Clinical Investment Insights
Neurosciences Market
Trends
Ready to Use Presentation Slides
Prepared October 2014
2
Road Map
1
Volume and Financial Outlook
2
Service Line Strategy
3
Care Quality
4
Clinical Innovation
5
©2014 The Advisory Board Company • advisory.com
Additional Resources
3
Volume and Financial Outlook
Neurosciences a Top Volume Contributor
Service Lines by Volume, US
Inpatient, 2013
General Medicine
Cardiac Services
Obstetrics
Neonatology
General Surgery
Orthopedics
Neurology
Oncology/Hematology
Spine
Vascular Services
Day Case, 2013
13.3 M
4.6 M
4.3 M
4.0 M
2.6 M
2.4 M
1.6 M
1.1 M
907 K
775 K
Cardiology
Orthopedics
ENT
Gastroenterology
Podiatry
Neurology
Gynecology
Vascular
Pain Management
Spine
80.7 M
65.9 M
26.9 M
21.9 M
12.3 M
12.0 M
10.6 M
10.6 M
8.1 M
1.0 M
Poised for Growth: 10-year Volume Forecasts
©2014 The Advisory Board Company • advisory.com
7%
43%
Inpatient
Neurosciences
Day Case
Neurosciences
Source: Advisory Board Inpatient and Day Case Market Estimator
tools.
4
Volume and Financial Outlook
Sizeable Growth in Volumes Led by Spine
Stroke Most Voluminous Inpatient Specialty
National Inpatient Neuroscience Growth Trends
2001-2013, US
576,477
Total
Growth
575,535
451,625
252,400
237,353
143,925
+1%
+79%
289,315
+22%
155,585
+8%
79,885
+12%
71,598
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Craniotomy
Acute cerebrovascular disease
Epilepsy, convulsions
Spinal Fusion
Headache, including migraine
Source: HCUP Nationwide Inpatient Sample (NIS)
©2014 The Advisory Board Company • advisory.com
5
Volume and Financial Outlook
Neurosurgery & Spine Key Drivers of Revenue
Cost Containment Key to Maximising Margins
Neuroscience Sub-Service Line Average per Case Revenue
Inpatient, 2013, US
While neurology cases have a
lower per case revenue, these
services are the gateway to
more lucrative surgical cases
$25,010
$22,790
$9,280
$10,340
$17,000
$8,230
$12,450
Brain
$15,730
$8,770
Fusion
Peripheral &
Cranial Nerve
Disorder
$10,670
$4,370
$7,650
$6,810
$7,200
$6,550
$6,410
$6,300
$3,640
$4,010
$3,580
$3,230
$3,350
$3,850
$3,150
$3,400
$2,920
$3,490
Other Surgical
Spine
Degenerative
Disorders
Multiple
Sclerosis
Stroke
Direct Cost
Higher
Contribution
Margins
©2014 The Advisory Board Company • advisory.com
Seizure/Epilepsy Medical Spine
Contribution Margin
Lower
Contribution
Margins
Source: Advisory Board Hospital Benchmark Generator tool.
6
Volume and Financial Outlook
Majority of Growth Expected in Day Case Setting
Tempered Inpatient Growth Due to Outmigration
All-Payer Volume
Growth Projections, US
Volume Growth Projections
by Key Sub-Service Lines, US
2013-2018
2013-2018
23%
Surgical Spine
Neurology
Services
Neurosurgery
Services
Spine
Services
22.9%
19.2%
Neurodiagnostics
19%
Sleep
19%
Pain Management
17.3%
15%
14%
Brain
(0.1%)
Peripheral & Cranial Nerve
Stroke & TIA
2.4%
Outpatient
0.1%
Inpatient
Fusion
12%
3%
2%
Seizure/Epilepsy
2%
Other Neurology
2%
-7%
Medical Spine
Outpatient
©2014 The Advisory Board Company • advisory.com
Inpatient
Source: Advisory Board Inpatient and Day Case Market Estimator
tools.
