October / November 2018 by Healthcare Sales and Marketing Magazine

™ OCTOBER/NOVEMBER 2018

the publication for healthcare sales & marketing leaders™

TOP 50 MED DEVICE COMPANIES IN THIS ISSUE

MED DEVICE COMPANIES

Astellas, UCB, Admedus, Retrophin and Takeda Execs on Patient Focus The 10-Second Rule: From a Leader Who Built Successful Commercial Teams at Medtronics, Advanced Bionics, Entellus and More Alkermes COO on Authenticity Great Minds: EMD Serono’s Tim Moore on Supercharging Sales Amalgam Rx and BCG Execs on Digital Medicine Award-Winning MedTech Innovators 2024 Outlook: Medtronic Still Leads, Other Forecasts From Evaluate MedTech Where Docs Are Listening: How To Reach Your HCPs

FINDING EMOTIONS IN EVERY MOLECULE, CELL, PATHOGEN, AND ANTIBODY At AbelsonTaylor, we get emotional about science. For us, there’s real emotion buried in everything from molecules to K-M curves. So we get down to the cellular level to find emotion in the science that lets us tell a human story. One that HCPs will connect with. Because we’re not just inspired by science— we feel the data.

the publication for healthcare sales & marketing leaders™

TABLE OF CONTENTS Publisher’s Letter..............................................................................................................................................4 Editor’s Letter.....................................................................................................................................................5 Editorial Board....................................................................................................................................................7

ARTICLES Spotlight: The 10-Second Rule: From a Leader Who Built Successful Commercial Teams at Medtronic, Advanced Bionic, Entellus and More.................................................................9 Roundtable: Astellas, UCB, Admedus, Retrophin and Takeda Execs on Patient Focus........... 15 Amalgam Rx and BCG Execs on Digital Medicine................................................................................ 23 Top 50 MedTech Companies...................................................................................................................... 27 Alkermes COO Jim Robinson on Authenticity...................................................................................... 33 Award-Winning MedTech Innovators..................................................................................................... 37 Industry Trends: By The Numbers............................................................................................................ 43 Great Minds: EMD Serono Field Force Lead Tim Moore on Supercharging Skill Sets............. 45 Motivideos: To Use In Your Meetings.....................................................................................................49 Why I Work in Healthcare............................................................................................................................ 53 Agency and Provider Spotlight.................................................................................................................. 55 Where Docs Are Listening: How To Reach Your HCPs...................................................................... 59 2024 Outlook from EvaluateMedTech.................................................................................................... 65 3 | HS&M OCTOBER/NOVEMBER 2018

Publisher’s Letter

Why Medical Device Is A World Leader As CEO of Jacobs Management, as well as publisher of HS&M, I get a detailed view every day of the rapid changes in this industry. In our Why I Work in Healthcare feature, we show the many reasons people choose to dedicate themselves to this field. In this issue, we turn the spotlight on the medical device sector, in our regular listing of the Top 50 Medical Device companies of the past year. It was comforting to see that growth has continued with an 11% increase in revenues for the Top 50, with all CARI KRAFT but 5 companies on our list experiencing a revenue growth. The industry as a whole dedicates a high percentage—about 7%—of revenue to R&D, more than most industries, and as a result generates a wide spectrum of breakthrough products. Every year there are numerous startups contributing to the lifeblood of medtech. One of the most impressive aspects to me is the sheer volume of innovation. So we are adding a feature to the magazine showcasing just that, beginning with the recent MedTech Innovations awards, which recognize emerging technologies likely to change medicine significantly. We will follow this up with the Cleveland Clinic’s annual Top Ten In our next issue. Medical device is also directly related to many other industries, benefiting from and influencing advances in microelectronics, telecommunications, instrumentation, biotechnology, and software development. The Department of Commerce notes that “Collaborations have led to recent advances including neurostimulators, stent technologies, biomarkers, robotic assistance, and implantable electronic devices. Since innovation fuels the medical device sector’s ongoing quest for better ways to treat and diagnose medical conditions, when coupled with patient life expectancy increasing and aging populations globally, the medical device sector should continue growing at a positive rate in the future.” All of which reinforces my own belief in and dedication to healthcare in the US. Congratulations and thanks to everyone working tirelessly to make our lives better. And always, please keep the feedback coming. It all goes to making the magazine better for all of us.

Cari Kraft, Publisher CLICK HERE TO GET TOP 50 MED DEVICE COMPANIES

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HS&M OCTOBER/NOVEMBER 2018 | 4

Letter from the Editor

Grit As we have been doing for a while, in this issue we again feature images of people who express why they work in healthcare. Most fall into the category of wanting to help others—patients, doctors. This is a wonderful motivation. But can we sustain it on a long term basis, day in and day out? I’m thinking back to a Motivideo we ran a few years ago, one by Angela Lee Duckworth, author of “Grit.” In it, the innovative psychologist explained that high achievement may be assisted by intelligence, talent, upbringing and other factors, but it primarily depends NEIL GREENBERG on one key factor: grit, a combination of passion and persistence. It’s what virtually all successful people have in common. She offers the example of being a teacher in the New York City schools, where she discovered that the distinction between the best and worst students was in no way directly related to IQ, which is what she had assumed. Going to grad school to become a psychologist, she observed officer candidates in military training and children competing in a spelling bee. She also went to corporations and examined their sales forces to determine who would keep their jobs. In these and other circumstances, her initial predictions turned out to be wrong by a longshot. It wasn’t social intelligence, good looks or physical health It was gritty—having the stamina to stick it out for long-term goals. I recently read an account by a woman who had met with Mother Teresa. Expecting a sweet, grandmotherly angel, she was surprised to meet a very tough, practical, determined woman. Mother Teresa said to her “You have to be tough to do what I do every day and get up the next day and do it again. This kind of work is only for people who are tough and not for people who want to feel good. They do their job no matter how it makes them feel.” I offer this because I admire the grit of people in our industry who do stick it out. Some days are really tough. Some years are really tough. Sometimes you lose an account or your job. But if you really got into this to make a difference—as most of our Why I Am In Healthcare respondents did—you obviously have that combination of passion and perseverance that Ms. Duckworth celebrates. It’s easy to want to help on Volunteer Day at your child’s school, or a couple of times a year for the charity you admire. To do it every day for years is the real accomplishment. So here’s to those of you who embody that trait of grit. We will continue to feature, celebrate and support all you do. We try to keep up with all this, and bring you the people who have a grasp on change. We hope that it will be informative, and assist you in furthering the work you do every day. Let us know what topics will be most useful to you!

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

5 | HS&M OCTOBER/NOVEMBER 2018

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 Associate Publisher Natalie Newcamp 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 © 2018 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 Natalie Newcamp at nnewcamp@hsandm.com

7 | HS&M OCTOBER/NOVEMBER 2018

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

President and CEO, Menarini Silicon Biosystems Bob Roda is a senior commercial executive with extensive experience in delivering business growth and profit in the medtech and diagnostics sectors of healthcare. He currently serves as the President and CEO of Menarini Silicon Biosystems, where he is responsible for driving the commercialization of novel cancer diagnostics. Previously, Bob held a variety of roles of increasing commercial responsibility at Becton Dickinson. Most recently, he was VP and General Manager of the MPS business unit as well as leading the commercial integration of the CareFusion acquisition. Bob also had a successful career within the MD&D sector at Johnson & Johnson. His diverse background includes positions in business development and senior leadership roles 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. Bob is a highly respected, successful global leader with proven abilities in diverse disciplines. He holds a Bachelor of Arts degree from The College of Business Administration at 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 OCTOBER/NOVEMBER 2018 | 8

EXECUTIVE SPOTLIGHT

The 10-Second Rule: From a Leader Who Built Successful Commercial Teams at Medtronics, Advanced Bionics, Entellus and More

James Surek CEO, Medical Sales Nation 9 | HS&M OCTOBER/NOVEMBER 2018

James Surek has spent the last couple of decades building successful commercial teams that increase the value of companies, which results in strong exits. He has done this at Medtronic Sofamor Danek, Advanced Bionics/Boston Scientific and Entellus Medical, as CCO of Stimwave, and is now taking on a new role as the CEO of the Medical Sales Nation.

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EXECUTIVE SPOTLIGHT As VP Sales at Advanced Bionics/Boston Scientific, he oversaw sales growth from zero to $198M, with a 31% market share, in just three and a half years, resulting in a $489M acquisition by Sonova. Under his leadership as VP Sales and Development, Entellus achieved a 63% market share in a space formerly dominated by J&J, and was bought by Stryker for $664M. He is also co-founder of Medical Sales Nation, which offers medical sales professionals a community of peers and experts to interact with and learn from, using podcasts, interviews and other tools to communicate best practices and assist in collaboration. He’s about to publish an ebook that details out the step by step process he’s used to build these sales forces. The book is free, and he has agreed to share some of what he’s learned about building a commercial team. There are four key areas of focus he has determined are vital: 1 Drilling down to the differentiation, which he facilitates in a unique way, challenging marketing and engineering to work together towards developing a targeted market value matrix 2 Designing and building the right commercial team, taking into account speed of uptake, competition, and service 3 Improving the training process to match the market demands, with strategies like the 10 second rule. 4 Putting in place a continuous feedback and improvement system

so that field learnings are incorporated in marketing messaging and sales training 1. DRILLING DOWN TO THE AHA MESSAGE: FIND YOUR DIFFERENTIATION James has developed a process of going deep with marketing and engineering first towards the creation of a market value matrix. It begins with interviewing marketing on how they perceive the landscape—clinical, financial, strategic, competitive—and looking at who benefits and how: the patients, physicians, practice and facility. He then goes to engineering and engages the same process. Do engineering and marketing agree? If so, great. If not, they need to listen to each other and come to an understanding of how to proceed. Sales leadership is present in these meetings not as a mediator but as a student trying to learn from two great teachers with possibly different perspectives who bring the meaning together. He shared an experience he had with engineers at Advanced Bionics. The engineers were confident that they knew what made the product attractive, but were not convinced that the sales organization would have the understanding to sell it. What they explained were a lot of features. For instance, the product had four independent channels that could stimulate four areas of the body—knee, foot, etc.—simultaneously and independently. No other product could do that! “Engineering is very passionate about the performance of a prod-

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uct, which is good,” says James. “But their view of it doesn’t always translate into a benefit a doctor can understand.” If a patient has back, knee and foot pain on the right side, and knee pain on the left, all four areas could be treated at once. But what is the desired outcome? After a detailed conversation, he was able to determine that the four independent channels made treatment more comfortable, tolerable, accurate and defined. That, he knew, was something that would make physicians sit up and listen. Then the strategy was to translate the benefits so they expressed a clinical, strategic and financial value. There must be a benefit to the physician, the patient, the practice and the facility. “The value propositions for physicians, patients, practice and facility, refined by this feedback, form a kind of matrix that informs everything we do from that point forward. What is the doctor interested in? What is the pushback from the office manager? What is the evaluation of your technology? Where is your clinical evidence? What does your product portfolio look like? What is your financial impact on customers?” Not everything on the market is a disruptive technology. “But you need to understand and explain how differentiated your product is in order to make it stand out in the mind of healthcare professionals,” says James. “There is no point in trying to sell a commodity product, unless you have a price advantage, and only the largest companies can compete on that basis.” In the early part of his career, before

Potential Value propositions

Technology Value to the market

Business (ROI)/Clinical Value

Financial Value

Strategic Value

Product portfolio Value

Overall Company Value

What is the value to the market for this technology?

