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Adriaan Hart de Ruijter, Preventicus - Reduce Stroke Risk Simply in Your Sleep | LSI Europe '24
Adriaan Hart de Ruijter, Preventicus - Reduce Stroke Risk Simply in Your Sleep | LSI Europe '24
LSI Europe '24
The Preventicus Service searches and finds undetected atrial fibrillation, identifying a significant major risk factor for stroke.
Adriann Hart
Adriann Hart
Chairman, Preventicus
00:02
Adriaan Hart de Ruijter
And good afternoon. My name is Adriaan Hart de Ruijter. I'm the chairman of Preventicus. And first of all, thank you very much for this opportunity to speak. And thank you very much to the audience for coming to listen to this story about preventive health. Preventicus is well known in Germany for large-scale prevention programs in atrial fibrillation. My own personal background is that I'm a medical doctor. I've been trained as a medical doctor, but have always worked in the pharmaceutical industry, presently working as an investor and helping my companies. First of all, maybe some audience engagement. Whoever went to the doctor's office and got their cholesterol diagnosed? Nobody? Some people? Whoever went to the doctor and the doctor took your pulse and took your blood pressure? That should be everybody. That's a standard routine, right? So these three measures actually give the risk profile of your cardiovascular status and tell the doctor a lot about your cardiovascular system. However, one thing is missing, and that is a good detection of atrial fibrillation, which is also a huge risk factor for cardiovascular disease. Health care today is still primarily focused on symptomatic disease, serving on the surface of the water, while preventing this is going below the water, trying to find early onset disease and trying to treat that. I will demonstrate to you how Preventicus actually makes a business out of this, increasing the screening yields for early onset disease by a factor of three compared to standard health care practice. Typical examples of early onset disease are, of course, atrial fibrillation, related to stroke. Stroke is a huge problem, but also dementia, hypercholesterolemia, hypertension, prediabetes, sleep apnea, and kidney disease. So this iceberg is growing over time due to the aging population. Unlike the real icebergs that keep, of course, getting smaller, the health care system is slowly being forced to do something about this, and especially in Germany now, where we have our biggest market, this is becoming urgent. Think of Preventicus as a combination of a tech company and a project management company, essentially an online hospital treating patients. Programs are optimized and made scalable for the insured population, allowing for advanced analytics. So we differ from other companies by not only offering the technology but also going deeper and helping execute these programs with our customers. We do that by running or helping them to run digital disease management programs using our virtual health center. So in Germany, we are effectively an online hospital, and the cost savings can be created within three to four years, being given back to the insurance companies so that these insurance companies come back for repeated programs, extended programs, and new programs involving other diseases. In this way, we achieved market leadership in Germany. Now the challenge in disease management is really to create cost savings for insurance companies and demonstrate that to them within three to four years. We know that cardiovascular disease leads to over 15% of total health care costs. We know that early screening, monitoring, and treatment, like we do with hypertension and like we do with cholesterol, is effective. We know that we have the tools, we have the telemedicine tools, the wearables that make it possible, but few people are actually running these programs that make it worthwhile. This is our status today. We're almost profitable. We have 18 contracts with health insurance companies in the download store, and we are in the top three. So we also sell directly business to consumer, and we have over 65,000 participants now.
04:37
Adriaan Hart de Ruijter
More about atrial fibrillation, so this is our first DDMP (Digital Disease Management Program) focused on stroke incidence reduction. AF, connected to stroke, is a very large disease management market with the potential for huge cost savings. In AF, a clot can form in the blood inside the heart and travel up to the brain, causing a stroke. Treatment with anticoagulants starts mostly too late because of the sporadic nature of AF. Giving patients a tool to screen themselves at home is the solution for this indication. It's not difficult nor costly to prevent AF and thereby stroke, because it can easily be detected, and anticoagulant treatment is now available as generic medication. The ESC and many other associations issued guidelines for exactly this type of screening. In fact, there are eight cardiology associations that describe exactly this type of screening and early treatment; the only one absent, the big one, is the American Society of Cardiology. But I expect that also will come. The high and strongly rising cost of stroke right now, 60 billion, comes from disability and long-term care enforced by the rising average age. If we extrapolate the revenues that we have in Germany, per capita, per person, to the rest of the world, outside of the US, we arrive at a total market size of 10 billion. So it's not a small market. This is for AF, AF coaching, and management after diagnosis, heart failure, and stroke related to myocardial infarction. Now, how does it work? We chose to work with the tool that everybody has in their pocket, the phone. This type of detection using PPG is already known for 10 years. It works really well. It's very selective, very sensitive, and the data can be used to differentiate between the different forms of AF. People get a letter from their insurance company, they get a login code, and they start measuring twice a week for a year. Suspicious measurements are being reviewed by the telecare service, and they can decide to transfer to a cardiologist. So we have a network of cardiologists that are linked to our system, and they are being paid per performance. They can decide to prescribe a 14-day Holter monitoring, which is still the official diagnostic that people need to go through in order to get reimbursement for their treatment, which is oral anticoagulants. Then the patient goes back, and the doctor follows up. The DDMP is built on the continuum of care. That means that after diagnosis, we continue to measure to determine the AF load of the patient and to potentially suggest other treatments. Earlier intervention, as