A World of Opportunity

Marie-France Tschudin

Marie-France Tschudin, Novartis’ president, innovative medicines international, and chief commercial officer, is always up for an adventure. While it might be difficult to imagine this pharma exec rounding the corner of a dusty motocross track in full gear—one of her current favorite pastimes with her husband and sons, 8 and 9—once you understand her nontraditional upbringing, her openness to new experiences and taking chances makes sense.

A Swiss national, Tschudin grew up among six countries and speaks six languages—France, Portugal, Brazil, the US, Spain, and Switzerland. Though she didn’t appreciate it at the time, she now recognizes the effect that living in a number of different places can have on one’s personality, including enhancing culture awareness, appreciating diversity, and building resilience. “The way it shapes you is just incredible, and I would never change that,” she says.

At Novartis, Tschudin’s international IQ has helped her in many ways, from understanding the value of a diverse team to providing a unique perspective on the challenges of market access around the world. Today, she utilizes her global gumption to help the company develop novel ways to bring its medicines to more patients.

Finding her calling

Tschudin followed in the pharma footsteps of her father, a lifelong industry employee who started his career in sales then progressed to various positions of responsibility. When Tschudin graduated from Georgetown University in Washington, DC, she was ready to forge a career in sales herself.

“He inspired me to start as a pharma rep,” she says. “He said once you learn sales, you learn the backbone [of the industry]. So I went in as a trainee, started working at Johnson & Johnson at Janssen-Cilag in Lisbon. I thought I’d stay there for maybe a year or two and learn about sales, and I ended up living in Portugal for six years.”

Because she partly grew up in Portugal and Brazil, Tschudin already spoke Portuguese and was excited to take the position in Lisbon. She appreciated having the language to fall back on yet yearned to explore the country some more as an adult. In addition to falling in love with Portugal, she fell in love with pharma and has now been in the industry for almost 30 years.

After positions at Schering-Plough and Celgene, Tschudin settled at Novartis. In April 2022, she transitioned from the position of president of Novartis Pharmaceuticals—it’s largest business, with a $29 billion portfolio and 30,000-plus employees—to her current role.

“My new job is really part of a broader transformation in the company,” she says. “We’re bringing together two divisions that were separate, oncology and pharma, into a single innovative medicines unit to drive impact—that’s one part of the transformation. The second part is around customer centricity.”

As part of the second initiative, Tschudin is analyzing Novartis’ commercial model, which essentially hasn’t changed in decades. She’s assessing current needs and developing creative ways to sharpen capabilities in the company’s digital execution. She wants to bring patient insights to the table to influence the types of clinical trials Novartis conducts and the formulations it brings to market.

“We need to rely on outside insights much more than just what we think is the right thing to do,” she says. “That’s one of the key changes that we’re trying to bring across: What are the capabilities we need for the future to meet customer needs? For example, population health and policy are areas where we are going to need to get much more expertise if we want to make broader public-private partnerships a reality.”

Disrupting the norm

Innovative science is essential to move drug development forward, but in order to carry through that science, the industry needs to focus on eliminating barriers to care.

Tschudin believes there currently is not an alignment of incentives for healthcare professionals to take certain actions, and these barriers can cause an imbalance where what’s right for one part of the system isn’t right for another part of the system.

She offers this example: “A hospital wants to reduce costs. But if you’re in a specific department, you actually want to keep your beds full and have a cost structure that will allow you to put in more budget for the following year. So just within the same institution, you see that incentives are misaligned. When you look at the whole system, there’s just a massive amount of challenge and barriers across a patient journey. That’s what we have to try and eliminate. Because if you do that, you can get people around the same table. That’s where the public-private partnerships come in.”

While president of Novartis Pharmaceuticals in 2021, Tschudin ranked No. 22 on Fortune’s Most Powerful Women International list. Part of that recognition was for the executive’s work in thinking outside the box regarding distribution and access in one of those public-private partnerships.

When Novartis started talking to healthcare systems about the crisis of cardiovascular health, it became evident that it is the biggest cause of death worldwide and biggest cost burden for the healthcare system.

“The reality is that 80% of premature heart disease and strokes are preventable,” says Tschudin. “When you put those factors together, it’s clear that the toll on healthcare systems is enormous, and we can prevent it. We need to lower the number of cardiovascular deaths, which are on the rise after many years of decline, and we can help reduce spending in the process.”

This current portrait begged for a new way to address the situation and forced Novartis to think and act differently. In 2021, Tschudin brokered a novel partnership between Novartis and the UK’s National Health Service (NHS). As part of their efforts to systematically improve the health of the population, NHS digital developed a digital tool used by general practitioners (GPs) to identify and approach patients. (Novartis does not see any of the patient data.)

As physicians bring up their patients’ data, the tool allows them to see which patients are at risk.

“It’s almost like a nudge in the system to say, ‘You need to have this conversation with your patient, and then the system rewards these GPs for doing that work,” says Tschudin. “It’s not the only area, but it’s one of the areas where the NHS has said it will incentivize GPs to actually do the exams and follow up with that patient.”

