1.
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)

2.
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

3.
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

4.
 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

5.
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

6.
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?

7.
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
value
To 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

8.
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

9.
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

10.
Market size
• Average cost US$22,000 per annum (AHA)
• Average cost of US$16,000 per annum (MOH)
Singapore
Local: US$3billion
Medical Tourism:
US$1billion
Research from 12 local
wellness clinics
o Average 9000patients per annum per
clinic
o Average foreigners (40%)
o Average spending of US$800 per
patient
US$72 Million
Asia Pacific
US$90billion
USA
US$200billion
CADRA

11.
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

12.
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

13.
Financial Projection (II)
CADRA
-1
0
1
2
3
4
5
6
7
8
9
Year 1 Year 2 Year 3 Year 4
SGDMillion
-13%
20%
32%
52%

14.
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

15.
THANK YOU!
Live your life
L ve your heart
TEAM CADRA