DealroomMTIP-2021年數(shù)字醫(yī)療報(bào)告（英文）-2021.4正式版

Digitalhealthcare:patient-first?Proactive,decentralized,personalized,value-based.April2021Europeanearly-stageventurecapitalfirminvestinginhealthcareandtech.Pan-EuropeangrowthinvestorfocusedontheHealthTechsector.Globalstartup&venturecapitalintelligenceplatform.MTIPisaSwiss-basedgrowthinvestorthatspecializesinscalinguphealthtechcompaniesinrapidlyexpandingglobalmarkets.MTIPinvestsindigitally-connected,decentralizedandpatient-centricmedicaltechnologyleaders,basedprimarilyinEurope,witho?eringsthatprovideclearhealth-relatedeconomicbenefits.MTIP’sentrepreneurialinvestmentteam,whichhascomplementaryprivateequityskillsandexceptionaldeal-makingcapabilities,activelyworkswiththeirportfoliocompaniestoboostgrowth.MTIPe?icientlydeployscapitaltounlockvalueandgenerateattractivereturnsfortheirinvestors.Dealroom.coistheforemostdataprovideronstartup,early-stageandgrowthcompanyecosystemsinEuropeandaroundtheglobe.INKEFCapitalisaventurecapitalfirmbasedinAmsterdam,backingpromisingearlystagecompaniesinEurope.INKEFtakesprideinbeingapatient,long-terminvestorwiththeabilitytosupportcompaniesthroughseveralroundsoffunding.Fromtheearlystagesofbeingatechnologyorlifescienceventure,INKEFCapitalsupportsentrepreneursbuildingtheirideasintosuccessfulinternationalbusinesses.FoundedinAmsterdamin2013,wenowworkwithmanyoftheworld'smostprominentinvestors,entrepreneursandgovernmentorganizationstoprovidetransparency,analysisandinsightsonventurecapitalactivity.Thecombinationoftechandhealthcare,makesHealthtechattheintersectionofINKEF’sinvestmentthesis–wehavetheambitiontobringourexperienceindevelopingnewdrugs&devicesandourexperienceinbuildingso?warecompaniestotransformhealthcare.Visithealth.dealroom.co

formoreinfoAlthoughMTIPisgenerally“stageagnostic”,MTIPpreferstoinvestinfirmsthatareinagrowth(later-stage,expansionary)phase,withaproventechnologythatcanbee?ectivelyscaledtosuccessfulandsustainableglobalenterprises.HealthcareinvestmentsOthernotableinvestmentsThisreportcoverstechforpatients,professionals,hospitalsandbiopharma.MedicalpracticemanagementTelemedicine,AIdoctors,&appointmentbookingPlatformsfordigitalproductsTechforprofessionalsTechforpayersandemployersDigitalhealthinsuranceCollaborationtoolsHometestsDigitaltherapeuticsDecisionsupportsystemwithAIContinuousmonitoringPatientsTechforhospitals&clinicsTechforpharma&biotechHospitalOperationsSurgicalrobotics&AR/VRforsurgicaltrainingPatientrecruitment&clinicaltrialsDrugdiscovery&developmentwithAIPage/3Healthcareisaglobal$8trillionecosystemchangingcourse;anopportunityfortechcompanies.Covid-19acceleratedinnovationatpatientinterfacelevel,buttransformationjuststarted.Healthtechisalikelycandidateforthenext$50B+techcompanyinEurope.Thecostofhealthcarekeepsrising.Yet,thatdoesnotalwaysmeansbetteraccess.DigitalHealthisa$350Bmarket(McKinsey),settonearlydoubleinthenextfiveyears.EuropeisstartingtoseebigHealthtechcompaniesemergeintelehealth(Babylon,Kry),operationsso?ware(Doctolib,Docplanner)andinsurance(wefox).Ageingpopulations,servedbyacomplex,slow-adaptingmarketmeanhugesavingstobemadeinthelargestconsumercategory-thenextbigdigitalfrontier.Politicalandregulatoryinnovation,combinedwithtechnologicaladvancescanenableimprovedoutcomesandcost-e?iciencyinhealthcare,wellbeyondthepandemic.ThescaleofthemarketmeansHealthcarecouldsupportEurope’snextmulti-decacorn(s).