Naji Gehchan: Hello, leaders of the world. Welcome to spread love in organizations, the podcast for purpose-driven healthcare leaders, striving to make life better around the world by leading their teams with genuine care, servant leadership, and love.
I am Naji, your host for this special episode in partnership with MIT Sloan Healthcare and BioInnovations Conference, an event that brings the Healthcare Ecosystem Together. I am joined today Andrew Plump President of Research & Development and Board Member at Takeda. His career spans nearly 30 years in the pharmaceutical industry and academia. Andrew has been recognized for his contributions to the healthcare industry, education and the arts. He serves on several non-profit boards including the Board of Trustees for the Boston Symphony Orchestra, the Sarnoff Cardiovascular Research Foundation, the Biomedical Science Careers Program and as Chairman of the Board of Directors for the PhRMA Foundation. Prior to Takeda, Andrew served as head of Research & Translational Medicine, deputy to the president of R&D at Sanofi, based in Paris, France. Prior to Sanofi, he served as worldwide cardiovascular research head at Merck. Andrew received his M.D. from the University of California, San Francisco (UCSF), his Ph.D. in cardiovascular genetics and his B.S. from the Massachusetts Institute of Technology (MIT). He completed a residency in internal medicine and a fellowship in medical genetics at UCSF.
Andrew – I’m humbled to have you with me today!
Andy Plump: Hello Naji. And, and thank you. Uh, thank you so much for the privilege of joining you on this terrific podcast.
Naji Gehchan: Thank you. Before we dig in, challenges in scaling biotech innovation, the topic of your panel at, uh, S H P C, uh, I am eager to hear more about your personal story, really what brought you to medicine than pharma and now leading R n Z at Takeda.
Andy Plump: Well, it, it just so happens the timing for that question is impeccable because this past Sunday I gave a talk, something I’ve never done before. It was actually a mentorship talk to a group of. Emerging diverse, uh, scientists and clinicians and organization called the Biomedical Sciences Career Program or B S E P, I think you mentioned.
I sit on the board of this, this organization, and it’s an organization that’s existed for 30 years. Has about 10,000 members, incredible individuals. Many come from underprivileged or marginalized beginnings, so motivated to, to grow and to make the world a better place in, in life sciences. So I had a chance to give a talk and I was able to unpack some of my beginnings.
And so, so I thought through this and. This is audio so nobody can see the picture. But I had a slide that had a picture of me in my 1970s plaid bath, you know, bath ba bathrobe, um, with my mom at the age of four. And then a picture of me in, uh, uh, tuxedo actually as I was getting married in 1992 with my dad.
And, you know, and I think back, it’s, it’s a large measure to my parents and to my, my upbringing when I start to think about my journey. And there’s one piece of my childhood that was enabled so wonderfully by my mom and my dad that has really carried me through these many years, and that’s curiosity.
I’ve always been so interested and curious in what’s happening around me. And the two stories I told at the conference, which I’ll share with your, your audience, Naji are my mom at the time that I was four years old, maybe three, three and a half, with, in that bathrobe I was the third born. We ultimately had five of us in the family, but the twins were, you know, unexpected.
And so I was meant to be the youngest child of, and I had an older brother and sister who were five or six years older than me in school, and I would just, Follow my mom around everywhere and ask her question after question after question, and finally she looked at me one day and she said, Andrew, It’s time for you to go to school.
And the other question that you know resonated was I told, took my dad aside very earnestly one day and I said, dad, you know, if you could bring the person who had all the answers in the world and give me that person for a full weekend, I still wouldn’t be able to ask as many questions as I have. So curiosity has been what has propelled me.
Naji Gehchan: But thank you for, for sharing, uh, Enzi and I, I love how you’re bringing it, uh, with the fact of being curious. And, you know, I, I was thinking as you were saying this, how many times we actually as parents make this mistake of stopping our kids from asking so many questions. And I, I’m, I’m sure you, you throw.
By asking questions and learning. So now if we go into really the challenges in scaling biotech innovation and what you shared, uh, during the conference itself, I would love first your view on the most exciting current innovations in biotech. How do you define those? How do you look at those personally.
Andy Plump: Well, I, I, we’re in a golden era of healthcare, and if we get it right by the end of this century, we, we can have a, um, a therapy, maybe even a cure for every disease that’s, that’s known to Man. There’s no question we have all of the tools and foundationally there are, they’re the three pillars that allow us to be so bold and aspirational.
Our human genetics, we learn so much. But by dissecting the human genome in terms of target identification, in terms of somatic mu mutations that affect cancers, that’s one. The second is tried and true mechanistic biology that typically occurs in academic laboratories. So thinking through what it takes to generate a hypothesis and test that hypothesis in unraveling biology.
