August / September 2017 by Healthcare Sales and Marketing Magazine

™ AUGUST/SEPTEMBER 2017

the publication for healthcare sales & marketing leaders™

THE TOP 50 PHARMA COMPANIES

IN THIS ISSUE

pharma companies

How Marketing can Support Sales: Leaders from Boston Scientific, Orasure and more Lilly Bio-Medicines Prez: A Passion for Patients and Brands Head of MedImmune on Her Success Defying the Odds Shire’s US Marketing Lead on Helping Physicians Understand Patients Making a Launch Cost Less The View from Today to 2022: The Top 15 Pharma and Medtechs: Revenue, Rx, R&D Spend and More Docs and Digital: a Survey on How to Reach Them

WHY GIVE LESS THAN 100%? You could hire a separate digital agency to build your website. Maybe another to manage your social media. But multiple agencies struggling to keep content aligned while also trying to pilfer each other’s work is a recipe for inefficiency. And disaster. Why not give 100% to an agency that’s successfully incorporated digital media into its clients’ branding mix for more than 15 years? One whose only agenda is delivering the right content, through the right channel, to the right audience. Who’s 100% committed 100% of the time.

100% COMMITTED

TO YOUR BRAND IT’S THE WAY WE THINK

AbelsonTaylor

the publication for healthcare sales & marketing leaders™

TABLE OF CONTENTS pharma companies

Publisher’s Letter..............................................................................................................................................4 Editor’s Letter.....................................................................................................................................................5 Editorial Board....................................................................................................................................................7

ARTICLES Executive Spotlight: Christi Shaw, President of Lilly Bio-Medicines...............................................9 Roundtable: How Marketing Can Better Serve Sales.......................................................................... 15 The Top 50 Pharma Companies................................................................................................................. 25 The View to 2022: Forecast of Revenues, R&D, Rx and More......................................................... 31 By The Numbers...............................................................................................................................................41 Motivideos........................................................................................................................................................49 Great Minds: Shire Marketing Director Erik Cline............................................................................... 45 How HCPs Want to Hear From You Digitally........................................................................................ 53 MedImmune Head Bahija Jallal: Her Success Defying the Odds.................................................... 59 Driving Down Launch Costs with EPC...................................................................................................... 65

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Publisher’s Letter

Interesting Times We’re Living In There’s a legend that the Chinese say “May you live in interesting times”—and mean it as a curse. Well, all I can say is that things aren’t dull these days. As I note in our Top 50 Pharma Companies report, however, there’s still good news to celebrate. Revenue for that sector of the industry is not only up, but it gained even more in 2016 than in 2015. Drug prices are strong. Total deal amounts are up. Although NDAs were down, they’re picking up again this year over 2016. M&A activcari kraft ity was not robust, but that’s probably because the industry has seen a lot of consolidation already over the last few years, and the mergers and acquisitions have mostly led to healthier, growing companies. Moving over to our report on Evaluate’s Data Kit for 2017, you can see that the outlook for the next five years is generally positive, with Compound Annual Growth Rates (CAGRs) rising across the board, and some significant growth anticipated in a number of script and OTC product areas. Of course, as of this writing the whole industry is holding its breath to see what happens inside the Washington beltway with respect to healthcare legislation. But, as I also note in our Top 50 report, we enjoy a pretty solid heritage of both governing and financial markets in this country. Even when major upheavals occur, as we experienced in 2008 when the housing bubble burst, our systems and leadership have the capability of dealing with the crisis so that we don’t suffer the tragic consequences you often see in other countries without these strong institutions. I’ve spent many years observing this industry, and from my position as an executive recruiter and publisher I see and hear numerous points of view about where we’re headed. We are often portrayed as representing 1/3 of the US GDP. But we also represent a significant portion of the worldwide GDP. As a result, we continue to be a major force in world affairs, and I would say mostly for the good. I don’t mean to be overly sunny about healthcare. There are always problems to be solved, and we try to identify them and offer advice from leaders in the industry. But, on the whole, I continue to be proud that we work alongside some of the finest people I know—especially in these interesting times. And always, please keep the feedback coming. It all goes to making the magazine better for all of us. Click here to get Top 50 pharma companies

Cari Kraft, Publisher

Click to download to your mobile device of choice

HS&M AUGUST/SEPTEMBER 2017| 4

Letter from the Editor

I, Patient I recently had the great honor of being a recipient of the healthcare that we report on in this magazine. What I mean is that I was ordered into the hospital for a procedure. Nothing serious, and I won’t annoy you with TMI (too much information, as my kids say). But here’s the point of view of a patient, rather than an editor.

neil greenberg

I am a very lucky person. I live in a big city, near numerous teaching hospitals, and have access to extraordinary expertise, no matter what part of my body is experiencing a hiccup. But beyond medical skill, I was impressed by the “care” part of my healthcare.

At my initial appointment in the doctor’s office, I went through the experience all patients have, even during a routine checkup. Everyone—the receptionist, the nurse, the doctor, the woman who explained to me what was going to happen—asked my name and birthdate, even though I had given it to all the others. I had no objection to this, since I realize it’s a double/triple/quadruple check to be sure they don’t do my procedure on another patient and vice-versa. Unlikely, but it’s good to be certain. When they put on my hospital gown, I noticed it had a vent sewn into it. Turned out this was for a tube connected to a small machine that kept my body warm under the gown. Shows you that innovation is happening even in low-tech areas. As a group of very affable professionals fussed over me, not only did they ask the important questions about my medications, history and drug allergies, but they also exhibited a touching concern for small personal issues. As they removed my glasses, they asked if I would like them available in the recovery room. I would, and they were. Fortunately, all went well. Even though I was in the hospital for less than two days, I was visited by my surgeon, his partner, and two of the interns from his office. That’s in addition to my primary nurse and a number of people in her wake who tended to my IV, machines, breathing, vital signs, patient experience and more. Even the woman who delivered my meals seemed genuinely concerned about my state of mind. Let me point out that I am not a celebrity, even within my community. My name is not on a plaque anywhere in the hospital. And yet I could not imagine getting better care, both of the medical and human kind, from intake to discharge. It reminds you that training is a broad category that extends far beyond pills, potions and professional procedures. So thank you, healthcare system. From the viewpoint of this patient, you’re doing fine. As always, we continue to look for the value of your contributions. Let us know if you have an idea for an article—the people we write for are the people who write for us.

Neil Greenberg, Editor To become an HS&M contributing author or provide feedback, please email me at ngreenberg@hsandm.com.

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There are some things people just won’t tell you But they’ll tell us in confidence. And we’ll tell you. There are a lot of opinions people never offer you about your company. What the pain is. What you could be doing better. What they think of your competition. How to talk to them effectively. Big corporations get these answers through expensive research. Small to medium-sized companies don’t have that luxury. That’s why we created the Private Process . It’s a quick, cost-effective way of compiling information that people will offer us in complete confidence. Then we assess the results and give you the insight you need to adapt your sales and marketing messages accordingly. ©

For details on how the Private Process works, and the kinds of answers you can get, contact us now at ngreenberg@hsandm.com.

™

Editorial Board

the publication for healthcare sales & marketing leaders™

Chris Bergstrom Publisher Cari Kraft Editor Neil Greenberg Contributing Editor Jill Donahue Creative Director Hedy Sirico Digital News Rick Cataldo Digital News Chris Manning Sales Director Andrew McSherry Editorial Board: Kristen Sharron-Albright Head of Marketing at Noven Pharmaceuticals Chris Bergstrom Associate Director, Digital Health Expert at Boston Consulting Group Sebastian “Sebby” Borriello Vice President, Chief Commercial Officer SK Life Science Lewis Chapman Vice President, Global Commercial Operations AllCells, LLC Maria Finlay, MBA Associate Director of Oncology Marketing, Teva Oncology Nick Gurreri Vice President New Products at Alexion Pharmaceuticals, Inc. Bob Roda VP and General Manager at BD © 2017 CL Media Inc., Philadelphia, PA CL Media is not responsible for any unsolicited contributions of any type. Unless otherwise agreed in writing, CL Media retains all rights on material published in HS&M for a period of one year after publication and reprint rights after that period expires. Email ckraft@hsandm.com.

To advertise in HS&M, please contact Andrew McSherry at amcsherry@hsandm.com

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Associate Director, Digital Health Expert at Boston Consulting Group Chris brings almost two decades of commercial expertise as an entrepreneurial executive at large medical device and high-growth digital health companies, and he provides “on the ground” advice for implementing digital health solutions. He currently serves as the expert on digital health at The Boston Consulting Group (BCG). Before joining BCG, Chris was the chief commercial officer (CCO) at WellDoc, a pioneer in digital health. He also held progressive roles at P&G, Roche, and Becton Dickinson. Chris was a senior advisor to several digital health innovators, including MyOwnMed, LiftOff Health, HelpAround, Heart Beam, iSageRx, and Alere Home Monitoring. He also advised the Leona Helmsley Charitable Trust and the Saatchi & Saatchi Wellness Board. Chris holds two digital health patents and has won multiple awards.. Chris holds a Bachelor of Science degree from the Kelley School of Business at Indiana University and earned his MBA from Columbia University.

Sebastian “Sebby” Borriello Vice President, Chief Commercial Officer SK Life Science Sebby is currently service as the Vice President, Chief Commercial Officer at SK Life Science. Sebby’s career has included executive sales and marketing positions at Cempra, Mentor Worldwide LLC, Johnson & Johnson Healthcare Systems Inc., Ethicon, Inc. and OrthoMcNeil Pharmaceuticals, Inc. Sebby received his B.A. in Public Administration from St. John’s University in ‘81, and received his M.S. in Organizational Dynamics from the University of Pennsylvania in 2001.

Maria Finlay, MBA Associate Director of Oncology Marketing, Teva Oncology Maria has over 20 years of commercial marketing, sales leadership and operations experience. She has led multiple sales, women’s leadership, and cross-functional teams at Johnson and Johnson, AstraZeneca, and Teva Oncology. Maria has experience collaborating to launch and grow small and large molecule products across seven different specialty therapeutic areas.

Bob Roda

Editorial Board

VP and General Manager at BD Bob Roda is a Senior Commercial executive with extensive experience in delivering business growth and profit in the Medical Tech and Diagnostics Industries. He currently serves as VP and General Manager at Becton Dickinson where he is responsible for the global infusion therapy business. Prior to his role at BD, Bob held a variety of roles of increasing commercial responsibility within the MD&D sector at Johnson & Johnson. His diverse background included positions in Sales and Marketing at Johnson & Johnson Medical, Inc, Ethicon, Inc and Ortho-Clinical Diagnostics. While at J&J, Bob also served as the Executive Sponsor of the Commercial Leadership Development Program as well as the Chair of the VP Marketing Council for all of MD&D. He has a proven track record of delivering results and leading teams in competitive and diverse business environments. Bob is a highly respected and successful global leader. Bob holds a Bachelor of Arts degree in Economics from the University of Rhode Island.