we advocate, can reduce stroke by about 70 to 80%, demonstrating the immense value of the DDMP to patients and insurers. We have a system online with four different kinds of interfaces for all the participants. Customers are extremely happy. They provide feedback of high satisfaction, a feeling of security and protection, and a tendency to recommend to others. If the insurance stops paying after the first year, more than 50% continue paying themselves. Preventicus has produced more than 25 papers in the field. Our CEO is a thought leader in this space. And we have four different models for this business. In Germany, it's through payers. In Saudi Arabia, where we started, it's through providers. We have B2C, and we work through partners like online pharmacies, Pfizer, Boston Scientific, and many other partners based on the existing contracts that we have today. Already, we know that if we tweak the right buttons, we will be able to achieve 40 million in revenue in Germany. So again, this is based on existing contracts. Half of that will be EBITDA, will be profit. And this success in Germany is, of course, the basis for international growth in the UK, Europe, and the emerging countries. A quick example about Germany: if we would be running full scale in Germany, we're currently only covering one quarter, we would invoice the insurance companies 773 million euros per year on an ongoing basis towards the future, while creating cost savings of 165 only for stroke, and the costs of course also include dementia and the cost of
10:09
AFib itself. Adriaan Hart de Ruijter
The other DDMPs are in development. We recently launched monitoring so we can continuously monitor existing patients and suggest new treatments. I realize I'm running out of time. Our team: Dr. Thomas Hübner is a serial health tech entrepreneur and recognized leader in the field of heart disease and public health. And our CEO, Alexander Stanke, is an industry-experienced manager from Biotronik responsible for the German business. In total, we are more than 30 people at this moment in Germany. We are raising 15 million in the Series B to drive international expansion, enhance technological integration, and prepare for market entry in the United States. I think this is an opportunity for any investor to join us in this mission to reduce the global burden of cardiovascular disease. With our proven technology, robust financial growth, and strong partnerships, we are positioned to grow across Europe and the Middle East. We're seeking investors to join us in this next phase of growth. So I would suggest a follow-up meeting in case you are interested. Looking very much forward to further discussions. Thank you so much. Thank you.

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Adriaan Hart de Ruijter, Preventicus - Reduce Stroke Risk Simply in Your Sleep | LSI Europe '24

The Preventicus Service searches and finds undetected atrial fibrillation, identifying a significant major risk factor for stroke.
Adriann Hart
Adriann Hart
Chairman, Preventicus
00:02
Adriaan Hart de Ruijter
And good afternoon. My name is Adriaan Hart de Ruijter. I'm the chairman of Preventicus. And first of all, thank you very much for this opportunity to speak. And thank you very much to the audience for coming to listen to this story about preventive health. Preventicus is well known in Germany for large-scale prevention programs in atrial fibrillation. My own personal background is that I'm a medical doctor. I've been trained as a medical doctor, but have always worked in the pharmaceutical industry, presently working as an investor and helping my companies. First of all, maybe some audience engagement. Whoever went to the doctor's office and got their cholesterol diagnosed? Nobody? Some people? Whoever went to the doctor and the doctor took your pulse and took your blood pressure? That should be everybody. That's a standard routine, right? So these three measures actually give the risk profile of your cardiovascular status and tell the doctor a lot about your cardiovascular system. However, one thing is missing, and that is a good detection of atrial fibrillation, which is also a huge risk factor for cardiovascular disease. Health care today is still primarily focused on symptomatic disease, serving on the surface of the water, while preventing this is going below the water, trying to find early onset disease and trying to treat that. I will demonstrate to you how Preventicus actually makes a business out of this, increasing the screening yields for early onset disease by a factor of three compared to standard health care practice. Typical examples of early onset disease are, of course, atrial fibrillation, related to stroke. Stroke is a huge problem, but also dementia, hypercholesterolemia, hypertension, prediabetes, sleep apnea, and kidney disease. So this iceberg is growing over time due to the aging population. Unlike the real icebergs that keep, of course, getting smaller, the health care system is slowly being forced to do something about this, and especially in Germany now, where we have our biggest market, this is becoming urgent. Think of Preventicus as a combination of a tech company and a project management company, essentially an online hospital treating patients. Programs are optimized and made scalable for the insured population, allowing for advanced analytics. So we differ from other companies by not only offering the technology but also going deeper and helping execute these programs with our customers. We do that by running or helping them to run digital disease management programs using our virtual health center. So in Germany, we are effectively an online hospital, and the cost savings can be created within three to four years, being given back to the insurance companies so that these insurance companies come back for repeated programs, extended programs, and new programs involving other diseases. In this way, we achieved market leadership in Germany. Now the challenge in disease management is really to create cost savings for insurance companies and demonstrate that to them within three to four years. We know that cardiovascular disease leads to over 15% of total health care costs. We know that early screening, monitoring, and treatment, like we do with hypertension and like we do with cholesterol, is effective. We know that we have the tools, we have the telemedicine tools, the wearables that make it possible, but few people are actually running these programs that make it worthwhile. This is our status today. We're almost profitable. We have 18 contracts with health insurance companies in the download store, and we are in the top three. So we also sell directly business to consumer, and we have over 65,000 participants now.
