Reimagining the future of healthcare

Johnson & Johnson Innovation’s William Hait talks about how the company is aiming to change the trajectory of human health through new approaches to R&D

How J&J is connecting with the best external innovation
Why prevention, interception and cures are crucial for changing disease outcomes
Making cancer and other diseases “a thing of the past”

Johnson & Johnson’s global head of external innovation, William “Bill” Hait, describes innovation as often being “an overnight success you’ve worked on for many years”.

Hait began his career as a medical oncologist, spending almost 30 years in academia as chief of medical oncology at Yale, before starting the Rutgers Cancer Institute of New Jersey, which he led to receive the National Cancer Institute’s highest designation of Comprehensive Cancer Center in 2002. He joined Johnson & Johnson in 2007, assumed the role of global therapy area head, oncology, in 2009 and led Janssen Research & Development from 2011 through to 2018.

His current remit includes accelerating innovation at Johnson & Johnson by connecting the company with the best external science in strategic areas of focus across the pharmaceutical, medical device and consumer heath sectors.

As Hait explains, there are three basic components the company utilises to achieve this, starting with Johnson & Johnson Innovation – JJDC, a venture fund that invests in eligible start-ups and organisations. The company’s four innovation centres in Boston, Massachusetts, San Francisco, California, London, UK and Shanghai, China “allow us to meet and get to know the leading innovators in those regions with the idea that we could set up collaborations”, he says.

The third component is a series of JLABS incubators around the world, explains Hait. He says: “Through JLABS, we have now built a network of over 450 start-up companies. The idea is to help entrepreneurs focus on what they do best: develop new ideas into products and bring them to consumers, without having to worry about infrastructure or other resources and services JLABS provides to them.

“We provide entrepreneurs with extraordinary space and equipment, education programmes, introduction to venture capital, and advice such as how you make a submission to the FDA.”

The idea, according to Hait is “that these new companies will be closer to us than to other companies and when they wish to discuss a deal, they’ll come to talk to us.”

The three-pronged approach goes back to the vision of Johnson & Johnson’s vice chair and chief scientific officer, Paul Stoffels. “He said, ‘Let’s get out into key innovation hubs to make transformational solutions happen in partnership with young entrepreneurs’,” Hait remembers, adding: “So we went to create the cornerstones of Johnson & Johnson Innovation: We scout for promising external science through the Innovation Centres, support start-ups in our incubators and invest in some through our JJDC venture fund.”

Hait’s decision making is very much informed by rigorous training in the lab and in the clinic.

“My PhD adviser, Ben Weiss, was a highly respected pharmacologist – experiments had to be fully reproducible as we uncovered the existence of multiple forms of cyclic nucleotide phosphodiesterase that could be selectively inhibited by drugs. When people have asked me who has been important to my medical career, I name Ben.”

The decision to go from academia into pharma after a career as a physician and academic scientist was based on what Hait describes jokingly as a bout of “temporary insanity”.

Roy Vagelos, former CEO of Merck, a friend and mentor, suggested that Hait consider helping many more patients globally by joining the pharmaceutical industry. However, a head-hunter told Hait that he was too old to make such a bold career move. He said, “That works for me, I never wanted to join pharma in the first place.”

But the idea of broadening the impact he could have on patients through working in the pharma industry was still there when Hait began to develop close ties with J&J through his academic work, eventually joining the company in 2007.

“Because of my relationship with J&J through managing the Rutgers Cancer Institute, they asked me if I would take a look at what they were trying to do in oncology at the time.”

Hait began to contribute to the company’s plans in oncology so that the obvious move was ultimately to join forces. “I decided to give it my best and was able to create a structure and a strategy that I thought would work.”

Being a newcomer to the industry was in many ways an advantage, says Hait, who attributes his success and rise through the ranks at J&J to the leadership skills he picked up during his academic career. He became global therapeutic area head for oncology in 2009, and went on to lead Janssen’s global R&D from 2011 through to 2018 before starting his current role.

“I was well versed in oncology and basic research. I had held several leadership positions such as chief of medical oncology at Yale, and as the founding director of the Rutgers Cancer Institute of New Jersey. I believe that rigorous medical and scientific training and these leadership experiences made the transition from academics to industry easier than I might have expected.”

The grounding in academia also gave Hait an insight into how to innovate and a realistic expectation about the years of hard work required before one gets to a “eureka” moment.

How to be successful in innovation

Hait says that, to him, innovation is the result of a person or a group of people determined to solve an important and difficult problem that has never been solved before.

“What I’ve seen is that when someone is absolutely determined to solve a difficult problem that’s important to them they will stay with it for a long time to come up with a solution”.