Lewis Chapman Vice President, Global Commercial Operations, AllCells, LLC Lewis Chapman is currently the Vice President, Global Operations at AllCells, LLC.Â He has spent over thirty years in health care management. He served as VP of Global Strategic Marketing at BioMarin Pharmaceutical from 2007 to 2012, where he was responsible for strategic marketing and product portfolio analyses, and implemented medical education, brand enhancement and sales support programs on a worldwide basis. He oversaw the global launch of Kuvan, which in the U.S. was 112% to budget in 2008, the first year on the market.Â Previously, he worked with Alpha Inntech Corporation as Vice President Global Sales and Marketing, where global sales grew 26% in 2004 and 22% in 2005 under his leadership. Lewis started his career with Eli Lilly & Company, with roles at Syntex and Genentech, where he was responsible for the global commercial launch of Activase (t-PA), the largest biopharm product launch in the history of the industry up to that time (first year sales $187 million).

Nick Gurreri Vice President New Products, Alexion Pharmaceuticals, Inc. Nick Gurreri is a business leader and General Manager with over 25 years of consistently achievinghigh performance and profitability through strong leadership and cohesive team building in the biopharmaceutical and medical device industries. Nick has held executive positions at Medgenics, Insmed, Pfizer, Pharmacia and Bristol-Myers Squibb. Nick received a BS in Mechanical Engineeringfrom the University of Delaware, and also acquired a Master of Science in Information Assurance at Carnegie Mellon University.

Kristen Sharron-Albright Head of Marketing, Noven Pharmaceuticals Kristen Sharron-Albright, the current Head of Marketing at Noven Pharmaceuticals, was until recently VP Sales and Marketing, Anti-Infective Marketing and Institutional Sales Specialty Care Business Unit at Pfizer. She is an experienced business leader with 20 years of experience in the pharmaceutical and biotechnology industries. She has a strong track record of delivering results in highly competitive and complex markets. Starting her career in sales at Eli Lilly, she then held positions of increasing responsibility at Lilly, Neurogen, and Pfizer, where she was responsible for sales and marketing in a franchise business model. In her spare time she volunteers, serves on the leadership committee for her church, and enjoys hiking.

HS&M AUGUST/SEPTEMBER 2017| 8

executive spotlight

Lilly Bio-Medicines President: A Passion for Patients and Brands Christi Shaw, Sr. Vice President, Lilly and President, Lilly Bio-Medicines, on her unconventional path to success Perhaps the most poignant comment Christi Shaw has made about her career is that, after thirty years in the industry, Fortune mentioned her for the first time in 2016 when she resigned as U.S. president of Novartis to take care of her ailing sister. Despite her many significant accomplishments, this was the decision that made headlines, largely because it was such an unusual move in the midst of a vibrant career. She’s working to ensure that this kind of necessary and understandable choice is not “news” in the corporate world, but a more common and acceptable one. 9 | HS&M AUGUST/SEPTEMBER 2017

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executive spotlight The External Focus portion was a way of re-directing the company’s thinking to consider those it served. It resulted in exercises that would help everyone understand the patient journey. Beyond whether a treatment was working properly, what did it contribute to quality of life? A patient’s daily life should not be dominated by details about medication and an obsession with the disease state. How could the company help doctors assist in this process? How can the company help them get access? How do price and value figure into the equation? Dealing with these questions led to solutions that were about outcomes for the patient.

Throughout her career, there have been two main drivers of her passion and success. One, of course, is a dedication to the companies and brands she has worked for, propelling them in the marketplace. The other, which goes hand-in-hand with the first, is an unwavering focus on the patients and the people she has worked with. She explains that this grew out of her upbringing. With a father who was a businessman, and a mother who devoted herself to philanthropic organizations, Christi borrowed some of both personas and brought them together in a career that has been driven, successful and people-oriented. She explains it as a perfect way to combine philanthropy and business, by helping

hundreds of thousands of patients at a time. Translating Meaning into Managing When Christi joined Novartis, she made a mental journey through her career in order to determine the most important leadership policies she could institute. Why were certain teams successful and others not? What led to realizing the potential of products and people? What gave patients longer and fuller lives? She got it down to three main data points on a single slide (see above). The key determinants she settled on were Focus Externally, Create Possibilities, and Be One Team.

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To help executives understand the patient journey, she conducted exercises in what it’s like to be a heart failure patient For instance, she conducted exercises in which executives experienced what it’s like to be a heart failure patient: breathing through straws, walking with weights in their shoes, checking into a mock hospital, having to choose between paying for follow-up medications and groceries. It was important that everyone understand what the world is like for their patients. When they had to put medicines in a two-week pouch, only 25% of them got it right—and these were people who weren’t struggling with a life-threatening disease. It was a demonstration of how big a task

it is to find solutions for patients, rather than just providing medications. She has participated in a similar exercise at Lilly, simulating the experience of people with rheumatoid arthritis. Christi also changed the financial slides that reported progress, stating success in terms of how many patients were helped rather than how many dollars were earned. In board meetings, executives would discuss how patients might like Novartis to be directing its energies. The result? Expenditures were scrutinized more carefully, and financial expectations were surpassed. Another program she championed was “Signature,” a leadingedge way to match new oncologic therapies to genetic alterations in patient tumors. And consistent with her dedication to inclusion, Christi’s leadership team was made up of 60% women and 40% minorities. Create Possibilities, Christi says, is about excellence. What are all the ways we can help? How do we work with partners—payers, the government and others? Rather than try to find the one “perfect” solution, she encouraged staff to develop multiple solutions and share them. That way, you create more potential, because there’s rarely just one right answer to a problem. In this culture of innovation, all the options are considered. “It’s about options, not absolutes, and excellence, not perfection.” Christi points out that people and companies are often mired in the customary models they’re used to, while technological and other

kinds of disruption are happening all around. When patients can get an EKG and other indicators on their cell phones, companies need to be aware of and connected to that new world. “At Eli Lilly, we discovered that 20% of Alzheimer’s diagnoses were wrong. As a result, some of the prescribed treatments may actually be making the dementia worse. The industry has to catch up to the reality,” she says. “That’s why it’s important to look at all possible solutions.”

“It’s about options, not absolutes, and excellence, not perfection.” Another area needing attention, she believes, is healthcare policy and legislation. Lilly is currently working with payers on policy reforms such as fostering more effective conversations between pharma and payers before a product is approved. This is part of a larger effort around pricing reform. The Be One Team part of her chart is about overcoming politics in favor of recognizing strengths and improving impact. The overriding goal should be to leveraging the wisdom of each member and supporting the strength of a team that works well together, rather than letting individual agendas take over. She says that many people have insights to contribute, even from areas not directly under sales or marketing. Some are good idea people, others are good coaches. “When you create that dynamic, it’s really phenomenal,” she says. “If some are not achieving their

goals, others should be supporting them to improve their efforts.” For instance, top performing reps can ride with those who aren’t doing as well, to model certain behaviors and tactics. In the board room, Christi often doesn’t sit at the head of the table. This creates a more democratic atmosphere. “Middle management shouldn’t have to ask permission all the time, but just be able to offer ideas on an equal basis with everyone else,” she says. “The biggest ideas don’t always come from senior management or the brand leader. They often come from the people closest to the customer.” This is why she spends time in field talking to reps and reimbursement managers. At her town halls she brings in the field people to explain their tactics and successes. Transparency is also part of this process. Once, when a compliance issue over an off-label request was handled incorrectly, rather than hiding the incident, she decided to share it with others. It helped uncover the motivation, and discover what the right way would have been. The motivation to help the patient was the right thing. It was only the process that was wrong. Through this model, the team is better able to serve the larger purpose, the mission of the company. “We are able to examine where we’re going, and ask if we should challenge our own guidelines.” Putting Policy into Practice Christi recalled one product launch that didn’t go well. She was a district sales manager at the HS&M AUGUST/SEPTEMBER 2017| 12

executive spotlight time, and called a meeting of her team. She drew on all the strengths and suggestions of the team members in asking how they could best promote the brand, and whether everyone truly believed in it. Some people were good at messaging, others at science. After the meeting, people were on the phone, sending voicemails and emails, practicing messages, role-playing. They explored various tactics and created peer-to-peer programs. Eventually, her team became number one in the country, and she was asked as a leader to help replicate her strategy nationwide. In another instance of learning from mistakes, a mature brand she worked on was passed within six months by a me-too product new to the marketplace. What was the differentiation? “They knew the docs, they knew the patients. They understood that there was an arduous process for patients, who had to go to three places to complete their tests. They focused on flow, and made things more efficient for the patients. That’s understanding the customer.”

“When we focus on patient needs, success follows.” Many decisions involve a complex process. During the launch year of a new medicine, they gave away the drug for compassionate use, because many patients were desperate for any hope. But down the road this hurt the company’s chances of getting reimbursement. Christi had to work with patient

advocacy groups and motivate patients to lobby the government to straighten out the situation. “Patient demand often carries more weight than our efforts,” she says. Working beyond the narrow corporate realm was another example of her focus on patient-centricity. The sum of it is that “When we focus on patient needs, success follows.” Making the Right Personal Decision We mentioned above that Christi left Novartis at the height of her career to care for her older sister, who was in critical condition, suffering from multiple myeloma. Although she was deteriorating, she had been accepted to a promising new clinical study. But having a full-time caretaker was a condition of the study. A younger third sister was in the midst of preparing for her wedding, so Christi felt that it was her turn to take responsibility. Christi decided to resign from Novartis, which for her was not a difficult choice. Surprised colleagues, though, encouraged her to consider taking a leave of absence. But Christi didn’t think that would be the right decision for the company. They needed a full-time, long-term person to guide them through a growth period, and Christi couldn’t predict how long her sister’s care would take. For most people, questions about reentering the industry, lost earning potential and other issues would have given them pause. But Christi didn’t hesitate. Instead, she asked herself “What’s the choice you’ll wish you had made at the end of your life? In

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corporate America, you are so replaceable. The minute you walk out the door, there is someone to step in for you. Everyone says it. Do you wish you spent more time with your family, or at work?” Nor was it the first time she was faced with this kind of situation. She had taken a month off when her mother had breast cancer, and another three weeks when her father was sick. Both times, the companies she worked for were very understanding. And Christi believes that this kind of on-and-off-ramp policy actually helps companies be more successful, by appreciating their best talent. There’s a happy ending to the story. In August of 2016, Christi’s older sister was well enough to walk their younger sister down the aisle as matron of honor at her wedding. Keeping Her Hand In Even while caring for her sister, Christi was still a multi-tasker. She mentored other women often, explaining the factors that led to her decision. She encouraged them to do the thing they won’t regret later. Sometimes that means working out an arrangement with their companies. Other times it may mean a greater sacrifice, but one which is just the right thing to do. During this period, Christi also started working to create a foundation called “More Moments, More Memories” to help patients and caregivers with expenses like transportation, housing and food when they have to travel distances for clinical trials. This will give people more time with loved ones, what Christi calls “the moments

you get that you will have for the rest of your life.” What’s Ahead Christi’s decision to re-join Lilly was based on her view that “there are just so many more patients that I can help if I stay in Big Pharma.” And Lilly is on an upward trajectory. Its pipelines are healthy, and they’re on track to launch 20 new medicines by 2023. Among the most vital, from the Bio-Medicines unit: Taltz, a psoriasis drug also under FDA review for psoriatic arthritis, and Olumiant for rheumatoid arthritis; two potential migraine medicines; and Tanezumab, a potential non addicting treatment for chronic pain in co-development with Pfizer. Tanezumab now has fast-track status from the FDA. And there are more coming from other Lilly divisions. Taltz is in competition with Novartis’ highly successful Cosentyx, which Christi also helped launch. So now she’s in the interesting position of going head-to-head with a past achievement. Diversity and inclusion continue to be on her radar. The first part of this involves helping women and minorities learn how to advance their careers. When Christi was in sales, she spent seven years without getting a promotion. When she asked why, it turned out that the company had the impression she didn’t want to move in order to help her career. That, Christi says, was “a trigger, a sign that I have to be in charge of my own career.” The other part is holding CEOs and boards accountable. “We have to alert them to what they don’t understand, and what they’re miss-

ing by overlooking some of the talent they don’t hire.”

