I was formerly a doctor and a dentist, specialising in facial surgery.
I really loved working with patients, but I didn’t like all the bureaucracy, politics, and inefficient processes that come with working in a hospital, and I quickly realised that it wasn’t an environment where I could thrive. I thought that if I had a bigger lever in my hand I could potentially impact far more people than I could as a doctor. That was the guiding thought that ultimately led me to moving into the business world and joining a consultancy, where I worked with pharmaceutical companies, hospital systems, and payers and got a good understanding how the different players in the healthcare environment interact with each other.
Four years in I got the chance to join Zocdoc, a doctors appointment booking platform and one of the first tech disruptors in healthcare. After that I went to another startup in Germany, moving out of my comfort zone and into the energy industry. While this turned out to be successful as well, I also realised that my passion is in healthcare and I wanted to move back into that area.
Why did I take the opportunity at Sandoz? It was being able to go from an entrepreneur to an intrapreneur. At Zocdoc our main focus was to build a platform, build a marketplace and bring people onto it. At Sandoz it’s the other way round – we already have a platform of 500 or 600 million people, so it’s about how we leverage that platform with data and technology and make healthcare more accessible and efficient for patients. That was a challenge I was and still am very excited by.
There’s a lot of startup DNA within Sandoz already. We view ourselves as pioneers, and that goes back decades. The first antibiotic was developed by Sandoz, and more recently we pioneered the development of biosimilars and are still a leader in that field today. It’s in our DNA to venture into new fields.
Looking at the broader scheme of things, we see a push towards consumerism. More power is being shifted to the patient – they’re more educated, they expect better service, easier access to healthcare. I think it’s a natural fit for us to look into data and digital to see how we can facilitate this access for our patients.
The short answer is history will tell! At this point it’s too early to say who’s right and who’s wrong. Everyone is trying to learn and find out what the right areas to go into are. Digital is very broad and it’s easy to get lost, so you have to take smart risks in order to assess where you want to focus.
You can look at both internal and external focuses. Internal covers all the digital and data tools you can use in order to improve your core business. For simplicity’s sake let’s say our core business is generics – for our internal focus we might want to look at how we become more efficient and drive development in supply chain, in drug delivery, in increasing access as a whole. An external focus, for example, would be asking how can we tap into digital therapies, where is the world moving to and how we can leverage new technologies in order to increase access. In very broad strokes, this is how Sandoz has started to look at the world, and then within these two buckets we identified a couple of lighthouse projects to go after.
Usually when you ask two people about what defines digital therapeutics you’ll get three opinions! To us, digital therapeutics are something that is delivered or administered by a clinician to treat disease, that has been proven safe and effective in clinical trials and has been through a regulation process leading to a label with safety and efficacy claims. This is different from your typical health or wellness app.
At this point it’s more complementary. The big areas where they’re being used are fields like neuroscience, addiction, depression and insomnia, but people are also looking into fields like Alzheimer’s Disease, multiple sclerosis, and schizophrenia. The next stage will probably be metabolic diseases, and then mobility and aging.
These are all areas that include complex diseases where you cannot simply provide a pill and the disease is cured. In these areas you have to work with multiple modalities, and right now digital therapeutics are just another tool in your toolbox to help positively influence outcomes.
This is obviously a very important topic. With data comes a lot of opportunity but also a very big responsibility. We all know that there’s a lot of value in mining data and making smart algorithms to drive decisions. On the other hand, you have the need and the requirement for data privacy – no one wants their data to be exposed. It’s not 100% clear how this will play out, and we probably have to work with regulators and all involved parties, but it’s very clear that we have to keep patients’ interest in mind in order to not compromise any aspects of their privacy.
The pharma industry’s dirty little secret is that any drug that comes to market is a compromise. If there’s a pill on the market with 40mg strength, that is a compromise between limiting side effects and maximising therapeutic impact, and when it comes to the general population it’s an even bigger compromise because the strength that is right for you might be very different from the strength that is right for me.
I think the ultimate step towards personalised medicine would be dose optimisation and level monitoring in real time – a combination of a sensor, a smart algorithm, and a delivery system that optimises your drug dosage.
But while it’s very interesting to think about things that are ten years out, right now our biggest focus is to make the first digital therapeutics a success and lay the foundation for this therapeutic class.
When you talk to people with experience of digital transformation, they usually tell you that its 20-30% technological transformation and 70-80% cultural change and mindset shift. I’m excited about the continuing culture shift within Novartis and Sandoz – moving to a looser hierarchy and agile teams, and realising that it’s ok to run a smart risk, fail and learn from that failure and move on. That’s what I’ll likely be most proud of in five years’ time.
Dr Paul Tunnah founded pharmaphorum in 2009, which is a content and communications company offering industry leading publications (www.pharmaphorum.com) and a strategic consultancy (www.pharmaphorumconnect.com). He is a recognised author, speaker and industry advisor on content marketing, communications and digital innovation, having worked with many of the world’s leading pharmaceutical companies and the broader ecosystem of healthcare organisations.