Predicting Coronary Artery Disease Risk with Genetic Information

CADRA

TEAM CADRA:

Total number of interviews: 135

A/Prof Heng Chew Kiat(PI)

Delicia Ooi(EL)

Daniel Kirilly(EL)

Henrik Glarbo(Mentor)

Audrey Long(Mentor)

Background• CAD is leading cause of death in many parts of the world

• No.2 killer in Singapore (One out of every 5 Singaporeans)

• One third of heart attack without warning signs

• Genetics can account up to 60% of heart disease

CADRA

Problem: Current cardiac assessment cannot predict risk and does not take genetics

into account e.g. ECG/Treadmill test

Gold standard angiogram is invasive

Solution: CADRA uses both genetic/non-genetic data to predict risk of heart disease

over time

Non-invasive and genetic data remains unchanged over time

So what is the problem?

CADRA

Local cohort of 3000 healthy/CAD patients National Science & Technology Board Grant

91% sensitivity, 76% specificity and overall accuracy of 83%

Genotyping of 32 CAD susceptible genes

Unique Prediction Algorithm

Patient

CADRA

Cost structure Revenue streams

Key resources

Key activities

Key partners

Value proposition

Customer relationships

Customer segments

Channels

• Hospitals

• Clinics

• Insurance companies

• Gyms

• Biotechnology companies

• CAD risk prediction• Family

members of CAD patients

• High risk patients

• Public

• Biotechnology company

• Direct sales of CADRA tests

• License fees

• Doctors

• Marketing

• Mass customized

• Communities of interest

• Genotyping

• Updating database

• Marketing

• Genotyping

• Database

• Manpower

• Reagents

• Genotyping

Hypotheses WHO? Insights

15 Institutional doctors(NUHS, National Heart Centre, National Cancer Centre)

• Prefer diagnostic tool rather than prediction tool

• May have commercial value in private hospitals

• 5 family members of CAD patients

• 5 high risk patients

• Interested in CADRA

• Will take it under doctor’s recommendationHOW?

WEEK 5

(PIVOT)

Value Key Partners Channels Customer Segments

Cost Structure

Key Activities

Hypothesis CAD risk prediction

Wellness clinics

Wellness Physicians

Health screenees

Service Providers

Regulatory compliance

Experiment Genetic test Medical directors

Clinical significance

CADRA survey

MDC/Axil Scientific HSA/MOH

Lesson Learnt

Add on to current

screening Commercial

valueTo advise lifestyle

adjustments

90% willing to take up

CADRA Reduce cost

by 50%Class III medical device

Valid/Invalid Valid Valid Valid Valid Valid Valid

CADRA

Customer archetype 1-Doctor

Dr Crystal Ng

Medical Director of Parkway Shenton

80-120 patients daily (Asian patients)

Genetic testing is important

CADRA adds on to clinical diagnosis

Genetic testing for other diseases e.g. cancer

Launch CADRA across 6 clinics:Gleneagles Hospital Mount Elizabeth Hospital

Parkway East Hospital Mount Elizabeth Novena Hospital

Paragon The Arcade

CADRA

Customer archetype 2-Health Screenee

Madam Yvonne Yap

44 years old, married with two kids

Goes for annual health screening check

Wants to know more about her own health

Add on to health package e.g. ECG/Treadmill test

Interested to take up CADRA

Lifestyle adjustments to improve health

Willing to pay 1000sgd for CADRA

CADRA

Market size• Average cost US$22,000 per annum (AHA)• Average cost of US$16,000 per annum (MOH)

SingaporeLocal: US$3billionMedical Tourism:

US$1billion

Research from 12 local wellness clinicso Average 9000patients per annum per

clinic

o Average foreigners (40%)

o Average spending of US$800 per

patient

US$72 Million

Asia PacificUS$90billion

USAUS$200billion

CADRA

Business Model

SPIN-OFF(CADRA)

Genotyping laboratories

Outsource

Results

Sales

Report

Health Screening

Clinics

NUS

License

Generation of reports

Marketing/Business development

Medical workshops/seminars

Safety and regulations

CADRA

Financial Projection (I)Start-up Expenses (Year 1) $ (SGD)

License Fees 10,000

Company registration 5,000

Product development 20,000

Regulatory Compliance 50,000

Office Overhead 15,000

Manpower 120,000

Marketing 15,000

Other start-up expenses 25,000

Total 260,000

CADRA

Financial Projection (II)

CADRA

Year 1 Year 2 Year 3 Year 4-1

0

1

2

3

4

5

6

7

8

9

SGD

Mill

ion

-13%

20%

32%

52%

Progress Timeline

Phase 1 (Sep’13-Feb’14)

Phase 2 (Mar’14-Aug’14)

Phase 3(Sep’15-Feb’16)

Phase 4(Mar’16-Aug’16)

License

Company registration

POV grant

Partnerships

Kit development

HSA approval

MOH evaluation

HPB

Marketing

Medical Seminars

Asia Market

R&D

CADRA

THANK YOU!

Live your lifeL ve your heart

TEAM CADRA