Why can’t we get to outcomes based pricing faster vs per treatment?

“When I came into pharma in 1989, it was a badge of honor to be a rep. Now we rate down with the tobacco industry. It breaks my heart.”

Streamlining the industry will also contribute to another major goal: being a trusted partner. “When I came into pharma in 1989, it was a badge of honor to be a rep. Now we rate down with the tobacco industry. It breaks my heart,” she says. “But we can turn this around. We just need to find and get behind the solutions that are available.”

Finally, she sees major issues that have to be resolved in the industry as a whole. Why doesn’t insurance cover the things patients need it to cover? Why are business people making treatment decisions that should be made by physicians? Is too much money being taken out of the equation by the middlemen?

As a member of BIO and other industry organizations, she’s doing her part. “For a long time, we saw our responsibility as creating innovative medicines. Now it’s about so much more. We have to bring everybody to the table and make this again the best healthcare industry in the world. And we can.” •

Christi Shaw started her healthcare career at Lilly in 1989 and returned there this April as senior vice president and head of Lilly Bio-Medicines. In-between, she has been an executive in the Janssen and Ethicon divisions of J&J, and head of North America Oncology and U.S. President and country head of Novartis. She has also served on the boards of the Biotechnology Industry Organization (BIO), the Healthcare Leadership Council and the Young Women’s Leadership Network. Christi has been a recipient of eyeforpharma’s prestigious Lifetime Achievement Award, was listed by PharmaVOICE among its 100 Most Inspiring People list, and was recognized by Diversity Journal as one of its Women Worth Watching. She has spoken at numerous industry events and has been featured in Working Mother and Life Science Leader magazines.

COMMENT HS&M AUGUST/SEPTEMBER 2017| 14

Roundtable

Helping Marketing Hit The Mark How people on the marketing side can assist in the success of sales

With moderator COLLEEN BURNS Founder, Cbm Group

Our panel of experts: Rob Dâ&#x20AC;&#x2122;urso

Ryan Hartman

U.S. Country Manager Isdin

Global Director of Marketing, Endoscopy Boston Scientific

Mark Foster

Tony Zezzo

Chief Commercialization Officer & Vp Worldwide Sales Trice Medical

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Executive Vice President, Marketing & Sales OraSure Technologies

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Roundtable In Healthcare Sales & Marketing, we often look at the prism of these two disciplines to determine how they can better coordinate, collaborate, strategize and execute. Marketing needs to know more about sales. Sales needs to know more about marketing. And both groups need to know more about customers and the everchanging landscape. Recently we held a panel to examine how sales and marketing could better understand and work with each other. In this issue’s exercise, we look more closely at the responsibilities and actions marketing can take in bolstering the role and success of sales. What can marketing professionals do to really move the needle and be a true business partner? What contributions and actions create an environment of mutual respect? How can marketing communicate the research, rigor and reasons behind how decisions are made, so sales professionals can maximize the strategies, tools, programs and tactics that are created to ensure their success? Today HS&M talks to four leaders who have seen the territory from both sides, and offers here their insights and best practices on optimizing the collaboration between sales and marketing. When did you first notice a marketing team’s effort making a real difference in the success of your team? How did it happen? What were the results? MARK FOSTER: At Smith & Nephew we had a marketing team that did a nice job with analytics and identifying opportunities. Our product manager went above the call of duty to do analytics to push to the field to identify opportunities in their territory. As you know, sales reps gravitate towards easier products to sell, the low-hanging fruit. Through analytics, the marketing team identified our actual territory gaps. They really handed

to each sales rep on a platter a place to go, and they followed it up with talk tracks, brochures, what to say. Doing the work from both a targeting perspective and arming them with tools of what to say when they got there. RYAN HARTMAN: Prior to the launch of SpyGlassTM DS System, a single-use, single operator digital cholangioscope, we transitioned to an evidence-based, value-based economic marketing model. In the past we would launch innovative products that we would put into the marketplace, see how things went, and then support it with value propositions, sales collateral

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and clinicals after launch. With this launch we were able to hit the mark right away, at the time of launch, meeting sales force expectations in providing evidencebased pricing, value propositions, collateral and value briefs. There was a laundry list of things we provided to sales to substantiate the economics of our product. This was one of the most recognizably successful launches we have had. TONY ZEZZO: A recent example focused on our HIV point of care test. The CDC (Centers for Disease Control) communicated guidelines to use the most sensitive test available. To be able to communicate this information and position our product effectively in alignment with these guidelines, we had to translate technical information into messaging that our field force could easily communicate, and that a customer could understand. The marketing team effectively did this. And in this instance it helped us protect our customer base and in some cases gain new clients. What do you feel are the most important activities a marketing team should focus on to help drive sales? ROB D’URSO: In my opinion, marketing’s role is to define what success looks like, determine how it will be measured, develop the road map, and provide tools and direction for sales to achieve it. In this light, the most important activities a marketing team can do: • Early on, develop a full understanding of a market to ensure that

US VS. THEM MENTALITY WRESTLING WITH COMPLEXITY

MISUNDERSTANDING ROLES

DIFFERENT GOALS

forecasts, expectations and positions are aligned • Work closely with sales and training to develop a launch plan or annual plan that is created to speak to sales organizations and are not designed as a marketing project • Listen, learn and develop tactical tools that the sales team request to achieve the above RYAN HARTMAN: I would say the #1 activity is simply connecting and collaborating with the sales leadership team. Regular, constant communication and alignment precedes everything. Without alignment, marketing materials will not get used, will not resonate. It’s not a good use of marketing’s

time to focus on program and activities without sales buy-in. Key alignment with sales leadership is the most important piece. MARK FOSTER: If you are in a marketing role, it is critically important to solicit people from the sales organization to be included in the development of the tool— both as advocates and to help you hit the mark on the piece because they are closest to the customer. And this will help with adoption in the field, too, because your advocates can say “this was developed with marketing” and they will help you launch it. This avoids the “us vs. them” mentality. The perfect tool, if not rolled out in a collaborative way, won’t be adopted.

What have been the best ways you’ve seen marketing help a sales team stay informed on market trends, competitive info, etc.? What is most effective way for sales and marketing to communicate with one another? ROB D’URSO: The use of marketing reports from the sales team is a great resource. They allow sales members to communicate realtime information, competitive activities and other information directly to the sales team. The marketing team needs to leverage this data to make changes, and they need to turn the information back around in a user-friendly manner so that other sales members can learn from it. HS&M AUGUST/SEPTEMBER 2017| 18

Roundtable RYAN HARTMAN: Publishing a bi-weekly newsletter—we call it a “highlight reel.” Marketing prepares the info and the vice president of sales sends it out to the field. Each newsletter contains no more than 4 items, which is the right amount of information to help them stay focused on the highest priority topics. Marketing can’t overload—less is definitely more here. And it narrows the communication down to critical information.

actively communicate what each is learning, seeing and working on. Marketing also can host update conference calls on a biweekly basis. Also, one of the primary responsibilities of marketing is to generate leads. Soliciting leads from various market segments through email blasts, webinars, and other tactics adds value, and a field organization responds to initiatives that add value to their efforts. It’s the best form of communication.

MARK FOSTER: Marketing needs to go into conference sessions and identify market trends, procedural trends, look at the competition, gather info holistically, look at international markets, look at journals, take information, listen to podcasts. The marketing team should serve as the “Cliff Notes” for sales for industry trends and literature. Break it down and keep the field abreast of those trends. Communication has to be consistent. As Ryan suggests, publish a monthly or quarterly newsletter and have everything housed in one warehouse site. Unless it’s urgent, it doesn’t go out.

Can you share an example in your career of a time when you were not meeting a sales forecast and marketing was able to help? What did marketing do and what were the results?

TONY ZEZZO: Marketing and sales need to collaborate. I’ve seen it take various forms but a very effective method is including the marketing teams when the field teams come together once a quarter for POA (Plan of Action) meetings. In my experience it has been invaluable for marketing to be face-to-face with sales, to establish relationships with the field teams and sales leadership. They need to

MARK FOSTER: Reallocation of resources—for example medical education. We were behind the number in a franchise and we shifted resources to education, driving more labs, physician training to drive adoption, as opposed to using marketing spend differently as initially allocated. We pushed marketing resources into shorter-term ROI and changed priorities to invest in hands-on training. ROB D’URSO: Marketing has a tremendous number of tools and levers available to pull when a sales organization is not meeting goals. The most recent example I have seen is a marketing team and sales team working together to enhance a rebate card program to drive additional physician adoption, while managing the net revenue levels.

19 | HS&M AUGUST/SEPTEMBER 2017

The teams worked together to understand the key driver of adoption and the impact to net sales. The program grew quickly and was able to be sustained. TONY ZEZZO: Our marketing organization is tasked with taking a strategy and translating it into executables. However, plans don’t always go as first anticipated. There have been situations when an initiative isn’t working as planned in the field. I look to marketing to solicit feedback on why not, to do their research and understand what needs to change, and then quickly and efficiently make adjustments. Plans constantly change and there is continuous need to monitor and adjust when necessary. When marketing can do this quickly and effectively, you can recover and close the gaps in business plans. RYAN HARTMAN: We conduct quarterly forecast meetings for sales and marketing leadership to gain alignment. These used to be solely forecast meetings and we would hone in on numbers, but they have turned into more of a collaboration meeting. We agree on numbers, but are now focused on how best to achieve a goal or support certain franchises. It’s a shared responsibility between sales and marketing to identify and address gaps. Have you ever experienced a situation when sales and marketing efforts were not aligned? How did it impact the business? RYAN HARTMAN: Poor commu-

nication or misalignment between senior sales and marketing can lead to missteps. It’s critical for marketing to gain alignment with sales up front, before you initiate work and execute the plan.

has been developed with input from sales and has been tested with the customer. When this process is in place you will end up with revenues that meet or exceed expectations.

