Pharmaceutical industry

changes and market insights

Survey of leaders in the pharma value chain
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Ernst & Young LLP and YourEncore alliance overview

Ernst & Young LLP and YourEncore have formed a strategic alliance to help life sciences and
consumer products clients accelerate product development, strengthen regulatory compliance
and improve productivity.
This first-of-its-kind relationship unites EY advisory, transaction advisory and tax services with the
real-world experience of YourEncore’s 10,000 on-demand industry experts to help clients innovate,
drive growth, manage risk and comply with increasing regulatory challenges.

About YourEncore
Indianapolis-based YourEncore, named a “100 Most Brilliant Company” by Entrepreneur Magazine,
is a leading provider of proven expertise, delivering flexible resourcing and consulting services to
the biopharma, medical devices and diagnostics and consumer goods industries.
With its network of highly experienced subject matter experts, including MDs, PhDs, regulators
and scientists, YourEncore mobilizes the wisdom and know-how of its experts to help companies
out-think, out-pace and outperform.
For more information, visit www.yourencore.com.

II | Parthenon-EY
Introduction
Parthenon-EY and YourEncore recently conducted a
nationwide survey of life sciences experts to query them
on recent market trends, uncover their points of view on
potential regulations, refine their current business models
and gain insights into what discovery efforts might yield
better results. With all the rhetoric surrounding the drug
industry from political, news and personal channels, we
wanted to know what “those who know” think of various
ways to improve the system.

We asked 10 simple questions, soliciting input from more

than 50 past and present industry executives and experts
from pharmaceutical, consulting and pharmacy backgrounds.
What we heard was informative, provocative and in some
cases unsurprising — but important to consider.

Here is what we have learned.

Parthenon-EY | 1
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q1 Which top regulations could have the greatest impact

on accelerating discovery and getting breakthrough
products to market faster?

Overall, respondents did not mind operating in a regulated stem cell research, and that domestic restrictions on their
environment, and we did not hear many say they would use will not stop experimentation. There is a belief that
prefer an unregulated market. In fact, many believed that US restrictions may result in long-term harm if research
patient safety regulations and those governing effective conducted in countries with fewer controls leads to harmful
clinical trials are both necessary and protect the general or false therapies that eventually enter the US market.
public. Of top concern for our respondents was the ability
of the Food and Drug Administration (FDA) to review trial
Figure 1: Number of new molecular entities (NME) approvals
results, issue opinions and findings and provide consistent by the FDA, 2006-2016
guidelines by therapy area.
Average: 36
This response was unexpected — we initially thought that drug approvals
fewer regulations would be preferred. There was wide per year between
2011 and 2016
support for the standard clinical trial model, with some
recommendations to create consistent protocols by
50
therapeutic area and streamline the process for disease-
45
specific reviews to include the same outcome measures, Average: 22
drug approvals 41
whether those are biomarkers or real-world evidence with 40 per year between 39
the same endpoints. 2006 and 2010

For novel therapies, especially in oncology, there was 30

30
a desire to allow smaller studies with greater definition 27
26
24
around endpoints and an accelerated approval path. 22 22
21
One participant responded, “a review of the clinical 20 The decline
18
requirements by therapeutic area should [occur] to ensure of NME
approvals
that the most streamlined processes are in place to speed in 2016
concerns
up the development process. Inclusion of real-life evidence 10 stakeholders
in supplemental applications [should also occur] across all across the
value chain.
therapeutic areas.”
0
There was also a consensus that the US is falling behind 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

