Oncological Health Insurance

CANCER WHAT IS THE BIGGEST CHALLENGE TO THE HEALTH INSURANCE FOR THE NEXT DECADES? LONGEVITY

“EPIDEMIC” OF THE DEVELOPED WORLD WE ALL KNOW ABOUT A CASE OF CANCER AND, MORE AND MORE, A CASE OF SOMEONE RELATED TO US

Cancer Incidence Worldwide New cases THOUSANDS + 58% Global data All cancers excluding Skin, non melanoma Source: Globocan 2012 (IARC)

Cancer incidence worldwide Both sexes BREAST PROSTATE COLORECTUM LUNG LUNG STOMACH LIVER COLORECTUM All cancers excluding non-melanoma skin cancer 242.9+ 172.3-242.9 137.5-172.3 101.3-137.5 <101.3 No Data Source: GLOBOCAN 2012 (IARC)

people having cancer during lifetime in Manuel Sobrinho Simões O Cancro, 2014 SURVIVAL WILL INCREASE 1 out of every 4 people of our generation 1 out of every 3 people born in the last decade 1 out of every 2 people born in the next decades http://www.ligacontracancro.pt/noticias/detalhes.php?id=242 http://expresso.sapo.pt/sociedade/cancro-nunca-matou-tanto-em-portugal=f888429

New drugs for cancer approved by FDA (Food And Drug Administration) Trastuzumab-emtasine afatinib dabrafenib lenalidomide mechlorethamine pomalidomide Ra 223 dichloride trametinib ibrutinib obinutuzumab New drugs for cancer approved by FDA (Food And Drug Administration) abiraterone acetate asparaginase Erwinia brentuximab vedotin crizotinib ipilimumab vandetanib vemurafenib ixabeoilone lapatinib nilotinib temsirolimus nelarabine soragenib everolimus ofatumumab 2004 2006 2008 2005 2007 2009 2011 2013 2010 2012 2014 … bevacizumab cetuximab cinacalcet clofarabine erlotinib pemetrexed dasatinib gardasil panutinib nitumumab vorinostat bendamustine degarelix cabazitaxel denosumab eribulin mesylate sipuleucel-T axitinib bosutinib cabozantinib carfilzomib enzalutamide Ingenol mebutate Omacetaxine mepesuccinate ponatinib regorafenib Tbo-filgrastim vismodegib aflibercept ramucirumab ceritnib … Source: SwissRe

Diagnosis and treatment costs (examples) PET – tomography with positrons 1.200 € Genetic tests 1.000 € Genomic tests 2.000 € to 3.000 € 1 chemotherapy session 3.500 € 1 chemotherapy session with a new drug 15.000 € Patient that spent more in the last 5 years 400.000 € http://www.ligacontracancro.pt/noticias/detalhes.php?id=242 http://expresso.sapo.pt/sociedade/cancro-nunca-matou-tanto-em-portugal=f888429

People exceeding capital limit in the 1st year of outpatient and/or inpatient coverage Breast 39% Prostate 32%

THE CONFIRMATION OF A CAPITAL INSUFFICIENCY Increase of disease incidence Increase of private healthcare offer The acknowledgement of the importance of a timely diagnosis New technics and new drugs that are more expensive THE CONFIRMATION OF A CAPITAL INSUFFICIENCY

1st Oncological Health Plan

New product New concept ONE DIAGNOSIS A SINGLE COVERAGE MULTIPLE COVERAGES MEDICATION OUTPATIENT STOMATOLOGY ONCOLOGY 100% INPATIENT T-GMK-04 (0)

New product New concept ONE DIAGNOSIS MULTIPLE COVERAGES MEDICATION OUTPATIENT STOMATOLOGY ONCOLOGY 100% INPATIENT T-GMK-04 (0)

Oncology Plan ONCOLOGY 100% ONE DIAGNOSIS A SINGLE COVERAGE Inpatient Outpatient Medication Stomatology Rehabilitation Recovery healthcare Palliative care Home care Nutrition Psycho-oncology Alternative medicine Support in transportation ONCOLOGY 100% T-GMK-04 (0)

Oncology Plan 2nd OPINION SERIOUS DISEASES 1.000.000€ ONCOLOGY REMAINING PATHOLOGIES Inpatient 500.000 € Outpatient 10.000 € Stomatology 1.000 € Medication 1.000 € Prostheses and orthoses 750 € Aternative medicine 500 € 1.000.000€ 2.000.000€ (lifetime limit) 100% 2nd OPINION SERIOUS DISEASES 1.000.000€ OPC

Oncology Plan ONCOLOGY REMAINING PATHOLOGIES 100% WITH DEDUCTIBLES SAME AS STANDARD OFFER WITH DEDUCTIBLES WITH CO-PAYMENTS MULTICARE NETWORK REIMBURSEMENT NO DEDUCTIBLES NO CO-PAYMENTS EXCLUSIVE NETWORK SUBSCRIPTION AGE LIMIT: 60 YEARS OLD NO AGE LIMIT TO STAY 90 DAYS GRACE PERIOD (60 DAYS IN LUZ SAÚDE HOSPITALS)

Exclusive Network Oncology Coverage T-GMK-04 (0)

Probability of survival PREVENTION AND EARLY DETECTION Cancer Causes 5% genetic PREVENTION AND EARLY DETECTION 95% environmental 5-year breast cancer

Prevention Program 50 40 Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 appointments: evaluation/family risk gynecology/urology dermatology evaluation evaluation gynecology/urology evaluation evaluation gynecology/urology evaluation dermatology Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 examinations: CBC + PFH +PFR+PFT Occult blood testing ECG Mammography + cytology + HPV Ultrasounds Full colonoscopy Helical CAT CBC + PFH +PFR+PFT Occult blood testing Cytology Ultrasounds CBC + PFH +PFR+PFT Occult blood testing ECG Mammography + Cytology Ultrasounds CBC + PFH +PFR+PFT Occult blood testing Cytology Ultrasounds CBC + PFH +PFR+PFT Occult blood testing ECG Mammography + Cytology Ultrasounds CBC + PFH +PFR+PFT Occult blood testing Cytology + HPV Ultrasounds Full colonoscopy Helical CAT

oncologicalsupport@multicare.pt 1. 2. 3. a dedicated administrative team which provides a personalized assistance service supported by oncologists and nurses 1. 2. 3. SUPPORT FOR THE ACTIVATION OF THE POLICY and in clarification of doubts regarding insurance coverage. SUPPORT IN 2ND MEDICAL OPINION and in treatments abroad. CLIENT AND FAMILY FOLLOW-UP THROUGHOUT THE PERIOD OF DISEASE, scheduling of appointments, complementary diagnostic tests, treatments, as well as all the necessary logistical support. Acompanhamento do colaborador e sua família durante todo o período de internamento, ou no acesso a cuidados de saúde em ambulatório complementares ao internamento - marcação de consultas, exames auxiliares de diagnóstico, tratamentos, bem como todo o apoio logístico necessário.