Fireside Chat with Bertrand Bodson, Chief Digital Officer, Novartis #213


You were here, I was interviewing Vas, who
I think was starting, the new CEO of Novartis, was starting maybe one week later officially. What was your impression of coming into the
StartUp Health Festival and meeting us for the first time? So you’re right. Unity, it was exactly a year ago. It was my day one on the job, pretty much. Day one. And I think first of all, congrats as well
for what you’ve put together. It’s like the, we sort of knew coming in that
there was a spirit that is incredible. You told me you had 2,500 people effectively
attending this over the next few days. So we wanted to be a part of it, when we saw
that, when we sense that the energy was just incredible. This year I didn’t even take my badge to JP
Morgan. I only came here pretty much and then a set
of meetings as well. So congrats for that. Thank you. Thank you. Well, you know, we were back in the green
room a year ago and what instantly connected us to Novartis at StartUp Health, and we care
deeply about who we partner with for the entrepreneurs, was the vision that you all had to become
a digital company to really transform what you are doing. So I wonder, you know, as the Chief Digital
Officer, if you could talk about that transition and maybe before we get there, you have such
a unique background because you’re coming from outside of healthcare into healthcare. So maybe we’ll start there. That’s right. I used to, I’m still discovering pretty, pretty
rapidly the healthcare space. I started a year ago. I was in retail before for quite a while. At Amazon over 15 years ago back in Seattle
when it was pretty much a little startup at the time, quite messy, and then compete against
Amazon in different digital transformation and also in the meantime, in between that,
I had my own business. So I loved retail to bits because there was
something about the speed at which it moves, the action, reaction, you get incredibly close
to your customers as well on a daily basis. But I have to say, there’s something I love
about this space as well. There is something about the purpose. Look at the 10 missions and 10 moonshots that
you’re driving as well. There is a skill as well to do things that
are just absolutely incredible. There’s a lot to discover. And I love the fact, and it’s probably what
attracted me as well to Novartis, is the fact that it was a blank canvas. There was really a mandate to say there is
an inflection point something is going to happen. Look at how much tech data and science is
starting to converge. How do we get into that space? What do we do on the research side? What do we do in terms of development? What do we do from a commercial point of view? How do we reinvent the model as well as part
of that? So it’s been a great, great first year. You guys have been moving so quickly, I mean
you’ve made several investments in digital therapeutics companies like Pear, our partnership
of course. It just seems like you got the pace of what’s
going on, it has been rapid. Yeah, I think so. I’d love as a dream, I’d love to be StartUp
Novartis in five years from now to some extent. It sounds a bit utopian to some extent, but
how do we embed some pace and to me a major piece of this is really those rooms as well
and those setups is how do we work more with startups, with entrepreneurs, really want
to change the world, really have good visions, big aspirations. How do we recognize they’re better than us
in some places and then it compliments the strengths that we bring to the party as well. Are you noticing a culture conflict there
with sort of a transformation taking place throughout your organization? I would say, I don’t want to say conflict,
but probably 50 percent of our job is probably a cultural transformation in one way or the
other. It’s how do we bring the 120,000 people that
we have onboard within the organization on that journey? And in some cases, it’s more about how do
we demystify what digital is all about; how do we really bring it to life? All the way to some basic trainings about
what it really entails to some areas where it’s more about organizational design. How do we showcase even take with a neighbor
which is very digitally savvy, or very data savvy with 6,000 scientists over there, but
we have 250 data scientists, which is a good start, but often not fully embedded within
the team. So how do we rethink the organization so that
we can really merge our teams much, much more. So do you nurse the cultural need from the
top down and bottom up or how does that work when you look at in 150,000 people around
the world, different companies, different regions? Where is the most, is it all throughout that
an organization is to change when it’s that large or is it top down or bottom up? Practically, where we started was first we
thought about the role. This role in particular specifically before
coming in, we moved quite a few teams across as well that were covering, that were different
entities within the organization. We moved them across. We started, so we’ve probably mobilized 1500
people now across the organization around the digital agenda, so across the company
itself. At the same time we set up 12 what we call
digital lighthouses, so those are 12 mega initiatives where we advocated the right funding
as well, the right resources to go after those and that has been quite hard work and took
a lot of of energy from us last year. And that’s probably more from the top where
as an executive committee we agreed on which ones are the ones that really matter. To finance those, what does it mean that is
so obscure that we are ready to close, which is never easy to do, but what’s absolutely
necessary as part of that. How do those get owned by the management team,
by the exec team is part of that, but then the rest is really the hearts and minds within
the organization. And I have to say the appetite has been incredible. To me that has been one of the big surprise