MARK FOSTER: [LAUGHS] Yes, I have had several of those examples unfortunately and they range from misalignment of goals where the marketing team is paid on franchise profitability and the sales team is paid on sales dollars. I’ve experienced instances where the marketing team felt they should be entirely downstream, marketing and designing products, but after products were launched, felt no desire to communicate with customers or drive adoption of that product. Fundamentally they thought their job was the R&D role and it wasn’t their responsibility to hit the mark on revenue after launch. Big gaps. Led to lots of misses on product launches, and also didn’t involve enough of field, physicians or voice of customer. Then after launch, you realize they missed the mark by a couple of degrees and it’s too late to get the right product into the pipeline at this point.

I’ll share an example. One of my best experiences was when I worked at J&J and we launched the first HCV assay for testing the blood supply . Prior to that, when you donated blood, it couldn’t be directly tested. In the messaging that was developed, there was excellent coordination between sales, marketing and the customer. The product was implemented quickly, customers understood the impact, how to use and optimize it. A high degree of coordination and alignment led to great success.

What’s the best example you’ve seen of sales and marketing working effectively together to drive business? What made it so effective? TONY ZEZZO: The best example of working together is when both teams have a complete and common understanding of the market and customer needs. Messaging

ROB D’URSO: The best practice I can share is forced communication that is frequent and on-going across the two departments, specifically the product management teams and sales management teams. This allows the frontline teams to talk about issues, challenges and opportunities in order to quickly react. In addition, the two teams can talk through potential issues early on and begin to plan the operational aspects that would be required. Culture is built slowly through trust and on-going communications. MARK FOSTER: When I was at BSCI (Boston Scientific) in the endoscopy division the alignment was really tight and we had quarterly forecast meetings and never missed a number. In most organizations, numbers are cre-

ated in advance (sometimes 12-18 months prior), and you don’t have a chance to adjust until the next budget cycle. With this process we had quarterly targets, and sales would present their assumptions on trends, and the marketing team would do the same at franchise level. The president would make a call at these meetings to align everyone on mission and objective. It really worked, especially because it was recent data and recent trends. I really liked that it allowed for great discussion with each other and for marketing not to get too far from what’s happening at field level. Have you gone from a sales position to an in-house marketing position? If so, what was most surprising about taking on that new role? Did it change your perspective on marketing at all? ROB D’URSO: Early in my career I went from a rep role into a marketing role. I had such little understanding of what marketing did at that point, everything was new. I’m a marketer at heart and by training at this point. TONY ZEZZO: I transitioned from a field sales role to a marketing role in my career. Most surprising to me was just how important marketing is to successful sales execution. In a field sales role you don’t necessarily appreciate the impact branding and messaging have on the ultimate purchase. You also might miss the importance of the research that goes into understanding customer HS&M AUGUST/SEPTEMBER 2017| 20

Roundtable needs and developing a successful strategy. There are a lot of moving parts that have to work together for good branding, strategy and execution to come together. MARK FOSTER: I have seen people on my team go through this. The eye-opening experience is the complexity of the marketing job. As a sales rep you don’t understand why something can’t be done TODAY! You don’t see the full list of priorities. You don’t see the process and regulatory and quality paperwork. What you think as a field rep is that the #1 company priority is “my” customer, but there are competing internal and other priorities as a business. Marketing’s function has to man-

age many different priorities and make decisions. Sales people don’t initially appreciate the complexity. Marketing also needs to appreciate, communicate and educate without a tone of arrogance. Needs to listen well to field and explain the rationale for decisions. RYAN HARTMAN: When you are in the field, you are in execution mode and working to satisfy customers. Your experience with a customer is second to none. You know the sales process well. When you are in sales you are focused on ways to install product and support your customers. When you transition in-house to marketing, you see the cross-functional groups that interact with mar-

keting. Portfolio decisions with R&D, working with regulatory, the importance of a strong commercialization strategy, and the range of priorities between teams. What do you anticipate to be the most important thing sales teams will need from their marketing colleagues in the future? MARK FOSTER: I’d say reacting to the customer, listening to the customer. Product innovation is not necessarily about having the faster, quicker way to do it any more with the product. “Value” is really important. Stretch yourself and look at innovation with regard to how you deliver product—shipping, packaging, technique, deliv-

Moving Forward WORK ON ALIGNMENT

360-DEGREE INNOVATION

CREATE ADVOCATES

21 | HS&M AUGUST/SEPTEMBER 2017

GATHER INFO HOLISTICALLY

ery of content, the holistic customer experience. It’s changed—it’s no longer just about a product and making it better for customers. Now customers are asking for value. Not necessarily cheaper, but another level of value. Broaden the scope in innovation to encompass the whole customer experience. RYAN HARTMAN: In the future I think marketing will need to arm the sales team with more economic value proof points. Hospitals want better outcomes at a lower cost. They will invest in technologies to deliver that, and marketing needs to be able to prove value so their sales teams can share this information with economically-minded customers. Today there is a blurring of the responsibilities and roles between sales & marketing—especially in terms of accountability. This has been a successful formula for us. At the end of the day, we have the same end goal. My biggest take-away is that success requires precise alignment between sales and marketing. ROB D’URSO: As technology continues to enter into the professional market and consumers are becoming more of the decisionmaker (after prescription, pricing, safety, etc.), sales teams will need tools to be integrated so that professional messaging is directly tied to consumer activities and the representative can play a valuecreating role in the chain. TONY ZEZZO: Marketing needs to provide good executables to the field. Things are always changing.

It’s important for marketing to stay on top of a changing environment, to understand what trends are developing, and to translate that information into tools that will enable a field sales organization to be successful. Bottom line: sales and marketing teams absolutely need to believe in each other. If you don’t have that, things are much more challenging. When sales knows and trusts the

marketing tools and strategies they hit the ground running. Trust and credibility are key. MARK FOSTER: I’ve found, especially in big organizations, when you can create sales and marketing teams that consist of individuals with expertise from both areas, that truly leads to the best cohesive culture and results for the organization. •

MEET OUR moderator COLLEEN BURNS Founder Cbm Group

Collen has 20+ years of experience in business consulting, advertising and communications and senior leadership positions with top global healthcare companies. She has worked with teams around the world to launch more than 30 products to healthcare professionals, patients and consumers in such therapeutic categories as cardiovascular disease, women’s health, molecular diagnostics for infectious diseases, surgical laser systems, custom orthodontics, ophthalmics and minimally invasive surgical systems for osteoporotic spinal indications. Colleen began her career at an ad agency, helping medical device and diagnostic startups develop branding, PR and medical education strategies. She left the agency world and moved into product marketing, market development and commercial leadership roles, successfully building marketing teams within leading healthcare companies such as Guidant, Boston Scientific and Abbott. She recently led the positioning and communications for IMS Health’s $6B IPO event. cburns@cbmgrp.com

CBM Group is a unique strategic marketing consulting, communications & talent solution for healthcare companies who need expert marketing personnel. Their community of experts helps clients focus marketing investments on developing compelling, relevant stories and strategies to influence behavior while delivering impactful programs across advertising, marketing, digital, PR and social media to quickly drive growth. HS&M AUGUST/SEPTEMBER 2017| 22

Roundtable

MEET OUR panel of experts ROB D’URSO

MARK FOSTER

U.S. Country Manager ISDIN

Chief Commercialization Officer & VP Worldwide Sales Trice Medical

Rob has led the US operations for ISDIN US since the launch in 2016. Prior to his tenure at ISDIN, Rob served as head of Sales & Marketing at Promius Pharma, Dermatology and held various commercial positions at Ferndale Laboratories. His career includes leadership roles in general management, sales, marketing and corporate development. rtdurso@hotmail.com

ISDIN is a Spanish-based dermatology company that has recently launched commercial operations in the US market. ISDIN was born 40 years ago in Barcelona, from the alliance between a global leader in fragrances and cosmetics and a benchmark pharmaceutical company with renowned medical products. The mission was to create a worldwide reference in skin health, treatment and beauty. Today it is a market leader in the dermo-cosmetics segment in Spain, with operations in Europe, America and Asia.

23 | HS&M AUGUST/SEPTEMBER 2017

Mark is a veteran commercial leader with over 20 years of experience in the medical device industry. He spent eight years at Boston Scientific in the endoscopy and neurovascular divisions, with several roles of increasing responsibility in sales management, sales operations and training. In his eight years at Smith & Nephew, he held several roles, the last of which was leading the U.S. Sports Medicine division with roughly 600M in revenues. Additional responsibility included being the U.S. Commercial Lead for the Arthrocare integration. Mark then became the CCO and VP WW Sales at Trice Medical, where he is responsible for all commercial activities of what was recently named one of the “hottest start-ups” in orthopedics. mfoster@tricemedical.com

Trice Medical was founded to fundamentally improve orthopedic diagnostics for the patient, physician, and payor by providing instant, eyes-on answers. Trice Medical has pioneered a fully-integrated camera-enabled technology, the Mi-Eye, that provides a clinical solution optimized for the physician’s office.

RYAN HARTMAN

TONY ZEZZO

Global Director Of Marketing, Endoscopy Boston Scientific

Executive Vice President, Marketing & Sales OraSure Technologies

Ryan is a proven competitive global leader of sales and marketing organizations with an outstanding record of enterprise leadership. He has a strong ability to build high performing teams and recruit and develop high potential talent. At Boston Scientific, he has developed a 5-year strategic plan to support the global endoscopy business. He manages global P&L and has executed a portfolio supporting the launch of 12 new products in 36 months. He has also served Boston Scientific as Global Group Marketing Manager for Pancreaticobiliary, National Market Development Manager and Regional Sales Manager. Prior to joining Boston Scientific, he was a Professional Medical Representative for Muro Pharmaceuticals. ryan.hartman@bsci.com

Boston Scientific Corporation is a worldwide developer, manufacturer and marketer of medical devices whose products are used in a range of interventional medical specialties, including interventional radiology, interventional cardiology, peripheral interventions, neuromodulation, neurovascular intervention, electrophysiology, cardiac surgery, vascular surgery, endoscopy, oncology, urology and gynecology.

Tony has responsibility for providing leadership and oversight for OraSure’s global marketing and sales operations, which includes the domestic and international sales teams for OraSure’s infectious disease and substance abuse businesses, marketing, and client services/customer care. He is an accomplished senior executive with 30 years’ experience in the diagnostics industry. He most recently served as Vice President, North America Sales and Marketing at the Ortho-Clinical Diagnostics division of Johnson & Johnson and was also Executive Director, Johnson & Johnson Health Care Systems. He has also been Executive Director, Marketing and Sales for the AIDS/Hepatitis Division of Ortho Diagnostics, and Vice President Sales and Marketing for all of Ortho’s businesses in the United States, Canada and Latin America. tzezzo@orasure.com

OraSure Technologies is a leader in the development, manufacture and distribution of pointof-care diagnostic and collection devices and other technologies designed to detect or diagnose critical medical conditions. Its first-to-market, innovative products include rapid tests for the detection of antibodies to HIV and HCV on the OraQuick® platform, oral fluid sample collection, stabilization and preparation products for molecular diagnostic applications, and oral fluid laboratory tests for detecting various drugs of abuse. OraSure’s portfolio of products is sold globally to various clinical laboratories, hospitals, clinics, community-based organizations and other public health organizations, research and academic institutions, distributors, government agencies, physicians’ offices, commercial and industrial entities and consumers.