This care pathway creates the ability to call in patients when they’re not adequately treated at the levels they need to be treated at. It also ensures physicians have an easier time identifying patients, so they can bring them into the system. By doing that, the NHS aims to treat 300,000 people in three years, says Tschudin. That’s where Novartis comes in—helping to treat 300,000 people in three years with broad access to its cholesterol-lowering medicine.

In addition to this arrangement, Novartis is actively working with 200 systems of care that represent about 65% of the atherosclerotic cardiovascular disease (ASCVD) patient and prescription volume within US healthcare systems. It is also talking to many other regions, institutions, and governments across the world.

“We hope that the NHS agreement will almost be like a blueprint for other institutions,” says Tschudin. “It doesn’t even have to be governments, because, obviously, the NHS is a single-payer system, so in a way, not replicable in other parts of the world where healthcare systems are much more fragmented. But it doesn’t prevent you from working with individual institutions or with regions depending on where you are in the world. We’re hoping that we can move forward with more of these agreements.”

Tschudin believes this could be a future model to identify and treat a variety of chronic conditions.

“When you think about chronic diseases like diabetes, asthma, even Alzheimer’s, why wouldn’t a healthcare system adopt a model that is more about trying to prevent it, instead of having all of these patients ending up in care, which costs the system billions and billions of dollars?” she ponders.

Supporting a successful system

In an effort to best service the needs of patients, Tschudin mentions two other areas that deserve special attention as the industry moves forward:

Patient centricity. Tschudin is a proponent of keeping patients in mind early on in drug development. Though the industry has been consistently product-focused in the past, companies should always consider what is right for the customer, whether that’s a healthcare system, a healthcare professional, or a patient.

“If we don’t bring those insights into our strategies and our decisions early on, we can have the best product in the world with the best team in the world, but we’re not going to get that medicine to patients,” she says. “We absolutely have to have a customer mindset from the get-go.”

Access to education and proper diagnoses for a patient population that is increasingly demanding a louder voice in their care is also important.

Collaboration. Whether among her team or throughout the industry at large, Tschudin sees collaboration as a building block for success. In fact, it’s one of the three things she consistently asks of her team (in addition to thinking boldly and having a holistic enterprise perspective).

“I don’t think you do anything really on your own,” she says. “Novartis isn’t going to change the healthcare ecosystem alone. The pharmaceutical industry isn’t going to change the healthcare ecosystem alone. We have to work with other industries, we have to work with each other, we have to work with payers, we’ve got to work with the system, to be able to enable change in the system.”

Tschudin also believes pharma needs to support overwhelmed physicians and the healthcare system to help them make faster decisions and alleviate some of their burden. This is one way the industry can help make the system itself more sustainable.

“In the US, think about the time that a medical practice spends on prior authorizations,” she says. “You look at those applications and work forms, and everything is done to basically disincentivize patients from getting on the right medicines. If we can work with the system together and say if you think about this differently, you actually can save costs, then you get all of this burden away from physicians who actually are here to do something else—spend time with patients.”

All about the people

Tschudin is inspired by the people she works with every day. “They’re all super smart and committed and gifted,” she says. “I don’t think there are many industries out there where you go to work and you’re learning from your colleagues every single day. It’s such an international, diverse industry, with different challenges, depending on the country, depending on what therapeutic area you’re working in, but the constant is the quality of the people, intellectually and from a human perspective.”

In general, Tschudin is very interested in people. She is also instinctive when it comes to reading them. She enjoys getting to know what makes people tick, how to get the best out of them, and how to understand what’s important to them.

“People tell me I have this kind of sixth sense about what’s not working, whether it’s professionally or personally,” she says.

Having had a global upbringing, Tschudin knows that even within Europe there are subtleties in every culture that can be very marked—from the concept of family to what is important vs. what’s not. Because of this, she understands the importance of diversity on her team.

“It’s not only about gender,” she says. “It’s incredibly important to have perspectives from all over the world, whether it’s Asia, India, the US, South America. You see all of that represented on my team, because the way your culture and experiences influence your thinking actually brings a lot of richness to making better decisions.”

Ever since she’s had to create teams, Tschudin has been very conscious of the fact that she doesn’t have all the answers. And as she has advanced in her career, she’s noticed the higher up you go in an organization, the harder it is to have all the answers.

To help her, she surrounds herself with “super smart, super capable” people who also are open to disagreement. Tschudin welcomes the variety of input when people bring their
own perspectives.

She finds strength in honesty and holds that as a critical part of her team building. She looks for people dedicated to doing more and having an impact on patients’ lives. She also aims to bring together the right people to have the right conversations to move forward with speed.

“Our role as a pharma industry is to bring more medicines to patients faster,” she says. “And if we can do that, we’re not only helping many more people live better and longer lives, but we’re influencing an entire ecosystem.”

Elaine Quilici is Pharm Exec’s Editor-in-Chief. She can be reached at equilici@mjhlifesciences.com.