█Well-being&focusedspending█CareandtreatmentfocusedspendingSpending&funding(1)CombinedvalueofEuropeanHealthtech$8trillion$8trillionBiopharma18%61%Insurers&government(payers)$$41BHealthcareproviders$8B2015Consumers83%39%SpendingFunding20192040E(2)Today1.DealroomanalysisofdatafromOECD,WHO.2.BasedonDeloitte.WhythisHealthtechreport.Contributionsandinsightsfrom:It’sbeeno?enrepeatedthattheCovid-19crisisresponsehasbrought“10yearsofmarketevolutionin10weeks”.Sofar,thishasbeenmostlyabouttheengagementlayer(e.g.telehealth).Isamoreprofoundindustry-wideshi?happeningunderneath?Andifso,whatwillthatchangelooklikeandwhatrolewilltechcompaniesplay?DanchenZhaoInvestmentManagerMTIPJessicaDiPaloHeadofMarketing&CommunicationsMTIPThijsCohenTervaertJuniorPartnerINKEFCapitalOnethingissure:thegrowthofhealthcareexpenditureisunsustainable.Structuraltrendscontinuetodrivehealthcarecostsupwards:ageingpopulation,chronicdiseases(inclobesity),andtherisingcostsofdrugdevelopment.Digitalizationhashelpedmanyotherindustriesimprovecustomerexperiencewhilereducingcosts.Whyishealthcareslowtocatchon?JulianTeickeFounder&CEOwefoxMark-JanHarteCo-Founder&CEOAidenceAliParsaFounder&CEOBabylonPayers(governmentsandinsurers)andconsumershavebeentoleratingslowchangeuntilnow,butnotanymore.Healthcarewillseebigmacro-changesinthecomingtwoyears.Thisreportexploresthenextbigthingsinhealthinnovationandwhatthefutureofhealthcaremightlooklike.Lars-OlofErikssonRobbieHughesFounder&CEOLumeonKlausMittererDerkArtsFounderCastorCSOCFOTrialbeeOvivaPage/5Tableofcontents.123Healthcare:an$8trillionindustrychangingcourseThefuture:decentralized,personalized,proactive,value-basedThenextbigthing:techforpatients,professionals,hospitalsandbiopharma1An$8trillionindustrychangingcourseThecostofhealthcareanditsburdenoneconomieskeeprising.Globalhealthcareexpenditureisnowaround$8trillion($2tninEuropeand$3.5tnintheUS).Itisprojectedtogrowby5%+peryear(fasterthantheoveralleconomy)to$10trillionin2022.Structuraltrendscontinuetodrivehealthcarecostsupwards:ageingpopulation,chronicdiseases(inclobesity),andtherisingcostsofdrugdevelopment.Asstandardsoflivingrise,healthcareexpendituresalsorise.Yet,thatdoesnotmeanbetteraccess.IntheUS,somehouseholdsaredrivenintopovertybyhealthcarecosts.Healthcarecosts(publicandprivate)as%ofGDPUSA17%Percapitahealthcarespendingbyageacross8developedcountries*Percapitahealthcarespending(viaDeloitte)**Europe10%$11K$12K+6%5%~$4-6K$3.6K$2.2K$541970USA2019PakistanEU0-1920-6465+*DatabyAmericanCenturyInvestments,basedonstudyonUS,Australia,Canada,Germany,Netherlands,Japan,Switzerland,UK.**Pakistanincludedforillustrativepurposes.Spendinggoestopharma,hospitals,physicians,andotherproviders.Thesearebeholdentolegacyreimbursementsystemsandcomplexregulations,whichcanmakethemslowtoadoptchange.Globalhealthcareexpenditurebytype(2019)~$0.8T$8T~$0.8T5-10%***~$3.6T10%**Physicians*15%=$1.2T*IntheUS,15%ofspendgoestophysicians.InsomeEuropeancountries,physiciansworkmostlyfromhospitals/clinicsOtherproviders30%=$2.4T**Combinedbiopharmarevenueisover$1.4T,whereas$0.8Tisvalueaddedwithinthehealthcarevaluechain.~$2.8T***AdmininEU?

5%/AdmininUS?

