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Spotlight: Astellas U.S. President, Percival Barretto-Ko, on Purpose, Pricing, and Better Access to Healthcare

Astellas U.S. President Percival Barretto-Ko: Better Access to Healthcare is the Goal

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Percival Barretto-Ko, Astellas U.S. President, comes from a background as a chemistry and biology teacher at a high school in a small town just outside of Boston. He credits his time spent in the classroom as opening his eyes to the possibilities of science. It also equipped him with the tools needed for leadership. “Authentic storytelling is at the heart of teaching,” he says. “As a science teacher, to engage students in the world of STEM, it’s important that you paint a convincing story that excites and motivates them — stories that show the value of science in their lives. This inspires them, crystallizing and painting a vision so that they will gain a better understanding.” In his role at Astellas, he implements the same philosophy in developing vision and strategy for Astellas employees. He is intent on creating a vivid image of how Astellas will continue to create and deliver value for patients and envision their path forward. “This ensures we have a collective story in mind as a patient-centric organization. Externally, it’s important that

I continually share Astellas’ story with external stakeholders, about who we are, what we stand for, and what we believe in.”

EARLY INFLUENCES Following business school, Barretto-Ko joined Roche, where he held commercial leadership positions across a spectrum of therapeutic areas, ranging from oncology to virology. In 2005, he joined Astellas Pharma and after occupying several leadership roles in the US and Europe, he was appointed as President of Astellas Americas in March of 2018, overseeing Astellas’ operations across the region. Plugging the gap between innovation and access is his top priority. Barretto-Ko’s move from academia to the life science industry was driven in part by this motivation. “Growing up in the Philippines, I saw firsthand what it means to lack access to healthcare. Without a doubt, this early perspective — as well as the experiences I’ve had professionally in Europe and in other regions— has shaped my philosophy about the importance of both innovation and access to quality care. Innovation must be paired with access, and the combination of the two is what creates value for patients. Innovation on its own serves no purpose. It’s a personal mission for me.” “Growing up in the Philippines, I saw firsthand what it means to lack access to healthcare. This early perspective…has shaped my philosophy about the importance of both innovation and access to quality care.”

While he is encouraged by the innovative therapies that have come out over the last 10 years, he also acknowledges that getting them to patients remains a grave challenge. “Part of my focus is to work with my colleagues and external stakeholders to ensure that our healthcare system is able to keep pace with the science. This is the essence of value,” he says.

LEARNING LEADERSHIP At Roche, Barretto-Ko was part of their Leadership Development Program, giving him a unique opportunity to experience a variety of roles. “In addition, I was blessed to have influential mentors who guided me along the way. A lesson these mentors taught me early on was to take risks in my career and to pursue roles that, at first, may seem like lateral moves, but were new experiences that would stretch me in different ways.” “As a result, in 2003, I jumped at the opportunity to do an expat role at Roche UK, responsible for the hematology franchise. Within weeks of taking on my new role, I found myself in an infusion ward in Manchester, meeting several non-Hodgkin’s lymphoma patients undergoing treatment. At that moment, my career shifted from a job to something much, much more.”

UNLOCKING VALUE Barretto-Ko outlines Astellas’ approach as focusing on three pillars: patients, people and performance. “If you have a dogged, tenacious focus on the patient, and at the same time you have the right people and culture in place, the performance will follow. By focusing on the patient and the people, performance will surely follow.” The Astellas business model is centered around “value” — creating value through innovation and through enhanced services and capabilities for patients. “We spend 100 percent of our time and effort creating and delivering value for patients every day. This means moving from a massmarket approach to individualized and personalized care, measuring health outcomes, utilizing realworld informatics, listening to and learning from patients, and creating greater transparency in the system.” Last year, Astellas launched the “value gene,” a global strategic plan to translate innovation into value for patients. It delves beneath the surface of value and find ways to practically apply it to patients.

Astellas launched the “value gene,” a global strategic plan to translate innovation into value for patients.

Astellas is starting to structure clinical trials, research, development, and partnerships around this philosophy, says BarrettoKo. “What is the real value to the patient? How does our work impact their lives? Not just from an efficacy point of view, not just from a safety perspective, but from a psychosocial perspective, from an out-of-pocket perspective; from a logistics perspective.”

These holistic measures are essential to bringing value to patients. Additionally, Astellas recently announced the establishment of a new global division that is focused on the entirety of the patient experience. More broadly, patient experience includes all aspects of a patient’s care journey. The focus also extends to caregivers, who play an integral role in patient care, to better understanding and support of their experience.