7
Volume and Financial Outlook
Four Forces Impacting Future Neuroscience Volumes
Demographic Shift
Funding Pressures
Day Case Growth
• Aging population
driving
neuroscience
volumes
• Hospitals required
to provide costeffective care
• Patient preference,
clinical innovation
shifting procedures
to the Day Case
setting
• Incidence of
chronic disease,
multiple
comorbidities
rising
Services Impacted
• Stroke
• Degenerative
disorders
• Spine and pain
management
©2014 The Advisory Board Company • advisory.com
• Incentivises
standardisation,
cost control, and
chronic care
management
Services Impacted
• Stroke
• Spine and pain
management
• Degenerative
disorders
• ASCs and doctor
offices new
competitors for
hospitals
Services Impacted
• Sleep
• Spine and Pain
Management
Clinical
Innovations
• Technology
improvements driving
utilisation
• Minimally invasive
surgical techniques
key innovation
Services Impacted
• Stroke
• Neurosurgery
• Surgical spine
• Sleep
Source: Clinical Investment Insights research and analysis.
8
Road Map
1
Growth and Financial Outlook
2
Service Line Strategy
3
Care Quality
4
Clinical Innovation
5
©2014 The Advisory Board Company • advisory.com
Additional Resources
9
Service Line Strategy
Four Key Components of Service Line Strategy
Develop Full
Continuum of Care
Comprehensive offerings
for core neuroscience
services (stroke and spine)
ensures full continuum
coverage and optimal
disease management
Ensure Access & Efficiency
Streamlined referral
pathways and timely
access to providers
minimises leakage of
patients from system
Differentiate with
Subspecialty Offerings
Niche neurology services
offer differentiation
opportunity and help
regionalise a
neuroscience programme
Engage doctors
Strong relationships
between doctors and
administration enhances
communication and
increases likelihood of
success of new
programmes
Source: Clinical Investment Insights research and analysis.
©2014 The Advisory Board Company • advisory.com
10
Develop Full Continuum of Care
Scattershot Approach Creates Shallow Offerings
Spine, Stroke Focal Points Given National Demand
Unbundling the Neuroscience Service Line
Specialty
programme
Key Services
Specialists
US National
Inpatient Market
Size, 2013
• Fusion
• Decompression
•
•
Neurosurgeon
Physiatrist
907,141
• IV tPA
•
•
Neurologist
Interventional
neuroradiologist
729,924
• Epilepsy Monitoring Unit
• Epilepsy Surgery
•
•
Epileptologist
Neurosurgeon
285,795
Degenerative
Disorders
• Parkinson’s Disease
• Alzheimer’s Disease
•
•
Neurologist
Neurosurgeon
133,874
Peripheral &
Cranial
Neurosurgery
• Neuroplasty
• Peripheral Nerve Surgery
•
Neurosurgeon
43,429
Spine
Stroke &
Neurovascular
Epilepsy
©2014 The Advisory Board Company • advisory.com
Source: Advisory Board research and analysis.
11
Develop Full Continuum of Care
Specialty Gaps Result in Missed Opportunity
Comprehensive Pathway Ensures Appropriate Utilisation, Patient Satisfaction
Covering the Spine Care Continuum
Back Pain Care Pathway
Identified Spine Opportunity
Imaging and
Intake
Pain Management,
Physical Therapy
Spine Patients Population
by Treatment Type
Surgical
candidates
10%
90%
Require pain
management, PT
Surgery
1) Pseudonym
©2014 The Advisory Board Company • advisory.com
Source: Advisory Board research and analysis.