10%35%HospitalsOtherprovidersPrescriptiondrugsAdmin&netinsurancecostsGlobalhealthcareexpenditurePage/9Source:DealroomanalysisofdatafromOECD,Eurostat,CMSforU.S.data,WHO.“Healthcareisbroken-despitespendingtrillionsofdollarseachyear,halftheworld’spopulationhasnoaccesstohealthcare,whilst100millionpeoplearedrivenintopovertyfromthefees.“Almost70%ofhealthcaremoneygoesintopredictablepreventablediseases.Seeingaproblemearlyoncouldmeana$10solutionratherthan$4,000byseeingittoolate.”AliParsaFounder&CEOBabylonHealthcareisoneofthelargestspendingcategoriesforhouseholds.Butalmostallspendingisindirect(insurance&tax).Therefore,consumershavelimitedinfluence.Monthlyhouseholdexpenditure(1)Out-of-pocketpaymentsandvoluntary$300insuranceaccountforlessthan20%ofhealthcareexpenditureinmostlargedevelopedcountries–10%intheUS,15-20%inmostofEurope(butgrowing).>80%Gov’t&insurersTheremainderispaidviabygovernmentschemesandcompulsoryhealthinsurance.Asaresult,consumershavelimitedincentivesandinfluence.However,consumershavealreadygonedigitalinmanyaspectsofmanagingtheirlives.Expectationshavebeenli?ed.Consumersexpecttechnologytofollowthesamepathinhealthcaretoimproveaccessandoutcomes.Consumers:out-of-pocketpaymentsandvoluntaryinsurance<20%$50$83$83$100$200$283MediaPage/111.DealroomanalysisofEurostatandOECDdata.ChartInspiredbyLocalGlobepresentation.However,“payers”(mostlyinsurersandgovernments)dohavemajorinfluence,wanttocontrolcosts,improveoutcomesandgetvalueformoney.Spending$8trillionFunding$8trillionBiopharmawantstofindtreatmentsforbigmarketsandbringdowncostofdiscoveringnewdrugs.BiopharmaPayerswanttocontrolcostsandimproveoutcomes.Inordertoachievethistheyneeddatatransparencytofollowthepatientjourney,havepredictabilityandbeabletomeasuretheROIofPayers(insurers,governments)Providerswanttoalignthemselvesmorecloselywithpayers.ReimbursementProviders(healthprofessionals,hospitals)interventions.Professionalswanttoincreasetheirproductivityandreduceburnoutduetoadmin(1).Paymentsystemsaremovingtovalue-basedcareConsumerswantbetterhealthcareandexpectittobemorelikeotherconsumerproducts.ConsumersSource:DealroomanalysisofdatafromOECD,Eurostat,CMS,WHO.1.AccordingtoMedscape,administrationisthemaincauseofphysicianburnout.Page/12Hugeopportunityfortechtoeliminateine?icienciesandwastefulspendingwhileimprovingoutcomes.Healthcareindustryisspending$200-300billionperyearonIT.ITspendingisroughly$200-300billiongloballyifwetakeGartner’sestimate3.9%ofsalesinhealthcareand3.3%ofsalesinpharma&medical.Anotherreportestimates$208billionin2019,growingto$280billionby2021*.ThisincludesspendingonlegacyITsystems(andsomefaxmachines).IntheUSalone,wastefulspendinghasbeenestimatedtobearound25-30%*withthebiggestwastecategorybeingunnecessarycareandexcessiveadmin.McKinseyreckonsthathealthcaredigitizationlagsmostothersectors.AccordingtoTheEconomist

70%ofAmericanhospitalsstillfaxandpostpatientrecords.ITspendingas%ofturnover,bysector**So?warePublishing&InternetServices8.1%6.6%4.7%4.6%4.5%4.1%3.9%3.4%3.3%2.8%2.8%2.8%2.3%2.0%1.7%1.5%1.3%1.1%1.0%1.0%Banking&FinancialServicesEducationMedia&EntertainmentProfessionalServicesTelecommunicationsHealthcareProvidersInsurancePharma,LifeSciences,MedicalTransportationUtilitiesMedianIndustrialElectronics&EquipmentConsumerProductsIndustrialManufacturingRetailandWholesaleFood&BeverageProcessingChemicalsConstruction,Materials&NaturalResourcesEnergy*ReportbyMarketsAndMarkets,alsousedbyDeloitte.**Sources:MorganStanley,Bain,LocalGlobeanalysisofGartnerandFortunedata.Page/13*VarioussourcesincludingJAMA.InEurope,governmentandprivateprovidersofcompulsoryinsurance,havethepower.IntheUSA,employersplayanimportantroleandtheycanadoptinnovationearlierbeforeclinicalevidenceisdemonstrated.▉