Our ability to do that at scale. And it’s not systems biology. Typically it’s an individual student or a postdoc, really thinking through the details of a, of a problem. That’s the, that’s the academic medical system that exists today. And then thirdly, this explosion of modalities that has come about over in principle in, in particular, over the last decade.
When I started in this industry, we had 90 plus percent of the molecules in pipelines were synthetic small molecules, natural products, or vaccines. Now if you look at the aggregate pipeline across our industry, those three form the minority. We have recombinant proteins, we have genetic therapies of multiple flavors, and we have cell therapies.
And so our ability to put these three together allows us to have the courage and boldness to think that we can tackle any disease. And in fact, the last 10 to 15 years has, has told us that, that with this toolbox we can, we have the potential to do anything that. That we can now, there are forces that work against us.
You know, one, one are intrinsic forces to our industry and it’s greed and avaris and, and behaviors that damage our reputation because we’re a highly regulated. Industry, what, you know, what we do really matters. Not just, it’s not just a business. There, there it, there’s a right to healthcare. And when we are, when we’re egregious in our pricing, when we, um, fail to abide by the compliance and quality codes that countries ask us to abide by, we’re damaging ourselves.
That’s our own intrinsic potential roadblock. But extrinsically, there are many roadblocks and we’re seeing this with. Regulatory agencies, which, which move up and down in terms of their conservatism. And we’re moving today towards a much more conservative regulatory landscape, particularly in the us. Um, there’s reimbursement policies, you know, especially in, in Europe, it’s, it’s very hard to demonstrate in diseases where you have existing therapy, um, that you have a better therapy that, that deserves reimbursement.
Because, because it’s impossible to show oftentimes in head-to-head studies. Um, that you are better and, and that’s what’s being asked of us. And so, so there’s, there’s, there’s this, um, the, the, this tunnel vision, I think that’s happening. We saw this with Ira, was having conversations recently, the inflation reduction act.
There are elements of IRA that make a lot of sense. We need to reduce costs in the US for patients, but there are a lot of elements in the I I R A that will squash innovation. So huge potential, but also, uh, huge, huge headwinds. So let’s
Naji Gehchan: double click, and I love how you framed it and so agree with you on the interest intrinsic, uh, roadblock that that we bring and those external ones.
And when we think about those innovation biotech, we’re frequently think about those nascent biotechs, those startups who are trying. To nail down one of like the most challenging targets, the most challenging technology science. Whe when you think of those, wh wh where do you see the biggest challenge for starting a biotech?
Like if, I want to think from those startups, what are the main challenges for them in 2023 after probably a boom in the last decade? How do you see those these days?
Andy Plump: Well, it, it’s, it’s a terrible time right now for, for the biotech, uh, ecosystem. And the, the, the challenge is getting funded right now.
There’s, there’s, there’s still a tremendous amount of venture capital available, but there’s a, there’s a, uh, fear a bit in, in the market, and so there’s been much less investment in new ideas. Now than there have been in the past. I, you know, we’ve seen cycles like this before, so I’m, I’m convinced that we’ll cycle out of this and that we’ll end up in a better place.
I don’t know if that’s gonna take a year, three years, or five years, but we’re in a particularly depressed market. So funding for biotech is, is taking a, a really big hit. But I think there’s a more fundamental concern, which gets back to my comments earlier around some of the extrinsic headwinds that we’re facing.
It’s just, You know, when you’re, when you’re dealing with more conservative regulatory agencies, more challenging reimbursement, um, environments, when you have the country, the country in the us which is responsible for 50% of reimbursement on our industry starting to really limit, um, access and, and price, um, that’s a problem for biotech because it all.
You know, it all cascades downward. And the starting point for most innovation is biotech. You know, two-thirds of what any pharma company will ultimately bring to a patient in the marketplace starts in laboratories outside of our own. It starts in biotechnology laboratories and academic laboratories.
And so if we’re not funding that and supporting that early innovation, it’s going to greatly damage, uh, access for patients.
Naji Gehchan: So I’d love to double click on the access piece because as you said, breakthrough innovations, uh, and really in a global environment that is becoming more and more challenging to bring those innovations, not only from an r and d standpoint, but once they are in the market to patients across the globe.
How, how do you think about this in a global aspect, again, of those breakthrough innovations for. All patients who need that.
Andy Plump: Yeah. And maybe I’m not using the word correctly. Cause when I’m, I’m talking about for biotechs, it’s not about access, it’s about actually being able to make a medicine, having it approved and having it reimbursed at some level.