other developed countries in the use of genomics and

Food and Drug Administration

2 | Parthenon-EY
Q2 Which top regulations or agency reform
would have the biggest impact on lowering
the cost of drugs?
Our respondents named several potential changes that could
help lower the cost of drugs. Mentioned quite often was
reforming how the US uses generic drugs. For many years,
payers and pharmacy benefit managers (PBMs) have driven
the “generic conversion rate” — mandating that patients
switch from branded drugs to generics — with the belief
that costs would decline.
Role of generics
Drug prices have continued to rise due to how drugs
are placed on formularies, the use of non-transparent
incentives, and the lack of generics in high-cost disease
states. Several respondents indicated that the role of
generics may be limited as new therapies and biologics hit
the market. Others believed that generics still have a long
way to go and can be lower-cost alternatives for the right
disease states. These respondents believed that payers
need better guidelines for how products are reimbursed,
such as comparing the net retail costs between a generic
and brand after all incentives are included. Affordability
for the patient should be the priority, not unit costs of a
single product.
Accelerating generic drugs to market through improved
processes was seen as one path to less-expensive
alternatives making it to market faster. There was a belief
that introducing competition to the pioneer product
earlier can impact overall drug costs. Rapid approval of
biosimilars was another category believed to lower costs as
brand patents expire. One respondent said savings could
be realized if Code of Federal Regulations Part 314 were to
require third-line drug approvals to be superior to the first
two products on the market and have the same or better
safety and efficacy profile.
Medicare/Medicaid price negotiations
Some said that Medicare, Medicaid and other government
programs should be able to negotiate prices similar to
those in European countries where list prices are public
and competition is more open. There was a broad
consensus that pricing needs to be transparent, not only
for manufacturers, but for everyone in the value chain —
particularly PBMs and pharmacies — that profits from
unit price arbitrage vs. services provided.
Patient and provider education
Marketing and direct-to-consumer advertising is the one
area that most respondents agreed is a huge cost to
manufacturers and drives up the wholesale price of the
drug to recover investment for capturing patients. Use
of paper for product inserts, packaging and marketing
materials, rather than moving to electronic labeling were also
considered to drive up unit cost. Patients’ lack of allowed
time with physicians creates both a greater burden to educate
the public and costs associated with paper-based materials.
Formulary reviews
Other respondents believed that formularies need to be
overhauled and that exclusions, substitutions, and non-preferred
products need to be thoroughly reviewed with new guidelines
and clinical protocols, not just price comparisons. There was
a consensus that payers need to apply more clinical rigor in
making decisions and focus on outcomes instead of unit price.
Figure 2: Year-over-year growth of branded drug prices in US, 2012-2015
12.5%
10.0 10.1%
8.0% 8.3%
7.5 7.5%
5.0
2.5
0.0
2012 2013 2014 2015
EY analysis, Morgan Stanley and UBS industry analyst reports
Parthenon-EY | 3
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q3 Which top regulations or agencies

create the largest barrier to collaboration
(research or otherwise)?

In looking at the regulatory environment, we had to ask assume this role. Supporting biotech incubators and helping
whether current legislation and agencies were a barrier to fund partnership creation were seen as a way to increase
clinical collaboration between pharmaceutical manufacturers. competition and collaboration.
We heard that there is significant concern about collusion,
One respondent indicated Hatch-Waxman Amendments
patent protection and sharing of information. However,
(patent reform and generic drug regulations) may help
when we queried the market, many told us that these fears
with price, but they also favor generic drug companies.
are overblown, and that internal legal and leadership risk
Moreover, the respondent indicated patent protections
tolerance represent the largest barrier.
for new chemical entities should be extended so larger
One respondent said that “regulations and agencies pharmaceutical companies have the money needed for
are not a meaningful barrier to collaboration among additional research.
companies or between companies and medical institutions/
Lastly, there is also a belief that PBMs and payers have not
universities/NIH (National Institutes of Health). The barriers
fostered collaboration when they could have largely helped
are far more related to the diverging interests of these
reconcile inconsistencies in the industry around common
organizations.” Another responded, “Much could be done
practices and data sharing. One respondent said insurance
on the industry side to encourage collaboration, especially
companies could have implemented clearer requirements
in therapeutic areas that are advancing cures in areas of
for routine standards of care and covered the increased
unmet medical need. This has always been a problem due
frequency of testing to capture data on valuable health
to competitive environment and patent enforcement but
outcomes.
is worthy of a dialog session to discuss solutions.”

Other respondents believed that the FDA and NIH can

do more to foster collaboration, but that the current
complexity of different departments with different
processes makes it seem as though they are dealing with
multiple agencies. Every submission and request seems to
be a “first” or “one-time exception” rather than a standard
operating procedure.

Several respondents felt that funding should be directed

to small start-ups and innovative companies that are willing
to partner. These respondents suggested government
assistance in identifying partners and financing or,
alternatively, private equity and smaller investors could

4 | Parthenon-EY
Q4 What components of the value chain
(discovery, manufacture, distribution)
contribute the most to drug prices?

