1. U.S. Disease Awareness Launch
Paul Janczyk
Manager, Global Health Economics & Reimbursement, Disease Awareness, U.S.
(with Anna Sohlberg
Director, Health Economics & Reimbursement, THV, EMEA
And
Annabell Merklin
Communications Manager, Marketing Communications, EMEA)

2. Most sSAS patients are out-of-system (undiagnosed)
The disease awareness work aims to diagnose more patients
Estimated 2016 U.S. sSAS Patient View
Patient “Leak” Points
Total Prevalence: ~650K
Patient stays home (asymptomatic/unaware)
Patient sees doctor and symptom/murmur missed
Doctor finds symptom/murmur but doesn’t refer for echo
Echo ordered but AS missed
AS identified but not diagnosed or followed No
Echo
Out-of-System
Echo
In-System
Treated
with AVR
Age
sSAS = severe symptomatic aortic stenosis

3. Learning essential to developing strategy
DA Kick-off and Learning Tour
Direct-to-Patient (DTP) Messaging Ideation
Develop Quality Measure Concepts
D.C. Heart Valve Disease (HVD) Awareness Day
Policy Strategy Mapping
D.C. Screening Coalition Meeting
Patient “Leak” Points Research and Analysis
KOL Workshop and **Strategy Development**
Today
Jan
Feb
Mar
April
May
June
Jul
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2017
2018
In progress
Accomplished
Projected
DA = Disease Awareness. DTP = Direct-to-Patient HVD = Heart Valve Disease

4. Disease awareness strategy
Proof and Focus
Activators
Enablers
Solidify evidence to support the unmet need and establish strategic foundation
Engage stakeholders to facilitate
patient journey
Build on current Edwards and external development of enabling technologies
Develop public evidence of disease burden, including costs and prevalence
Leverage current research
Explore new data sources
Expand patient awareness of AS via non-traditional Direct-to-Patient (DTP) messaging
With Corporate Strategy, support and accelerate development of external tools to enable diagnosis
POC identification tools
Functional screener to identify potential AS patients
Support screening and policy initiatives for AS in select patient populations
Clear patient journey research to understand unmet need
Establish call to action for AS
Identify underserved patient
Engage cardiologists and patients
to raise targeted PCP awareness
Collaborate with HCS to invest and develop internal capabilities
Other opportunities to be explored
Evidence
Policy and
Legislation
Awareness
Campaign
Strategy Expansion from
KOL Workshop
POC = Point of Care PCP = Primary Care Physician HCS = Healthcare Solutions

5. Disease awareness strategy  initiatives  projects1
Evidence of
burden
Retrospective secondary research
Prospective secondary research
Patient
experience
Primary research on patients and caregivers
Primary research on underserved groups A
Proof and
Focus B 2 C D
DTP
messaging
Create DTP pilot roadmap
Launch DTP pilots
Screening
and policy
Activities to generate/consolidate screening evidence
Collaboration with patient advocates and industry
initiatives
Screening legislation development
Quality strategy to support screening and policy
PCP
awareness
Create PCP pilot roadmap
Launch PCP pilots 3 E F 4 G
Activators H I 5 J K L 6
Enabler
accelerator
Assess emerging diagnosis tools
Act on tool investment strategy
Enablers M
= Begun
in 2017 N

6. Direct-to-Patient (DTP) complements evidence generation
Direct-to-Patient (DTP) Pilots
Evidence Generation
Increase ECHO/AS treatment rates locally
Identify key motivators for each segment
Validate DTP model for future expansion
Provide evidence for pathway gaps
Bolster screening policy and guidelines
Quantify patient fall-out at each step
Expand definition of treatable AS
Inform DTP targeting and approach
Advance our policy agenda, challenge skepticism,
and address the unmet need

7. DTP pilot planning in-progress for Q1 2018 launch
DA Kick-off and Learning Tour
Direct-to-Patient (DTP) Messaging Ideation
Develop Quality Measure Concepts
**DTP Pilot Planning**
Submit Medicare Echo Abstract
Launch DTP Pilot(s)
D.C. Heart Valve Disease (HVD) Awareness Day
Policy Strategy Mapping
D.C. Screening Coalition Meeting
Finalize Data Agreement with OxVALVE
Submit CMS Quality Measure Grant Application
Patient “Leak” Points Research and Analysis
KOL Workshop and **Strategy Development**
Today
Launch AS Fact Sheets
Complete US Cost Burden Analysis
Accelerate Diagnostic Technology Development
Jan
Feb
Mar
April
May
June
Jul
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
2017
2018
In progress
Accomplished
Projected
DA = Disease Awareness. DTP = Direct-to-Patient HVD = Heart Valve Disease

8. It is normal to begin to have difficulty with every day tasks.
Can we change thinking?
From To
Fatigue, shortness of breath and difficulty exercising are simply signs of aging.
It is normal to begin to have difficulty with every day tasks.
As long as there is an annual physical exam when the doctor listens to my loved ones and my heart, I’m sure that any heart problems will be properly diagnosed.
These symptoms are more than just normal aging and I will discuss these changes with a doctor.
To protect the ones I love and myself, I will make sure the doctor does more than just listen to the heart – I will make sure we verify heart health by asking for an echocardiogram.

9. Europe can leverage U.S. evidence consolidation, generation and primary research
AS burden of illness
Ex. OxValve follow-up work
‘Part of the solution beyond the technology’

10. Build on existing disease awareness work
Heart Valve Disease Day
Initiative by five European patient groups
Supported by PCR
Local events and European event with policy-makers planned
European-specific circumstance
Across countries and languages
Patient outreach restrictions

11. Build on existing disease awareness work
Awareness Surveys
Survey of people over 60 years old
11,000 people in 11 European countries
Survey results to be published in scientific journal
Survey results to be used for national media campaigns
In 2013 and 2015, awareness surveys were conducted amongst people over 60 years old across Europe
2017 follow-up survey will aim to evaluate if awareness has improved
Survey of 11,000 people aged 60 years or older in 11 European countries
Survey to published in scientific journal
Survey results to launched on first European Heart Valve Disease Awareness Day 2018