Consumers(out-of-pocket)andother▉

Compulsoryinsurance▉

Governmentschemes$3.9T$0.3T$0.1T$0.4T$0.1T$0.1T$0.3T10%16%78%17%16%USA19%Europe21%29%4%IntheUS,employersplayabigrole78%InEurope,governments,privateinsurersandregulatorshavethepowertogether.Theywanttocontrolcosts,butcoordinationisrequiredtogetthingsdone.Thismeans75%inprivateinsurance.Those34%employerswanttocontroltheirhealthcarepremiums.Thismeansstartupscangotomarketbystrikingdealswithcorporates;evenwithaproductthatdoesnotyethaveclinicalevidencetoqualifyforreimbursement.AnexampleisLivongo.significanttimebetweenwhenaPrivateinsurers(forprofit,Stateprovidedhealthcaretechnologyisacceptedbyregulators,whenitisadaptedinthehealthcaresystemandwheninnovatorsareabletogeneraterevenue.regulated)56%Medicare,medicaid,other67%84%79%5%6%6%Page/14Source:DealroomanalysisofdatafromOECD,Eurostat,CMS,WHO.“Adoctorbehindtheirmobilephonecoststhesameasadoctorinano?iceandisjustasbusy,sothisdoesnothelptoreducethestrainonourhealthcareprofessionals.Helpspatientsandprofessionalstoproceeddiagnosisandtreatmentsooner.Allowspatientsaccesstoremoteconsultations,“Beingabletoseeapatientviavideodoesn’tmeanclinicianscanseemorepatients.In2016,theWHOreportedthatwewereshortof5millionhealthcareprofessionals,andpredictedthatnumberwouldrisetoashortageof18millionhealthcareprofessionalsby2030.AndthatwasbeforeCOVID-19.Weneedtousetechnologytocareforfar,farmorepeoplethanwedoatthemoment.Developingthistechnologyisn’teasy,itrequiresacombinationofmedicalknowledge,hugeamountsofdataandrelevancetoeachpersonintheircountryandfortheirdemographic.ThatiswhyweareleveragingthepowerofAItoincreaseaccess,putmoreinformationinthehandsofpeople,ensureearlieropportunitiesforinterventionandasaresultimprovetreatmentoutcomesandhelptoreducecosts.”AliParsaFounder&CEOMorestateinfluenceLessstateinfluenceGovernmentsandregulatorsareincreasinglyputtingincentivesinplacetoimproveoutcomesandreducecosts-ahugeopportunityfortechcompanies.StateisproviderofhealthcarePrivatefor-profitprovidersPrivatefor-profitRegulated,privateforprofitinsuranceandprovidersprovidersStatefinancedCompulsoryinsuranceGermanySwedenDigitalHealthcareActadoptedin2019tosupportdigitalhealthinnovationIntegratedelectronichealthrecordsolutions(EHRs)ande-prescriptionsinSweden’s21regionssince2018€500incentiveforstartupvideoconsultationsTeleconsultationreimbursedsince2016,enablingstartups(KRY,MinDoktor,Doktor.se)Firstcountrytocoverprescribedapps:Kalmeda(tinnitus),Velibra(anxiety)UKFranceNHSXInnovationAcceleratorand$330MAIinhealthinvestmentpledgedOnlinediagnosis&treatmentsince2018CentraldigitalrecordslocatorandbookingappCross-bordertreatment:EUdoctorsteleconsultingpatientsinFranceVideoconsultationavailablethrougheverydoctor’ssurgeryKRY(Livi)andDoctolibmarketleadersinFrenchtelemedicinePage/16ClassificationaccordingtoBoehmmodel.AdaptedbyDealroom.Asaresult,biggerHealthtechcompaniesarealreadyemerging.B2Chasbeenscalingfaster.B2Btakeslongertounlock,butisatleastasbiganopportunity.Enterprisevalue$2.0B$1.75B$1.5BPatient-facingMonetizedviadealswithpayersand/orreimbursementsystems.