Unsurprisingly, research and development (R&D) was
most often cited as the most expensive component and
contributor to drug prices. Obviously, the sunk cost of failed
trials was the primary driver, as these investments need to
be incorporated into the cost for successful programs.
According to one respondent, “In my opinion, manufacturing
(i.e., cost of goods) has a major impact on the ultimate drug
price. Having said that, however, the cost of development is
very high and very risky. Numbers of studies, numbers of
patients, late-stage failures all contribute to the soaring cost
of drug development and therefore drug prices.”
There was, however, a new category that has emerged
recently as a contentious element in the cost of drugs:
the expenses associated with “middlemen.” This includes
prescription benefit managers (PBMs) and wholesalers that
are using their dominant positions in the value chain to
drive up profits by demanding more rebates or “discounts”
for products that are not passed on to consumers and do
not add value to the process. One respondent called the
distribution chain an “antiquated model” that involves
far too many middlemen. Restrictions around distribution
have created excessive handoffs before a product reaches
the consumer.

Phase 3 or late-stage clinical trials were also cited because

The issue with the middleman has become very prominent
of the number of endpoints that need to be evaluated and
in recent national conversations, as the market asks why
the manual process by which data is collected and evidence
there is still a need for handoffs in a highly consolidated
is submitted to the FDA for approvals. Several respondents
sector. One respondent indicated “distribution, insofar
indicated the clinical trial process heavily depends on
as insurance companies and PBMs increase their profits
inefficient processes that are not automated or consistent
at the expense of patient choice and co-pay/co-insurance
and even incremental improvements could yield significant
increases … also leads to increased noncompliance to
savings to the industry.
prescribed therapies.”

Other components cited were product recalls, packaging,

destruction costs and labor associated with the management
of product in the channel. Of course, also on the list was
marketing, especially direct-to-consumer advertising,
which is more expensive than a sales force that calls
on physicians. Recent rules on how much time a drug
rep can spend with a physician have shifted marketing
expenses into digital and media advertising, which
requires significant investment and constant updating.

Parthenon-EY | 5
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q5 What changes to regulations would

lower prices the most?

While respondents indicated many diverse approaches
to lowering prices, many were in agreement that the
quantity and complexity of regulations can contribute to
higher drug prices. One respondent said, “The relationship
between regulatory expansion and higher prices cannot
be ignored. Price increases caused by regulation have
a disproportionately negative effect on low-income
households. The poorest households tend to spend
a larger proportion of their income on goods that are
heavily regulated and are subject to both high and volatile
prices. This cost should be recognized in policymakers’
efforts to consider the costs and benefits of new and
existing regulations.”
Other respondents focused significantly on the
manual, inefficient compliance processes that require
documentation by requesting a “commonsense approach
to documentation requirements.” “Eliminating the
requirement for printed packaging and physician leaflets
and transitioning that information to electronic labeling”
could reduce costs. One respondent indicated “lowering the
preclinical burden and opportunity potential for approval
with one pivotal trial (or counting a good Phase II as a
pivotal in some cases)” could also lower costs. This is done
now in some orphan indications but “should be allowed
more generally.”
Some respondents believe that allowing Medicare and
Medicaid to negotiate prices or limiting prices to a ceiling
based on European price lists will have an impact. The
topic of value-based pricing came up quite a bit, and one
respondent said, “Regulators should allow for more
value-based pricing innovation. The current minimum
discounts and best price rules around Medicaid,
Department of Defense (DoD), and the bloating of 340b
(the federal drug discount program used by hospitals to
benefit lower income and vulnerable populations), [and]
the complex negotiations with PBMs all conspire to cause

Figure 3: Percentage of respondents indicating type of reform

40%

31%
30

20 19% 19%

12%
10 8%
4% 4% 4%

0
Clinical trial CMS Physician/consumer No change Value–based Documentation Drug Patent
reform negotiation communication needed pricing reform packaging reform
of prices

Parthenon-EY and YourEncore pharmaceutical survey results, 2017

6 | Parthenon-EY
inflated list prices. Changing the rules to allow for more
innovation and more simplified market competition would
be beneficial. Allow drug companies to share information
with payers, including Medicaid, about future drugs so that
health systems can plan better.”

Others discussed the rise of direct-to-consumer advertising

in response to tight restrictions around profiling and
educating physicians directly. One respondent said that we
should “limit direct-to-consumer advertising and sales calls
to physicians. Information on medicines should be provided
to physicians from objective, peer-reviewed sources, funded
publicly or by the industry as a whole — not by individual
companies.”

Some respondents indicated a preference for limits to

direct-to-consumer advertising and rebalancing those
with physician education and the establishment of
“an industry-wide, peer-reviewed resource as a central
depository for drug information.”

