Digital Health: Connecting Your Medicines to the Internet Means Better Care at Lower Cost George M. Savage, MD Cofounder & Chief Medical Officer May 2, 2013

2 ©2013 Proteus Confidential 6,000,000,000 87%

3 ©2013 Proteus Confidential Personal Medical Records Percent of People with Type 2 Diabetes <4% 4% 5% 7% 9% >12% Chronic Illness is an Enormous 21 st Century Medical Challenge

4 ©2013 Proteus Confidential Over 50 Percent of Prescription Medicines are Not Taken Correctly WHO Poor adherence to treatment of chronic diseases is a worldwide problem of striking magnitude Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. The impact of poor adherence grows as the burden of chronic disease grows worldwide The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs Improving adherence also enhances patients’ safety Adherence is an important modifier of health system effectiveness” Medication adherence in heart failure 1 Sources: (1) Hauptman J, Heart Fail rev 2008;13:99 (2) Wong J, Can J Neurol Sci 2011; 38: 429 (3) Sabate E, WHO 2003, pp xiii-xiv. Medication adherence in multiple sclerosis 2

5 ©2013 Proteus Confidential The Patient’s View of Medical Therapy

6 ©2013 Proteus Confidential Digital Health Feedback System: Internet-Enabled Medicines

7 ©2013 Proteus Confidential

8 Digital Medicines Deliver a Continuous, Unified Picture of Life Therapeutic Information Medication Dose Timing Adherence Supply Chain Physiologic Information Heart Rate Respiration Activity Posture Gait Sleep Stress Temperature Mobile Information Sociability Engagement Cognitive Assessment Environment Location Context Subjective Information Side Effects Symptoms QOL Mood Emotion

9 ©2013 Proteus Confidential Patient Engagement is the New Blockbuster “Drug”

10 ©2013 Proteus Confidential As With Phones, Complexity Invisible to User and Privacy Assured Web/Mobile Applications Patient/Caregiver Networks Clinician and Clinical trial tools Analytics Patch attached to user and Paired to Phone, data upload periodic and automatic, always on Phone receives data from Patch, forwards to cloud. Analytics returned from cloud Ingestible sensor activated upon fluid contact

11 ©2013 Proteus Confidential $32B HF cost forecast to grow to $70B by 2030 (source: AHA) 25% of 1M discharged HF patients readmitted within 30 days Overwhelming majority of readmissions are preventable Solution: Digital health system to monitor medication taking and patient response Opportunities from Heart Failure to Tuberculosis to HIV and More

12 ©2013 Proteus Confidential How best to regulate and reimburse cross-disciplinary digital health platform? How to allow business model innovation yielding improved patient care and productivity gains that lower cost? How to allow public and private sector payers to experiment with new, possibly transformative digital health technologies? How to keep platform implementation patient-centric, allowing the individual to control privacy, particularly the flow of personally-generated data? Blue ribbon panel Innovators and policymakers tasked with exploring what steps are needed to get digital health to patients White paper/report to Congress Scientific innovations associated with digital health platform technologies, challenges from regulatory and reimbursement perspectives, and potential policy solutions Policy Considerations and Next Steps