Neuro Technology

Journey 2013 Conference

October 17, 2013

Jim Willenbring

Senior Director, Portfolio Strategy

Medtronic Neuromodulation
Context for today

It is change, continuing change,

inevitable change, that is the dominant
factor in society today. No sensible
decision can be made any longer
without taking into account not only the
world as it is, but the world as it will be.
– Isaac Asimov

2 | MDT Confidential
To contribute to human welfare by the application of biomedical
engineering to alleviate pain, restore health, and extend life
 Our therapies treat many significant unmet
medical needs with innovative technology

Diabetes Spine Endovascular

Therapies

Coronary and Neuromodulation

Renal Denervation

Cardiac
Surgical Structural Heart
Rhythm
Technologies
Disease
Management

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 Changing healthcare landscape
Opportunities Challenges

Aging patient populations Infrastructure and access

with increasing chronic challenges in emerging
diseases markets
Fragmented patient care
Rising global middle class –
pathways; low therapy
more income for health care
awareness
Rising investment in Pricing pressures in
healthcare in emerging developed markets
markets
Longer regulatory review
Significant numbers of cycles & increased
underserved patients evidence needs

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 Evidence needs driving costs up
Increasing requirements around the world are raising the cost of
commercializing new therapies significantly

100 Number of Health Technology

96
90
Assessment Organizations (Global)
80
69
70
60 Clinical and economic
50 44 evidence needed not only
AHRQ for initial approval, but to
40 CADTH US
maintain reimbursement
30 PBAC Canada
NICE coverage
20 Australia 14 UK
5
10 2 3

0
1960 1970 1980 1990 2000 2010 2013

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Medtronic’s perspective: Where healthcare will evolve

Prior Future
Fee for service Fee for value
Reward volume Reward outcome
We
Clinical evidence Clinical & econ evidence
Are
Physician primary Here
Expanded decision makers
decision maker
Innovation in technology Innovation across care
continuum & health
systems

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 Medtronic strategies to address healthcare
transformation
Universal Strategies
Healthcare Needs
New Therapies Develop new therapies and technologies to
Improve clinical address unmet clinical needs and drive them
outcomes to standard of care

Globalization
Develop tailored solutions to address market-
Expand access specific needs and expand access in global
markets

Optimize cost Economic Value

Translate the clinical value of our therapies,
and efficiency programs and services into economic
benefits for the health care system

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 Medical technology addresses many chronic conditions
Cranial Repair Hydrocephalus Parkinson’s Disease
Brain Tumors Sinus Diseases Essential Tremor
Sinus Augmentation Dystonia*
Sleep Disordered Breathing
Obsessive-Compulsive Disorder*
Cervical Degenerative Disc Disease
Epilepsy
Thyroid Conditions

Otologic Disorders
Neuromodulation
Atrial Fibrillation
Heart Failure Meniere’s Disease
Started with Congenital Heart Disease Aortic Disease
cardiac Heart Rhythm Disorders
Severe Spasticity associated with Multiple
Coronary Artery Disease
pacemakers Heart Valve Disease
Sclerosis, Cerebral Palsy, Stroke and Spinal
Cord and Brain Injuries
Scoliosis Chronic Pain
Spinal Fracture Nausea and Vomiting associated with Gastroparesis*
Lumbar Spinal Stenosis
Diabetes
Degenerative Disc Disease
Overactive Bladder and Urinary Retention
Pelvic Trauma
Fecal Incontinence
Peripheral Vascular Disease
Tibial Fractures

Vagal Nerve Stim

Functional Electrical Stim
Neuroprosthetics
Transcranial Magnetic Stim * Humanitarian Device in the United States –
the Effectiveness for this use has not been demonstrated
 Medtronic Neuromodulation Technology

New New New New New

Products Technology Indications Partnerships Directions

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 Neuromodulation technology innovation
Industry-wide
More
Automatic &
Tailorable
Therapy Posture
Brain Sensing Adaptive Stim Advanced &
Alternative Stimulation

Less
Invasive
New Trialing External Minimally
Systems Magnetic Stim Invasive Stim

Improved
Patient
Outcomes
MRI Safety Objective Pain
Measure

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 Business development expectations have changed
Consistent criteria: Unmet need, safety and quality

Past Today
Stage-gated process: minority
Early, outright investment, milestone payments,
acquisition licensing, sale or distribution, research
collaborations
Proven concept with supporting data
Great idea! CE Mark/FDA approval increasingly
important

Clinical efficacy Clinical & economic evidence

Technology suited to specific needs of

Interesting
targeted market for a specific
invention! indication
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 Business development needs

Core products
& therapies
Improving & extending
our technology

Core Core Call

Indications Point
Leverage
Capturing the
current sales
care continuum
force

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 Improving
Another Life
Every 3
Seconds

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