And that doesn’t, that’s not, you’re right. That’s not the same as access. And in fact, when I think of access, I think about it in the context that you’re articulating, which is access to the seven plus billion people across the globe. But even within the United States, you know where you have 300 plus million individuals and you have marginalized and underprivileged groups who have poor access to many of these medicines, and we saw that in during the Covid Pandemic.
When you looked at the groups that were most affected by this lethal virus, it ended up that many of the more marginalized, socioeconomically depressed groups were much more affected. So we have an issue here in the United States that we have to get on top of. Of course the issue on the global scale is, is much larger.
You know, many companies have, global pharmaceutical companies will have marketing presences in 30 or 50 or 75 countries across the world. And so more than 50% of countries are not actually represented by commercial organizations. And that’s a real problem. It means we’re not developing, studying our medicines in those other countries, and we’re not bringing our medicines to those countries in in a systematic way.
Um, I think, I think we’re, we’re up and down in, in access, you know, one area where we’re, we’re, we’re driving immense accesses in China. You know, where you have, you know, one point, what is it, 1.4 billion people, which means 1.4 billion potential patients. And you know, What, what the Chinese, the C D E, the C F D A, the regulatory equivalents in China have done over the last eight or nine years.
China has made it a mandate that we, China wants innovative medicines available for its population. And so they’ve overnight, it feels like they’ve changed the regulatory policies to enable development in China, and they, they’re stimulating innovation. So an example, the c d E, the one of the, the F D A equivalent essentially had listed a couple of years ago what they consider the top 50 most innovative medicines.
And they said, we know we, we want you to be developing your medicines in Chinese patients, so we understand how those medicines perform in pat in patients in China, but for those 50, let’s just register them and then you commit to a phase four study to study them after they’re registered because they’re just too important not to be available to patients.
So that’s a great example of a business model for companies. Company stepping in and, and a government really opening up the for, for those individuals. But we have a long way to go. I agree. We have a long, long way to go to, to achieve access at the scale that each of us would, would truly want. Now thanks
Naji Gehchan: for this example.
It really shows this collaboration of stakeholders at the end. And if we really can work as partners, uh, the, you know, co every time I think of this, I think of Covid and how we developed and brought innovation with speed, like vaccines, treatments, et cetera. Cuz we were all together. Uh, As key stakeholders of the healthcare for the patients we serve, keeping the patient at the heart.
You talked about funding. I would love to hear your view about not only funding for biotech, which is a ch obviously one of the biggest challenges, but what is the role of leadership in building up and scaling biotechs?
Andy Plump: Leadership in, in what context? Within the companies themselves? Yes. Yeah, in the ecosystem.
Oh, well, I mean, everything is about leadership. You know, I, and, and I can take, I I’m asking for you to qualify the question because I can take it in so many different directions. You know, I think it starts with policy and how we, as we’re talking about and how, how, how, let’s just focus on the United States, how we create policy, regulatory policy, reimbursement.
Policy pricing policy, that’s leadership, and there’s a trickle down effect if we’re too shortsighted about some of the decisions we’re making. I mentioned the inflation reduction Act, where there are many provisions that are absurd and will destroy innovation. I’ll give you one example, by the way, which is that there are provisions in ira, which allowed.
The cms, which is the kind of federal agency that manages pricing for Medicare and Medicaid products. There are provisions that allow CMS to step in and to negotiate price with a sponsor. That’s okay and and there as long as that’s managed correctly. But that timeline for when C M S can step in and negotiate is different if you’re a recombinant protein or a small molecule.
If you’re a recombinant protein, they can step in at 13 years, and if you’re a small molecule, they can step in at nine years. Why? It makes absolutely no sense. In fact, it should be the opposite because it’s much harder to make a generic version of a recombinant protein than of a small molecule. But the reality is both can be transformative in terms of their potential for patients.
That’s an absence of leadership. That’s, there’s, there’s something behind that. I’ve actually spoken with many former, former officials in the, in the government, several ex FDA chiefs, to try to understand where that’s coming from. And the only answer I can get is there’s, it’s politicized in some way, in ways that I can’t even begin to, to understand that’s poor leadership.
So leadership is important at, at all levels. There’s, there’s also, there’s also something about our business, which I find quite interesting, which is that, Our business is somewhat stochastic, right? You can be, um, you can have poorly run organizations and toxic organizations that can do quite well for a short period of time, and maybe in your career you’ve been in bad situations that you were just not happy as an employee for where a company has done well.
