PILSH2014 Rabobank
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The future of the healthcare sector is not what it used to be!From an Ego- to an Eco-system
Michel van Schaik, Director Healthcare
LifeKIC Update 1
Partnering in Life Sciences & Health 2014
Artis Amsterdam, November 27th 2014
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Diagnosis 2025: about the future of Dutch Healthcare
Interest Rabobank:
•Business (providing funding) •Coöperative mission
2010
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3 Scenario’s
Important ‘drivers’:
•Dutch economy (GNP)•Politics
Conclusion: the Dutch healthcare system is not sustainable!
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Diagnosis Health InnovationHow to improve quality, accessability and affordability of care?
“Innovation and entrepreneurship need to be improved in order to make the healthcare system sustainable”
Great need for disruptive innovations.
2013:Including a health innovation agenda supported by a strong coalition
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And: > 350 patiënts, professionals and experts
involved
“Coalition of the willing” (Public-Private-Partnership)
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Elderly related health issues (multimorbidity, loneliness, frailty,
etc.)
COPD en AstmaCancer
Chronic Heart disease
Focus
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405.000 chronische aandoeningen (+16%):•171.000 1 chronische aandoening (+9%)•234.000 > 1 chronische aandoening (+20%)
19 jaar en ouder
16.100 chronische klachten/aandoeningen (+8%):•10.400 1 chronische klacht/aandoening (+8%)•5.700 > 1 chronische klacht/aandoening (+8%)
56.000 risico op psychische aandoeningen (+27%)
70.000 functioneringsproblemen (+60%)
Projection of HC needs in Amsterdam 2030Estimate based on demographic developments
Functioneringsproblemen 65 jaar en ouder:• 3.500 lichte/matige dementie•35.000 mobiliteit -/+ lichte/matige dementie•21.000 mobiliteit en zelfzorg -/+ lichte/matige dementie• 7.100 ernstig fysiek -/+ lichte/matige dementie• 3.600 ernstige dementie
Chronische aandoeningen 19 jaar en ouder:•202.000 bewegingsapparaat• 62.000 Astma/COPD • 56.000 Incontinentie • 56.000 Diabetes Mellitus• 41.000 Kanker• 22.000 Hartinfarct• 19.000 CVA• 12.000 Dementie
Chronische klachten/aandoeningen 13-17 jaar:•6.300 Hoofdpijn•4.900 Astma/bronchitis•4.000 Eczeem•3.800 Chronische vermoeidheid•2.400 buikklachten•1.800 ADHD•450 Hartaandoening•300 diabetes mellitus• 300 Anorexia/Boulimia• 50 Kanker
Psychische aandoeningen (alle leeftijden):•15.000 Stemmingsstoornissen (bij huisarts)• 6.200 Angststoornissen (bij huisarts)• 1.700 Schizofrenie (bij huisarts)
78.000 (+54%) 65-74 jaar
61.000 (+56%) >75 jaar
170.000 (+5%) 0-19 jaar
560.000 (+4%)20-64 jaar
81.000 risico op eenzaamheid (+29%)
65 jaar en ouder
50.000 mobiliteitsproblemen (+ 19%) 19 -64 jaar
13-17 jaar
6.800 risico op psychosociale problematiek (+10%):•3.700 matig risico (+10%)•3.100 hoog risico (+10%)
13-17 jaar
870.000 (+10%)Amsterdam:
383.000 Nederland (-2%)164.000 ov Westers (33%)122.000 ov NWesters (+47%) 83.000 Marokko (+15%) 60.000 Suriname (-13%) 46.000 Turkije (+10%) 12.000 Nld Antillen (-2%)
Source: TNO
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Central government
Central government
InsurersProviders
Healthcare consumers
InsurersProviders
Healthcare consumers
Eco-networkEco-network
Personal Pre-emptive
PredictiveParticipatory
Regulation of central supply
•Input financing: budget and permits•Focus: institution and healthcare professional•Disease & Care
Managed Competition•Output financing: Pay for performance•Focus: Healthcare consumer (pathogenesis)•Health and behaviour
Sustainable health-value systems
•Outcome financing: Individually and socially•Focus: Functioning & Participation•Focus: Citizen and Health (Vitality & Well-being, Salutogenesis)
Healthcaresystems
Innovation / technology development
Medical technology
Pharma
Information & Communication technology
GeneticsRobotics
Nanotechnology
Bio-techNutri-tech
Pater-systemWelfare state
Central governanceTop-down and instructivePatronizing
Ego-systemMarket mechanism
Governmental frameworkMaintenance and remote monitoring
Eco-systemValue creation
Connecting governmentReciprocityStyle flexibility
Role government
Besides a main focus on the patientwe need to change management philosophy
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Transition of the Dutch healthcare system:
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• Sharing vision and knowledge;
• Help setting stage for “Healthy & Vital” Amsterdam;
• Facilitate HC entrepreneurship (incubator?);
• Provide hands on support for SME’s (businesscase);
• Connection with other HC innovation platforms;
• Share local, national and international networks;
Rabobank’s role in LifeKIC?
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Investment strategy
1. Other includes for example: Clean processing and Sustainable agriculture 2. % are an indication of the investments per theme over the lifetime of the platform, the actual year on year allocation will vary. The platform has the flexibility to invest up to 15% in
innovations outside the themes, e.g. clean processing (which is considered a theme across the themes). 3. Average investment size based on a € 60M fund size
I mpact investing based on themes
Geographic scope
I nvestment phase
Venture capital investments
Phased investment in national frontrunners3
4 current DGF portfolio companies
16 entry tickets (seed/series A): € 0.75M
14 follow-on (series A/B): € 2M
6 growth: € 3M
Total portfolio of 20 companies targeted
Maximum of 12.5% of committed capital invested in one venture
Clear focus and strategy to achieve financial and strategic return by accelerating innovation
Other1 Nutrients
Food & Health
B io-refinery
Revalue waste
25%
25% 25%
25%
Allocation of investments2
Bio-refinery
Revalue waste
Nutrients
Food & Health
National base and focus with global outreach
The platform looks to invest from a strong Dutch base with an international reach through its network
Investment predominantly in Dutch companies with possibility to invest up to 20% outside of the NL
Current platform has an established network throughout the world in over 100 countries across 6 continent
€10M
€ 1M
Regional support /
seed capital
National frontrunners
Industry network / knowledge
Venture Capital
Own global network with
partners
Global player
Local MKB
International VC Corporate VC
National VC with global reach
Local banks Regional funds
I mpact investing
Environmental and social impact are key conditions for investments. The impact will be assessed and monitored on venture and fund level.
I nvestment themes
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• Excellent HC professionals and providers;
• Highly ranked research institutes;
• Innovative corporations (HC technology & nutrition);
• (Sense of) urgency;
• We need entrepreneurs with great ideas and execution power;
My ambition:Help develop, implement and export Dutch HC solutions
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