COMMENT HS&M AUGUST/SEPTEMBER 2017| 24

Pharmaceutical Click here to get Top 50 Pharma Companies

Pharma Companies

Revenue on the Rise: The Top 50 Pharma Companies The good news is that we saw an upswing in growth last year with our Top 50 Pharma Companies’ revenue growing by $38.6B, up 5% from 2015 after a lackluster 2% the year before. Not quite the 10% increase we saw with the Top 50 Medical Device Revenue, but formidable compared to the 2%. Drug prices remained strong with the average cost per patient per year for an orphan drug of $143,333, and a non-orphan drug of $27,765. New Drug Approvals were down (27 vs. 56 in the prior year), however, we are already up to 26 approved in 2017. Mergers and acquisitions slowed in 2016. Biggest mergers included the Shire and Baxalta’s $32B deal, Pfizer’s $14B buyout of Medivation, AbbVie’s $9.8B purchase of Stemcentrx, Mylan’s $7.2B purchase of Meda, and Pfizer’s $4.5B acquisition of Anacor. The jury is still out as to whether that was an election year blip. The first quarter of 2017 had a lower deal volume than 2016 but a higher deal amount ($49.6B over the prior $36B), a trend which continued in the second quarter with a 44%

increase in deal value of $77.7B. Oncology, neurology, dermatology and ophthalmics were highly soughtafter areas in 2016 with a total deal volume of 20%, 13%, 8% and 7% respectively. It is hard to comment on anything in the healthcare industry without wondering about the impact of the current political climate. The threat of a drug pricing squeeze, the legislative next steps for healthcare, and the market as a whole are huge influencers which could swing in many directions. Our best hope is to trust in the collective wisdom of legislators and the stability orientation of the markets. Together, we believe they will bend toward sanity. Here’s a snapshot of where the Top 50 (based on 2016 revenue) were at year’s end. We have tracked move-

25 | HS&M AUGUST/SEPTEMBER 2017

ment up and down the list with regard to both ranking and revenue changes as compared with 2015. Companies are ranked by their 2016 medical revenue as furnished by their annual reports and publicly available sources, Edgar and Morningstar stock information websites (figures of non-U.S. companies were converted to U.S. dollars from various currencies using end of the year exchange rates for 2016 and 2015). Pharmaceutical revenues were extracted from reports to create an equal playing field. We also revised 2015 earnings to align “apples to apples” revenue reporting with 2016 figures. Companies that had revised 2015 revenues from our last year’s report include: Novartis, Johnson & Johnson, Sanofi, Novo Nordisk, Reckitt Beckinser, Actavis and Bayer.

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Companies are ranked by their 2016 revenue as furnished by their annual reports and publicly available sources such as Edgar and Morningstar stock information websites. Figures of non-U.S. companies were converted to U.S. dollars from various currencies. Pharma Companies

Click here to get Top 50 Pharma Companies

Ranking Company Location 2016 Revenue in US$B

Pfizer

New York, NY, USA

$52.82

Novartis

Basel, Switzerland

$42.71

Merck

Kenilworth, NJ, USA

$39.81

Roche

Basel, Switzerland

$38.42

Sanofi

Paris, France

$35.59

GlaxoSmithKline

Brentford, United Kingdom

$34.43

Johnson & Johnson

New Brunswick, NJ, USA

$33.50

7 8

Gilead Sciences

Foster City, CA, USA

$30.39

Medipal Holdings

Tokyo, Japan

$26.87

AbbVie

North Chicago, IL, USA

$25.56

AstraZeneca

Cambridge, United Kingdom $23.00

Amgen

Thousand Oaks, CA, USA

$22.99

Bayer

Leverkusen, Germany

$22.46

11 12

13 14

Alfresa Holdings

Tokyo, Japan

$22.03

Teva Pharmaceuticals

Petach Tikva, Israel

$21.90

Eli Lilly

Indianapolis, IN, USA

$21.22

Abbott

Chicago, IL, USA

$20.85

Bristol-Myers Squibb

New York, NY, USA

$19.43

Fresenius

Bad Homburg, Germany

$17.91

Boehringer Ingelheim

Ingelheim am Rhein, Germany $16.73

Novo Nordisk

BagsvĂŚrd, Denmark

$15.82

Merck KGaA

Darmstadt, Germany

$15.81

Takeda

Osaka, Japan

$15.45

Actavis

Dublin, Ireland

$14.57

Biogen

Cambridge, MA, USA

$11.45

17 18

19 20

21 22

24 25

27 | HS&M AUGUST/SEPTEMBER 2017

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Ranking Company Location 2016 Revenue in US$B

Shire

Dublin, Ireland

$11.40

Celgene

Summit, NJ, USA

$11.23

Astellas

Tokyo, Japan

$11.21

Mylan

Canonsburg, PA USA

$11.08

Otsuka

Tokyo, Japan

$10.22

Valeant Pharmaceuticals

Laval, Quebec, Canada

$9.67

32 NEW Daiichi Sankyo

Tokyo, Japan

$8.17

Teijin

Osaka, Japan

$6.34

28 29

CSL Behring

King of Prussia, PA, USA

$5.91

Perrigo

Dublin, Ireland

$5.28

Zoetis

Parsippany, NJ, USA $4.89

Regeneron Pharmaceuticals

Tarrytown, NY, USA

$4.86

Eisai

Tokyo, Japan

$4.61

Brussels, Belgium

$4.40

Grifols

Barcelona, Spain

$4.26

UCB

40 41

Sun Pharmaceutical

Mumbai, India

$4.25

Chugai Pharmaceutical

Tokyo, Japan

$4.20

Reckitt Benckiser

Slough, United Kingdom

$4.11

Endo Pharmaceuticals

Dublin, Ireland

$4.01

Mitsubishi Tanabe Pharma

Osaka, Japan

$3.63

Sumitomo Dainippon Pharma

Osaka, Japan

$3.52

47 NEW Mallinckrodt

Dublin, Ireland

$3.38

Tokyo, Japan

$2.93

49 NEW Shionogi

Osaka, Japan

$2.75

KwaZulo-Natal, South Africa $2.58

43 44

Kyowa Hakko Kirin

Aspen Pharmacare

29 | HS&M AUGUST/SEPTEMBER 2017

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industry

The View from Today to 2022: The Top 15 Pharma and Medtechs: Revenue, Rx, R&D Spend and More EvaluatePharma and EvaluateMedTech do in-depth studies of topics like this, and recently published some that anticipate where various companies will be between now and 2022. We thought it would be interesting to look at these charts—now, and again in the future—and see how accurate the analysis is. Sources: EvaluatePharma®, Month and Year of data, © Evaluate, and EvaluateMedTech®, Month and Year of data, © Evaluate, www.evaluate.com

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Top 15 Companies Ranked on 2022 R&D Spend Although in the top tier R&D spending does seem to bear some relationship to growth and CAGR, among the rest of the list results are very mixed. Pfizer and Merck are not predicted to gain much, but Celgene, GSK and Boehringer Ingleheim are seen as deriving substantial benefits from their research investments

37 | HS&M AUGUST/SEPTEMBER 2017

Worldwide Total Prescription and OTC Pharma Sales by Therapy Area Itâ&#x20AC;&#x2122;s little surprise that the major growth area here is oncology, where much of the R&D is going and much of the return is expected. Systemic anti-infectives, central nervous system medications and anti-diabetics also look like they will experience an upswing, while cardiovascular products may experience a modest comeback after several years of decline.

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industry

Top 15 Companies Ranked on Total MedTech Sales Medtronic is seen as holding its place as the leader of the pack, followed closely by Johnson & Johnson. Phillips and Abbott Labs appear to be poised to gobble up a bigger share than they have today, with the next group (Siemens, Stryker, Roche, BD) maintaining their places without posing much of a threat to the others.

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Top 15 Device Areas Ranked on Worldwide Sales In vitro diagnostics will not only stay in top position but make a great leap in the next few years, closely followed by cardiology. Everyone else, while posting healthy CAGRs, looks to stay pretty much the same with respect to market share.

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industry

Top 15 MedTech Companies Ranked on 2022 R&D Spend Again, Medtronic and J&J are securely in places 1 and 2, but Abbott Labs looks to be making a major investment in medtech in the near future, and is expected to gain both in CAGR and market share as a result.

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Top 15 Drugs Ranked on 2022 Worldwide Sales Finally, Evaluate looks at the individual products that will bring in the greatest revenue from here to 2022. They are dominated by oncologics (Revlimid, Keytruda, Opdivo, Ibrance and others), while HIV meds (Triumeq, Bictegravir) will also be in demand, as will autoimmune treatments (Humira), the pneumococcal medication Prevnar, and others. The only product on the list not aimed at a serious or life-threatening condition is Botox, originally prescribed for migraines but now largely used to erase facial lines and crows feet.

EvaluatePharmaÂŽ delivers exclusive consensus sales forecasts and trusted commercial insight into biotech and pharmaceutical performance. @EvaluatePharma EvaluateMedTechÂŽ sets a new standard in commercial analysis and consensus forecasts of the global medical device and diagnostic industry. @EvaluateMedTech

COMMENT

HS&M AUGUST/SEPTEMBER 2017| 42

industry trends: by the numbers Compiled by Cari Kraft, Jacobs Management Group, Inc.