12
Develop Full Continuum of Care
Full Continuum Coverage Needed for Quality Care
Mastering Each Step Critical for Disease Management
Components of Comprehensive Stroke Care Pathway
Community &
PCP Office
•
PCP
Providers
Involved
•
Key Action
Items
•
Provide
community
education
Monitor risk
factors
Emergency
Department & OR
•
•
•
•
•
•
EMS
Neurologist
Hospitalist
Radiologist
Interventionalist
Stroke
coordinator
•
Diagnose in
timely manner
Ensure quick
access to
radiology &
pharmacy
Administer IVtPA and/or refer
for advanced
intervention
•
•
ICU/CCU
•
•
•
•
•
•
Rehab &
Follow-Up
Med Surg Floor
Intensivist
Neurologist
Neuro-trained
nurses
Stroke
coordinator
•
•
•
Transition to
critical care
Stabilise patient
after acute
intervention
•
•
•
•
•
•
•
Neurologist
Hospitalist
Neuro-trained
nurses
Stroke
coordinator
Obtain rehab
consult
Provide
discharge
education
Transition to
post-acute
setting
•
•
•
•
PT/OT/ST
Neurologist
Stroke
coordinator
PCP
Ensure access
to IP and OP
rehab services
Follow-up to
ensure
compliance
Track
outcomes
Source: Advisory Board research and analysis.
©2014 The Advisory Board Company • advisory.com
13
Differentiate with Subspecialty Offerings
Neurology Clinics Offer Differentiation Opportunity
Disease-Based Clinics Match Service to Market Need
Components of Disease-Based Clinics
Diagnosis and
Medical
Management
Multidisciplinary
Collaboration
Referral
Pathways to
Advanced
Care
Nurse Navigator
Patient Outreach
and Follow-Up
Common Disease-Based Clinic Opportunities
• Epilepsy
• Amyotrophic Lateral Sclerosis (ALS)
• Parkinson’s Disease
• Dementia and Memory Disorders
• Sleep Disorders
• Headaches
©2014 The Advisory Board Company • advisory.com
Source: Advisory Board research and analysis.
14
Differentiate with Subspecialty Offerings
Assess Market Forces Before Subspecialising
Careful Consideration Ensures Investment Success
Assess Internal
Capabilities and
Resources
• Assess internal
capabilities, in terms of
doctor interest and
specialty training
• Appraise the availability
of resources, such as
dedicated clinic space,
mid-level staff, and
capital needed for the
clinic
©2014 The Advisory Board Company • advisory.com
Evaluate Market
Demand
• Assess the demand in
the market for the
specialty service
• Determine if demand
necessitates dedicated
clinic; if disease is rare
and well-managed by
medication, clinic may
not be necessary
Appraise
Competition
• Gauge external factors,
such as competition
• Evaluate whether
hospital will be able to
attract patients and
maintain volumes based
on services available in
local area
Source: Advisory Board research and analysis.
15
Ensure Access & Efficiency
Triage Driven Patient Pathway Enables Efficiency
Reduces Burden of Inappropriate Referrals and Wait Times
Standard Care Pathway is
Repetitive and Time Consuming
Triage Driven Pathway is
Efficient and Productive
PCP
Pain Mgmt.
Specialist
Inappropriate
Subspecialty
Neurosurgeon
PCP
Spine Triage
Specialist
Neurosurgeon
Pain Mgmt.
Specialist
©2014 The Advisory Board Company • advisory.com
Source: Vickrey et. al (1999). “General neurologist and subspecialist
care for multiple sclerosis: patients' perceptions.” Neurology, 53 (6):
1190-7; Clinical Investment Insights research and analysis
16
Ensure Access & Efficiency
Utilise Advanced Practitioners to Improve Capacity
APs A Cost-Effective Method of Improving Throughput
AP Staff Capabilities
Administrative
Tasks
Provide diagnostic/
therapeutic care
Improvements in Wait Time to
Appointment (Days) at the Cleveland
Clinic
14
10
Before Utilizing APs
1) Results from Medical Group Management Association
2011 survey
©2014 The Advisory Board Company • advisory.com
After Utilizing APs
Manage preand post-op
care
Assist in
surgery
Write
prescriptions
Finances for Midlevel Staff1
$80K
USD
$437K
USD
Mean Salary for PA/NP
Median Gross Charges
in Surgical Practice
Source: Avitzur, O. (2002). “Neurologists Turn to doctor Assistants and Nurse Practitioners.”