Translate and provide proof that the F&B add value to a market?

Who in the market benefits financially and why.

Who in the market gains a strategic benefits from the product and why?

Does the market want and need a vast product portfolio?

How is the company structure, people, and financial stability viewed in the market

List the F&B

he joined Medtronic Sofamor Danek, he did a lot of homework because he had offers from several of the larger companies. People told him it was a tough area—there were a lot of litigation problems with spinal implants and pedical screws. But he also saw that other products—like hip and knee replacements and scopes—were largely commodity sales which would require years of relationship building to excel, and that Sofamor Danek had an opportunity to stand out in a marketplace where uniqueness would be valued. “If there is no uniqueness,” he says, “you have no clinical value.”

“You need to understand and explain how differentiated your product is in order to make it stand out in the mind of healthcare professionals”

But how do you assess the wisdom of that positioning? Here’s where we get to the market analysis part of the process. 2. BUILDING THE COMMERCIAL TEAM AROUND THE SPEED OF UPTAKE There are three major factors that influence his approach to building the commercial team: the speed of uptake, the competition, and service requirements. James points out, “With a $25,000 product, like the one we had at Advanced Bionics, you can develop your market slower. With crisp messaging and a new cutting-edge technology, we were able to build a team without medical experience. They came from B2B backgrounds—FedEx or Pitney Bowes—and had strong selling techniques and could apply their hunger and passion.” At Entellus, “With a $1500 product, we had to sell a lot of them

to hit our revenue number. Entellus had to build an office-based ENT market, it was not just about converting OR business. We had to build a brand new market. Plus we had significant competition from J&J and needed to bring in skilled reps with market knowledge and tap their more in-depth knowledge, to hit the ground running.” At the beginning of any sales strategy, James says a lot of field feedback is required. That’s why he often hires regional managers first and has them do the legwork in specific territories. What they learn from this is a kind of beta test that will inform three things: the needs and beliefs of the customers (with respect to things like their image of the competition); the type of messaging that will make your product seem unique and valuable; and the kind of sales team you have to build to deliver the marketing message. “Mike Tyson said all his opponents had plans…until they got punched

HS&M OCTOBER/NOVEMBER 2018 | 12

EXECUTIVE SPOTLIGHT in the face. We needed to absorb some of those punches to evaluate our strengths and weaknesses,” James says. “You have to know what the objections are going to be so you can do objection handling. You have to know what the saturation of competitors in the marketplace is.” You also have to deal with the realities of the company. If it can only afford to pay reps X dollars, then that will also influence who you can hire. 3. TRAINING IS TOPS “Training is foundation of success,” says James. This covers a lot of territory. He has taught companies to create real-life scenarios so the sales force learns how to do role playing and objection handling across the spectrum, from the receptionist to the office manager to the physician. “You need to have an authentic conversation about your products and how they benefit the patient practice, patient, physician and facility. It’s like fighter pilot in-flight simulations.”

“Training is the foundation of success… You need to have an authentic conversation about your products.”

He has also built simulations of ORs with cadavers, so reps experience what the doctors do in a hospital setting. “In the end, we put them through an even tougher boot camp than anything they will deal with in the field. That prepares them for anything that comes up.” Asked for an example, he said “Let’s say the product is purple. Well, why is it purple? So you can see it better. What’s the result of that? If you can differentiate it from the tissue or vessel, this will cause surgical errors to go down by 20%. Success rates increase. Now you’re talking language the doctor can get excited about.” He’s also become a proponent of memorization, which he resisted at first. “But I learned that memorizing the key messages gives you a library of solid answers to any objection that comes up. It’s said that in a stressful environment, you lose about 10 IQ points. Your skill sets diminish. Memorization helps you relax and stay on top of your game. Over time the sale reps put the memorization in their own words, but at training it needed to be exact.” The market value matrix also covers such things as objection handling. If you know in advance any situation you’ll run into, you’ll be ready to answer all questions without hesitation. What are the ASC or hospital objections? We know that no product is perfect, so we need to be able to respond to a multi-headed customer and deal with every possible concern.

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“At Advanced Bionics, the proof of the process was that we started out as the underdog, but—even with a B2B sales force not well-acquainted with medical devices—we captured one third of the marketplace in just three years.” His ultimate measure is the 10-second rule: The proof in the message. He saw that the rep has to be able to express clearly and concisely the value message to every relevant party—physician, patient, practice, facility—in what might be called the 10-Second Rule. “If you can’t capture the essence in one brief statement or question to raise the conversation to an engaging level to think about things differently, you haven’t positioned yourself properly in a competitive marketplace,” says James. 4. FEEDBACK FUELS THE FUTURE “Once you’re ready to go out with your primary messaging, once your sales team is trained and disciplined, there’s still a lot of learning ahead,” he says. “There will always be new competition, new objections, new developments. So we are always on a listening tour. We solicit and incorporate feedback from all our sales personnel, and re-evaluate what we’re saying in response.”

This keeps you in a continual state of improvement, so you’re always ahead competitively and with respect to your messaging.

“In five years we owned 63% of marketplace, overcoming the dominance of Johnson & Johnson.” At Entellus, James had the challenge of introducing a product that not only changed the instrument doctors were using, but the site of service and the anaesthesia technique as well. Doctors had to be willing to work with an awake patient, in the office, with a new tool. The clinical benefits to patient were phenomenal, but they found out that they had totally underestimated what was going to be needed for surgeon training. They were surprised at the issue, and so created cadaver labs, and started to engage with surgeons at a higher level. They were taking the time and teaching sales how to make the product and procedure more accessible for the doctors . Then they did summits based on feedback from the field and let doctors teach doctors about everything they were learning to do office based procedures. They also found out that they had a technology issue. They didn’t have a light at the end of the balloon for the sinuses. The engineering team had to respond to that need very quickly. “That is engagement,” says James. “Bringing it forward. Listening rather than

being defensive and understanding the market demand. ”It took a little time, but in five years we owned 63% of marketplace, overcoming the dominance of Johnson & Johnson in that sector. We tripled the national sales in the first two years, exceeding targets, doubled sales in the third year, and increased sales by over 80% in year four, exceeding the forecast. We disrupted the market because the messaging was on point and created value for the ENT healthcare market place.” IT’S ALL PROCESS At Medical Sales Nation, James is building on the belief of creating a learning environment for anyone who wants to engage, share and learn. The team at Medical Sales Nation is helping companies build, turn around and re-brand a sales and commercial organization that incorporates the strategies that are built on the methods and processes that he has used over the last 25 years. All that is impressive, but it needs the support of everything he has learned in his career. Following James Surek’s advice, we can see that what he advises is always in a state of process. Learning about the marketplace. Learning about the beliefs and needs of customers. Learning about the competition. Understanding what kind of sales force you need. Understanding what kind of training they need. Understanding how to deliver the message concisely. And, finally, getting the feedback that will allow you to apply those lessons to continual improvement of everything you do.

What it adds up to is a seamless interaction and cooperation of all parties, contributing to satisfying the goals of everyone involved, from the engineers who create the product to the team enjoined to sell it, to the healthcare professionals who use it and the patients who benefit from it. Here’s how James says it: “Put your egos aside. Learn from your mistakes. Accept the reality of the marketplace and the customers. Design your product and your messaging to address differentiation for the physician, patient, practice and facility. Once you’ve engaged all those elements, you’re on your way to success.” Engaging the sales organization with marketing and engineering to get agreement is always a process, not an event. Engineers and marketers think sales people should be more effective sooner than James thinks is reasonable.—“We need the support of everyone. We have to build the team to read from the same page and understand the others’ concerns. This means not taking anything personally, putting your ego aside, admitting when you’ve screwed up. That allows you to make changes quickly and efficiently in response to the market. “You’re building a learning organization. Everyone is open to learning from each other. And that helps you build the fastest response system.” •

COMMENT

HS&M OCTOBER/NOVEMBER 2018 | 14

ROUNDTABLE

UCB, Admedus, Retrophin, Takeda Execs: Patient Centricity’s Impact on Sales and Marketing Do you feel it? A cosmic shift in our industry. The business model of the healthcare industry has always been based on innovation in medical discovery and commercialization. But in the last 5 years, first slowly and now so significantly that you can’t miss it, a shift is underway from molecule and machine focused to patient focused. Key to that shift is establishing a patient-focused culture. The ‘Why’ to doing it is compelling. Our people become more engaged and engaging. Collaboration increases both internally and externally when we are all on the same team—the patients’ team! More patients are served, which means more revenues are earned. So how do we create a patient-focused culture in sales and marketing? We would love to hear your ideas. Here’s how four thought leaders responded.

JILL DONAHUE

Our moderator:

Principal, Engage Rx Contributing Editor, Healthcare Sales & Marketing

Our panel of experts: DAVID FORTANBARY Head of UCB US Performance Training President, Life Science Trainers and Educators Network

BRYAN SELBY Vice President, Sales & Marketing Retrophin

DAVID ST. DENIS

GAMZE YÜCELAND

Chief Operations Officer Admedus

General Manager Takeda Canada Inc.

15 | HS&M OCTOBER/NOVEMBER 2018

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ROUNDTABLE All comments reflect the views of the panelists and are not necessarily those of their companies. What are the top ways that you are establishing a patient-centric culture? BRYAN SELBY: At Retrophin, our mission is to identify, develop and deliver life-changing therapies to people living with rare diseases. One of the most important things that enables us to deliver on that mission is the patient-focused culture that has been established within the company. Building and maintaining a culture is something you never finish. There is a constant need to be reminding and enabling your people how to be patient-focused. Our first step begins with hiring people who truly believe in, and are willing to live, the Retrophin culture. This is the key idea in Good to Great: “getting the right people on the bus.” “Right” for us is foremost about keeping patients at the center of our priorities. The second step is to train our people to be able to share their own purpose story—their “Why.” It’s not enough to have a corporate mission statement—it has to be personal. There’s one story I love that embodies that spirit. At a recent home office meeting with ten sales people, one of Clinical Account Managers (field sales reps) shared an experience she recently had while conducting an educational lunch program with two doctors. While she was explaining one of our approved therapies, a third doctor that she didn’t know walked in and said, “I couldn’t help but overhear you talking about cys-

tinuria. I just diagnosed my first patient with cystinuria last week and frankly, I don’t know how to treat it.” So the Clinical Account Manager invited that doctor to join the conversation. At the end the doctor said, “Well, now I know what to do. Congratulations - you just made a sale!” As she recounted this part of the story, the other sales personnel listening collectively reacted with an almost audible gasp—like they had just been insulted. In continuing her story, the Clinical Account Manager politely said to the doctor; “Doctor, you don’t know me yet, but if you did, you’d know that I’m not here to make a sale. I’m here to help you make someone’s life better.” As I listened to her story, and watched the offended reactions of the ten sales personnel in our office that day, I concluded that we are getting this culture thing right! They are living the power of their purpose. When our reps deeply believe they are there for the patient—- not the sale — that’s a proud moment for Retrophin. GAMZE YÜCELAND: At Takeda, patients are the primary consideration in everything that we do. In fact, one of the four company priorities is to put the patient at the forefront in everything that we do. The top three ways we are establishing a patient-centric culture include: • Truly understanding the patient journey by learning and hearing about their experiences and the realities they live through, either in person at special events coordinated by Takeda for employees or through video testimonials that are shared company-wide • Engaging in partnerships or collaborations that deliver programs supporting patient needs beyond