$6.5B Patient Assistance Program spending by pharma Pharmaceutical manufacturers poured over $6.5B into Patient Assistance Programs (PAPs) in 2014, the latest year for which there are statistics. PAPs make up 10 of the largest 15 U.S. charities and represent 8% of manufacturer operating costs. Source: The Foundation Center

84 million

Americans with prediabetes The Centers for Disease Control and Prevention (CDC) estimates that about 84 million Americans have prediabetes, 90% of them undiagnosed and unaware. Highly treatable, this condition when unnoticed will lead to Type 2 diabetes in 5% to 10% of that population.  Source: CDC,A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina, Volume 14, June 29, 2017 43 | HS&M AUGUST/SEPTEMBER 2017

$1.06T Projected size of worldwide pharma market by 2022  The total worldwide size of pharma sales is anticipated to reach $1.06 trillion by 2022, according to an EvaluatePharma analysis. This represents a Compound Annual Growth Rate (CAGR) of 6.5%.  Orphan drugs are expected to represent $95B, or 32% of the increase in sales Source: EvaluatePharma, World Preview 2017, Outlook to 2022, July 2017

84%

of covered workers have prescription coverage choices The Kaiser Family Foundation has found that nearly all (more than 99%) of workers who get employee healthcare coverage also have some form of prescription drug coverage, and that 84% have a choice of three, four or more tiers of cost sharing for prescriptions.   Source: Kaiser Family Foundation, 2016 Employer Health Benefits Survey, September 2016

$7.61B

66%

of MDs prefer email for industry news Of all available communications platforms, 66% of doctors prefer email for accessing industry news, product updates and research opportunities. The same study found that 75% of NPs and PAs also prefer email. Source: Healthlink, Annual Healthcare Professional Communication Report 2017

Estimated size of global eClinical solutions market by 2022 Technological solutions in clinical research are growing at a rapid pace, and are expected to have a CAGR of 12.4% from now through 2022, reaching $7.61 billion. Electronic data capture (EDC) and clinical data management systems (CDMS) are currently the largest segments, but the electronic clinical outcome assessment (eCOA) area is expected to achieve the highest CAGR.  Source: Markets and Markets, eClinical Solutions Market by Product, April 2017

Size of biologics market by 2022 EvaluatePharma expects biologics to contribute 52% of the top 100 product sales by 2022, which would represent over $550B in total worldwide sales. Roche is expected to be in the lead. Source: EvaluatePharma World Preview 2017, Outlook to 2022, July 2017

COMMENT

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Pharmaceutical

Great Advice from Great Minds: How Shire Works in the Sweet Spot Erik Cline, Shire’s Director of Marketing, talks to Jill Donahue, Principal, Engage Rx By Jill Donahue, Principal, Engage Rx

It happened again recently; a passionate conversation with senior sales and marketing leaders about how to make patient centricity work. “Have we gone too far?” they challenged me. We talked about Adam Grant’s research. Grant found that people fall into one of three categories; Givers, Takers or Matchers. “Which one do you think does best?” I asked them. I shared with them the book he wrote called “Give and Take” (watch the HS&M interview about it here) in which he proves that “givers” win.

“The defining quality of the most successful pharma rep, Grant discovered,” I told them, “is being a giver.”

“So how does this play out in our pharma world?” they asked. Grant studied that too, I assured them, and I excitedly quoted page 140 from Give and Take.

Grant said that being a giver was the only characteristic to predict performance of pharma reps. And I again quoted from page 140 (my favorite page in his book!)

45 | HS&M AUGUST/SEPTEMBER 2017

What did he mean by a “giver” they wondered? “A giver is someone with an intent to help and serve with no expectation of reciprocity,” I explained. So basically, a rep who offers the solution best suited to patients’ and HCP’s needs.

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Pharmaceutical “It didn’t matter whether the salespeople were conscientious or carefree, extroverted or introverted, emotionally stable or anxious, and open-minded or traditional. The defining quality of a top pharma salesperson was being a giver.” “But…. can’t we risk giving too much?” these leaders questioned insightfully. “Yes!” I jumped in, “And that’s a problem for us. You see, Grant also discovered in his research that givers can also be the least successful. When givers have no self-interest, they risk being doormats. Givers can be either the top or the bottom of the success ladder. Matchers are always squarely in the middle.” “So how does this work for us?” they queried. I showed them the image above and explained that we need to find the sweet spot—the intersection when the best interest of the patient, the HCP and the company all collide. We continued discussing examples of when they had worked inside or outside of that sweet spot. It proved to be highly illuminating! They realized where they should say “yes” and where to say “no.”

Great example of working in the sweet spot Erik Cline, Shire’s Director of Marketing, shared in my interview with him at eyeforpharma Philladelphia, a great example of working in the sweet spot and making the impossible work—when rallied around the patient. What gets Erik out of bed each day is his connection to the patients. He noticed that the human connection between physicians and patients can often get lost. One might think it happens naturally but daily challenges can hinder their connection at an emotional level. Erik and Shire saw an opportunity to humanize the connection between HCPs and patients. They brought adult patients suffering from Binge Eating Disorder to speaker programs to share firsthand with doctors their experience with their disorder and their treatments. The result? It changed the way the docs thought, how they

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felt and treated these patients. It built their confidence and helped them identify the patients and feel empathy for them. What about legal? “My legal and compliance would never let us do that!” you might be saying. And I asked Erik about this. His solution? Involve legal and compliance early and show them how this is in the best interest of the patient. Rally together around your combined goal to compliantly help the patient. This is consistent with what Ed Wallace teaches in The Relationship Engine; “People like to work with people with whom they share common goals.” Best-selling author and behavioral scientist Daniel Pink assures us that

“Raising the salience of purpose is one of the most potent—and most overlooked—methods of moving others.”

Learn more about the Patient Ambassador program

patients in front of them each day, also need help. So how does Erik help people at Shire connect with their purpose? He said a culture of putting patients first really starts at the top of the organization, with the CEO and leadership team. They demonstrate the difference between saying and living it. “We are advocates for the patient throughout the whole organization,” Erik said.

Watch Jill’s interview with Erik

Erik is practicing proven influence strategies in behavioral science by helping everyone connect to their purpose.

well. Not just in increased engagement of their associates, but ensuring that more patients were better understood. A true win for all.

The program Erik describes is a great example of working in the sweet spot. As a result of this program, not only were the patients better understood, but the HCPs won, too; they felt more confident. And, of course, the company won as

Creating the culture If the HCPs need help connecting with their purpose—the quality of life of the patients -- then clearly people in our organizations, who don’t have the benefit of seeing

Their Patient Ambassador program for binge eating in adults, building empathy in HCPs, earned them the Finalist category in the eyeforpharma awards. •

Jill Donahue, HBa, MAdEd is on a mission to lift our industry, building purposedriven, influential people. Through her keynote talks, workshops and awardwinning mobile-learning programs, she is helping pharma people build trust, open doors and make a bigger impact.

COMMENT

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motivation

MOTIVIDEOS By Cari Kraft, Jacobs Management Group With just a bit more chaos each day in the headlines, it’s always welcome to find something humorous or inspirational to kick off your morning. As usual, here are our picks for a meeting opener that will lighten the load, get staff thinking, and bring a little more energy to your workday. How to Sound Like a Leader

Crossing the Conflict Bridge

Presenting to a group is very much like acting: you want to make a certain impression, which depends on the way you say things as much as what you say. In other words, practice and perfect your “vocal executive presence.”

Is resolving differences about winning—or looking for a win-win? A short animated video to use when you need to defuse the tension of a team.

Can Happiness Be a Competitive Advantage? Shawn Achor’s book points the way to being more resourceful, effective and decisive. Surprise: it’s all about cultivating happiness. Three positives to every negative!

Quantum Leaps in Healthcare We know we work in an extraordinary field. Here’s more evidence of how our colleagues all over healthcare are making life better...and better...and better.

Submissions are welcome. If you have one you like, email a link to me at ckraft@jacobsmgt.com.

Cari Kraft leads a team of master level recruiters at Jacobs Management Group, celebrating 20+ years of executive recruiting in the healthcare (pharmaceutical, medical device, biotechnology) and high-tech industries, nationally. Prior to joining Jacobs Management Group, Ms. Kraft has held positions as a Senior Sales Executive, Director of Business Development and Director of Marketing. She also has deep knowledge of the technology/startup fields, having been in the industry through the rise of the Internet. Ms. Kraft is a University of Pennsylvania/Wharton alumnus holding a degree in economics and decision sciences. Cari can be reached at ckraft@jacobsmgt.com.

COMMENT 49 | HS&M AUGUST/SEPTEMBER 2017

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Sound Like a Leader: practice your vocal executive presence

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Crossing the Conflict Bridge: give a little, get a little

Happenings in Healthcare: the latest greatest

HS&M AUGUST/SEPTEMBER 2017| 52

medical device

Survey Says: How HCPs Want to Hear from You Digitally Healthlink Dimensions surveys hundreds of HCPs on their preferred communications The confounding thing about our new digital world is that there are so many ways to keep in touch. When it comes to reaching HCPs, you have to understand that they arenâ&#x20AC;&#x2122;t a monolithic group. Itâ&#x20AC;&#x2122;s crucial for marketing and sales professionals to understand the breakdown of preferences so that communication becomes efficient.

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In order to help life science organizations better gauge the most effective channels specific to their industry and audience, HealthLink Dimensions conducts an annual Healthcare Professional Communication Survey. This yearâ&#x20AC;&#x2122;s survey polled 787 physicians, nurse practitioners and physician assistants to glean insight into healthcare professionalsâ&#x20AC;&#x2122; needs and preferences. Survey respondents practice in the following areas: family practice, pediatrics, internal medicine, general surgery, obstetrics & gynecology, dermatology, cardiology, oncology, neurology, podiatry, rheumatology and otolaryngology. The responses from the survey yield important clues as to how organizations can best communicate with healthcare providers. Communication is not linear among all audiences. Preferences vary among nurse practitioners, physician assistants and physicians, so it can be a challenge to determine which channels are most effective to reach each group. EMAIL REIGNS SUPREME When searching for information on drugs, devices and disease state knowledge, NPs, PAs and MDs all leverage online sources, mainly UpToDate, WebMD, ePocrates and medical journal websites. While itâ&#x20AC;&#x2122;s important to be aware of this, email still comes out on top as the favored channel for communication for a variety of purposes among all parties.

medical device For example, 75 percent of NPs and PAs and 66 percent of MDs prefer email for communication regarding: • Industry news • Product updates • Research opportunities And while all three groups believe more interaction is necessary from insurance carriers and other payers, 50 percent of doctors believe email is the best tool for these organizations to provide timely updates. MOBILE DEVICES AND HOW TO USE THEM To keep up with these busy healthcare providers’ schedules and preferences, life science organizations and insurance networks must stay aware of access preferences. Specifically, almost 52 percent of NPs/ PAs and 46 percent of MDs utilize mobile devices, while almost 53 percent of NPs/PAs and 51 percent of MDs use desktop computers to comb through their emails. Since both forms are similarly popular, industry professionals need to emphasize these choices when developing a communication strategy. Fast Facts: • Ensure that email campaigns are optimized for mobile in design, content and call to action (CTA) • To keep these working professionals engaged, all text should be kept concise while CTAs should require only a short amount of providers’ time

SOCIAL MEDIA FINDS ITS PURPOSE IN NETWORKING Although medical professionals may use today’s popular social platforms (i.e. Twitter, Facebook and Instagram) in their spare time, there’s not much of a purpose in their professional careers. Per the survey, 66 percent of NPs/ PAs and 63 percent of MDs don’t use social media to communicate with patients. Instead, only onethird of these medical professionals are active on social media— mainly Twitter, LinkedIn, SERMO and Doximity—primarily for networking with their colleagues and peers.

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That’s not to say this trend won’t change over time, especially when 57 percent of NPs/PAs and 56 percent of MDs see value in these platforms and stated they will likely participate in the future. THE PROMISE IN PROGRAMMATIC ADVERTISING Although social media is slow on the uptake for medical professionals, digital marketing strategies, such as display advertising, are popular. Just over one-third of respondents to HealthLink Dimension’s survey stated they would be likely or very

likely to click on programmatic ads if the content was relevant to their practice. This marketing method may be an efficient channel for brand awareness as time goes on, especially since even those healthcare providers who rarely click for more information tend to retain the overall messaging and source. EDUCATION IS IN HIGH DEMAND No matter the method of com-

munication, NPs, PAs and MDs all agree that the type of information they most desire from healthcare companies and patient advocacy organizations is educational in nature.