$1.25B$1.0B$750M$500M$250MProvider-facing2005201020152020Page/17Source:Dealroom.coandGoogleFinanceasofJanuary15th,2021.“Thebiggestchallengefordigitalhealthinsuranceisfromtheregulatorysidebecauseofthecomplexityandtimeittakestoobtainalicencefromtheregulatorybodies.”JulianTeickeFounder&CEOwefox“ThebiggestscalingchallengeIhaveseenissellingacompletelynewtypeofproductinaheavilyregulatedandconservativemarket.TherearemanyquestionsaroundwhobenefitsfromtheuseofAI,whopaysforitandwhetheritcanyetbetrusted.”Mark-JanHarteCo-Founder&CEOAidenceEuropeanHealthtechcompaniesarenowworth$41billion.CombinedenterprisevalueofEuropeanhealthtechstartups22%18%11%CombinedenterprisevalueofEuropeanhealthtechstartups(1)Remotemonitoring&WearablesDigitalhealthinsuranceOnlinepharmacies$41B$37B7%4%3%$25BDrugdiscovery&developmentwithAIDecisionsupportwithAIDigitalTherapeutics21%$16B$12BDigitalcare(incl.telemedicine)3%7%Surgicalrobotics&AR/VR$8BHospitaloperations1%Hometest1%20162017201820192020TodayPracticemanagement2%Patientrecruitment&clinicaltrialsSource:Dealroom.coandGoogleFinance.1.Healthtechexcludesbiotechnologyandpharmaceuticalcompanies.UsingestimatedvaluationsbasedonmostrecentVCrounds,publicmarketsandpubliclydisclosedvaluationsasofFeb10,2021.Page/19Covid-19iso?ensaidtohavetriggered“tenyearsofmarketevolutionintenweeks”.Butamoremeaningfulshi?willoccurinthenexttwoyears,andbeyond.HealthtechimpactIndustry-wideshi?sSomenewregulationsaremadepermanentCovid-19anditssecond-ordere?ectsProvidersneedtoalignwithpayersmorethanever:morefocusonvalue-basedcareConsumersexpectingincreasedvirtualcareRegulationsaroundvirtualcareloosenedLeadingupto2020VCandbigtechcontinuetoinvestheavilyinhealthtechDuetoincreasedadoption,trustinvirtualcareincreasedPayerspushingforvalue-basedcareTheUSfinalizednewrulesarounddatainteroperabilityGrowingnumberofconnecteddevices/IoHTLargeamountsoflate-stageventurecapitalfundingfordigitalhealthAccelerationsinAI,NLP,DNAsequencing,editing,digitaltherapeuticsDigitallynativepopulationTimePage/21Source:Dealroom.co“Thepandemichasincreasedacceptanceofdigitalhealthsolutions.Thismomentumshouldbemaintained;suchsolutionsarevitalinmakinghealthcaremoreaccessible,inruralsettingsorfortheelderlyorsick.”"Everysectorhasitsownchallengesandhealthisnodi?erent.However,therisksandsensitivitiesinhealtharegreaterthaninothersectors.Broadlyspeaking,themainchallengesfacingstartupsareregulation,reimbursementandsysteminertia.“Highregulatorystandardsunderstandablyexistinthehealthsector,companiesinthisspaceneedtodomoretogettomarketandtoremaincompliantthroughoutthelifecycleoftheirproductorservice.Thisrequiresknowledge,experience,expertise,resources,andbudget–allofwhicharesometimessparseforyoungercompanies.Reimbursementrequirementsforhealtho?envaryacrosscountries,whichprovidesfurtherchallengeswhenexpandingtonewmarkets,ortradingacrossborders.Suchrequirementsinhealthcanbechallengingevenforwellestablishedcompaniesbutareincrediblycumbersomeforstartups.”KurtH?llerDirectorofBusinessCreationEITHealth2Thefuture:decentralized,proactive,personalized,value-basedSofar,we’veseenaglimpseofwhatdigitalhealthcaremightlooklike.