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the innovative treatments that we offer • Integrating patient centricity into our goals and objectives to ensure patients are top-of-mind at all times DAVID FORTANBARY: Culture doesn’t happen overnight, and consists of many parts. Without question, this cultural change starts at the top. Our CEO and executive committee believe and create the right environment for all employees to experience the value and impact of patient centricity. Having that visible and consistent leadership voice for the organization to create value for patients is paramount. As important as the “tone at the top” is the “message in the middle.” We rely upon our local business leaders to embrace and model patient-centric behavior. When all of our employees (and potential new employees) see and hear this at UCB, they gravitate and want to be a part of an organization that places so much value in patient centricity. All of our new joiners to UCB undergo a full day of cultural training within their first three months in role. This live, instructor-led training program orients the new hires to our philosophies, our patient value strategies and expectations of the company on how to place patients at the center of all decision making and actions. I don’t think we always fully appreciate the impact that early experience has on someone joining an organization. This cultural orientation has been very successful and provides new hires with a sense of belonging and purpose for the important career choice they made to join UCB. We encourage all of our meeting times to begin with a question, “How can our discussion and ac-

tions today help people living with serious diseases?” If that question cannot be answered, the meeting is over. DAVID ST. DENIS: I think the most important thing we’ve done is to put our purpose front and center and ensure it is embedded in and embraced by our entire team. Like most companies, we have our values clearly articulated. But how are we ensuring those values are tied to something real? For us, it has been by linking those values to a clear purpose. We believe that our solutions are able to make a difference for patients. That’s our purpose: to make a difference. When we launch a new marketing campaign or sales drive, we try to ensure we are looking at “why” we are doing things a certain way as opposed to only “what” we want to come out of it. This constant reminder of our purpose is becoming woven into our culture. I expect this to be the most important aspect of our journey to becoming more patient-centric. As a result, what have your sales and marketing teams started and stopped doing? DAVID FORTANBARY: This seems simple, but we have stopped pushing what we think is right, and we started listening more to our stakeholders. We seek greater patient insights through various and numerous healthcare delivery channels. We spend more time trying to understand any problems or barriers our stakeholders face when delivering care to patients. Part of this change includes a mindset shift for our sales and marketing teams to “fall in love” with the problem. The deeper we understand these issues that are getting in the way of quality outcomes, lower costs and improved patient satisfaction, the closer we

MAKING SALES THE CHALLENGE OF CHANGE INTERNAL FOCUS IDENTIFYING AREAS OF NEED

very transactional thinking, and customers can be skeptical of how earnest we really are in advancing the standard of care for patients. We have been working to characterize winning, which is still important, in a more meaningful way: i.e., if we can build trust with our customers by demonstrating the value we bring to them and their patients, we will establish a long-term relationship focused on working together (health care delivery and industry) to serve the patient. This shift results in a variety of behaviors that are different.

are aligned to our stakeholders’ and customers’ (patients’) interest. And, that is good for business and what we believe in at UCB. GAMZE YÜCELAND: Takeda has had the same values for 237 years and that says everything about who we are as a company. Our values are the foundation of our decisions and drive the way we have operated as a company and will continue to operate. Patient, Trust, Reputation, and Business— in that order—are words we live every day. We are putting more emphasis on living those values in everything we do, even as part of our Code of Conduct. In particular, we look at what impact our sales and marketing activities have on Patients first, then building our Trust and Reputation and, finally, on our Business. Brand strategies for the different therapeutic areas we work in always start with Patients and consider how the work we do and the programs we create will contribute positively to their outcomes. DAVID ST. DENIS: Change is slow, especially within sales teams. By nature, sales professionals want to win, and this means convincing the customer to choose us over our competitors. This can also lead to

For example, when we discuss our competitors, we might point to a recent study where that competitor had some positive results -- rather than try to malign or “position” those results, we like to engage our customers in a discussion. Have they seen them yet? What do they think about those results? We tell them how we see those results and how we see our value proposition relative to those results. When you are convinced you have a better option, you shouldn’t fear being balanced. There are unlimited tweaks to our commercial posture we can make that keep us competitive, but also establish trust and increase influence. Additionally, we have started to engage patient soci-

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ROUNDTABLE eties more with a focus on bringing emerging trends and solutions to the front of the discussion. This activity is absolutely harmonious with our efforts to partner with HCPs for the same purpose. BRYAN SELBY: The Retrophin sales and marketing theme for 2018 has been RY*PT—which is short for “Our WHY is a patient”. You’ve got to keep finding ways to grow your patient-focused culture and remind people who we want to be. As senior management, we often look to communication devices to help center our organization on our mission and values. RY*PT is an example of how we can build that patient-centric culture. I especially love when I see RY*PT as an e-mail sign-off or hashtag. The RY*PT campaign has been accompanied by a corporate “Our Why” campaign for all employees and partners of Retrophin. The “Our Why” campaign is designed to showcase how we, as Retrophin team members across the organization, put patients at the center of everything we do. It also gives us an opportunity to engage other members of the rare disease community to join with us in sharing their individual “Why” stories and build a stronger sense of community. What have been the outcomes from creating that patientcentric culture—for patients/ caregivers, employees, HCPs and other stakeholders? GAMZE YÜCELAND: For patients and caregivers, we are continually looking for ways to improve quality of life for patients. This starts with the new therapies we have brought and will continue to bring

to them, and making sure that these innovative treatments are available to patients as quickly as possible. We then move on to establishing our very comprehensive patient support programs. It also means helping do more of what’s important to patient organizations, such as supporting the Crohn’s and Colitis Canada GoHere washroom access program. For employees, when a team comes together with one goal in mind it makes collaboration much easier. Our shared values are what drive us. Ask anyone at Takeda why they come to work each day and they will tell you it’s because they want to make a difference in the lives of patients. We each understand that, regardless of our role, the work that we do does make a difference. Patients are our passion. For HCPs, we remain committed to ongoing research and collaborations. New therapies come as a result of investments in research and development and this is very important to us as a company. One vital area we share with healthcare professionals is that we want to help patients. We see our role as providing treatments and tools so those professionals can maximize what they can do for patients. Other stakeholders, such as patient organizations, are another important conduit for us to help patients. We collaborate with patient organizations to provide different types of support including education programs, disease materials, special projects that make a difference to patients, and fundraising activities. We also work collaboratively with government authorities to ensure that patients have continued access to treatments that are essential to their wellbeing and quality of life.

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BRYAN SELBY: For Retrophin, being patient-centered allows us to be more driven, more focused, and more effective in assisting healthcare providers in diagnosing and finding patients who may benefit from our medicines, possibly leading to better health and better lives. Being patient-centered allows our people to be more engaged in their work and allows them to more easily comprehend the difficulties of living with rare disease. At the end of the day, when our people go home, they know they have made a positive impact on our patients’ lives. Isn’t that how we all want to feel? When your HCPs trust you and believe you’re in it for the same reason they are, they are far more engaged in your educational message and benefit more from interactions. By orienting our actions around the patient, we create opportunities to partner with all healthcare stakeholders. I love the metaphor of the pit crew around the patient. We at Retrophin are part of that pit crew for patients and families with rare disease. DAVID FORTANBARY: Outcome measures are different depending upon your customer or stakeholder. For example, we are seeing an influx of responses and letters written to UCB from patients and caregivers sharing their stories and gratitude to UCB. Those stories are routinely shared across the organization to remind every employee that what they do makes a real impact on the lives of others. There is no greater satisfaction than reading these stories of how patients overcame or controlled their disease with the help of UCB. For our employees, having a patient-centric culture has created a strong sense of purpose for everyone. Whether you are in IT, finance, operations,

HR or in a more direct line role in delivering patient solutions, our employees celebrate what we are accomplishing at UCB. Interestingly, our focus on patients has attracted like-minded, very skilled and passionate employees. This, in turn, further accelerates our culture to a more patient-centric organization. We measure the impact of our patient value cultural through frequent employee surveys (where we consistently receive high marks on patient focus), and improvements in retention and engagement. For our shareholders, we only need to look at our company’s performance. Our quarterly results are our report card on how well we are executing our patient centered strategies. For HCPs, I believe we are convincing them through our actions that we are very much aligned to their priorities—improved access to care for patients, improved health outcomes, lower costs and improved patient satisfaction. We have many examples where we have achieved that level of trust, alignment and success with HCPs. DAVID ST. DENIS: We are at the beginning of our journey, but I’m happy with the progress we made so far. For patients I believe we have been successful in inserting ourselves into their treatment decisions along that patient journey. That has resulted in them potentially getting better options as a result of a more informed HCP. For our employees this shift has resulted in an empowered team, driven by the power of purpose and belief that what they do every day makes a difference, not just a paycheck. For investors, beyond the obvious financial results, we are building a brand identity that establishes us as an important player in our space; a player who is driving innovation and improve-

Moving Forward SELLING BASED ON VALUE

EXTERNAL FOCUS

TAKING TIME TO FOSTER CHANGE

ment in providing patient care. This ultimately makes the company they are invested in more valuable and sustainable. Finally, for HCPs, here is where we still have so much opportunity. HCPs today are under tremendous pressure to increase the quality of care while containing its cost. This results in them potentially having less time to look at changes in their practice that could be beneficial but risk costing them more time in the near term. We have been successful at convincing many of our customers that we can be trusted and intend the best for their patients, but we are still struggling with the best way to get them comfortable with the investment in change. Much has been done in patient centricity, but much remains to be done. What are the next steps in your company with respect to this important effort? BRYAN SELBY: Culture matters! Culture wins! Positive culture doesn’t just happen. Our patientcentric culture, as strong as it is, needs continued nourishment and continued recognition throughout the organization, especially from senior management. It’s easy to

MEASURING RESULTS

lose sight in the pressure and challenges of the day, but we at Retrophin try hard to remind ourselves daily of why we are here—to help save or improve a life of someone living with rare disease, one patient at a time DAVID FORTANBARY: We must stay the course. Living in a VUCA (volatile, uncertain, complex, ambiguous) world, it is very easy to lose focus and become distracted on our purpose and desired outcomes. However, with our leadership, our employees and our purpose deeply rooted into our organization, I am very optimistic that we will continue to succeed and fulfill our mission to help patients living with serious diseases. This is who we are at UCB. GAMZE YÜCELAND: Being a patient-centric company is at the core of who we are and is part of our global and local strategy. We have built a very strong foundation that puts patient centricity at the core of how we do business. It is imperative that everyone in the company has a patient-centric mindset—patients must always come first. There is always room

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ROUNDTABLE for improvement and to better understand the patient needs and where the gaps are so that we can provide the right support to patients. In our external activities and programs, we must always ask ourselves what more we can do directly or with our customers and stakeholders to support patients, including to ensure that our innovations are and remain available to patients. Internally we must always look at how we can best structure our teams, change our processes or communicate among ourselves to ensure that it all comes back to putting the patient first. It’s not a do-once-and-you’re-done activity. It’s a continual process of learning, change and improvement. DAVID ST. DENIS: We intend to invest a lot more in building tools that enable us to discuss value and outcome. The discussion right now is focused on cost. We need to show that the long term benefit far exceeds the perceived costs, which are not just financial, but more importantly, costs to the patients long term quality of life. The cost of not getting the right outcome is too high. •

MEET OUR PANEL OF EXPERTS JILL DONAHUE Principal, Engage Rx

Jill, HBa, MAdEd, is on a mission to lift our industry, building purpose-driven, influential people. Through her keynote talks, workshops and award-winning mobile-learning programs, she is helping pharma people build trust, open doors and make a bigger impact. She also serves as Associate Editor of Healthcare Sales & Marketing.