Many respondents want to see more rapid approval of

biosimilars and shortening of the time allowed before
generic approvals. Respondents generally do not want to
see broad decreases in FDA oversight, and they mentioned
patient safety as a critical issue that the FDA should
continue to oversee.

Parthenon-EY | 7
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q6 What changes to the value chain (discovery,

manufacture, distribution) need to occur to
eliminate unnecessary costs or reduce prices?

The responses to questions #5 and #6 had subtle
differences. Responses to this question focused more on
R&D, price transparency and stakeholder collaboration
across the entire health care value chain. One respondent
indicated incentive structures are misaligned for some
players in the value chain and questioned whether drug
companies should be publicly traded with Wall Street’s
financial performance expectations imposed.
One respondent said R&D is a long, risky process and
collaborations are needed to enable greater value delivery
in product discovery. The respondent further indicated
there is a need for the public to differentiate between
a small number of “bad actors” that create a negative
public perception of pharma, and the majority of honest
companies that invest in research and development.
savings could potentially be realized, some respondents
said, especially if trials could be conducted in a collaborative
environment, reducing redundancies for similar trials.
One interesting observation is that there may be issues
with near monopolies in the distribution channel as
secondary and tertiary wholesalers and payers/PBMs
retain deep discounts they receive from the pharmaceutical
manufacturers. Respondents said that all discounts and
savings, including rebates, should be passed on to consumers
in the form of lower co-pays and co-insurance rates. One
respondent said product liability expenses are a hidden
form of costs as well.

There was also a willingness to work within an environment

with greater price transparency for the market to see
relative pricing/value along the entire distribution channel
and know who really profits from drug delivery. Many
respondents believe there are too many players profiting
from low-value services, such as distribution and price
triaging by intermediaries.

Some respondents also referenced inefficient internal

practices within pharma, such as excess production
capacity in manufacturing plants that is not well-utilized.
If fewer studies and patients studied were required, cost

8 | Parthenon-EY
Q7 What should providers be doing that they
are not doing today to improve prescribing
patterns or therapy outcomes?

When asked specifically about providers, respondents

commented on how the physicians’ role has changed
and how critical their attention to the details
surrounding appropriate drugs matters to overall
clinical outcomes. Most respondents believe that
physicians have a significant responsibility to better
understand how drugs work in the body, when it is
medically necessary to prescribe a drug and how
it will interact with other agents. Several respondents
commented about how most treatments are now a
prescription vs. a procedure and that not allotting
enough time to educate physicians may detrimentally
affect their efficacy in treating disease.
Respondents want more time for physicians to learn
about new therapies/products and assess and ensure
the appropriateness of their use after initial availability.
There were comments about bringing more physicians
into trials to better understand how investigations are
conducted and suggest improvements to the process.
Many physicians are never a part of trials and often
don’t understand how to enable patient therapies, so
only a small pool of physicians shapes how trials are
conducted.
A common barrier noted was the shortage of physicians
in primary care and payer pressure to see more patients.
This pressure leaves little time for continuing medical
education and patient counseling, thought to majorly
impact clinical outcome improvement. Compliance and
adherence were mentioned repeatedly as a responsibility
of both the patient and the physician, who should check in
to evaluate the progress and efficacy of the therapy.
Respondents want to see payers take more responsibility
in enabling physicians and electronic medical record
(EMR) standards rather than delegating those standards
to a fragmented provider market. A specific comment
around EMRs was that “electronic medical records must
be reorganized to capture therapeutic outcomes so they
can be a tool for real-world evidence (value) — and not
just for cost assessment (price).”
Many buzzwords were also mentioned, such as value- and
outcome-based reimbursements, real-world evidence and
evidence-based medicine. However, there were some specific
recommendations for more head-to-head trials between
competitor products in the same therapy class, especially
with interchangeable products — the goal being to
gather more data on the drivers for efficacy and better
understanding of clinical performance vs. patient behavior.
Other respondents wanted to see more pressure on
physicians to stop overprescribing, especially antibiotics
and to polypharmacy patients, without doing more
research into the patients’ history.

Parthenon-EY | 9
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q8 What improvements need to be made in

the prescribing process to balance costs,
access to therapies and patient safety?