04:37
Adriaan Hart de Ruijter
More about atrial fibrillation, so this is our first DDMP (Digital Disease Management Program) focused on stroke incidence reduction. AF, connected to stroke, is a very large disease management market with the potential for huge cost savings. In AF, a clot can form in the blood inside the heart and travel up to the brain, causing a stroke. Treatment with anticoagulants starts mostly too late because of the sporadic nature of AF. Giving patients a tool to screen themselves at home is the solution for this indication. It's not difficult nor costly to prevent AF and thereby stroke, because it can easily be detected, and anticoagulant treatment is now available as generic medication. The ESC and many other associations issued guidelines for exactly this type of screening. In fact, there are eight cardiology associations that describe exactly this type of screening and early treatment; the only one absent, the big one, is the American Society of Cardiology. But I expect that also will come. The high and strongly rising cost of stroke right now, 60 billion, comes from disability and long-term care enforced by the rising average age. If we extrapolate the revenues that we have in Germany, per capita, per person, to the rest of the world, outside of the US, we arrive at a total market size of 10 billion. So it's not a small market. This is for AF, AF coaching, and management after diagnosis, heart failure, and stroke related to myocardial infarction. Now, how does it work? We chose to work with the tool that everybody has in their pocket, the phone. This type of detection using PPG is already known for 10 years. It works really well. It's very selective, very sensitive, and the data can be used to differentiate between the different forms of AF. People get a letter from their insurance company, they get a login code, and they start measuring twice a week for a year. Suspicious measurements are being reviewed by the telecare service, and they can decide to transfer to a cardiologist. So we have a network of cardiologists that are linked to our system, and they are being paid per performance. They can decide to prescribe a 14-day Holter monitoring, which is still the official diagnostic that people need to go through in order to get reimbursement for their treatment, which is oral anticoagulants. Then the patient goes back, and the doctor follows up. The DDMP is built on the continuum of care. That means that after diagnosis, we continue to measure to determine the AF load of the patient and to potentially suggest other treatments. Earlier intervention, as we advocate, can reduce stroke by about 70 to 80%, demonstrating the immense value of the DDMP to patients and insurers. We have a system online with four different kinds of interfaces for all the participants. Customers are extremely happy. They provide feedback of high satisfaction, a feeling of security and protection, and a tendency to recommend to others. If the insurance stops paying after the first year, more than 50% continue paying themselves. Preventicus has produced more than 25 papers in the field. Our CEO is a thought leader in this space. And we have four different models for this business. In Germany, it's through payers. In Saudi Arabia, where we started, it's through providers. We have B2C, and we work through partners like online pharmacies, Pfizer, Boston Scientific, and many other partners based on the existing contracts that we have today. Already, we know that if we tweak the right buttons, we will be able to achieve 40 million in revenue in Germany. So again, this is based on existing contracts. Half of that will be EBITDA, will be profit. And this success in Germany is, of course, the basis for international growth in the UK, Europe, and the emerging countries. A quick example about Germany: if we would be running full scale in Germany, we're currently only covering one quarter, we would invoice the insurance companies 773 million euros per year on an ongoing basis towards the future, while creating cost savings of 165 only for stroke, and the costs of course also include dementia and the cost of
10:09
AFib itself. Adriaan Hart de Ruijter
The other DDMPs are in development. We recently launched monitoring so we can continuously monitor existing patients and suggest new treatments. I realize I'm running out of time. Our team: Dr. Thomas Hübner is a serial health tech entrepreneur and recognized leader in the field of heart disease and public health. And our CEO, Alexander Stanke, is an industry-experienced manager from Biotronik responsible for the German business. In total, we are more than 30 people at this moment in Germany. We are raising 15 million in the Series B to drive international expansion, enhance technological integration, and prepare for market entry in the United States. I think this is an opportunity for any investor to join us in this mission to reduce the global burden of cardiovascular disease. With our proven technology, robust financial growth, and strong partnerships, we are positioned to grow across Europe and the Middle East. We're seeking investors to join us in this next phase of growth. So I would suggest a follow-up meeting in case you are interested. Looking very much forward to further discussions. Thank you so much. Thank you.

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