DAVID FORTANBARY Head of UCB US Performance Training President, Life Science Trainers and Educators Network

David is a 33-year veteran in the pharmaceutical industry, having held numerous

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leadership positions at Bristol-Myers Squibb for 28 years and with UCB for 5 years. David’s current role, as Head of US Performance Training for UCB and President of the Life Science Trainers and Educators Network representing over 2,000 life science learning professionals worldwide, has contributed to healthcare panels, educational symposia, books, articles and keynotes at major conferences and events. His passion for patients and caregivers stems from his personal experiences at home and at work. He began his journey to evangelize patient-centricity in healthcare following the death of his father, who struggled with his health and fragmented care. David said recently, “I get up every day thinking of my parents, and what they did for me. For the longest time, I felt guilty about how difficult it was to coordinate care for my dad. And, in some ways, I believe that lack of coordinated care contributed to his death. I’ve turned that guilt into my purpose, and will do all that I can to see things through the patients’ eyes and what they are experiencing.”

UCB’s ambition is to transform the lives of people living with severe diseases. They focus on neurology and immunology disorders, putting patients at the center of their world. Their medicines treat thousands of people around the world and they are engaging with patients, their families and healthcare professionals to address unmet needs. They want to enhance understanding of disease and the real-life experiences of patients so that their teams are able to deliver the right drug and the right care to the right patient. UCB is leveraging scientific advances and skills in areas such as genetics, biomarkers and human biology. DAVID ST. DENIS Chief Operations Officer Admedus

David St. Denis is an accomplished senior healthcare leader with a systematic and metrics-driven approach spanning 20 years of proven business results at

the regional and global levels within the life sciences and pharmaceutical sectors. Most recently at Merck in Germany, he headed commercial operations for Europe and Canada. He has an extensive track record in charge of complex cross-functional and multicultural teams that have achieved impressive business objectives in both mature markets (US, Europe, Japan) and developing markets (China, India, Brazil, Russia, Mexico). His core competencies include operations management, strategy development, marketing and sales, new product introduction and launch excellence, market access and pricing. dstdenis@admedus.com

ADMEDUS (ASX:AHZ) is a medical technologies company delivering clinically superior solutions that help healthcare professionals create life-changing outcomes for patients. Its focus is on investing in and developing next generation technologies with world-class partners, acquiring strategic assets to grow product and service offerings, and expanding revenues from our existing medical sales and distribution business. The company has assets from research and development through clinical development as well as sales, marketing and distribution. BRYAN SELBY Vice President, Sales & Marketing Retrophin

Dedicated to building a team that advocates for patients, Bryan advocates for raising the bar of expectations and for hope for patients with rare diseases. He has 25 years of experience in sales and marketing of pharmaceuticals and clinical diagnostics. At Retrophin he has led the creation of the commercial team. Prior to Retrophin, Bryan was head of marketing at Prometheus Therapeutics and Diagnostics and Millennium Labs, where he built two marketing departments that managed 18 pharmaceutical and diagnostic brands. Bryan started his career in sales with GlaxoSmithKline and went on to hold numerous roles in marketing leadership positions. His WHY of being patient-centric goes back to a hug he received from a patient in the Emergency Department of St. Ann’s Hospital in March of 1992. That started him down the path of truly understanding that what we do in the pharmaceutical industry can have a profound effect on patients’ lives.

RETROPHIN is a biopharmaceutical company specializing in identifying, developing and delivering life-changing therapies to people living with rare diseases. The company’s approach centers on its pipeline featuring late-stage assets targeting rare diseases with significant unmet medical needs, including fosmetpantotenate for pantothenate kinase-associated neurodegeneration (PKAN), a life-threatening neurological disorder that typically begins in early childhood, and sparsentan for focal segmental glomerulosclerosis (FSGS) and IgA nephropathy (IgAN), disorders characterized by progressive scarring of the kidney, often leading to end-stage renal disease. Research in additional rare diseases is also underway, including a joint development arrangement evaluating the potential of CNSA-001 in phenylketonuria (PKU), a rare genetic metabolic condition that can lead to neurological and behavioral impairment. GAMZE YÜCELAND General Manager Takeda Canada Inc.

Gamze has been the General Manager of Takeda Canada Inc. since April 2018. She brings more than two decades of experience in the pharmaceutical industry to this role, having held a number of senior sales and marketing positions as well as country management roles over her 21year career,. Prior to this position, Gamze served as General Manager of Takeda in Turkey. Her leadership was instrumental to the growth of Takeda in Turkey, contributing to the significant expansion of the company’s reach.

TAKEDA CANADA Takeda established operations in Canada in 2009 and is one of the fastest-growing pharmaceutical companies in Canada. They are delivering leading innovations in their disease areas of focus, gastroenterology and oncology, and strive to become a best-in-class specialty care provider focusing in the areas they work to serve the needs of patients.

COMMENT

HS&M OCTOBER/NOVEMBER 2018 | 22

DIGITAL

Amalgam Rx and BCG Execs on Digital Medicine: A New Kind of Pill In our last issue, we ran an article featuring Dr. William H. Carson, President and CEO, Otsuka Pharmaceutical Development & Commercialization, Inc. He outlined Otsuka’s history of introducing Abilify MyCite, an innovative first in digital therapy. As a sign of the growing importance of this area of investigation, there is now a publication devoted entirely to it, npj Digital Medicine. It defines the term as meaning “using digital tools to upgrade the practice of medicine to one that is high-definition and far more individualized,” and says it gives us “the means to process the vast data generated via algorithms, cloud computing, and artificial intelligence. It has the potential to democratize medicine, with smartphones as the hub, enabling each individual to generate their own real world data and being far more engaged with their health.” As a follow-up on this exciting area, we asked Chris Bergstrom, a member of our Editorial Board, to provide a broader view of digital medicine and its implications for the future of the industry. Here is his report, developed with his colleagues at BCG Digital Ventures and Ryan Sysko, CEO of Amalgam Rx.

GUNNAR TROMMER Partner and Head of the Healthcare Practice Area, BCG Digital Ventures

NATE BEYOR Venture Architect Direct, BCG Digital Ventures

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CHRIS BERGSTROM Lead Digital Health Expert and Diabetes Lead, BCG Healthcare Practice

RYAN SYSKO CEO, Amalgam Rx, Inc.

the publication for healthcare sales & marketing leaders™

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DIGITAL WHAT IS DIGITAL MEDICINE? Digital medicine, also known as digital therapeutics, is a new frontier in healthcare at the intersection of medicine and technology. This novel field of healthcare technology has the potential to transform the way in which patients and doctors manage disease and disorders. While software has been a part of healthcare for decades, digital medicine has unique attributes that set it apart. Industry experts generally characterize digital medicine according to the following qualities: • Clinically & behaviorally oriented • Validated • Regulatory cleared/approved • Prescribed/ordered • Reimbursed Digital medicines can manifest in many forms, from software-only to any combination of software, hardware and human support. For life sciences companies, digital medicine represents a radically different, yet exciting, opportunity as we explore ways to create new value. Whether used alone or in combination with traditional medical devices and pharmaceutical products, digital medicines have the potential to improve clinical outcomes and reduce healthcare costs. WHAT’S THE POTENTIAL FOR DIGITAL MEDICINE? Digital medicine is gaining traction. Governments and health systems around the world are beginning to integrate digital medicines. Signs of acceptance and adoption abound, with the inclusion of digi-

tal medicine in official policy and payment strategies in the U.S. and U.K. For example, the National Health Service in England is now providing some reimbursement support for digital mental health services. In the U.S., many private and governmental payers are reimbursing for digital solutions supporting diabetes management and/or prevention. The attractiveness of these solutions lies in their potential to help improve patient outcomes and accelerate the transformation of healthcare systems from fee to value-based. Digital medicine holds promise in three key areas: 1. Transforming Care Delivery Healthcare systems globally face a massive and well documented challenge: successfully managing an ever-increasing population of chronically ill patients, including more than 100 million Americans with diabetes or pre-diabetes, 75 million Americans with hypertension and nearly 50 million Americans with respiratory disease (asthma and COPD). In many cases, managing these diseases requires more frequent intervention than a provider can offer through traditional office visits. To this end, digital medicine offers the opportunity to scale healthcare providers’ reach, and can also transform the way that care is delivered through automated interventions. Technology can enable patients to access the knowledge and support they need to manage their conditions—anywhere, anytime—under the auspices of their healthcare providers. Technology also enables support to be delivered through multiple modalities, including curated

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content, asynchronous messaging, real-time feedback loops, video conferencing, as well as connecting the digital care world to hardware such as IoT (Internet of Things) and virtual reality. Transforming care delivery from episodic to realtime and continuous is critical to achieving optimal disease management; digital medicine enables this transformation. 2. Impacting Social Determinants of Health There is strong evidence that stress, nutrition, exercise, social, environmental and other factors significantly impact clinical outcomes. In fact, these factors contribute to epigenetic modifications in patients and, depending upon the therapeutic area, may be as or more important than traditional therapies. Unfortunately, these factors are often ignored or undertreated, often because the systematic collection and analysis of the data signatures cannot be connected to appropriate interventions. This is the perfect domain for digital medicine. Evidence-based interventions that change patient behaviors, selfmanagement and self-efficacy can be delivered through digital means and create dramatic improvement. Pervasive consumer technologies provide the mechanism to capture and analyze self-management data, provide instant feedback and support, triage critical patient and connect patients and providers. Digital medicine provides a level of scale and frequency of care that cannot be matched using traditional means, and it requires a careful approach to design an implementation to ensure that interventions are matched to new clinical endpoints. Clinical studies

of digital medicine are required to validate these improvements and can also secure a competitive edge as new modes of therapies are brought to market. It’s not unthinkable to imagine a time in the near future when digital medicines are defined and compared based on their digikinetics (DK) and/or digidynamics (DD). 3. Creating Digital Biomarkers and Care Pathways Historically, data collection in healthcare has been relegated to physical exams and laboratories (“traditional healthcare data”), which is episodic and often incomplete in terms of formulating understanding among patient, doctor and condition. Further, the multiple modes of data collection have led to a disparate mix of siloed datasets, which have to be manually mined, matched and analyzed to unlock any value. When designed right, digital technology is changing the efficiency with which data signatures can be identified and tied to interventions. High mobile phone penetration coupled with inexpensive biosensors allow for continuous capture of physiological, behavioral and other patient self-management data, previously only possible within inpatient settings. Combining this data with traditional healthcare data, such as EHR records and insurance claims, presents new possibilities to redesign chronic disease management. Additionally, in very recent years, major investments in machine learning and artificial intelligence along with increased processing speed have unlocked the potential for almost real-time analysis of patient data. In the future, combining these approaches with—omic data,

such as genotyping, next generation sequencing and proteomics, will unlock a future of truly personalized medicine.

through risk-sharing and successbased payment models.

WHAT DOES THIS MEAN FOR LIFE SCIENCES COMPANIES?

Big data will fuel the drug discovery of the future at all stages in the R&D process through clinical development. It will decrease development life cycles and lead to more effective and precise medicines.