Neurology Today, 2(7): 33-35; Cleveland Clinic, Cleveland, OH; Montgomera J, Reimbursement
Strategies for PA Billing in the Clinic and OR, NASS 2012 Annual Meeting, October 2012;
17
Engage doctors
Doctor Support Integral to Programme Development
Multiple Planning Imperatives Require doctor Engagement
Survey Respondents’ Descriptions of
Service Line Alignment Models
Alignment
Categories
n=229
Quality
45%
Volunteer Medical Staff
50%
32%
Full Employment
17%
Clinical
Comanagement
Medical Service
Organization
Neurosurgery
©2014 The Advisory Board Company • advisory.com
5%
Protocols
• Stroke Care Guidelines
• tPA Protocol Compliance
• Spine Triage
Growth
Strategy
• Support doctor Relations Outreach
Efforts
• Promote Hospital Innovation and
Research
Strategic
Planning
• programme Development and
Service Offerings
• Capital Investment
5%
5%
Readmissions
Falls and Trauma
Surgical Site Infection
Pressure Ulcers
Core Stroke Measures
• Length of Stay
• Implant and Device Costs
• Cost per Case
24%
6%
•
•
•
•
•
Cost
31%
Paid Directorships
Key Metrics
Neuroscience
Source: HealthLeader’s Intelligence, “doctor Alignment in an Era of
Change,” available at:
http://content.hcpro.com/pdf/content/256536.pdf, accessed
November 28, 2011; The Advisory Board Company, “Neurosciences:
Service Line Strategic Outlook,” Washington, DC; Marketing and
Planning Leadership Council and Clinical Investment Insights
research and analysis.
18
Engage doctors
Involvement in Planning Key to Doctor Engagement
Traditional Models for Developing Doctor Leadership
Strategic Planning Partner
• Doctors attend strategic planning
meetings with hospital administrators
• Involve doctors in capital prioritisation,
programme development, and
recruitment
Performance-Based Directorship
• A portion of the medical director’s
compensation is dependent on meeting
incentive targets
• Incentive metrics based on quality,
operational, leadership, administrative,
and strategic goals
• Present doctors with budget, volumes,
market share, and individual
performance data
©2014 The Advisory Board Company • advisory.com
Source: HealthLeader’s Intelligence, “doctor Alignment in an Era of Change,”
available at: http://content.hcpro.com/pdf/content/256536.pdf, accessed November
28, 2011; The Advisory Board Company, “Neurosciences: Service Line Strategic
Outlook,” Washington, DC; Marketing and Planning Leadership Council and Clinical
Investment Insights research and analysis.
19
Road Map
1
Growth and Financial Outlook
2
Service Line Strategy
3
Care Quality
4
Clinical Innovation
5
©2014 The Advisory Board Company • advisory.com
Additional Resources
20
Care Quality
Measuring Quality Integral to Defining Value
Shifting Imperatives for Measuring Value
Cost Conscious Care Delivery
Quality of Outcomes
•
Patient input
•
Episodic care/
readmissions
©2014 The Advisory Board Company • advisory.com
Value
•
Value of premium
technology
•
Surgical vs.
conservative care
Source: Clinical Investment Insights research and analysis
21
Care Quality
Collaborative Approach Improves Outcomes
Blinded Benchmarking Elevates Care
Surgeon evaluates
patient, develops
surgical treatment plan
Treatment
Plan
Outcomes are
presented to surgeons
as blinded report cards
Treating surgeon adjusts
plan as necessary,
performs surgery
Peer Review
Committee
Surgery
Team of surgeons
review plan, make
suggestions for
changes
Data
Collection &
Analysis
Outcomes
Review
Patient outcomes are
collected and analysed
Case in Brief: Gilman Hospital1
• 11-clinic system in the Northeast region
• Peer review programme supports team input on complex surgeries
• Quality tracking programme benchmarks surgeon performance against rest of
practice
• Peer review process affected treatment choices for 20% of patients
1) Pseudonym
©2014 The Advisory Board Company • advisory.com
Source: Shivers, Jennifer. “Advantages of Aligning Stakeholder
Expectations.” Presentation at the NASS 2013 Annual Meeting, New
Orleans, LA, October 9-12, 2013.