$ProactiveDecentralizedPersonalisedValue-basedMosthealthcarespendinggoestopredictablepreventablediseases.Connectivityandcontinuousmonitoringaregamechangersforpreventionandproactivecare,recoveryaswellasinsuranceandfinancing.Patientempowermentthroughself-care,homecare,hometests.Datamanagementandanalyticsarethecriticalsuccessfactor.GettingtherightAtmolecularlevel:geneeditingallowsfornewandPayersandregulatorsarepushingforevidenceofbetterclinicaloutcomesand/orforlowercosts.personalizedtreatments.Atasystemlevel:treatmentselectionandtreatmentoptimizationthroughAIso?ware.informationattherighttimetotherightprofessional.Page/24Healthcare≠betterhealth.Shi?ingtoprevention&well-being.Studiespointtohealthcarebeingonlya10-20%contributingfactortohealthoutcomes(qualityandlengthoflife).Socialdeterminants(employment,socialcare,education,neighborhood)areknowntohaveagreaterimpactonhealthoutcomesthanhealthcareitself.Preventioniskeytolowerhealthcarespending.ADeloittereportprojectsavisionforhealthcareshi?ingfromcareandtreatmentsdominated(83%)tohealthandwell-beingdominated(63%).Ontopofprevention,anotherpartisfasterdiagnosisandtreatmentwiththehelpofAI(e.g.Babylon).Newformsofenablement,data,platformsanddeliverywilldrive85%ofrevenue,Deloittesays.HealthdeterminantsSource:CountyHealthRankingsSpending:shi?ingfocustoprevention(viaDeloitte)-Smoking█

Prevention&well-being30%Healthbehaviors-Diet&exercise18%-Alcohol&drugs█

Careandtreatment-Sexualactivity61%20%-AccesstocareClinicalcare-Qualityofcare-Education83%-Employment40%-IncomeSocialeconomicfactors39%-Family&socialsupport-Communitysafety10%-Air&waterqualityPhysicalenvironment-Housing&transit20192040EPage/25"Theillusioninhealthcareisthattheconsumerhasachoice,butactuallythatchoiceisadecisionwhichinvolvestheentirevaluechain.“Thenexttwoyearswillseebigmacrochangesintheentirehealthcarevaluechain,thatwouldhavetaken20years.”“Consumershavelongwantedtobeabletointeractwithhealthcarelikeanyotherconsumerproduct.AshealthcareproviderswereforcedtoshuttheirdoorsduetoCovid-19,careshi?edonlineovernight,withtalkof10yearsofmarketevolutionhappeninginthecourseof10weeks.“Thecrushingreimbursementproblem(especiallyafactorintheUS),hasalsoreachedacriticalmomentin2020/21.Thecostofcarehasbeengoingupforalongtime,andit’smoreorlessbeentolerated.Butthepandemiclargelyforcedtheclosureofthetwobiggestmargingeneratorsinhealthsystems-electivesurgeryandtheemergencyroom.Thismeansaprofitcentreofthehealthsectorceasingtoexist.Andthat’sacatalystforinnovation.“Payers,whohavenotbeenspending,aresittingonalotofcapital.Ibelievetheywillstartinvestinginthingsthatallowthemtocontroltheirpatientjourneyandgainpredictabilityinhowtheircareisdelivered.Thatisgoingtodriveabigmacrochange.Meanwhile,providerswillmorecloselyalignwithpayers.RobbieHughesFounder&CEOLumeon“Changethatwouldhavetaken20years,isgoingtotaketwo.”Digitalhealthisalreadya$350billionmarket,accordingtoMcKinsey.GlobalDigitalHealthMarket(McKinsey

data)$600B%CAGRInadditionto$200-300BhealthcareITspendingmentionedearlier,thereisalsodigitalhealth:providinghealthcaredigitally.McKinseyestimatesthisdigitalhealthcaremarkettobe$350billionin2019andgrowingto$600billionby2024(shownontheright).ThereisprobablysomeoverlapbetweenITspendinganddigitalhealthbuttheyaretwoseparatethings.$150B8%Globalvaluepool$350B$100B$50B$84B$39B11%8%ReplacingITsystemsanddigitalhealthtogetherhaveahugeopportunitytoeliminatewastefulspendingandimproveoutcomes.AnotherMcKinseyreport