• Data-Driven Product/ Drug Development

The landscape in healthcare is shifting faster than ever. The skyrocketing costs of care supporting existing commercial and business models is not sustainable, increasing at more than than 5% a year. Meanwhile, outcomes have not shown a concomitant increase with average life expectancy in the US at 78.6 years and decreasing for the last few years. Winning in the healthcare market of the future will be defined by value creation– not “widget” sales. And the underpinnings of value creation start with the ability to transform data into actionable knowledge and meaningful outcomes. For life sciences companies, this means combining traditional therapies, digital medicines, and other services to create new value for customers and users. These new offerings will allow life sciences companies to leverage their size and scale to make meaningful change. This change will manifest in the following areas: • Business Model Innovation & Pricing Enhanced information and improved outcomes will enable life sciences companies to rethink their approach to contracting from fee to value-based. Digital approaches will be required to understand outcomes based on precision, accuracy and timing intervals needed to create a sustainable value-pricing model. Ultimately through incentive alignment, there will be greater revenue-generating opportunities

• Enhanced Customer Relationships Life sciences companies have traditionally maintained strong relationships with healthcare providers. However, moving towards more solution-oriented products will enable them to build deeper and more meaningful relationships with patients and payers. Amalgam’s team helped pioneer the field of digital medicine and built a leading technology platform and quality systems designed to support clinically-validated, behaviorally-driven and FDA-regulated digital solutions. Together, DV and Amalgam are helping healthcare partners accelerate and de-risk their Digital Medicine efforts. BCG Digital Ventures’ global team of experienced digital entrepreneurs, design and technology experts help corporate partners think and act like nimble startups and venture capitalists. They build and launch strategic ventures with clients. To best support bio/pharma, medtech, payer, provider and other life sciences companies, DV has partnered with Amalgam to expand its offerings into the field of digital medicine.•

COMMENT

HS&M OCTOBER/NOVEMBER 2018 | 26

MEDICAL DEVICE CLICK HERE TO GET TOP 50 MED DEVICE COMPANIES

MED DEVICE COMPANIES MEDICAL DEVICE TOP 50 The medical device sector continues to post healthy gains. The sector comprises medical device, medical equipment, capital equipment and medical technology companies. The 10% revenue uptick from 2016 was followed by 2017’s 11% rise, with the Top 50 company revenue totaling $365B, up 11% from $329B, in 2016. All but five of our Top 50 companies experienced a revenue increase from 2016. Abbott moved up into the top 10 with its purchase of St. Jude last year, bumping Baxter off the list. Medtronic remains on top of this list as it continues to digest and integrate Covidien. (You can see that the EvaluateMedTech report in this issue suggests Medtronic will continue to lead through 2024.) The biggest deal of this year remains Beckton Dickinson’s $24B purchase of C.R. Bard. Other notable deals include: Cardinal Health’s acquisition of Medtronic’s patient monitoring and recovery business for $6.1B, Hologic’s acquisition of Cynosure for %1.7B, and Teleflex’s purchase of Vascular Solutions for $1B.

Here is a snapshot of the Top 50, ranked by 2017 revenue. As always, we have tracked movement up and down the list with regard to both ranking and revenue changes as compared with 2016. Companies are ranked by their 2017 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 2017 and 2016). Medical device, equipment, and medical

27 | HS&M OCTOBER/NOVEMBER 2018

technology revenues were extracted from reports to create an equal playing field. We also revised 2016 earnings to align “apples to apples” revenue reporting with 2017 figures. Companies that had revised 2016 revenues from our last year’s report include: Getinge, Ship Healthcare Holdings, Varian Medial Systems and Nihon Koden. Additionally, 2017 Becton Dickinson revenue does not reflect the C.R. Bard acquisition pending the release of their 2018 annual statement.

WE HELP CONSUMERS WHO HELP THEMSELVES People now spend less time with doctors and more time taking healthcare into their own hands. In-aisle is where consumers actively search for products and medicines. And Rx EDGE is the only targeted media located exactly where they’re looking. That’s why brands that use Rx EDGE campaigns see an average script lift of 12.5%. Get your brand in the most motivating media. Contact Mike Byrnes at 610.431.7606 or michael.byrnes@rx-edge.com. Connect to Consumers with

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MED DEVICE COMPANIES

Companies are ranked by their 2017 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. CLICK HERE TO GET TOP 50 MED DEVICE COMPANIES

RANKING COMPANY LOCATION

2017 REVENUE IN US$B

MEDTRONIC

Dublin, Ireland

$29.70

JOHNSON & JOHNSON

New Brunswick, NJ

$26.60

FRESENIUS MEDICAL CARE

Bad Homburg, Germany

$21.34

PHILIPS

Amsterdam, Netherlands

$21.34

GENERAL ELECTRIC

Fairfield, CT

$19.12

SIEMENS

Munich, Germany

$16.20

ABBOTT LABORATORIES

Chicago, IL

$14.53

DANAHER

Washington, DC

$14.36

CARDINAL HEALTH

Dublin, OH

$13.50

STRYKER

Kalamazoo, MI

$12.44

ROCHE

Basel, Switzerland

$12.42

BECTON DICKINSON

Franklin Lakes, NJ

$12.10

BAXTER

Deerfield, IL

$10.60

BOSTON SCIENTIFIC

Marlborough, MA

$9.05

ESSILOR

Charenton-le-Pont, France

$8.99

B. BRAUN

Melsungen, Germany

$8.15

ZIMMER BIOMET

Warsaw, IN

$7.82

OLYMPUS

Tokyo, Japan

$6.66

CARL ZEISS

Oberkochen, Germany

$6.42

NOVARTIS

Basel, Switzerland

$6.02

Saint Paul, MN

$5.81

SMITH & NEPHEW

London, United Kingdom

$4.76

TERUMO

Tokyo, Japan

$4.58

24 NEW HITACHI

Tokyo, Japan

$4.26

Tokyo, Japan

$4.26

NEW HOYA

29 | HS&M OCTOBER/NOVEMBER 2018

What do over of the top 20 pharmaceutical, biotech, and medical device companies have in common? They choose Jacobs Management Group as their recruiting partner.

We Are PleAsed To Provide The resulTs of our 2018 CoMPensATion rePorT Is the position you are trying to fill competitive? Jacobs Management Group is pleased to offer you a full copy of our 2018 Compensation Report.

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MED DEVICE COMPANIES

RANKING COMPANY LOCATION

2017 REVENUE IN US$B

DENTSPLY SIRONA

York, PA

$3.99

HARTMANN

Frankfurt, Germany

$3.56

EDWARDS LIFESCIENCES

Irvine, CA

$3.43

INTUITIVE SURGICAL

Sunnyvale, CA

$3.13

DRÄGER

Lübeck, Germany

$3.09

HOLOGIC

Marlborough, MA

$3.06

GETINGE

Gothenburg, Sweden

$2.75

BIOMERIEUX

Marcy l’Etoile, France

$2.75

HILL-ROM

Chicago, IL

$2.74

SONOVA

Stäfa, Switzerland

$2.72

NIPRO

Osaka, Japan

$2.67

VARIAN MEDICAL SYSTEMS

Palo Alto, CA

$2.67

STERIS

Mentor, OH

$2.61

COLOPLAST

Humblebaek, Denmark

$2.50

SHIP HEALTHCARE HOLDINGS

Suita-Shi, Japan

$2.35

41 NEW BIO-RAD

Hercules, CA

$2.16

TELEFLEX

Wayne, NJ

$2.15

THE COOPER COMPANIES

Pleasanton, CA

$2.14

WILLIAM DEMANT

Smørum, Denmark

$2.13

RESMED

San Diego, CA

$2.07

FUJIFILM

Tokyo, Japan

$2.07

BRUKER

Billerica, MA

$1.77

CONVATEC

Deeside, United Kingdom

$1.76

49 NEW IDEXX LABS

Westbrook, ME

$1.70

Tokyo, Japan

$1.55

47 48

NIHON KOHDEN

31 | HS&M OCTOBER/NOVEMBER 2018

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EngagE your Way: advIsory, projEct, staffIng Enzyme Life Science Experts | Pierce@EnzymeLifeScience.com | EnzymeLifeScience.com | (215) 383 3013

PHARMA

Shocked into Reality About Authenticity At eyeforpharma Philadelphia 2018, Jim Robinson spoke about his experience with patient centricity. It was an eyeopening journey, replete with surprises, disappointments and, ultimately, insights into how to change a culture properly. Here are some of his lessons, followed by a link to videos of his presentation. We think youâ&#x20AC;&#x2122;ll glean a lot of wisdom from what heâ&#x20AC;&#x2122;s learned.

Jim Robinson, President and COO, Alkermes 33 | HS&M OCTOBER/NOVEMBER 2018

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PHARMA him up for failure. But Jim was determined, and kept pursuing the consultant until he relented. They eventually became the first pharma company that the consultant worked with. The ensuing exercise unearthed data that shocked people into consciousness. They needed to change their ways in order to deliver real value. But to change the culture, you can’t do it with just a commercial organization or a medical affairs organization. It has to be everyone in the entire company working from the same hymnal. They had a long way to go, but in the end it was worth the work. Jim said you have to start within your own four walls if you want to change the patient-centricity approach and deliver on real value. He said “We do patient summits, market research, we engage with patients— WE are patients, our families are patients. We’re good at talking the talk.” But he found out, at a former company, that what they were not good at was evaluating their own performance. He read a book called Service Fanatics, by a physician, Jim Merlino, who had been tapped by the Cleveland Clinic to improve their patient experience. They were delivering amazing clinical care, but the patient experience was below expectations. What Dr. Merlino discovered, and wrote about in his book, was an inspiration to Jim Robinson. So he brought in someone to look at his company’s performance from the provider side— an independent point of view. The company Jim

worked for at the time thought they were on the leading edge of patient focus. The consultant, however, did not. He provided examples of how they were disconnected from the patient. For instance, how many phone calls did it take for a patient to get an answer? Over 50! Brand numbers, medical information numbers, a long list that a patient had to drill down just to get a simple answer. The company thought that having phone numbers that lined up with their website and brand name was a killer idea— but it made no difference if it didn’t help the patient! They were also way off on how they were doing informed consent, health literacy and more. In sum, it was a humbling lesson. Jim was even more disappointed when he asked the consultant to help them change. He refused to work with them on fixing it, because he thought that would just set

35 | HS&M OCTOBER/NOVEMBER 2018

Now Jim moved to Alkermes, and conducted his first patient summit there. Alkermes creates CNS therapies to treat such conditions as severe depression, schizophrenia, and opioid use disorder. Jim said his aha moment was when he spoke to a patient advocate, and threw “pharma guy” questions at him. The conversation went something like this: Jim: “What’s important to you in terms of the patient journey?” Advocate: “What’s the patient journey?” Jim: “What’s important to you in terms of the treatment paradigm?” Advocate: “What’s that?” After about thirty minutes, it came down to this: you have to talk language the patient is familiar with, and meet goals they are passionate about. But what the patient and the company are trying to accomplish is simple: staying alive. At this point, Jim started to understand. “Tell me more about that.”

Jim Robinson on Patient Centricity

And the patient wanted what we would all want— to be treated with dignity and respect. “We can smell BS,” he said. “We can smell ulterior motives, sense when people don’t really care about us.”