last year. The appetite to do this. I think under the impulse of Vas, under the
impulse of setting up the tone that we’re going big on data and digital has been everywhere. There’s been a hunger for it. A huge hunger. That’s amazing. So the last two days we’ve been talking all
about this concept of thinking bigger of health moonshots. And that’s our whole mission here at StartUp
Health. How do you describe Novartis’ moonshot? What’s your impossible dream? How do you think about the future and where
do you all want to go? I think we’re positioning ourself, as we mentioned
in medicine powered by data and digital, and this translates into different ways. It translates into look at the moves we made
last year. We have closed some of the assaults, the GSK
entity on over the counter, to make massive bets and investment into new platforms. So we’ve made massive investment into AveXis,
which is an incredible company, biotech company, 260 people that we bought for $8.7 billion,
but it’s really a technology platform at the core. About SMA kids less than 12 years old at high
risk of dying. Pretty much the current state of affair is
effectively them dying, but with the right treatment can effectively completely recover
now. We’ve made, but this is really a platform,
so it’s the manufacturing of it. It’s EAV, it’s all the methods that is beyond
[inaudible] to me is a technology play as well. That is just incredible. It’s personalized medicine at the extreme. When you look at the investment we’ve made
into Radioligand for example, with endocide with AAA those are pretty impressive repositioning
of the company that we’ve made on how do we really go long on some of those platforms
that we can really own and on which we can truly bring transformational medicine to the,
to the, to the world. And I would say if you take AveXis for example,
you cure babies, so it’s babies who are about to die versus many of our medicine quite frankly,
are an improvement on a small subset of the population that is struggling with those. So I think that’s the type of bet that we
are, we’re willing to make. And as you’re thinking about your moonshot
to becoming a digital organization, how do you think about collaboration? How do you think about the best possible way
to get there? Obviously we’ve talked about some things you’re
investing in. Are you exploring other types of collaborations,
unique collaborations that may be different than how legacy pharma companies have have
used to, you know, have always operated? Yeah, come back to the point that partners
are a key pillar of what we’re doing. Beyond the lighthouses themselves, it’s also
how do we find the very best of the best that can help us drive a lot of things in which
honestly, the best a search. How do we open the pipeline, how are we credible
within the ecosystem. That’s why we opened the Biome here in San
Francisco three months ago. We’re very grateful to… We’re so excited. The StartUp Village in San Francisco is based
with Biome which is at 44 Montgomery, so we hope you will visit us there. It’s an extraordinary space just a few blocks
from here and we’re honored to to be co-hosted there. So all of you are welcome over there. I see some of the Founders, [inaudible]. Can you tell us all what the Biome is and
kind of the genesis, but really what the objective is. Sure. The idea there was our customer is the startup,
and startup of some of significant skills, have already raised $40-$50 million. So a different stage, but how do we make it
attractive to work with us? We recognize it’s not historically easy to
work with pharma. There are many, many different entry points
as well. We don’t necessarily have champions with your
organization to make it easy. So we spent a lot of time with startup understanding
what, what are their needs. Many wanted to get much more access to data. So we’ve packaged sort of sandboxes of data
to make it easier to get after that. Some wanted to get access to clinical data
and clinical settings as well so that we could really speed up the way that they could experiment
while working with us and prove their cases altogether. In some cases it’s a 12 month program where
we effectively have our champions helping them, very modular depending on what they
want to do as well as part of that. That’s really cool. You know, over the last few months I’ve met
with different business units from Novartis, so it’s really cool to be at TechCrunch here
in San Francisco and to see your Novartis team there meeting with tech startups, right. We were recently in Argentina. There was a whole health innovation week. There was, I don’t know, seemed like 100 companies
from around South America. How are you thinking about global innovation? How are you thinking about startups, specifically,
as part of the solution for where you’re trying to go? So I think you’re right. I think what you’re doing here, I know you’re
thinking about extending that as globally as possible as well. It was great to do that together in in Latin
America, we’re clearly thinking about where should we put different flags as well. In Asia, in particular, Shanghai would probably
be a natural one. Where in Europe should we set flags as well
as part of that? That’s where we are in Latin America together. Horses for courses as well. When you think about on data science for example,
Montreal being probably the center of the world, more and more familiar point of view. There are some great collaborators over there,
is something to be done, so we’re exploring those. But It’s more than the setup and the Biome. It’s also in those lighthouse, in those projects
that we really want to scale. For example, we work with a company we’re
very proud of, OCTANe, and another one called Shyft. They really help us mine the 100,000 visits
we do to doctors by our reps every single day to better educate us on how to go and
which doctors to go when to go to them and see them with the right type of content. So sort of reps, powered by AI. If you look in decentralized trials, we work