22
Care Quality
Data Collection Goes Beyond Clinical Outcomes
Tracking a Range of Metrics Key to Programme Improvement
Patient
Satisfaction
CAHPS; Word-of-Mouth
Health-Related
Quality of Life
Health
Outcomes
Process
Metrics
Surrogate
Outcomes
©2014 The Advisory Board Company • advisory.com
Complexity of Collection
Functional
Outcomes
EQ-5D; HRQOL-14
Data Tracking
Supports…
• Improved Outcomes
ODI; NDI; RMDQ; VAS; SF-36
• Reimbursement
Complications; Readmission Rates
• Patient Satisfaction
• Clinical Collaboration
SCIP; Antibiotics
• Care Pathway Efficiency
Alignment; Range of Motion;
Blood Pressure; Seizure
Frequency; Sleep Latency
Source: Golish, S Raymond. “Surgical Success: Aligning
Expectations.” Presentation at the NASS 2013 Annual Meeting, New
Orleans, LA, October 9-12, 2013.
23
Road Map
1
Growth and Financial Outlook
2
Service Line Strategy
3
Care Quality
4
Clinical Innovation
5
©2014 The Advisory Board Company • advisory.com
Additional Resources
24
Clinical Innovation
Technology Pipeline for Neurosciences
Future-Looking Technologies and Procedures
Intraoperative Imaging
Real-time imaging
platforms and surgical
suites designed to
improve surgeon
visibility
O-Arm
– Portable imaging
platform designed to
improve accuracy of
pedicle screw placement
Intraoperative CT
– OR/Imaging suite
improves visualisation of
bony structures during
surgery
Intraoperative MRI
– OR/Imaging suite
improves visualisation of
soft tissue during surgery
©2014 The Advisory Board Company • advisory.com
Neurology
Technologies aimed at
increasing access to
neurology services
Portable Sleep Monitoring
– Diagnostic tool enables
ambulatory testing for
obstructive sleep apnea
(OSA) in high-risk patients
Teleneurology
– Platform allows for two-way
communication between
hub and spoke hospital to
deliver neurology care
ranging from acute stroke
to general follow-up
Neurosurgery
Advanced surgical
techniques expand
treatment options for
complex conditions
Deep Brain Stimulation
– Implanted
neurostimulation system
treats and alleviates
symptoms of movement
disorders
NeuroBlate
– Laser system ablates
soft tissue and lesions
considered inoperable
using traditional
techniques
Source: Clinical Investment Insights research and analysis
25
Clinical Innovation
O-Arm Results in Marginal Improvements for Fusions
Doctor Satisfaction Main Strategic Benefit
Misplaced Pedicle Screws in
Spinal Fusions
Perforation Rate; n=346, p<0.001
National Market for O-arm
Eligible Procedures, US
IP & OP, 2013
12.8%
3.0%
Conventional
Fluoroscopy
491K
O-Arm
230K
Operation Time for MI
Spinal Fusion
114K
In minutes; n=94, p<0.03
Fusion
221
Decompression
Kyphoplasty/
Vertebroplasty
200
Conventional
Fluoroscopy
©2014 The Advisory Board Company • advisory.com
O-Arm
Source: Houten et al (2012). “Clinical Assessment of Percutaneous
Lumbar Pedicle Screw Placement Using the O-arm Multidimensional
Surgical Imaging System.” Neurosurgery, 70(4):990-995; Advisory
Board Inpatient Market Estimator.