“It’s not only the right thing to do in terms of how we engage with our patients to deliver real value, but there’s actually a business benefit to it as well.” “So if you’re going to be successful in delivering real patient value,”

liver real value, but there’s actually a business benefit to it as well.”

said the advocate, “engage with authenticity. You’ll be able to hear stuff you never heard before. Then you’ll be able to be a partner with us.” When they started to walk the walk, the impact permeated the organization. For instance, the clinical development team worked on such items as informed consent, instituting a legal review for clinical trials. Jim notes that the diminishing return trend in the industry can be corrected by a focus on speed, in this case by increasing accruals, making it as easy as possible to onboard patients into clinical trials. He says “It’s not only the right thing to do in terms of how we engage with our patients to de-

Where Jim came out was easy to express, but difficult to understand if you’re locked inside your four walls. You have to get out there and really hear the patients, then speak to them in language you can both understand. “Engage authentically,” Jim says, “and deliver on what you say you’re going to deliver on. •

COMMENT

HS&M OCTOBER/NOVEMBER 2018 | 36

INNOVATION

Sana Health Leads MedTech Innovators This is a ground-breaking time in medical technology, and nowhere are the breakthroughs more evident than at the MedTech Innovator Showcase & Accelerator event. At MedTech’s annual Showcase & Accelerator program, the 50 most innovative medtech startups from around the world are featured. The selection process is demanding, with only 3% being accepted as finalists, and 25 of the 50 receiving a place in the four-month MedTech Innovator Accelerator virtual program. In the final round, five industry finalists and five execution award finalists are chosen, with one of those being the year’s winner. This year, Sana Health earned

that honor for a neuromodulation device that integrates a heart rate variability sensor for personalized chronic pain management. MedTech Innovator has a vast and supportive network of industryleading partners that help provide unparalleled resources and guidance to the most innovative startups in medical technology. Its founding partners are Johnson & Johnson and RCT Ventures. And annual program partners are AdvaMed, Amgen, Baxter, BD,

BTG, EdgeOne Medical, Fujikura Ltd., Grant Thornton, Health + Commerce, Hoya Corp., MedTech Strategist, NIPRO Medical Corp., Nordson Medical, Olympus Medical Systems Group, Wilson Sonsini Goodrich & Rosati, W.L. Gore & Associates, Inc., and Ximedica. We’re happy bring news of these breakthroughs to you by featuring the companies and products that were highlighted at the Showcase & Accellerator program this year. Here they are:

Industry Competition Finalists SANA HEALTH Sana Health is developing a noninvasive neuromodulation device that integrates a heart rate variability (HRV) sensor to treat patients with severe chronic pain. The Sana Sleep Mask, comprising a mask with earbuds, is worn when the user is ready for bed and pulses specific algorithms of light and sound to effect neuromodulation. With a skin-contact HRV sensor built into the forehead area, the device is designed to monitor minor fluctuations in a patient’s nervous system for tailored audio-visual stimulation to the nervous system’s unique responses to help patients achieve a deep, natural state of relaxation and reduce pain levels quickly. 37 | HS&M OCTOBER/NOVEMBER 2018

ABLACARE Ablacare is developing a minimally invasive device and procedure to treat Polycystic Ovary Syndrome (PCOS) related infertility. The one-time device uses an ultrasound-guided approach and aims to replace Ovarian Drilling (OD), a safe and effective, yet rarely performed, approach that corrects hormonal imbalances by destroying ovarian tissue, which often results in spontaneous ovulations and pregnancy. Compared to current options, Ablacareâ&#x20AC;&#x2122;s procedure in development is less invasive, less costly, less labor-intensive, and would not require a referral, as it can be performed by surgeons, reproductive endocrinologists, and general OB-GYNs alike.

CROIVALVE Tricuspid Regurgitation (TR), a disorder that occurs in patients with heart failure due to dilation of the tricuspid valve, affects 550,000 people annually. Current medical therapies for TR are ineffective, and surgery is associated with high operative mortality, therefore performed only in 5% of patients. CroiValve is developing a minimally invasive device to repair the tricuspid valve and reduce regurgitation in high risk patients without the need for surgery. The device is designed to sit across the native valve and is held in place by a non-penetrating anchoring system to facilitate simple and predictable delivery using conventional techniques for improved clinical and economic outcomes.

HS&M OCTOBER/NOVEMBER 2018 | 38

INNOVATION FINEHEART Heart Failure (HF) is the second cause of death in the G20 countries. FineHeart is developing the ICOMS, a hybrid system that combines a Pacemaker and a Left Ventricular Assist Device (LVAD) designed to offer patients a new way to manage heart failure disease. Unlike other LVADs, the implantable ICOMS device does not involve heart bypass surgery, allowing for the preservation of innate heart contraction by implanting the device in a patientâ&#x20AC;&#x2122;s beating heart, a mini-surgical procedure that requires only a thoracotomy and two small incisions. Described as an electrical bicycle of the heart, the ICOMS will propel blood to support the native cardiac contraction by accelerating the blood at every beat with no external wiring, reducing the risk of severe infections and providing patients with an improved quality of life. SPECT An estimated 40-45% of the 30 million Americans who have diabetes will contract diabetic retinopathy, an asymptomatic disease that causes rapid vision loss, but is treatable if detected early. Less than 40 percent of diabetics receive their mandatory annual eye screening due to cost, inefficiency, and lack of specialist availability. Spect is developing the EyeLogic platform, a point-of-care device intended to provide diabetics with a 15-second vision screening for no additional cost by bringing the eye exam to the primary care doctorâ&#x20AC;&#x2122;s office. The platform combines proprietary hardware with a machine-learning algorithm to capture high-quality images of the retina using a smartphone attachment for instant analysis and diagnostic capabilities. 39 | HS&M OCTOBER/NOVEMBER 2018

Execution Award Finalists ATACOR AtaCor Medical is developing a novel pacing system that will deliver temporary and permanent bradycardia pacing therapy without the need for vascular access or device placement within or on the heart. The implant procedure uses a custom delivery tool and can be performed within five minutes by eliminating the need for fluoroscopically-guided lead placement in the heart or veins and allowing physicians to rapidly deploy pacing therapy in the patientâ&#x20AC;&#x2122;s existing bed location. Current cardiac pacemakers inevitably involve invasion of the vasculature and heart, with significant short- and long-term complications. AtaCorâ&#x20AC;&#x2122;s pacing lead is designed to reside in the tissue above the heart and can be inserted without medical imaging, reducing the time to deliver treatment for patients and saving cost for hospitals. AURIGEN MEDICAL Atrial Fibrillation (AF) is the most common heart rhythm disorder in the world, and treating patients with long-standing persistent atrial fibrillation (LSPAF) is expensive, timeconsuming, and most often ineffective, significantly increasing the risk of stroke in patients. AuriGen is developing a cardiac implant designed to electrically and physically isolate the left atrial appendage (LAA), a leading source of arrhythmia generation, making it the first minimally invasive implant that would reduce both arrhythmia and stroke risk in patients with long-standing AF.

HS&M OCTOBER/NOVEMBER 2018 | 40

INNOVATION PERCUSENSE PercuSense aims to improve outcomes and reduce the cost of sepsis, the primary diagnosis in more than 1.2 million hospitalizations in the U.S. The companyâ&#x20AC;&#x2122;s device, SIRSDx, is being developed for the early identification and treatment of sepsis to prevent its progression in patients. The lowcost, minimally invasive sensor device is designed to continuously measure lactate, glucose, tissue oxygenation, tissue perfusion and temperature to enable rapid feedback for therapy optimization in a disease where time is critical, thus improving sepsis mortality and saving patient lives. The device can be placed on at-risk patients not only in the hospital, but also in ambulatory settings for early monitoring and diagnosis of sepsis risk.

PHOTONICARE Ear infections occur in four out of five children, yet care providers have had no choice but to make subjective diagnoses based largely on the surface appearance of the eardrum due to outdated technology, and resulting in misdiagnoses of up to 50%, overprescription of antibiotics, and unnecessary or delayed surgeries. PhotoniCareâ&#x20AC;&#x2122;s handheld ear imaging tool uses an advanced light-based technology designed to see through the eardrum and into the middle ear. The non-invasive imaging technology is similar to the ultrasound, except that it uses near-infrared light waves instead of sound waves to provide 3D views inside living tissue to eliminate guesswork, replacing subjective diagnosis with objective data.

41 | HS&M OCTOBER/NOVEMBER 2018

PNEUMONICS Pneumonics is developing PneuMotion, a respiratory monitor for the detection of opioid-induced ventilation impairment, a serious and potentially lethal adverse side effect of prescription opioids. The sensor device is specifically designed to detect an airway obstruction, a critical sign of impending opioid overdose, by monitoring a patient’s breath sounds and diaphragm motion. When critical parameters are met, an immediate alert would be sent to a care provider’s mobile device, facilitating early life saving intervention. The PneuMotion platform was developed to merge with the hospital’s existing network infrastructure, allowing mobile alerts, EMR integration and opioid-use data collection for a cost effective and reliable solution to opioid safety in hospitals.

Honorable Mention EMOVI INC. Emovi stands for Emotion, Movement, Vision. The company develops solutions to better assess and treat human joints. It has completed the development of the KneeKG, a proprietary and innovative weight-bearing 3D High-Tech Dynamic Knee Assessment tool for patients. This non-invasive tool provides objective kinematic information critical to diagnosing a specific pathologic pattern and developing a focused treatment strategy to restore optimal knee function. The KneeKG or “Knee Kinesiography”, transforms the knee care pathway, enhance patients’ care, maximizing their satisfaction and reducing costs. KneeKG is now present in eight countries with thousands of satisfied patients and is FDA cleared, HPB approved (Canada) and CE marked. •

COMMENT HS&M OCTOBER/NOVEMBER 2018 | 42

INDUSTRY TRENDS: BY THE NUMBERS Compiled by Cari Kraft, Jacobs Management Group, Inc.

$391B Net brand spending in 2018 in developed markets Net brand spending for this year is expected to decline in developed markets from 1% to 3% from 2017, approximately $5B less. This is expected to remain relatively flat through 2022, due to caution about reimbursement and access. Source: 2018 And Beyond: Outlook and Turning Points, IQVIA

27%

Percentage of voters who consider healthcare the top issue they want candidates to address Healthcare was measured as the most important issue to 27% of voters, coming in right behind corruption in Washington and ahead of the economy and jobs, immigration, Russian meddling in the 2016 election and gun policy. An additional 54% considered healthcare somewhat important. Source: Kaiser Health Tracking Poll, September 2018

31%

Number of physicians in private practice vs. employed In 2018 only 31% of physicians have identified as being in independent private practices as owners or partners as differentiated from being employed by hospitals or medical groups. This is down significantly from the 2012 figure of 48.5% who were in private practices. Source: 2018 Survey of Americaâ&#x20AC;&#x2122;s Physicians Practice Patterns and Perspectives, conducted by Merritt Hawkins on behalf of The Physicians Foundation

51-69%

Rate of non-adherence among major depression patients Major depression patients are estimated to have among the highest rates of nonadherence, followed by those suffering from schizophrenia (30-60%), coronary heart disease (40-50%), ADHD (26-48%), and bipolar disorder (21-50%). Source: Medication Matters: Causes and Solutions to Medication Non-Adherence, National Council for Behavioral Health, September 2018 43 | HS&M OCTOBER/NOVEMBER 2018

69%

Patients who said the benefits of a product are more important than the brand In a survey of over 8000 patients in the US, UK, Germany and France, over two thirds of respondents said that the benefits of a product were more important than the brand. Only 31% reported having a â&#x20AC;&#x153;strong affinityâ&#x20AC;? for brand names. Source: Product Launch: The Patient Has Spoken, Accenture, 2018

269

Number of biosimilars currently in development by China China currently leads the world in the development of biosimilars, with an estimated 269. India is close behind, with 257, and the US comes in third, with 187. Other countries active in this area are South Korea (109), Russia (97), Switzerland (57), Argentina (48), Japan (45) and Brazil (37). Source: 2018 Global Life Sciences Outlook, Deloitte

COMMENT

104,900

Projected physician shortage by 2030 Comparing supply and demand, current doctor shortages are at around 40,000, and are anticipated to grow to over 104,000 by 2030. Source: Complexities of Physician Supply and Demand, 2017 Update, prepared by IHS Markit for Association of American Medical Colleges

HS&M OCTOBER/NOVEMBER 2018 | 44

SALES

Great Advice From Great Minds: EMD Serono Field Force Effectiveness Lead: Supercharge Skill Sets! Tim Moore , U.S. Field Force Effectiveness Lead for EMD Serono, talks with Jill Donahue, Author, EngageRX Tim Moore is U.S. Field Force Effectiveness Lead for EMD Serono, and he has a great attitude about how change happens. It’s not about focusing on deficits: it’s about looking at opportunities.