Many respondents indicated that the physician, being
on the front lines of medical care, can drive change in
prescribing trends. Improving continuing medical education
of physicians can position physicians to prescribe the most
effective medicine, either branded or generic, that provides
for improved clinical and financial outcomes.
Continuing medical education and the need to integrate
electronic medical records with pharma databases was
cited as critical for physicians to immediately access
important information around drugs and their impact on
patient physiology. Once again, the topic of polypharmacy
patients and the “sickest of the sick” came up as a specific
area requiring much greater coordination, especially as
these patients are the highest cost claimants.
they are best educated about pharmaceuticals and better
understand how drugs work and how they affect patients:
“I would like to see pharmacists prescribe, based on physician
diagnosis. Pharmacists are the most underutilized brain
trust in the US.”
Lastly, one respondent made a bold statement that we
need to “change the system totally. Insurance companies
have no value, they only add cost. The best system I’ve
heard of has the care of each patient managed by a team
that includes providers and patient advocates. Without that,
we have people who go to a doctor because they are bored
or because they heard an ad on TV. The present system
including ACA [Affordable Care Act] will not work nor will
Medicare for all.”

Some respondents also advocated for simplified national

policies from regulators and guidelines from payers around
how care should be triaged. One respondent said, “The
US should adopt NICE-like (National Institute for Health
and Care Excellence) reviews of therapies.” Others said
that payers need to start making the hard trade-offs
between products to rationalize the number of treatment
options without denying care and reviewing it after the
fact. Respondents want to see payers hold physicians
accountable to complying with safety requirements and
not just prescribe off label without the existence of a
standardized protocol.

Another respondent said the US can combat the shortage

of physicians by allowing pharmacists to prescribe, as

10 | Parthenon-EY
Q9 What improvements need to be made in
the reimbursement process to balance costs,
access to therapies and patient safety?

This question resulted in many very direct responses from
our survey respondents. The role of the payer has been
widely debated, and the responses from even a diverse
set of survey participants were quite blunt about payers’
responsibility to contribute to positive outcomes and not
focus solely on costs.
Respondents want the reimbursement process to make
therapeutic outcomes the primary measurement of
reimbursement decisions, not price. Some want to see
PBMs “disappear” and be replaced with a single-payer
system and greater empathy for getting new therapies
to patients with life-threatening diseases.

One respondent said, “Currently, payers look at drug Lastly, respondents want to see a shift in “giving more
costs over the short term, because most of their insured power to personal physicians (of course with supportive
population will be covered by that particular payer for documentation) rather than layers and layers of ‘case
only a few years. Thus, payers have no real incentive to management’ who do not care about individual responses
spend on preventive and long-term therapies that could or needs. Make the physician responsible to confirm why
benefit the patient in the long run. So payers tend to the patient needs certain drugs or therapies. Now with
focus only on the immediate cost of drugs, not the value-based purchasing being tested in nine states, patients
long-term cost/benefit ratio.” are the guinea pigs – i.e., their orthopedist may limit or
deny necessary home care or outpatient PT after a joint
In fact, several respondents agreed that “payers need to
replacement.”
look at costs from an immediate and long-term perspective.
Some expensive therapies are not covered, which can lead
to longer term use of less expensive therapies that erode
the cost savings they seem to provide. We need revised
standards of care based on independent review of
therapies and outcomes.”

Another said, “Patients do not have transparent

information as to the cost of care. Require that the cost
of doctors, hospitals and drugs all be made clear when
treatment options are discussed. Patients learn about
costs at the back end after treatment is given — that is too
late to get involved in the right dialog. Weirdly, the only
cost patients know in advance is at the pharmacy. Doctor
offices, diagnostics centers and hospitals all say ’the cost
to the patient is up to the insurance company’ and never
answer what their billings will be or the net to the patient.
Both payers and providers need to start to deal directly
with the public on pricing.”

Parthenon-EY | 11
Pharmaceutical industry changes and market insights: a survey of leaders in the pharma value chain

Q10 What practices do payers employ that don’t

contribute to improved clinical outcomes or
cost reduction?

Once again, we heard from respondents that “arbitrary
and generalized limitations imposed on prescribers, solely
based on cost, interfere with the individualization of the
patient-physician decision-making relationship” and that
there is a “great amount of administrative costs that
are burdensome to users and especially patients.” One
respondent said “the fix would be either regulation of the
payers in a way that requires a long-term perspective, or
a single-payer option for pharmaceutical coverage.”
more expensive treatments, non-reimbursement for
companion diagnostics, and excessive and burdensome
prior authorization practices were cited as other drivers
of hidden costs. One respondent said payers “should
require less outcomes/pharmacoeconomic data on novel
products where there is no appropriate generic. The cost
of copays in tier three+ products is generally too high
and restricts use of good drugs in patients who are likely
to benefit.”