with certain sense 37 irrespective of the place of how can we really go to patients
much more than them having to come to our centers, as part of that. Here in the US, we’re working with Pear Therapeutics. I know you were talking about addiction earlier
today. They have a great project, protocol reSET
and now reSET-O that we officially launched yesterday for opioid addiction. So again, there is a recognition that those
partners are really great at developing the right products. It’s a different type of drug. It’s a virtual drug. We are probably good at helping them commercialize
it. So how do we combine forces to really go after
that together? And you know, one of the biggest challenges
that startups have is finding the right doorway into an organization as vast as Novartis. What is the right doorway? Obviously you’ve invested in StartUp Health,
which has given us the opportunity to invite more companies into StartUp Health Academy. You have the Biome, you invest in companies. What would you recommend? What would your advice be to, you know, there’s
a room full of entrepreneurs here. What’s the right way to start a relationship
with Novartis? I think first of all, had an interesting question
yesterday of having worked in retail for a long time and worked in healthcare. First of all, I would say to make a choice
right now, I would definitely, and I wanted to launch my own business, my own startup,
I would go in healthcare without any hesitation. I think the space is ripe. The scale of the ambition of what you can
do is absolutely incredible. The moonshots probably bring that to light
very nicely. How to work with us? I think that’s what we’re setting up in the
biome, but the one thing I would probably think about is what really matters to us,
so what are the things that are on our path to scale? At the end of the day, we have a 200 million
market cap business and we keep talking about as a team as well is how do we make it from
200, 200 billion to 250? So how do we create 20 to 50 billion of market
cap additional as well to that. If you think in those terms, you really need
to move the dial in significant ways. So we are going to be focusing on, for example,
the commercial side on 12 mega launches of the next three years. Study launches. Learn about those launches. We have big ones coming in into migraine with
Aimovig, with big ones coming with RTH into ophthalmology. We have big franchises with COSENTYX and ENTRESTO. So anything where we can help improve the
launches over there will ever have a lot of attention span within the organization for
that. We have, what are the pain points around those
launches? For example, in psoriasis with COSENTYX , which
is a major franchise for us, it still takes nine years for patients to be diagnosed on
the drug itself, on psoriasis, so how can you help us get patients to realize their
symptoms earlier. Many of the issues, we’ve talked a lot about
adherence over the past few days. We’re still struggling with 40-50 percent
non-adherence on that. How can you help us create something scalable
that we can go after? If I take decentralized trials, the main problem
we still have is only five percent of eligible patients in oncology right now get access
to trials. So we need entrepreneurs to help us think
about how do you build, how do you bring telemedicine sensors together that we all talk about to
create experiences where we can really go and in which conditions we can go to patients
as part of that. So my one advice would be really understanding
the pain points that we currently have, where we struggle, where the center of energies
really are to come and really insert yourself into that. Because once you insert yourself into that,
then there will be a lot of champions inside to really go and make that happen at scale
and we then we can help you scale. Yeah. It’s an interesting point because oftentimes
these early stage companies are, they’re not going to move the dial on a $200 billion company,
but you, with your background from Amazon during the early days, know that sometimes
it just takes time and then pretty soon you’re that $200 billion company. How do you think about integrating innovation
in when it’s almost too early and taking a risk before others maybe throughout the organization
are willing to and fostering an environment where that’s possible? Is that something you’re trying to infuse
in the culture or is it just not realistic? We definitely are and, take each of the main
project and I see some of the leaders of some of those areas in there. We’re really embedding some product owners
properly. We’re trying to properly work in an agile
way. It’s not as easy as if a startup wanted to
do it, so we need help as well. Again, I’ll take the Pear example. So the partnership with Pear is a Korean team
have developed an incredible product in the context of substance use, substance abuse
disorder, SUD, and for, we said, oh, in the case of opiates right now, so they have about
40 modules where the current standard of care right now is go to psych analyst or a psychiatrist
to go and help you on a three months program having a visit every single month. So the product they came up with is 40, 45
modules that when you have a craving, you’re on the road, you can tap into your support
network that is around and you have modules that can really help you. The first one to be FDA approved and getting
twice the efficacy of the current standard of care. So the way we, the reason we bring them in
is because we think they really have an incredible product. We can help them scale so there’s a natural
fit in a space where, broader than that, if it works and it’s a bet we’re making, we can
open up the broader digital therapeutic space, which is probably a 5 billion business. that is behind. But it’s not easy. We’ve created a different culture because
Pear is incredibly entrepreneurial and they’re pushing us all the time, while we don’t necessarily
have some of our centers that are ready or reimbursement centers that are ready to keep
