How have the recent leadership changes made Novartis a different company?
We've definitely gone through a lot in a short time. I would describe Novartis Pharma over the last 10 years as an incredibly successful model for the pharma industry as it existed. But as the world changed, I think we were slow to change. As the regulatory environment and generic competition became tougher, we were still operating in the old model.With new people such as myself, [Global Head of Exploratory Clinical Development] Trevor Mundel, and [Global Head of Development Franchises] Andrin Oswald, we've been able to make some significant changes that will position Novartis well for the future. For example, we've restructured the entire drug development organization into smaller, cross-functional teams—down from 30 to eight. We told them we want biotech-like intensity. At the same time, we've elevated safety.
How are you doing things differently in terms of safety and regulatory?
We're spending more time talking to the agencies on a scientific basis. We're engaging the FDA and the EMEA more in our processes. But we're not picking up the phone every time we need something.
Trevor Mundel is one of the big industry proponents of modeling and simulation and what that means for drug development down the road. With FDA's interest in those new technologies, we're working collaboratively with them. That's something we had not done previously.
You have a strong consumer background. What aspects of that business do you apply to your current role?
With consumer packaged goods, you must understand the consumer at a deeply emotional level. When you transfer that to the pharmaceutical industry, you realize that we need to understand the motivations of a patient, the role of the disease in their life, and the role that the therapy plays in mitigating their disease. For example, it's very interesting for me to see how little we really understand about the causes for the lack of drug compliance. I've worked with our marketing people to take away the negatives and give the patient the positives to increase compliance with our medicines.
Across the industry, we see changes at every level. What change has had or will have the single biggest impact at Novartis?
The external change that's had the biggest impact is the customer base—the shift away from the physician and toward the payer. The physician, in some markets, is having much less say about what's actually dispensed than even two or three years ago. And not just in the US; it's also happening in Europe and Asia Pacific. It's having a profound effect on the way we're going to have to go to market. If you look at our commercial model, it's based on visiting the physician numerous times per month with multiple sales forces. That's just not going to be effective going forward.