framesthisopportunitythroughthreeinnovationlayers:R&D(e.g.enhancedrugdevelopmentprocesses)Wellness&prevention(e.g.wearableactivity)$81B$96B10%14%1.2.Engagementlayer(userexperiencesandpaymentmodels)Infrastructurelayer(healthrecords,datasharinginteroperability)Screening&diagnosis(e.g.genomics,diagnostics)$25B$50B&DecisionsupportTelemedicine3.Intelligencelayer(AIandanalytics)$50B$101B$54B15%17%Digitalpharmacies$50B$25BWeusethisframinginthefollowingslides,addingtheR&Dlayerasafourth.Finance(value-basedcare)20192024Page/27Source:Dealroom.coSofar,mostVCinvestmentactivityandvaluecreationhasbeenintheengagementlayer:buildingnewuserexperiences.Combinedenterprisevalueofcompaniesfoundedsince2000bysegmentandinnovationlayerR&DlayerIntelligencelayerInfrastructurelayerEngagementlayer$90BDigitalcareincltelemedicineProfessionals$5BPracticemanagement<$10B$25BProvidersBiopharmaPayersSurgicalrobotsContinuousremotemonitoring<$10B<$10BHometestsAIdecisionsupport$15BHospitaloperations$90BDigitalpharmacies$45BAI-firstdrugdiscovery$10BDigitaltherapeutics$10BSo?wareforclinicaltrials$40BDigitalhealthinsurancePage/28Sourceforvaluations:Dealroom.coanalysisofprivateandpublicvaluations.Techgiantsarebuildingfull-stackcapabilities.Forthem,healthcare’shugemarketisanopportunitytosustaingrowth.Notableinvestments,acquisitionsandhome-grownproductsR&DlayerIntelligencelayerInfrastructurelayerEngagementlayerLifesciencesDataclinicalresearchNeuralresearchInsuranceGoogleCloudforhealthcareandlifesciencesAWS,AmazonComprehendMedical,AmazonHealthLakeOpensourceso?wareDigitalcareFitnesstrackingDigitalcareDigitalcareDigitalcarePharmacySleepsensorsFitnesstrackingTelehealthDigitalcareDigitalcareDigitalcareMicroso?Immunomics,ProjectInnerEye,ProjectTaliaSpeechrecognitionMedicalAIlabsHealthdataAzureforthehealthcareindustryEmergencyresponseAI-baseddrugdiscoveryCancerresearchdataGenomicsCovid-19CloudResourcesSupportProgramDigitalhealthDoctorbookingsInsuranceAI-baseddrugdiscoveryDecision-makingReal-worldevidenceDigitalTherapeuticsDigitalcareplatformDigitalTherapeuticsCardiovasculardiseasesPage/29Source:Dealroom.coDigitalhealthcareplatformsareseekingtointegrateandcreateone-stop-shopsolutions.ThiswilldrivemoreM&Aactivity.GSKand23andMePersonalgenomicscollaboratingonR&DofnewtreatmentsusinghumangeneticsDrugdiscoveryPharmaintegratingdigitaltherapeuticsintotheirpipelineDigitalTherapeuticsHealthinsurancePingAnwillpartnerwithShinogiondata-drivendrugdiscoveryTelemedicineMentalhealthAlanhaspartneredwithLivitoeasilyscheduletelemedicineappointmentsAlanlaunchedAlanBaBytohelpparentswiththehealthoftheirbabies(contactdoctorsandeducateparents)WellpartnerswithPushDoctor&ZoomDoctoo?erteleconsultwithapharmacistinsteadofdoctorwhenappropriateTeladocmergedwithLivongoin$18.5Bdealtoimprovepreventativecareserviceswithdata-driveninsightsTeleclinicacquiredbyZurRose.Pharmaciesobject:drugscan’tbesoldbytheprescriber,bylawDoctolibpartnerswithFollowonapatientrecordmanagementsolutionAmwellpartnerswithCloverHealthintegratesremotemonitoringtoreducecostsTytoCareonpatientself-examsguidedbyaclinicianremotelyOnlinepharmacyHims&Hers(USA)iscreatingaone-stopshopincl.Telehealth,products,andmentalhealthsupportRemotemonitoringTeladoctoo?eraccesstotelehealthviaCVSPharmacy’sappPage/30