26
Clinical Innovation
iCT Comes With Significant Upfront Investment
Yet Limited Benefit Over Fluoroscopy, O-Arm
Estimated iCT Investment Costs
Component
Estimated
Cost
BrainLAB Systems
$3,185,000
LEAD Shielding
$100,000
Floor Rail System Reinforcement
$100,000
Electrical Filtering Design,
Engineering
$15,000
Siemens CT System
$1,100,000
TRUE System 7500 Fixed Pedestal
Table
$600,000
1 FTE CT Technologist & 1 FTE RN
Salary/Benefits
$134,000
Annual Maintenance/Support
$100,000
Marketing
Y1: $15,000
Y2-5: $7,500
Total Initial Costs
$5,100,000
©2014 The Advisory Board Company • advisory.com
Pedicle Screw Inaccuracy
Using iCT
n=12
5.2%
1.2%
iCT
Traditional
Fluoroscopy
Source: Clinical Investment Insights Interviews and Analysis;
Tormenti et al, “Intraoperative computed tomography image-guided
navigation for posterior thoracolumbar spinal instrumentation in spinal
deformity surgery” Neurosurg Focus 28 (3): E11, 2010.
27
Clinical Innovation
High Price Tag for iMRI May Outweigh Clinical Benefits
Allows for Advanced Offerings, Boosts Progressivity Profile
Mean Residual Tumor Mass in
Resection Surgeries
Average Intraoperative
MRI Investment Costs
n= 47 surgeries
Component
Estimated
Cost
Two-room home-grown 1.5T
iMRI-OR suite
$6,000,000
USD
Build-out
$3,000,000
USD
MRI compatible instruments
$280,000
USD
Annual maintenance
software, support contracts
$100,000
USD
Annual marketing
$10,000 USD
MR technologist
$56,650 USD
Radiology nurse
$78,000 USD
Total Costs
$9,524,650
USD
©2014 The Advisory Board Company • advisory.com
26%
20%
10%
Low-Grade Glioma
Without iMRI
5%
High-Grade Glioma
With iMRI
Incremental Direct OR Costs of 1.5T
iMRI
2011
$5,250
$22,157
24% increase
$22,157
Craniotomy Without Craniotomy With
iMRI
iMRI
Sources: Senft et al. Intraoperative MRI guidance and extent of
resection in glioma surgery: a randomised, controlled trial. The
Lancet Oncology, 2011; Nimsky, C. et al. Volumetric assessment of
glioma removal by intraoperative high-field magnetic resonance
imaging. Neurosurgery. August 2004, 55(2), 358-70; Clinical
Investment Insights research and analysis.
28
Clinical Innovation
Portable Sleep Monitoring Taps Into Vast OSA Market
Cost-Effective Device Supports Chronic Care Management
Sensitivity and Specificity
of Portable Sleep
Monitoring
Market Opportunity for
Ambulatory Sleep Medicine, US
2013
n=102
91%
85%
0.9 M
9M
Sensitivity
Specificity
18M
3M
These levels of sensitivity and
specificity compare favorably to
conventional polysomnography
31%
Overall 5-Year Sleep
Study Market Growth
in the United States
©2014 The Advisory Board Company • advisory.com
5.1 M
Prevalence of Diagnosed Patients with PSM False
Obstructive
Population Comorbidities Negatives
Sleep Apnea
Total
Ambulatory
Market
Opportunity
Source: Ayappa et al. “Validation of a self-applied unattended monitor
for sleep disordered breathing.” J Clin Sleep Med. 2008. 4(1): 26-37;
Healthcare Cost and Utilisation Project (HCUP); Advisory Board Day
Case Market Estimator.