45 | HS&M OCTOBER/NOVEMBER 2018

SALES How many people do you know who have had long careers in this industry at just two companies? Tim started at Eli Lilly as a sales rep, moved into sales training in neuroscience, and then to payer planning and strategy, district sales manager, payer marketing director, and Alzheimer’s platform payer marketing director. It was only after all those responsibilities that he moved on to EMD in 2015 as neurology and immunology payer marketing director and ultimately to his current role. After speaking with him, we would ascribe Tim’s tenure and rise to his thoughtfulness, tenaciousness and insight. We caught up with Tim at the 2018 meeting of LTEN (Life Sciences

Trainers and Educators Network) this past June in Phoenix. He’s a real change agent, and not afraid to challenge customs and practices. At Serono he was put in charge of sales training, but then changed the title of the department to Field Force Effectiveness, and for good reason. Training, he says, is an occasional thing. Effectiveness, on the other hand, is a system of continuous improvement. What needed improving? That in itself was a major question. As Tim explains, Serono has a highly tenured and impressive sales force. When he first introduced the idea that they could do even better, he got some pushback. They were already doing pretty well. But that

Timothy Moore

47 | HS&M OCTOBER/NOVEMBER 2018

was where Tim’s view of opportunity vs. deficiency came into play. There was additional territory to be had, if only the company could assess the potential of its people. The goal was to assess and optimize specific skill sets associated with being effective sales reps. It was based on data, which, as Tim says, doesn’t lie. To discover what the opportunities were, he knew he needed an impartial partner. Here’s how the plan progressed: • Impartial partner: He brought in a vendor that helped define the needed skill sets. This avoided self-examination, which is often unreliable

• Culture of accountability: This revolved around holding not just the reps, but also the DSMs accountable for assessing both skills and performance • Continual upgrading: Knowing what you could be doing better, and having a plan for achieving that. It’s not easy with a field force already performing well, but Tim’s attitude was that anyone can do better with a little insight and incentive • Dive into the data: This is what you might call evidence-based selling. If the data tells you something different than what you believe, question your beliefs • Teamwork: Have the coaches and the field force do independent assessments, and then compare them to see where the discrepancies are. This fosters a conversation about how to measure and track progress. Again, a third party helps bring an unbiased eye to the discrepancies. It’s what Serono calls the Platform for Growth • Score! Finally, developing a system for scoring both skills and progress gives everyone a way of looking at success in an agnostic way. It takes the personal out and puts the scientific in Tim says he really valued his time as a DSM, which allowed him to form a trust relationship with his colleagues and help them develop themselves. He also subscribes to the patient-centric point of view, and says that it, too, requires work to achieve. “It’s easy to lose sight of the end goal, which is helping patients. As trainers, it’s up to us to stay true to that.” In pursuit of this, Serono has brought in patients to talk about their struggles, and how their disease state impacts their day-to-day activities and their families. They also launched an initiative specific to caregivers called Embracing Care, to help these caregivers help the patients. Tim says that, in designing workshops and training, the key question should always be “How is this going to help the customer?” The mindset is “How would you want someone close to you to be treated?” What he appreciated about being at LTEN was that the natural competitiveness of salespeople is put aside, and they are there to learn from each other and share best practices. Many thanks to Tim for sharing his with us! •

Jill Donahue Principal, Excellerate Author, Engage Rx: The 3 Keys to Patientfocused Growth Co–founder, The Aurora Project Jill, HBa, MAdEd, is a keynote speaker, author and thought leader who has authored two books on Influencing in patient-focused ways and co-founded The Aurora Project, a global patient-centricity group. She also serves as Associate Editor of Healthcare Sales & Marketing. Jill.Donahue@excellerate.ca

COMMENT

HS&M OCTOBER/NOVEMBER 2018 | 48

MOTIVATION

MOTIVIDEOS By Cari Kraft, Jacobs Management Group You arrive at the office scrubbed, groomed, caffeinated and motivated—or do you? Some dawns are tougher than others. That’s why we have this regular feature to kick off the morning with an inspirational, thoughtful or humorous video that will energize your meeting and give you a reason to face the day with optimism. Technology to the Rescue Every day something amazing is happening in our field of healthcare. We all know how the ravages of Parkinson’s Disease disrupt lives and dismay families. Here’s some hope from the technology forefront—an incredible change in one patient’s ability to function. Teamwork! Does your team need a little motivation for working together? Kevin James, in the movie “Here Comes The Boom,” shows how to get all of those cells to work together…to become a team.

Lookers, Listeners and Touchers—and How to Communicate With Them Lynne Franklin explains how to read the person across the table, and how to make meaningful rapport without judgment—just insight. The Secret to a Joyful Life Ingrid Fettell Lee wanted to do things that were meaningful and useful. When a professor said her work gave him “joy,” she was disappointed. But then she discovered how important it is to awaken joy in others—in both professional and personal settings.

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 OCTOBER/NOVEMBER 2018

TOP LISTS the publication for healthcare sales & marketing leaders™

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Technology to the Rescue

Teamwork!

51 | HS&M OCTOBER/NOVEMBER 2018

Lookers, Listeners and Touchersâ&#x20AC;&#x201D;and How to Communicate With Them

The Secret to a Joyful Life

HS&M OCTOBER/NOVEMBER 2018 | 52

INDUSTRY

Why I Work In Healthcare

From Attendees at the 2018 Digital Pharma East Conference We recently attended Digital Pharma East, here in our home city of Philadelphia. As usual, there was a lively and engaged group of people from all over healthcare, eager to catch up with the latest developments and collaborate with colleagues to advance sales, marketing, IT and other skills in our industry. Here are some participants who agreed to participate in our Why I Work in Healthcare campaign, highlighting the ideas that keep them inspired.

COMMENT

53 | HS&M OCTOBER/NOVEMBER 2018

Accelerating Better Business Results

Gender Parity Collaborative

Founding Member Organizations of the HBAâ&#x20AC;&#x2122;s Gender Parity Collaborative

The Gender Parity Collaborative is a unique consortium of healthcare and life sciences companies dedicated to accelerating gender parity through environmental and systemic changes. Together, our Collaborative members commit to taking an active role in defining strategies, measuring performance, creating change and inspiring others. Join a select group of senior leaders, men and women, committed to change and to accelerating better business results through gender parity.

GenderParity.HBAnet.org #4GenParity

AGENCY AND PROVIDER SPOTLIGHT: YOUR CHOICES WILL BE IN FRONT OF THOUSANDS OF INDUSTRY EXECUTIVES WHO READ HS&M To be sure most of our readership is aware of this new feature, we’re re-running our inaugural Spotlight entry on the RxEdge agency. This will be an ongoing focus on the industry’s leading agencies and consultants. Because of demand from our readers, we are digitally compiling a searchable directory that will ultimately give you access to the who’s who, their strengths, vision for the future, strategies and successes. This will be your compendium of all the best resources in healthcare.

RxEdge was founded in 2000, and were already ahead of their time. RxEdge is a visionary company in providing access to patients through its extensive network of close to 30,000 pharmacies, representing 70% of total retail prescription volume. Having worked with many of the pharma majors, such as Merck, Astellas, Takeda, Allergan, Sanofi, Novo Nordisk, AstraZeneca, GSK, Pfizer, Lilly and BMS, RxEdge puts brands frong and center in America’s number one healthcare destination: the pharmacy.

Submit your choices for this new Spotlight. HS&M is driven by the input of our readers, so please let us know if you have an agency or provider who would be a good candidate. Every agency we feature will come out of these recommendations. You’ll see the leaders, with links to their relevant data, their philosophy and history, as well as the skills that make them stand out. As always, we want the hottest industry companies and the top thought leaders in these pages. Our goal is to constantly expand the value we bring to you.

If you have an agency or a provider to recommend, please reach out to our Associate Publisher, Natalie Newcamp, at nnewcamp@hsandm.com, so that we can evaluate your choice for exposure to the thousands of our industry executive readers.

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SPOTLIGHT LEADERSHIP

Rx EDGE Media Network In 2000, when we formed Rx EDGE, little did we realize that we were ahead of our time. Our vision of helping consumers take more control over their healthcare by providing information about Rx brands through influence media is exactly where both healthcare and media would end up today. WE HELP CONSUMERS WHO HELP THEMSELVES

JIM O’DEA President and CEO

MIKE BYRNES EVP, Sales

KEY STATS Rx EDGE was founded in 2000, and is a division of LeveragePoint Media LLC.

INSIGHT No matter where consumers are they are bombarded by unwanted ads for products that may or may not be relevant to them. And they have learned to ignore them. But we have a completely different relationship with consumers.

PHILOSOPHY These days, media is defined differently. It’s about fans and followers, and being where the action is. If you have the scale to influence, you’re media. Think of Rx EDGE Media Network as the most efficient and effective in-pharmacy influencer.

CONTACT Michael Byrnes, EVP, Sales michael.byrnes@rx-edge.com Office: 610.431.7606 Cell: 856.577.6388

These days, people spend less time with doctors and more time taking healthcare into their own hands. They’re mindful and resourceful. The pharmacy is the new healthcare hub and in-aisle is where consumers are actively searching for products and medicines to care for themselves, their ailments, conditions, and related needs. When consumers are in the pharmacy, Rx EDGE is the only targeted media that’s exactly where they’re looking. That’s why brands that use Rx EDGE average script lifts of 12.5% and ROI of $8.12. Visiting the pharmacy is not a one-time event. The average American lives within just two miles of a community pharmacy and over 275 million visit a pharmacy each week. Without over-the-counter medicines 60 million Americans would not seek treatment. Pharmacies are increasingly becoming a healthcare destination, with many offering on-site vaccinations and frequently hosting wellness events and health screenings.

AS CONSUMERS APPROACH HEALTHCARE DIFFERENTLY, BRANDS NEED TO APPROACH THINGS DIFFERENTLY, TOO. Rx EDGE Media Network is different for all the right reasons. No other media delivers like Rx EDGE. • Our displays get noticed and motivate action through takeone booklets that deliver product information, doctor-patient discussion guides, savings offers, and disease education.

Read our white paper to learn more about the emergence of the pharmacy as a healthcare hub and trusted patient resource. Participating in the media opportunities created in the new, diverse pharmacy is an ideal way to support brand goals to deliver more targeted and more effective messages to patients.