It’s actually very hard in most sectors to sustain yourself for any period of time when you have a toxic culture. In our industry. You’ve had many companies that have been able to do that. Now, of course it’s, it has a runway. If you have a toxic culture, bad leadership, you will. You will Peter out. But in our industry, because our life cycles are 10 to 15 years, if you have a Keytruda and you’re America, not suggesting that Merck is a toxic culture, but that can propel you for, you know, 10 to 15 years and give you an immense amount of funding for that period of time.
And so you do have organizations where you have bad leadership, where you, you see stochastic breakthroughs. Oftentimes they’re not because of brilliance or because of luck, and that happens in our business, and you can sustain those environments, but I’m not advocating for that. But really, if you wanna be successful in the comp, in the environments that we work within, where the, the competition for talent is so intense, especially in your area, Naji in oncology where everybody is in oncology and there’s such a talent, a dearth.
If you’re not leading, if you’re not creating cultures that are positive cultures, you’re gonna, you’re gonna lose there. There’s a great line that now I think every biotech c e o uses, which is, excuse my language, but the no asshole culture right now. But, and actually that was something that 10 years ago, I don’t think anybody was really that concerned about.
Cause everybody was so caught up in that stochastic luck process. But now everybody tries to create a culture that’s strong and, and leadership is the foundation of all of that.
Naji Gehchan: This is a great segue to the next section where I would give you one word and I would love your reaction to it.
Andy Plump: So the first word is leadership necessary.
So I, did you want a one word reaction or did you want a Uh, you can give more. Well, I mean, I’m just shaking my head because it’s very interesting. I’ll take an aside here. Cause you’re, you’re, you’re, you know, you’re, you’re kind of, um, rattling you, you’re sha you’re shaking me, and then you’re, you’re hitting a chord.
So, so one, one of the things that struck me in r and d in our industry is that oftentimes the leadership within r and d organizations, Is more variable than what you see in in other parts of, of our organizations. You know, for example, to be a commercial leader, you obviously need to be smart, you need to be accomplished, but you know, you, you’re often selected more on your leadership.
Whereas in r and d organizations, especially in in highly technical areas, you know, where the pool size of individuals gets to be quite small. Where accomplishments and intellect and technical expertise tend to be valued more greatly, let’s say, than leadership. You’re often seeing organizations promote individuals based on their technical merit merits in intellect accomplishments rather than their leadership.
And so many r and d organizations are mismanaged with, with poor leaders. And, and actually it kind of makes some sense because you’re. You’re, you’re we’re dealing with people who have trained as physicians, who’ve trained as scientists and as engineers and have never really thought about leadership. So I think it’s abs it’s an absolute necessity.
And one of the things I’ve done, you know, I we’ll see if this will work out at Takeda cuz, cuz our we’re judged over a long period of time, is I’ve first and foremost emphasized character and leadership. Technical excellence expertise is a necessity, but you can’t be on my team unless you have strong leadership chops, uh, and strong character.
The next word is health equity a problem. I mean, you know, it’s, it’s a challenge and actually, um, we come out of covid. And there’s the, you know, the, some of the silver linings that come out of the pandemic are a recognition of the inequities that exist in society and what, what make, what’s quizzical about my saying that is, why should that be something that we’re, we figure out in 2022 and 2023, this has existed for decades and centuries.
Um, you know, hopefully these realizations will stick and something that I’ve really. Um, become more and more aware of and more cognizant of my, my privileges as a white male and my responsibilities in terms of being an ally and stepping up. Um, we have a long way to go and, you know, fundamentally it starts within r and d, certainly within our institutions, ensuring that we’re creating cultures that are diverse, equitable, and inclusive.
And all three of them, not just diversifying our, our population, but ensuring that we’re listening and being truly inclusive. That’s really requires learning, education and growth. Um, but then as we start to think about the patients that we’re aiming to serve, you know, if we’re not studying the effects of our experimental therapies in diverse patient populations, we’re doing.
An injustice to, uh, to those patients and, and not contributing to health equity. And so it starts early on in the process. And when you look at, um, when you look at industry across the industry and you look at clinical trials, they’re still nowhere near where they need to be. I think we’re on the right track.
You have guidances coming out of, you know, f FDA for example, and other organizations. So I think we’re all moving in the right direction, but it’s something we all have to own. And I still don’t see that ownership as. Uniform is, is what it needs to be. Even within my organization where we have, you know, there’s a huge foundation and focus on health equity and clinical trial diversity, I sometimes listen in meetings and, you know, it’s not oftentimes the first thing that are, it’s brought up when we’re talking about our program.
I think if we’re really equitable, we’re really thinking about health, equity and access. It’ll be the first or second thing that comes up in almost every conversation, and I just don’t, don’t see that we’re not quite there yet. I love
Naji Gehchan: it. I can’t agree more with you on diversity. Not only it starts internally, as you said, this is parts we can influence immediately, but definitely clinical trial diversity is a big, is a big topic we need to be
Andy Plump: focused on as leaders.