In this sense, he says it is important to decide on a few areas to which you want to make a real contribution. “Once you’ve selected an area to focus on, you then get a group of people with diverse expertise together and ask them what it will take to solve that problem.

“I prefer that approach to someone who comes up with a platform and then tries to figure out what it might be good for. By being agnostic to the platform, you get people with diverse interests and backgrounds who are just completely focused on that particular problem and you can bring everything to bear to solve it.”

This was the approach Hait brought to Janssen Oncology, which began as a “start-up” with limited resources compared to J&J’s peers. He decided to only study prostate cancer and B-cell malignancies, and Janssen’s oncology pipeline became very competitive.

Recently, Johnson & Johnson launched its Lung Cancer Initiative, a new cross-sector initiative which aims to eliminate this devastating disease through prevention, interception and cures.

“We brought together a very diverse group of scientists from across all parts of the J&J enterprise, as well as external consultants. I asked the question, ‘What causes lung cancer?’ Everyone said that it was cigarette smoking. Then I said, ‘What causes cigarette smoking?’ And there was silence. So we started by trying to get to the bottom of the lung cancer problem.”

The Lung Cancer Initiative ties into Johnson & Johnson’s World Without Disease strategy, which looks to prevent and intercept disease rather than waiting until a person gets sick to only then treat them.

“We want to prevent or intercept the process that leads to lung cancer and other major diseases,” says Hait, “and if that fails, diagnose it so early that you can cure them. That’s different from standard practice at the moment, where lung cancer is typically diagnosed late, and we then figure out how to treat it.”

A challenge associated with this, though, is a lack of knowledge about the process leading to many diseases.

Hait explains: “There’s a massive amount of knowledge about cancer cells and the cancer microenvironment that has built up over the last decade or two. But, in terms of pre-malignancies, there’s extremely little knowledge of what’s going on.”

“We’ve had to create knowledge. We’ve had to invest in a ‘pre-cancer genome atlas’. We got access to pre-malignancies and did what the National Cancer Institute has done with the cancer genome atlas. We invested in GRAIL, a life sciences company whose mission is to detect cancer early, to learn whether circulating tumor DNA in the blood could help diagnose cancer at an earlier stage when it can be cured.”

He uses smouldering myeloma as another example: “Multiple myeloma, like all malignancies, is preceded by a pre-malignancy that is well-defined. Why wait until you develop a fatal disease? Why not eliminate it before it becomes fatal? It is likely that the earlier forms of neoplasia will be more sensitive than the more advanced forms.”

Another research area for Hait is the inflammatory changes that occur in the lungs before cancer develops.

He cites the example of Novartis’ anti-inflammatory substance canakinumab, which targets interleukin-1 beta.

The company tested canakinumab in people with atherosclerotic vascular disease and produced positive results, but it was a secondary analysis that piqued Hait’s interest – in the 10,000 patient study there was a 67% decrease in the incidence of lung cancer and a 77% decrease in lung cancer deaths in patients treated with canakinumab.

The results were an “eye opener” and suggest a relationship between inflammation and the progression of lung cancer.

In the pre-cancer genome atlas, pulmonary nodules that progressed or were stable appeared to have less of an immune infiltrate than ones that regressed.

This kind of shift in thinking will require input from more than just pharmaceutical experts – Hait speaks to the potential of bringing people from across J&J’s three sectors together to tackle medical problems.

“We have behavioural scientists, engineers, pharmacologists,” he says. “We have biologists. We have people who know why someone chooses Neutrogena rather than a different brand. We know how to make things happen that I would never have thought possible before. We have a huge diversity of thought and different approaches – if we can bring that group together and solve major diseases it could be transformational. Lung cancer is a tough place to start but I think it’s a good one.”

He adds: “If as many people devoted themselves to this as now devote themselves to established diseases using the technologies we already have at our disposal, it would really progress. But there’s such a mismatch. In the last ten years, there were almost 2,000 clinical studies done in advanced disease, but only 50 done in pre-malignancies and 400 in prevention.

“It would be great if we could move the needle. The difference it makes in diagnosing an oncology patient in stage 4 versus stage 1 is massive. If you can even improve that by 20%, you save hundreds of thousands of lives.

“In my many years as a physician treating patients I’ve never met anybody who wanted to be sick so that they could be treated. Every patient I ever met wanted to not become sick in the first place, and to get better as fast as possible. We need to make sure we don’t keep doing the same thing and aren’t just happy with extending a patient’s life by a few months – that’s no longer acceptable. To make a real difference for the many patients and consumers out there, and for healthcare systems around the globe, we must aim for a world where advanced disease is a thing of the past and where we focus on preventing or intercepting disease before illness occurs.”

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.

Connect with Dr Tunnah at Linkedin or email paul.tunnah@pharmaphorum.com.

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