pushing us. They’re sort of the adolescent pushing and
rightly so. We are, Sandoz and Novartis, adults saying
slow down kids. We need first of all to have reimbursement
facility to have the right payors on board, to have the right mechanism where we can prove
the case, let’s make sure we get payment well approved in the proper setup. So there is a natural friction on that, but
that friction is really healthy. It’s really transformative inside because
you see startup and scale starting to come together and that’s, so I cherish those and
I wish we could have more of those. And one point I’ll add as well is we often
consider pharma, big pharma as being slow or highly regulated. It’s tough to move the dial to make things
happen. I keep coming back to the point that at least
on the research and development side where there’s a lot of help we need as well. We spent within Novartis alone, 10 billion
per year on research. That’s pretty much the biggest startup, one
of the biggest startup on the planet, when you think about it. For 10,000 experiments, we try for only one
that works at the end of it. Now where we need help is how can we find
more startups that help us reduce the need to do 10,000 experiments that really can help
bring it down much faster to the $500. How can we shrink to 12 years that it gets
us to time to market, what are all the steps with way too manual, so that’s where we are. We’re always looking for for help on the path
as well. Yeah, could you talk a little bit more about
your, your ask. If there’s innovators out there, entrepreneurs
out there, doctorpreneurs out there working on solutions. If you could wave a magic wand, what would
more of them be working on that would help you? I don’t think, that’s a great question. I don’t think it’s just one because we’re
covering and that’s what I love about what is happening in this space right now. It’s probably more complex than retail. It’s, It goes across the entire value chain,
but if I take on research, clearly I love, we’re seeing many, we’re trying to really
structure data so they can have hypothesis generation that are really shrunk down so
they can work faster and go to the one that really matters and focus on those. I’d love to believe personally, I’m absolutely
convinced, that drug hunting will become a computational challenge and we see many over
the course of the four days where some are really mind growing. It’s a combination of engineering, science,
data, that is starting to come together with different types of profiles, so we need them. We have some who are really starting to put
switches into DNA that you can activate based on a combination of the genomes and the proteins
that with different types of combination depending on what happens there. That’s very intriguing at least. So we’re cherishing that space and we want
to understand better. If you take clinical trials, that’s still
the bulk of our cost to get our drugs to market, highly sensitive, still highly regulated,
but also highly manual. How can we improve patient recruitment? So we’re looking there for big part of startup
can be as big as Google from that point of view to startup who really understands where
the patients are. How can we tap into them, how can we really
bring them based on geography, across investigation centers that we have. On the commercial side, I would go back to
my point from earlier, how do you go more to the launches that we have to really understand
the pain points around those launches because there we have a lot of appetite for that. So I could go on and on, but and probably
the last one is we are more and more intrigued as well by what I call the what ifs, so the
more transformational model. So what happens when we don’t get access to
doctors anymore directly with our reps. What happens when patients really own their
data directly? What happens? Some are helping you stink at the extreme
of what happens if we have to reinvent Novartis from scratch, we call it zero based pharma. Almost starting from scratch, what would be
the asset that really mattered to us? So if you’re a startup, how can you help us
be much, much lighter from that point of view? So we, have an impossible dream at StartUp
Health, which is to improve the health and wellbeing of 7.5 billion people. Everybody in the world. And you know, it’s crazy, right? But we believe that it’s possible if we work
together, we support thousands or tens of thousands of entrepreneurs and innovators,
get organizations like yours, investors around the world to all start collaborating, to all
start investing, to all start working together to find solutions. And we think that we can solve the biggest
challenges of our time. I guess my question for you would be what
advice would you have for StartUp Health? So that we can, we can accomplish our impossible
dream? As you know, we cherish the partnership, i
cannot dream of anything better than you being almost hosted within, within the Biome as
well. I think that really helps. Making sure that we’re really connected to
every single day pretty much from that point of view. I think, again, I love the burst. 2,500 people coming over the course of the
three, four days, spending time upstairs. It’s just incredible. It’s magical. You’re connecting something. There’s an energy that is, that is palpable
everywhere. How do you scale? How do you bring that internationally as well? I think this is a model that is, that has
legs everywhere. It was the same when we were in Latin America
together. It’s same and a different recipe, but in China
as well, in Asia, in many ways, you see more and more countries at national level really
putting the data and making it available. So that should make all this easier over time
as well. So I think you’re definitely doing your part. Keep pushing it, and we cherish that collaboration. Well, let’s do it together. I thank you for your partnership, it’s an
honor to have you here at the StartUp Health Festival. Thank you. Thanks, Unity.

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