• 50 percent of NPs/PAs and 46 percent of MDs frequently use printed materials provided to their practices, as well as both sponsored and unsponsored websites for patient referrals

Fast Facts:

• Information and care revolving around the patient are becoming increasingly popular

• At the top of the list for all these groups are disease state materials, followed closely by pharmaceutical and medical device educational resources

PATIENT CENTRICITY IS A SUCCESS As the shift from fee-for-service to value-based care becomes more widespread, pharmaceutical companies and other life science organizations are dedicating more resources towards assisting in the effort to improve patient outcomes. For some organizations, it may be difficult to discern if patient-centric initiatives such as patient education resources and apps, patient assistance programs, etc. make a significant impact. According to survey respondents, they do. Fast Facts: • Around 63 percent of NPs and PAs and 55 percent of MDs feel patient-centric initiatives are having a positive impact • As the provider’s patient load and administrative requirements continue to increase, life science organizations can help lessen the burden by helping to inform and support the patient from diagnosis through treatment THE FUTURE OF HEALTHCARE While NPs and PAs are split as to whether they believe future

HS&M AUGUST/SEPTEMBER 2017| 56

medical device

changes will have minimal or detrimental impact, MDs are surer of the outcome. Around 46 percent of doctors expect possible healthcare reform to be harmful to their practices, while only 20 percent feel optimistic about the changes they may see in their business. Itâ&#x20AC;&#x2122;s critical for industry leaders and healthcare providers alike to be cognizant of any present or forthcoming legislation that could influence the field. Communication between the two parties will become increasingly important as the new administration implements changes. CLEAN DATA MATTERS Developing a communication strategy is no easy feat for life science organizations, but utilizing the aforementioned information is a good place to start. To maximize the effect of these outreach efforts, these groups need to ensure their data is clean and accessible. Lack of usable information will only result in dissatisfied health57 | HS&M AUGUST/SEPTEMBER 2017

care providers and the desire for more helpful insight and materials. Furthermore, approaching communication from a multi-channel perspective will likely be the most effective, as medical professionals rely on various forms of technology during their daily activities. Itâ&#x20AC;&#x2122;s critical for life science organizations, PPO networks, insurance carriers and more to truly understand their audience and its communication preferences to not only identify the most powerful channels but create successful marketing and educational materials. â&#x20AC;˘ To see the full report, click here

For a video version of this information, click here:

HS&M AUGUST/SEPTEMBER 2017| 58

WOMAN OF THE YEAR

The Woman of the Year Brings Her Culture to the Culture of MedImmune and AstraZeneca Bahija Jallal, PhD, EVP of AstraZeneca and head of MedImmune, shares her extraordinary journey In our last issue, we featured the professionals honored at the annual Healthcare Businesswomen’s Association Woman of the Year award ceremony: STAR Ceci Zak, Honorable Mentor Joaquin Duato, the numerous Luminaries, and of course the Woman of the Year herself, Bahija Jallal. We thought it would be fitting to expand on Ms. Jallal’s recognition in this issue.

59 | HS&M AUGUST/SEPTEMBER 2017

2017

HBA Annual Conference 6-8 November | Philadelphia More than 1,000 healthcare leaders are expected for • pre-conference seminars • main-stage (plenary) presentations • more than 20 interactive workshops • network-building and social events • exhibit hall • Reading Terminal Market reception • “Tri” movie screening

Keynote speakers Vernice “FlyGirl” Armour America's first African American combat pilot

Angela Duckworth psychologist, professor of psychology at the University of Pennsylvania, co-founder of the Character Lab and author of Grit: The Power of Passion and Perseverance, a New York Times bestseller

WOMAN OF THE YEAR Although she currently works in the quiet town of Gaithersburg, Maryland, Bahija Jallal is a true citizen of the world. Born in Morocco and university-educated in Paris, Bahija started her work in oncology in Germany, later came to California to work in research at Sugen, spent a few years in drug evaluation and translational medicine at Chiron Corporation, and since 2008 has been at MedImmune and AstraZeneca. Today she is EVP of AstraZeneca and head of MedImmune. She has taken MedImmune R&D from 40 drugs in its pipeline to more than 120, has authored more than 70 peerreviewed publications, holds more than 15 patents, and is a member of the American Association of Cancer Research, the American Association of Science, the Pharmacogenomics Working Group, and sits on the Board of Directors of the Association of Women in Science. The culture that formed her Her early experiences reveal a picture of the dedicated and insightful woman she was to become. She was dating the man whom she would ultimately marry, who himself was French, when she surprised him by her deep knowledge of Paris. It was just natural for her to absorb all she could from the world around her. Today she is fluent in her native Arabic, plus French, German and English. She explains herself partly by noting her Berber blood. The Berbers refer to themselves as “Amazigh,” “the free people,” and see themselves as courageous and resilient. Those and other traits clearly define Bahija and her career. Bahija was the quintessential

“why?” child who was always asking the adults around her about how the world worked. (Today, she says “I have a child like that, so there is karma.”) As a youngster she recognized science as a “journey of curiosity and creativity that, when coupled with perseverance and resilience, gets to the discovery where every answer leads to new questions.” It’s an insightful portrayal of what healthcare is about: always moving forward, never feeling that the job is over. When she was nine, her father went into the hospital with a kidney stone and ultimately died from a medical error. That was the spark that ignited Bahija’s career. She turned the experience into a lesson: “From adversity, good can follow—if we make that choice.” Her mother then had to raise five daughters and two sons on her own in a patriarchal society. Bahija admits that “The odds for me to get a university-level education were not very high.” Even though her culture believed in the axiom that it takes a village to raise a child, and that she had much love and help, their expectation was that, “like most Moroccan women of the time, I would marry and have children. So I did not need an advanced education. But my mother was determined that all her children would accomplish their dreams. She told us every day that we could be whatever we want to be, that we would have the opportunity to get an education and go as far as we desire. All this from a woman who didn’t go to school herself.” Her dedication to science meant that she would have to leave Morocco to pursue her education. From there, everything else followed.

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Convictions and career AstraZeneca Executive Director and CEO Pascal Soriot notes that she has put her job on the line many times to defend her convictions, which frequently proved to be accurate and valuable. When AstraZeneca acquired MedImmune, and with it Bahija Jallal, there was a concern in the industry that they had overpaid for the company. Today, Pascal says, half of AstraZeneca is biologics, and that would not have happened without Bahija’s brilliance and tenacity. He jokes that her dream is one day to hear that AstraZeneca underpaid for MedImmune. She has some of the most talented scientists in the world on her team, largely because she inspires them—she creates an environment that helps people make the impossible possible. She also champions gender and ethnic diversity, having created the Women’s Forum in Gaithersburg, which was ultimately rolled out in Sweden, the UK and other countries around the world. Today 49% of the employees at MedImmune are non-white and 51% are women.

“We all share the same goal—to improve the life and health of patients.” From some people this comment would be just an industry cliché. When Bahija says it, though, it carries a lot of weight, based on who she is and what she’s done.

She also says “I’ve never felt like I worked a single day in my life.” This is the viewpoint of someone who has found a true calling. Bahija celebrates where we are: “The science has never been better. We are really in unprecedented times. There are so many innovations and breakthroughs in healthcare that are benefiting patients today. New medicines, new devices, new technologies are changing the way we think about healthcare. That’s why we do what we do.” True to her view of science as a never-ending quest, she says there are still too many patients affected by cancer, diabetes, asthma and other medical needs. “By following my heart, my career has taken turns that I would never have anticipated. I have never done a development plan, have never chased titles. I think if I had planned every step of my career I would have missed many happy turns. This winding path has given me many lessons.” The lessons learned Bahija summarizes what she’s learned, and how she interacts with others, in four succinct lessons: 1 Don’t be afraid to fail. Her career started with a failure. At a small startup when science was sequencing the human genome, protein engineering was opening doors to targeted therapy. “With this approach that had the potential to replace radiotherapy and…even chemotherapy, we looked at making inhibitors for protein kinases that were over-expressed in cancer.” But the first compound they

came up with, although promising, failed. They persevered, but the second failed as well. Bahija’s interpretation was “Adversity was testing us.” Taking two weeks off from the research itself, the company looked at the lessons learned—what could they have done better? How could they start over and not make the same mistakes? It was a useful exercise. The third compound was successful, and today, it’s still helping patients. “So I’m really happy I didn’t start my career with a success,” she observes. “I don’t think I would have learned the valuable lessons about drug development if I had started with a success. Don’t be afraid to fail. When you do, stand up, dust off, figure out what went wrong and start again. If we never fail, it means we’re not innovating enough.” 2 Dream big. Bahija believes “We can turn science fiction into science fact.” When AstraZeneca acquired MedImmune in 2007 it was a challenging time for the company. The MedImmune pipeline was not robust. But, again drawing from her childhood, Bahija remembered the words of Antoine de Saint-Exupery, famous author of The Little Prince. He said “If you want to build a ship, don’t drum up people to collect wood and don’t assign them tasks and work, but rather teach them to long for the endless immensity of the sea.” She searched for the ideas that would keep scientists energized and engaged during this trying time. Then she set a bold vision for MedImmune. She announced that from 2011 until 2016 they would

have one new biologics license application every year. “It seemed impossible at the time. But in those few years we tripled the size of the pipeline, and we achieved that vision one year earlier, by 2015.” Bahija says that in Morocco it’s considered wrong to speak of yourself too much, and in that spirit she gives much of the credit to her team. “The MedImmune scientists really inspire me every day. No challenge is too big for them. They work with purpose and urgency, and I learn from them every single day.” She also gives credit to Pascal Soriot, who could have cut the R&D budget at any time. This would have “made analysts and investors happy,” she says, “but Pascal knew that success lay in not reducing budgets and reorganizing but in focusing on the patients and on the science.” She admires his optimism and support, saying that even during tough times he will always find something positive. “He allowed me to stay true to my ideals and to dream big.” 3 Remember why we come to work every day. She encourages people to focus on the positive stories everyone has lived through. Early in her career she was in a meeting at which a patient with colon cancer attended, and spoke of how one of the company’s medicines had successfully treated her cancer and how grateful she was. “I will never forget that moment. This was the day that I realized I will give my all to drug development.” Bahija has repeated this experience for others, recently bringing a 23-year-old lupus patient to a meeting. This woman had already had two hip replacements and was HS&M AUGUST/SEPTEMBER 2017| 62

