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Vice President and Head, Innovation Center, Global Health and Value, Pfizer Inc.
Sachin Kamal-Bahl, Vice President and Head, Innovation Center, Global Health and Value, Pfizer Inc.
Pricing is the reputational frontier for big pharma today, so it’s no surprise that those who represent the
function- internally and externally-are feeling a bit exposed. But Pfizer’s Sachin Kamal-Bahl has a particular character trait that helps deflect those downside critiques: he always leads from the front. The 43-year-old pharmacist, originally from India, follows a career edict founded on just three short words: “Dare to Try,” a phrase derived from an internal Pfizer-wide initiative to encourage new ideas and taking thoughtful risks through innovative experimentation.
The fact is Kamal-Bahl looks at his career as a license to experiment. It began with an early decision to leave India to come to the US to broaden his academic exposure to the interdisciplinary aspects of health services provision-that politically tricky place where reform meets reality. The career path that followed put Kamal-Bahl at the epicenter of a then-emerging function in pharma called “market access,” leading up to today, where he manages the first internal company think tank that develops and integrates innovative approaches based on well-considered risks and strong technical content to address specific access, pricing and valuation challenges and opportunities facing the industry today.
The Pfizer Global Health and Value Innovation Center develops different approaches and prototypes and embeds them in internal processes to better position the company to demonstrate value and obtain market access for assets at launch. The Center also has a mandate to devise and test novel P&R models that improve patient access to drug innovations while moving the needle beyond the traditional approaches to drug pricing and financing. “Pfizer’s Executive Leadership Team (ELT) authorized the Center with its own budget, separate from operating unit P&L. It gives us greater leeway to take on new ideas and embed them in a project pilot or prototype; if it works, management will invest and the full business units can take it mainstream,” Kamal Bahl told Pharm Exec.
Some managers might be uncomfortable in that role because the Center’s work could be interpreted as an implicit challenge to standard practice. But for Kamal-Bahl there was no second-guessing. “When Pfizer contacted me about helping launch the Center, my instant reaction was I’ve got to give this a try.”
The Center’s status as an incubator of ideas suits Kamal-Bahl’s own background, which began along the traditional credentialing path with a pharmacy degree in Mumbai. A desire to branch out into something more strategic led him to the US and a PhD program in pharmaceutical economics and health services research at the University of Maryland in Baltimore. His research there attracted the attention of industry and in 2003 he joined the Merck & Co. outcomes research and management group, which in 2006 placed him on the Januvia diabetes launch team. “Involvement with this top-selling global brand gave me a front-row seat in the creation of a formal market access function at Merck -and I became a member of Merck’s first Global Access Team.” Later, Merck invited him to assume the role of strategy lead for global health technology assessment (HTA). At the same time, Kamal-Bahl continued to hold adjunct appointments at two leading academic institutions, the University of Pennsylvania’s Leonard Davis Institute of Health Economics and the University of Maryland’s pharmacy school.
After more than a decade at Merck, Kamal-Bahl joined Pfizer in 2014 to launch and lead the Global Health and Value Innovation Center, largely because of his interest in creating the first industry think tank specializing in this growth area. “I was excited about being involved in creating something from scratch, especially as it married the freedom of inquiry of my work in academia to the discipline of business strategy and execution.” It also appealed that ELT members like Global Innovative Health group President Geno Germano were early sponsors of the Center, which continues today under Germano’s successor, Albert Bourla.
Kamal-Bahl cites a number of accomplishments in establishing the Center’s bona fides, on both the internal and external front. A personal point of pride is expanding Pfizer’s engagement with relevant stakeholders, in a much more systematic manner. “We are reaching out to talk to payers, providers and especially patients to solve for access and pricing issues,” he says. This, in turn, has led to the creation of internal process efficiencies that make it easier for the company to demonstrate value for products at and prior to launch, and later in the post-marketing phase.
For example, the Center helped Pfizer participate in the first-ever early-stage parallel advice project with the EU’s European Medicines Agency (EMA) and five national HTA bodies for a rare disease product under development for Duchenne muscular dystrophy. Kamal-Bahl tells Pharm Exec that based on the experience with this pilot, the Center was able to obtain support from the ELT to embed consideration of the EU parallel advice pathway in all relevant Pfizer compounds under development. “It’s an important step. The process forces internal teams to focus on speed-to-market strategies that reduce development costs and advance patient access. It also guarantees the entire Pfizer organization is aligned behind pricing, access and the product’s overall value proposition. That’s because decisions to opt in or out of EU parallel advice must be taken cross-functionally, so everyone is involved.”
Looking forward, Kamal-Bahl predicts that his work at the Center will be critical in positioning Pfizer to identify innovative pricing and financing solutions for new drugs, including those for curative treatments like gene therapies, in order to address payer concerns about their pricing and budget impact. “The next wave of products from our accumulating knowledge of genetics will likely center on cures rather than treatments. Yet, today, the financing burden for drugs is entirely centered at the point of transaction-if a new gene therapy costs $1 million, then under the current system we would expect a full payment up front, subject only to a few performance contingencies; there is no way to amortize the full cost across a potential lifetime of benefit.”
Drugmakers should be thinking hard on “out-of-the-box” strategies on alternatives to the current way medicines are priced and paid for, Kamal-Bahl contends. Ideas from the industry are coming from far afield, including new cooperative lending facilities with the capital to finance pricing of expensive medicines over time. “No idea is too fanciful when you recognize the cost of new drugs is a policy issue that we must lead in solving. The alternative is government regulation of drug prices that will end up with the perverse effect of eliminating the market for innovation, not preserving it.”
To navigate through such turbulent waters, Kamal-Bahl highlights three skills that future biopharma leaders and their teams require to succeed.
First is to ensure your people are allowed to be creative, to incorporate ideas that are unconventional, and to take prudent risks -while acknowledging too, that some of these ideas will fail.
Second, your team should be a “safe haven” for members to stray from the path of the safe and narrow. If they can do that, many more useful ideas are likely to surface for debate.
Third is to be open to the world outside pharma. “Interesting ideas will come when we look and listen beyond traditional pharma,” says Kamal-Bahl. “There is a lot of promise in the space where the health and technology worlds intersect; we are already seeing disruptive innovations emerging in this area.”
Where does Kamal-Bahl see himself in 10 years? “Regardless of the setting, I see myself continuing on my ‘dare-to-try’ journey to generate innovative and influential ideas on drug pricing, value and access. With the explosive growth in specialty drugs and the coming tsunami of precision medicine and gene-based therapy, the stakes for accelerating the pipeline of approaches to address them have never been higher.”
- William Looney