THROUGH THE PRISM OF THE PATIENT Since launching its patient experience organization, Astellas has made improvements to its clinical trial consent forms to help patients. Astellas also understands that “no single entity can serve the patient fully and holistically” and that it needs to collaborate, internally and externally, with other key players in the healthcare system in ways that put the patient at the center. Their patient centricity function is dedicated to understanding patient needs through non-pharmaceutical focused collaborative projects with organizations that share similar aspirations and have the potential to deliver lasting effects for patients. To that end, Astellas has struck up a partnership with the Academy of Oncology Nurse and Patient Navigators (AONN+). “They play such a crucial role in navigating patients through a very complex

web of obstacles, not just clinical but the entire holistic treatment,” says Barretto-Ko. “One of the things that we’re developing with them is an evidencebased oncology-specific navigation tool for patients. This is intended to help patients clarify some of the questions that they might have, and when you get a diagnosis of cancer, you have a lot of questions to deal with and so do the caregivers.” It will have the potential to determine the level of support cancer patients may need from their oncology team to help them better understand their disease, treatment options and to empower greater engagement in their care along their journey.

“One of the things that we’re developing… is an evidence-based oncology-specific navigation tool…to help patients clarify some of the questions that they might have.”

When completed, the tool is intended to provide an opportunity to provide patients with the level of support that they need from a multidisciplinary oncology team.

THE PROBLEM OF PRICING Unlike some healthcare systems in the world, the prescription drug marketplace in the U.S. places a high priority on both access and choice for patients. “This is an important differentiator and strength. At the same time, our system is overly complicated and opaque — resulting in patients paying more out of pocket. At Astellas, we are working collaboratively with many stakeholders to help evolve our system in ways that preserve the effectiveness of market-based competition while improving affordability for patients in need.” Barretto-Ko says that modernizing the Medicare prescription drug benefit (Part D) is a prime example. Part D has successfully provided affordable access to medicines for millions of seniors over the past 13 years, but the program has not kept pace with the state of the science. “Due to the benefit design, seniors in need of cutting-edge specialty medicines are now facing significant cost burdens. We believe this challenge can be addressed through targeted, constructive policy revisions.” “Astellas, like many of our peers, focuses on science. But the fruits of that science must be translated into affordable access and value for patients. We can invent anything in the lab, but if it doesn’t reach patients, then the system isn’t working. Striking the balance between future innovation and sustained access is our priority. This requires creativity and collaboration as we work to implement innovative solutions — with a consistent emphasis on reducing out-of-pocket costs, strengthening and protecting intellectual property, incorporating the patient voice from discovery to delivery, and cultivating new partnerships with an open mind.”

SHAPING A SUCCESSFUL COMMERCIAL ENTERPRISE Looking ahead to 2019 and beyond, Barretto-Ko believes the true value of innovation will continue to drive conversations across the board. He cites the political landscape in the US, where the Trump administration has made pricing a hotbutton topic. Similar conversations are driving policy decisions in Japan, Canada, Latin America and Europe.

“This is no passing thought. It’s a good thing because, at the end of the day, it is a discussion about the needs of the patient.”

For Astellas, patient interests drive business goals and objectives. “For example, when we’re talking with employees about sales, we aim to translate that into the number of patients served, because it makes what we do real at the end of the day. Business results are important, but it’s the patients who we help that provides substance and meaning to our work and crystallizes who we are as a company.” “We are also empowering our people to make faster decisions and take calculated risks. For example, the patient centricity

team piloted two internal crossfunctional Results Accelerators, designed to fit within a 90-day timeframe and aimed at helping to achieve impactful results faster through enhanced collaboration and innovation. Results Accelerators are projects that can be completed in 30-60-90 days to deliver results that will have a significant impact to the organization.”

A CULTURE OF PURPOSE “For any enterprise to thrive, it’s important that there’s a clarity of purpose, a purpose that resonates across the organization. At Astellas, we are focused on creating a culture that is truly patient-centric, so we must appropriately represent and reflect the communities where we live and where we work.

“Diversity and Inclusion is a key strategic priority for Astellas that enables us to pursue what we believe in as a company. Creating a culture of diverse perspectives is at the core of serving patients, and we embrace diversity and inclusion in all forms as represented by seven dynamic employee resource groups (ERGs).” Recently, they brought on board their first Head of D&I, Eloiza Domingo-Snyder, who is responsible for developing and implementing a sustainable Diversity and Inclusion strategy that is embedded in the fabric of the organization, reflecting and enhancing their culture and work environment. GIVING BACK AS A COMPANY Looking back at his first year as president of Astellas US and what has been accomplished, BarrettoKo proudly reflects on the dedication of Astellas employees to the greater good through volunteer and community service efforts. “Our responsibility extends beyond our medical innovations — we hold ourselves accountable to our community and to those with whom we work and partner. Employees have volunteered more than 107,000 hours since 2005 to help address various community needs.” •

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