WOMAN OF THE YEAR about to have a shoulder replacement. “And all that was not a result of the disease itself, but from the steroids required to keep her lupus in check. She doesn’t have many options. Her story also reminded us why we come to work every day, and our obligation to work with a sense of urgency, because every minute counts.” 4 Give yourself permission to be imperfect. “This has formed the core of my leadership philosophy, and is the advice I give to women and men in the industry. It’s something I taught my daugh-

ters as they were growing up.” She counsels that we often get stymied by our pursuit of perfection, and our constant need for approval or fear of perception. By trying to be the perfect mother, perfect partner, perfect business colleague, we hold ourselves back. We convince ourselves not to pursue a new opportunity because we do not know everything needed for this role. “We think others know more than we do, and that others have it all figured out. I’ll let you in on a little secret: we don’t have to be perfect. No one is perfect.” She quotes

Eleanor Roosevelt, who said “You would not worry so much about what others think of you if you realized how seldom they do.” Let’s rid ourselves of this perfection and perception problem and empower ourselves to be imperfect. In sum, she advises we remember these basic things: “Stay true to yourself. Live your passion. Love what you do. Don’t be afraid to fail. Dream big. Good comes from adversity. And don’t worry if the road takes you on surprising detours. Listen to what your heart tells you.” •

See Bahija Jallal’s Woman of the Year acceptance speech here

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| TECHNOLOGY

Driving Down Launch Costs and Timing with EPC Edge Therapeutics, a young biotech, finds a better way to get ready for launch By Justin Zamirowski, Senior Director, Operational Excellence, Edge Therapeutics

In 2015, 29 new drugs were launched in the U.S. and all of them experienced some delay, ranging from 5 to 87 days with the average at 45 days delay. The price of such massive delays in today’s competitive marketplace can be, on average, $1 million per day, which is unacceptable. Now, with more pressure to bring down drug prices, life sciences companies need to plug the holes of leaky processes. Many are turning to modern cloud-based technologies but few are considering the role that improved project management can play in making a real difference in time to market. Project management plays a much bigger role in other industries, with many Fortune 500 companies creating entire centralized Project Offices equipped with enterprise software to run nearly every complex project at the company. However, there is not as much emphasis in the life sciences industry, for a range of reasons. Yet, there’s no more time left to be inefficient or rest on old processes. Real change is needed, and it’s coming in the form of enterprise project collaboration (EPC) software. EPC software can improve visibility and increase the efficiency of decision-making so life sciences companies can finally eliminate their delays to market. -Editor

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Edge Therapeutics is a clinical-stage biotechnology company founded in 2009 and based in New Jersey. The company’s lead product candidate, EG-1962, is in Phase 3 clinical study and has the potential to improve clinical outcomes over the current standard of care for patients experiencing a ruptured brain aneurysm. The product utilizes Edge’s proprietary delivery system that seeks to enable targeted and sustained drug exposure at the site of injury while potentially avoiding off-target side effects. While still the Senior Director of Commercial Operations at Otsuka, I was invited to join this very exciting and fast growing organization to lead the crucial stages of late stage development, portfolio management,

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TECHNOLOGY and the pre-launch preparation and commercialization planning for EG-1962. Edge had just 15 employees, very little technology infrastructure, and no formal project team structures in place. Fast forward to present. In under two years, the company has doubled in size and gone public. My goal was—and still is—to establish an agile commercial foundation for a successful global product launch and sustained ongoing portfolio growth. Be successful with our first commercial product and enable continued advancement of our pipeline candidates.

In under two years, the company has doubled in size and gone public. My goal was—and still is—to establish an agile commercial foundation for a successful global product launch and sustained ongoing portfolio growth. Shifting from a “larger company culture” to an emerging biotech has provided me with tremendous opportunity, and equally important responsibility to build a strong commercial foundation from the ground up. With limited resources, every purchase decision requires a close look as opposed to merely selecting the most expensive or well-known technology on the market—a.k.a. the “safe” choice.

Aligning the Objectives At a small company, things are constantly in motion, and you don’t have a lot of staff or layers of expertise to manage them all comfortably. In launch planning, you have to work out different scenarios for various timelines and departments—clinical, regulatory, marketing and more. When I started at Edge, our corporate objectives were not closely aligned with either our processes or technology, so there was no way to visualize the integration across functions, the interdependencies between teams and individuals. This also made it more challenging to focus organizational resources around common key goals. Nevertheless, we were getting much closer to starting our Phase 3 and ultimately launching our first product. Being well aware of this common challenge in growth oriented biopharmaceutical companies, I was determined to avoid misalignment from affecting us and wanted to establish processes and organized workflows that would enable company-wide collaboration and execution against our shared objectives. Getting Up to Speed Edge did not have any enterprise resource or financial planning (ERP) system in place so I had the benefit of establishing a system of record that would help project management across the entire organization. It was a fresh start, and opportunity to avoid developing bad habits.

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I had personally worked with a number of standard project management systems and supporting tools and so considered all options—including Microsoft Project as well as other enterprise project and resource management systems. I was prepared to invest in Microsoft Project Online but was concerned it was solving our issues with a sledge hammer. We needed a solution that was agile and flexible and had the reporting and capabilities we would use in the real world. Edge couldn’t afford to invest in functionality that we didn’t need, and then be required to additionally invest in add-ons like reporting tools to just get the basics done. Plus, we couldn’t afford to invest our people in maintaining the upkeep of a system like Project Online. I knew, once we started, the consulting and maintenance fees would only go up. During this process I was introduced by my industry peers to Eightspokes, the makers of a new generation of EPC, and we made the decision to utilize Enlighten. EPC—The Next Generation Previous EPC software I had used made it difficult to translate inputs and outputs in a meaningful way so that team members could collaborate. Charts were hard to understand. We weren’t all clear on input-in-results-out parameters. EPC needs to do a few things capably. It has to give everyone an immediate and understandable view of what’s happening across

timelines or use the system. The IT structure provides its own individual based security.

the enterprise. What is the data telling us? How do various inputs inter-relate? Are visualizations easily digestible and usable by team members? So I’m happy to say that the new generation of EPC has overcome those hurdles. The whole team now has a comprehensive picture of what’s happening. We can clone a project and put together different scenarios—in minutes, not days. Outputs are quickly available for executive level conversations— they don’t have to be translated to be digested and understood. Since this new version is an industry-specific cloud platform, we wouldn’t have to invest in any physical infrastructure or pay for ongoing maintenance or upgrades. And, with built-in features designed to suit our industry’s complex operating environment, we didn’t need to build or integrate a lot of additional applications yet could easily custom-configure it to meet our needs. The product’s flexibility, cost-efficiency, and scalability to grow with our organization organically (at our pace, and in sync with our changing needs) were other aspects that attracted us to it. At Edge, the single most important benefit we searched for in a work management solution was the ability, through visualization of the

work, to make better day-to-day prioritization decisions that everyone could see and understand to meet our corporate objectives. We wanted alignment, teamwork, and improved decision-making. The new EPC generation provided a single collaborative work environment that allows every team member to clearly see how their work impacts each other. It allows everyone to collaborate together to accomplish a single mission and execute confidently. It makes the organization more effective at executing the corporate strategy. It’s simple and intuitive, which means the entire organization uses the system. It reduces administrative effort and helps us stay in alignment. It includes all the training and implementation support we needed so that we were up and running in just one week. Any questions or requests are handled swiftly. Since we also deal with a lot of vendors—consultants, agencies— they need to get into the system and integrate their content with ours. This avoids us having to double-track activities, keep standalone spreadsheets, and one-off plans that go out of date. From an IT security standpoint, they don’t have to be on our email system to offer detailed and sophisticated

There also doesn’t have to be duplication of information. We don’t have to re-do data entry, vendor info, visualization. We can seamlessly export info into slides. Most important, this works with a multi-generational workforce: from senior executives still getting used to current digital platforms to Gen-X and Millennials. Information can be printed, downloaded to slides or viewed on the web or mobile devices. Results For the first time at Edge, we can each see the consequences of our decisions right away. We understand the interdependencies between functional teams and individuals, how the work flows, and who is doing what, and when. We know the implications of decisions right away that eliminates all the back-and-forth conversation between teams—it’s efficient decision-making. This also removes ambiguity. The less ambiguity, the better, as it prompts faster, smarter decisions that avoid repeat work. For example, we used to spend a considerable amount of time to pull together the stages and steps needed to develop different compounds and build individual plans. Now we use one plan and then clone it for six products, customize it and see if the plans were optimal from an operations standpoint. Just this capability has saved us weeks’ worth of time and effort.

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TECHNOLOGY It saves team members hours of creating PowerPoint slides. The project charts look better than what PPT consultants can make. It’s built to make information easy to input, understand, report, and take action upon without extra manipulation. It used to require several hours to create custom PowerPoint presentations for various stakeholders who needed to stay abreast of progress and problems relevant to their work streams. Now, everyone from middle management to senior executives use their personalized dashboards to stay updated about work important to them. And if they still need slides for offline use, they can print a custom slide deck with multiple reports, at the flick of a button - it’s like magic! Bottom line, helps our teams do quality work under tight timelines at fractions of the cost. Plus the reduced need to rework deliverables avoids add-on costs and delays. Our project managers are even more productive and can focus on managing issues versus making slides. The Prime Directive What’s the first commandment at an emerging company? Thou shalt save money. This new EPC generation gives us three big ways to do that. One, we don’t have to re-do, trans-

late and manipulate. Everything input is automatically available in easy-to-understand formats. Two, there are no onerous consulting fees for activities that the software doesn’t handle. This can add up to hundreds of thousands or even millions in extra expenses. It’s a major cash cow for consultants. With the new EPC, the license covers not just the product we initially installed, but ongoing upgrades that obviate ongoing consulting fees. And three, it’s a time saver. By the second day after installation we were using it across the company without the need for constant need for customization. For a growing biotech like Edge, going to market in total alignment is not optional. We have to get more work done, with less time and resources, without compromising on the quality or timeliness of our deliverables. The new EPC generation gives me the peace of mind that our teams will continue to be on the same page, our business leaders will be able to make more informed decisions in a timely manner and together, and we will all keep marching in lockstep towards achieving our common corporate objectives. Beyond Our Own Benefits Every company has its own point of view and its own goals. But I have to say that this new generation actually provides industry benefits that help others. What is learned from our experience informs the software that the next company will license, in a confidential and compliant way. •

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Justin Zamirowski Senior Director Operational Excellence, Edge Therapeutics Justin has over 18 years of life science experience across diagnostics, pharmaceutical, biotechnology and healthcare technologies industries.. He has held leadership roles in sales, market access, commercial operations, project and portfolio management, business development and alliance management. He currently heads Product Planning and Commercialization at Edge Therapeutics, Inc. Edge Therapeutics, Inc. is a clinical-stage biotechnology company that discovers, develops and seeks to commercialize novel, hospital-based therapies capable of transforming treatment paradigms in the management of acute, lifethreatening neurological and other conditions.

COMMENT

August / September 2017

Articles inside

Driving Down Launch Costs with EPC

MedImmune Head Bahija Jallal: Her Success Defying the Odds

Motivideos

By The Numbers

Editorial Board

Executive Spotlight: Christi Shaw, President of Lilly Bio-Medicines

How HCPs Want to Hear From You Digitally

Publisher’s Letter

Editor’s Letter