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SPOTLIGHT:

Rx EDGE Media Network

• We have generated 4.8 million incremental Rxs and created 3.5+ million displays for a breadth of categories spanning 155 brands and 85 manufacturers. • Our expansive reach delivers more than 750 million impressions in a 12-week period across a network that represents over 75% of U.S. Rx volume. • Consumers go to the pharmacy for a specific reason, and the pharmacy is a constant in consumers’ lives. No other media has their attention the way we do when they’re searching for answers about their health and most motivated to act.

• Our Insight EDGE targeting platform insures that your brand is present in the optimal pharmacy section and geographic locations so your message matters to the consumers it reaches.

country, across 29 of the 50 top Rx retailers, Rx EDGE puts brands front and center when consumers are most receptive and motivated to act.

• We use a matched-panel experimental design protocol to measure our programs. It is considered the Gold Standard in marketing measurement because of its validated statistical design and level of accuracy.

Today alone 2.9 Million consumers stood in front of one of our displays. If your brand was there you could’ve met them. All of them.

Unlike other media, consumers come to us…when they’re searching for the information we have about Rx brands. Across the

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SUBSCRIBE HS&M OCTOBER/NOVEMBER 2018 | 58

MARKETING

SOCIAL MEDIA: Are You Speaking Where Most Docs are Listening? A Major Survey by MedData Group Department store magnate John Wanamaker is famous for saying “I know that 50% of my advertising dollars are wasted. I’d just like to know which 50%.” Pharmaceutical companies have a similar dilemma. They are one of the largest advertisers in the overall marketplace and across all media, but in the avalanche of data collected about this effort it’s hard to tell what messages are working, to which demographics, on what platforms, at what time. It’s estimated that over $24 billion is spent advertising to the over 1 million physicians in the U.S. So, in a belt-tightening era, it’s natural that healthcare companies need to know what Wanamaker wanted to

know: where is the waste, and how can we be more efficient with our budgets? MedData Group is one of the companies working on answering those questions. It provides high quality professional healthcare data solutions to support and fuel healthcare professional (HCP) audience identification, segmentation, targeting, and insights about digital targeting, programmatic advertising, social media advertising, addressable TV, email marketing and postal mail.

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Their MedData Point surveys ask physicians across age, specialty, and practice size about their opinions, perceptions, and preferences on healthcare and pharmaceutical marketing geared toward them. This analysis provides insights into the latest trends, technologies and perceptions in healthcare among physicians and other healthcare professionals and across a variety of specialties and practice sizes. The following survey data is reflective of 245 U.S. physicians.

E Y E F OR PH AR MA AWAR DS 2 019

Because your patients want you to win You’ll already know if you’re a winner. Your patients or customers are telling you. We are searching high and low for pharma’s best innovators and future leaders who are prioritising patient and customer value and changing the face of pharma.

There are five award categories Most Valuable Patient Initiative

Most Valuable HCP Initiative

Most Valuable Collaboration

The Patient Champion Award

Lifetime Achievement Award

2018 North American winners included:

Most valuable patient initiative:

Most valuable HCP initiative:

Most valuable pharma collaboration:

Novocure/nCompass

BD/Vascular Access Management Program

Allergan, SonarMD and Illinois Gastroenterology Group/ IBS-D Patient Engagement Platform

ENTER NOW at eyeforpharma.com/awards Entries close 16 November 2018

MARKETING DOCTORS ARE CONSUMERS, ON AND OFF THE JOB Even when not “at work,” HCPs are alert to the topics that interest them professionally. MedData found that 90% read professional content in out-of-office settings.

THEY WANT THE NEWS ON EMERGING THERAPIES AND TREATMENT OPTIONS When asked if they are receptive to receiving information from pharma companies about new drugs and treatment options, 75% of respondents said they were. Further probing revealed the categories they were most interested in:

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A healthy 45% want drug information, and only 21% say they rarely engage with online advertisingâ&#x20AC;&#x201D; meaning that 79% do it occasionally or often. A deeper dive into that preference revealed the following:

AND THEY TRUST THAT NEWS Another positive trend is that many physicians value and trust the content they receive through social media campaigns

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MARKETING

LINKING UP WITH LINKEDIN Because itâ&#x20AC;&#x2122;s where you would expect to find professionals seeking industry-related information, LinkedIn was worth further investigation:

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BREAKDOWN BY SPECIALTIES Finally, a brief look at the habits of both primary-care physicians and specialists on social media:

Itâ&#x20AC;&#x2122;s a continual task to assess, target and refine messaging where the eyes and ears are. This data can put you on a clearer path to grabbing the attention of the HCPs you want. See the full report here.

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MED TECH

Evaluate MedTech: $595B Total Sales by 2024, and Medtronic Still Leads As a companion to our Top 50 Med Device list in this issue, we are providing these highlights from the The EvaluateMedTech® World Preview. Evaluate MedTech publishes this preview covering the world’s leading medical device and diagnostic companies. The full version can be downloaded at evaluate.com/MedtechWorldPreview2018.

The US remains the largest medical device market in the world, currently at around $156 billion, representing about 40 percent of the global market in 2017and responsible for almost 2 million jobs in the US. The Department of Commerce says U.S. exports of medical devices in key product categories exceeded $41 billion in 2017. Major findings that we gleaned from the report suggest that the medtech sector is expected to grow at 5.6% per year (CAGR) between 2017 and 2024, culminating in 2024 global sales of $595B. Mergers have been responsible for many of the recent shifts in the medtech sector. The purchase of C. R. Bard is expected to make

Becton Dickinson a top-five player by 2024, with a forecast annual growth rate of 8.3%. Interestingly, lens maker Essilor will jump three places in the table with forecast 2024 sales of $11.6B. Global medtech R&D spend is set to grow by 4.5% (CAGR) to $39B by 2024 The analysis is based on in-depth forecast models for the top 300 global medtech companies available within EvaluateMedTech. This sales forecast represents the only current consensus view from equity analysts of the entire medtech market. HIGHLIGHTS Once again, Medtronic is forecast to be the largest company by medical device revenues in

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2024, with sales of nearly $39B. Medtronic will also remain the top group in cardiology in 2024 with sales of $14.2B, a 20% market share. Medtronic spends the most on R&D, which is forecast to reach $2.7B in 2024, growing at 2.8% CAGR between 2017 and 2024. Heart valve specialist Edwards Lifesciences and French diagnostics company bioMérieux, however, are the top spenders when it comes to the percentage of sales they invest in R&D, each showing an R&D investment rate of nearly 16% in 2024 In vitro diagnostics will remain the number one device area in 2024 with sales of $79.6B, and diagnostic imaging sales are forecast to reach $51B in 2024; Siemens

Healthineers, General Electric and Philips continue to dominate the market. Amazingly, a new entrant, Exact Sciences, has rocketed 14 places. This group is expected to have sales of $1.8B in 2024, with a forecast 31.2% annual growth rate from 2017 Neurology is set to be the fastestgrowing device area, with a CAGR of 9.1% between 2017 and 2024; diagnostic imaging and orthopedics will be the slowest, with annual growth of just 3.7% between these years Essilor will continue to dominate the ophthalmic market in 2024, with forecast sales of $11.6B. The FDA granted first-time premarket approval to 51 medical device products in 2017, up from 40 the year before. This equals the record set in 2015 . The number of

the third largest player in 2024 with potential sales of over $26B. Becton Dickinson is currently the eighth biggest medtech company in the world, but it is expected to move into the top five by 2024 following its acquisition of C.R.Bard, which should boost sales that year to over $19B. However, Philips and Stryker are close behind with forecast sales just shy of $19B. (See figure 2)

products that gained supplementary PMAs and510(k) clearances reached new heights at 2,675 and 3,248, respectively. WORLDWIDE MEDTECH SALES BY DEVICE AREA IN 2024 Worldwide medtech sales are forecast to grow by 5.6% (CAGR) to $595B by 2024; IVD remains number one. (See figure 1)

WORLDWIDE MEDTECH R&D SPEND (2011-2024)

WORLDWIDE MEDTECH SALES IN 2024: TOP 10 COMPANIES Medtronic will remain the top medtech company in 2024; Becton Dickinson to enter the top five. Following Abbott Laboratoriesâ&#x20AC;&#x2122; acquisition of St. Jude Medical and Alere, and the disposal of its eyecare business to Johnson & Johnson, it is set to remain

Global medtech R&D spend continues to increase at a growth rate of 4.5% (CAGR) with expenditure of $39B expected by 2024. The R&D investment rate, as a percentage of sales, is expected to decline from 8.7% in 2017 to 8.1% in 2024. (See figure 3)

(Figure 1)

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MED TECH

(Figure 2)

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(Figure 3)

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MED TECH (Figure 4)

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MEDTECH R&D SPEND IN 2024: TOP 20 COMPANIES Medtronic tops table of R&D spenders in 2024 with $2.7B forecast, growing at a 2.8% CAGR between 2017 and 2024 Becton Dickinson and Edwards Lifesciences are forecasted to increase their annual R&D spend the most, growing at a CAGR of 8.4% and 8.3% respectively. Despite the fact that the majority of the top 20 companies are expected to spend a smaller percentage of their revenue on R&D in 2024 than they did in 2017, total medtech market R&D spend is set to increase by 4.5% each year. Edwards Lifesciences and bioMĂŠrieux are expected to invest substantially more in R&D as a percentage of their medtech sales than the other top 20 companies, with an R&D investment rate of nearly 16% in 2024. (See figure 4)

SECTOR PREDICTIONS In Vitro Diagnostics Market The in vitro diagnostics market as a whole is estimated to grow at 6.1% (CAGR) between 2017 and 2024 to a worldwide total of nearly $80B. It will remain the number one medical device segment for the forseeable future. Roche will still be on top, estimated to have a substantial 17.8% market share in 2024. Following the acquisition of Alere, Abbott is set to become the second largest IVD company, with 2024 sales forecast to top $10B. Third-placed Danaher also continues to invest in the space with the acquistion of Integrated DNA Technologies for $2B. Cardiology Market The cardiology industry is expected to grow at 6.4% per year to $72.6B in 2024. Medtronic continues to prevail as the largest cardiology company with 2024 sales expected to reach $14.2B, and a predicted market share of 19.5%. Abbott Laboratories will also make strides in the cardiology market following its acquisition of St.

Jude Medical, and is set to cement its top two position in 2024 with expected sales of over $11B and a market share of 15.4%. Diagnostic Imaging Market The diagnostic imaging market is set to grow from a global total of $39.5B in 2017 to $51.0B in 2024, at an expected CAGR of only 3.7%.. Siemens Healthineers and General Electric will lead this sector in 2024, with forecast sales of nearly $12B, representing 23.5% of the market. Following closely are Philips and General Electric, both of which are expected to have over 20% of the market in 2024. Orthopedics Market Growth in the orthopedic sector is expected to remain sluggish, with a CAGR of just 3.7% between 2017 and 2024, and sales in 2024 expected to be $47.1B. Johnson & Johnson will lead the way, with sales of $10.3B and a market share of 21.8% in 2024. The company gained 43 orthopedic device approvals in 2017, with over half of these being for hip and knee replacement systems. â&#x20AC;˘

COMMENT FOR MORE INFORMATION ON THIS REPORT, CONTACT: North America: Tom Moore Tel: +1 617 573 9454 / Email: thomas.moore@evaluate.com For general questions: Jennifer Dinkel Tel: +1 617 936 7783 / Email: jennifer.dinkel@evaluate.com

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