Another respondent believes forcing the use of generics Finally, one respondent said what we need is greater
does not always result in equivalent efficacy, safety or transparency overall, as well as the elimination of
manufacturing integrity. Several respondents said forcing paperwork, constantly changing reimbursement rules
prescribers to use generics does not always result in lower and hidden pricing deals with intermediaries.
costs and may in fact require multiple switches when there
are newer and better therapies available in brand-name
products. “Standard of care is for the average person.
It’s a waste of time and money for all of those instances
where a patient is not showing typical symptoms,” one
respondent said.

The use of step edits and second-guessing of physicians

drive up hidden costs to the system, according to
several respondents, as patients need more phone calls,
consultation time or additional visits with their doctor to
get on the right medication. Fail-first mandates, mandatory
generic switching, higher co-pay tiers for

12 | Parthenon-EY
Conclusion
There are many conversations taking place
in both public and private forums around the
current state of pharmaceuticals, drug prices
and public policy changes. Parthenon-EY and
YourEncore decided to conduct a survey to
ask leaders in the industry value chain what
they thought of the regulatory environment
and how changes may impact the industry.
What we heard was both interesting and
affirming of many of the sentiments being
reported by the general press. Everyone
seems to want change and there is still
widespread support around patient safety
and efficacy as a priority. The types of
changes needed range from simplification
of rules and guidelines to wholesale changes
around the economic models to usher in
greater transparency. The myriad of models
and processes that have evolved over the
years are putting additional burdens and
costs on a constrained system, so thoughtful
restructuring of business and economic
models is needed and welcomed by the
community of leaders in the industry.
Parthenon-EY has been helping clients
across the entire life sciences value chain
assess whether they need to change their
business, operating and economic models
to help them be better positioned in the
future. There is broad openness to doing
things differently, but many clients are
looking for guidance from regulatory
authorities to help them design more optimal
solutions. There are many ideas but little
clarity around expectations and desired
outcomes, much less how success will be
measured. Restrictions around sharing
information make it difficult for companies
to innovate and change their infrastructure,
so there is considerable stasis around
wholesale change. The will exists, the way
needs to be paved.
Parthenon-EY | 13
Parthenon-EY Life Sciences practice

Our team YourEncore contributors

Alex Jung Kyle Fenstermaker

Managing Director Managing Director, YourEncore
Parthenon-EY Bio-Pharmaceutical Practice
Ernst & Young LLP 1 609 240 5945
1 312 879 2778 Kyle.Fenstermaker@yourencore.com
alex.jung@parthenon.ey.com

Daniel Mater Joseph Lamendola

Consultant Senior Vice President, YourEncore
Parthenon-EY Bio-Pharmaceutical Practice
Ernst & Young LLP 1 609 937 4552
1 312 879 3345 Joseph.Lamendola@yourencore.com
daniel.mater@parthenon.ey.com

For more information on our Life Sciences practice and our team, please visit parthenon.ey.com.

About Parthenon-EY
Parthenon joined Ernst & Young LLP on 29 August 2014. Parthenon-EY is a strategy consultancy, committed to bringing
unconventional yet pragmatic thinking together with our clients’ smarts to deliver actionable strategies for real impact in
today’s complex business landscape. Innovation has become a necessary ingredient for sustained success. Critical to unlocking
opportunities is Parthenon-EY’s ideal balance of strengths — specialized experience with broad executional capabilities — to
help you optimize your portfolio of businesses, uncover industry insights to make investment decisions, find effective paths
for strategic growth opportunities and make acquisitions more rewarding. Our proven methodologies along with a progressive
spirit can deliver intelligent services for our clients, amplify the impact of our strategies and make us the global advisor of
choice for business leaders.

About the Parthenon-EY Life Sciences practice

The Parthenon-EY Life Sciences practice has dedicated life sciences professionals across member firms in 17 countries
spanning the Americas, Europe, Middle East and Asia-Pacific. Our global hub is based in the US and has life science leaders in
Boston, New York, Chicago and San Francisco. All Parthenon-EY Life Sciences professionals have extensive experience in life
sciences strategy consulting and academic degrees in science, clinical and business disciplines. The practice coordinates with
the Parthenon-EY Health care and Consumer practices as well, bringing the full gamut of convergence in consumer, health care
and life sciences offerings to clients in companies, investor groups, payers and providers worldwide.

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