29
Clinical Innovation
Telemedicine Covers More Than Just Acute Stroke
Platforms Utilised to Increase Access Across Neuro Specialties
20%
American Academy of
Neurology estimates the supply
of neurologists will fall 20%
below demand by 2020
5.2
Population ratio of 5.2
neurologists per 100,000 people
35
Number of days for a new
patient to see a neurologist
in 2012
Telemedicine Applications for
Other Neuroscience Specialties
Acute stroke
Sleep Medicine
Psychiatry
General Diagnostics
General Follow-Up
General Acute Consults
©2014 The Advisory Board Company • advisory.com
Source: Butcher, L. (2011). “Are There Enough Neurologists to Address US
Patient Population — Now and for the Future?” Neurology Today, 11
(17):1,11; American Academy of Neurology; Advisory Board research and
analysis.
30
Clinical Innovation
DBS Offers Clinical Benefits to Growing Population
Increasing Market Capture Key to Profitable Investment
Seizure Frequency in DBS
Patients with Epilepsy
DBS Applications
Condition
Estimated
Prevalence,
US
Drug
Refractory
Patient
Population,
US
Essential
Tremors
10,000,000
-
Dystonia
300,000
-
Obsessive
Compulsive
Disorder
2,200,000
220,0002
Parkinson’s
60,000/year1
-
Epilepsy
3,000,000
1,200,000
Depression
21,000,000
4,000,000
n = 110; 2010
Baseline
Month 0-1
Month 1-2
Month 2-3
Month 3-4
-14.5%
-22.2%
-21.3%
-25.3%
-28.7%
-33.9%
-42.1%
Control
DBS
Implantation
©2014 The Advisory Board Company • advisory.com
DBS
-40.4%
Emerging
applications
Source: Thompson, M (2010). “New Avenues in Neuromodulation.” MedTech
Insights, 12(6): 48-63; Fisher et al. “Electrical Stimulation of the Anterior Nucleus
of Thalamus for Treatment of Refractory Epilepsy.” Epilepsia. May 2010. 51(5):
899-908; Denys et all. (2010) “Deep Brain Stimulation of the Nucleus Accumbens
for Treatment-Refractory Obsessive-Compulsive Disorder.” Archives of General
Psychiatry, 67(10): 1061-1068
31
Clinical Innovation
NeuroBlate Allows for Resection of Inoperable Tumors
Early Results Promising, More Data Needed on Long-Term Benefit
First-in-humans Phase I Clinical Trial
Results for Recurrent Glioblastoma
(NeuroBlate)
n = 10
Benefits and Challenges of
NeuroBlate Adoption
Better access to difficult-toreach glioblastoma
multiforme
78%
316
Less invasive than traditional
craniotomy
Promotes quicker recovery
Percentage of tumor
treated
Median survival time
(days)
Requires extensive doctor
training and expertise
Long-term outcomes and
efficacy still under review
Large capital investment
($300-500K USD plus
associated software)
©2014 The Advisory Board Company • advisory.com
Source: CMS; Sloan, A. E., Ahluwalia, M. S., Valerio-Pascua, J., Manjila, S.,
Torchia, M. G., Jones, S. E., ... & Barnett, G. H. (2013). Results of the
NeuroBlate System first-in-humans Phase I clinical trial for recurrent
glioblastoma: clinical article.Journal of neurosurgery, 118(6), 1202-1219;
Advisory Board research and analysis.
32
Road Map
1
Growth and Financial Outlook
2
Service Line Strategy
3
Care Quality
4
Clinical Innovation
5
©2014 The Advisory Board Company • advisory.com
Additional Resources
33
Enhancing Neurosciences Service Line Strategy
A Comprehensive Solution for Your Neuro Strategic Needs
Clinical Investment Insights
•
•
1
2
3
Service Line Assessment
System Service Rationalisation
Technology and Service
Business Plans
Current and future service
line performance evaluation
to pinpoint growth and
development opportunities
Unique insights based on
market dynamics to drive
fine-tuned
recommendations
©2014 The Advisory Board Company • advisory.com
•
•
Strategic recommendations
on clinical asset deployment
and competitive strategy
based on current system
structure
Tactical recommendations
for service investments and
distribution
•
•
Comprehensive market and
financial analysis to
determine investment
decisions
Concrete plans and
prioritisation accounting for
institutional priorities,
budget, and goals
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