exceed $500 million between 2016 and 2017 Source: ZS analyses. GROWTH ESTIMATES

− 6 − © 2015 ZS Associates | CONFIDENTIAL POC communications are credible and drive consumer health behavior Sources: Healthcallings.com. AccentHealth Consumer Connections™. KantarMedia/MARS Consumer Health Study, & place waiting room materials among their most credible sources 65 % 81 % PHARMACISTS 88 % PHYSICIANS PATIENTS’ MOST CREDIBLE SOURCES for information on health decisions WHO DO PATIENTS TRUST? ADULTS EXPOSED TO POC ADVERTISING IN 2013 asked for a Rx for a specific medication 18 MILLION asked for a product sample of a Rx drug 17 MILLION INFLUENCING BEHAVIOR switched brands 11 MILLION

− 7 − © 2015 ZS Associates | CONFIDENTIAL TARGETED & MEASURABLE POC is highly targeted and delivers measurable impact Sources: Crossix.com. EXPOSED TO POC NOT EXPOSED ~ 62 %  in prescriptions among patients exposed to POC POC CONVERSIONS

− 8 − © 2015 ZS Associates | CONFIDENTIAL 2015: GOING FORWARD

− 9 − © 2015 ZS Associates | CONFIDENTIAL FUTURE LOCATIONS The definition of Point of Care is likely to change in the future as telehealth becomes more ubiquitous DOCTORS’ OFFICES PHARMACIES HOSPITALS CURRENT LOCATIONS HOMES

− 10 − © 2015 ZS Associates | CONFIDENTIAL FUTURE NUMBERS Telehealth is already large and is projected to grow rapidly in the coming years sites connected through these networks in the US telehealth networks operating in the US CURRENT NUMBERS Sources: HealthcareGlobal.com, April AAOS.org, December Forbes, December patients will contact their physicians remotely in MILLION %  projected annual growth of the US telehealth market YEAR 2YEAR 1

− 11 − © 2015 ZS Associates | CONFIDENTIAL Shifting consumer expectations about when and where they access health services Healthtech startups (and established companies as well) are eager to get in on the game Increasing number of policy and regulatory actions supporting reimbursement of telehealth There are 3 key drivers behind this anticipated trend

− 12 − © 2015 ZS Associates | CONFIDENTIAL CHANGING BEHAVIOR Consumer expectations are driving and evolving with the changing healthcare landscape CONSUMERS of adults prefer HCPs who communicate via 93 % of patients (25-44) use Facebook or to connect with HCPs 49 % HCPS of HCPs communicate with their patients via 35 % of emergency, urgent care, and HCP visits can be avoided with remote care technologies 78 % RETAIL CLINICS annual clinic growth 25 % − 30 % patients annually 10 MILLION clinics by end of Sources: CatalystHCR.com. JHSPH.edu. AAOS.org. Advisory.com. HealthyDebate.ca.

− 13 − © 2015 ZS Associates | CONFIDENTIAL Increasing number of policy and regulatory actions supporting reimbursement of telehealth Sources: National Conference of State Legislatures. CCHPCA.org. AACUweb.org. TELEHEALTH PAYER RULES reimburse for live video through Medicaid 47 STATES reimburse for a facility or transmission fee 29 STATES reimburse for remote patient monitoring 16 STATES

− 14 − © 2015 ZS Associates | CONFIDENTIAL PARTNERSHIPS Firms offering telehealth services are growing and some are partnering with major Payers

− 15 − © 2015 ZS Associates | CONFIDENTIAL THE ADVENT OF VIRTUAL POC

− 16 − © 2015 ZS Associates | CONFIDENTIAL CONNECTS WITH OTHERS ONLINE VISITS DOCTOR GETS SECOND OPINION ONLINE FILLS PRESCRIPTION FOLLOWS UP WITH DOCTOR VIA VIDEO CHAT FILES TELEHEALTH CLAIM ONLINE FROM HOME FOLLOWS UP AGAIN WITH DOCTOR HAS A CV EVENT vPOC will complement, not replace, “traditional” point of care venues − 1616 − CHECKS IN WITH DOCTOR VIA

− 17 − © 2015 ZS Associates | CONFIDENTIAL Point of Care noun Sponsored health and wellness education and marketing communications provided in venues where consumers receive healthcare—doctors’ offices, hospitals, pharmacies, and anywhere else the consumer happens to be. Point of Care noun Sponsored health and wellness education and marketing communications provided in venues where consumers receive healthcare—doctors’ offices, hospitals, pharmacies,