No, on this point I was, I mentioned this talk I gave on Sunday, which is a very, Powerful talk for me. It took a lot of time, a lot of preparation, and I thought a lot about it. It was not an easy talk to give, but my second slide after my title was two people sitting on a couch and in between the two people was a big elephant.
And I said, here the elephant in the room is here I am a 50 something white male. Talking to a group of 500 diverse, aspiring, um, healthcare and life scientists. You know, but, but the elephant, so what can I tell you? How can my experience help help you? And so my, my, my theme was that there are, there’s a perspective that I have that that can be helpful to anybody.
And there’s also a recognition that I have that we all, we all have our identities and our identities will shape. Our, our lives and our career, and for some of us, we’re able to be more opportunistic because of the color of our skin and our gender perhaps. And for others, we just need to be more purposeful.
But it’s not, it’s not incumbent. On just the diverse, marginalized individual. It’s incumbent on all of us to step up and to ensure that we’re helping create more, more equity in the world. And that’s where I think my, you know, my responsibility is as someone who’s actually experienced so much and through a life of white privilege.
Naji Gehchan: one is, uh, symphony Orchestra.
Andy Plump: It’s, I mean, the Boston Symphony Orchestra. So even more specific. Yes. Are you, are you musical naji? Are you musical yourself?
Naji Gehchan: Yeah. Yeah. Guitar and piano.
Andy Plump: Well, so, okay, here’s the story. I went to school, uh, pointing this way cuz Mass is right behind me. And m i t is right after the road. I went to school at m mi t as an undergraduate, and I’m not particularly musical, but when I came to Boston, it was a town.
I mean, it’s, it’s changed so much. It was a town with m i t and Harvard and then Townies, you know, and it had a very unique kind of small town culture, but there was one institution. That was that, put it on a world scale and that was the Boston Symphony Orchestra. And so I, I loved the institution. Um, six or seven years ago, uh, I, we, we actually at Decat became sponsors of BSL because we were trying to, we were trying to imprint ourselves in, in Boston and nobody knew who we weren’t, right.
And it was trying to hire and build an r d organization here. And I would talk to people and they would say, Taketa the airbag company, like, no, no, Takeda. So we needed to, to, to, to market ourselves a little bit. And so we had two opportunities. The Red Sox, the Boston Red Sox, or the Boston Symphony Orchestra.
I’m a New Yorker. I could never, I could never promote. And I’m a big fan of the Boston Symphony Orchestra. And so we became involved and then I got involved in some fundraising and some development efforts, and I realized how how distanced the life science community in Boston was from this iconic institution.
So you had to me, now today in Boston, there are two defining elements. There’s BSO and there’s the life science community. And so it felt like a match made in heaven and I was able to help to catalyze, um, that that match and. A couple years ago, they asked if I would be willing to step up and serve on the board of trustees, trustees, which of course, I, I, I’m more than willing, and it’s been an amazing experience.
Naji Gehchan: the last one is spread love at organizations.
Andy Plump: Well, I’m looking at you and I’m, I’m, you know, I didn’t, I have to be very honest. It’s one of my Achilles heels. I didn’t know about your podcast or your, your group until I was a, until I, I met your colleague. What was her name? Z. Z Zena. Zk. Zano, yeah. Z.
After my, after the panel at m i t, she came up to me and, uh, we talked for a few minutes and she asked if I would do this, and she told me a little bit about it. And, um, you know, I was more than, more than pleased to step in and, and I love what you’re, what you’re doing and reaching in and helping the, our community grow.
And asking the kinds of questions and that many people don’t ask. I never get asked about the Boston sy new orchestra. I get asked about leadership, but it’s not the most common thing I get asked about. And so the way you’re approaching this and the way you’re opening up our community to, to unique perspectives, perhaps from standard people like, like me, I think it’s really terrific.
So thank you for doing this and congratulations.
Naji Gehchan: Oh, thank you, Angie. That means, that means a lot. Any final words of wisdom for healthcare leaders around the world?
Andy Plump: Well, I’m an internal optimist, you know, and I, I, I have to be in our business, as you know, Naji, cuz a lot of what we do doesn’t work. And so you need to really be optimistic, um, and.
You know, as I said earlier, I think we’re in the golden era of, of healthcare and I, I, i, I, I don’t know if our, if these decades will be remembered for life science or for computer science, cuz both are making huge headways. Um, but okay, but I’ll, I’ll tell you a bit of an, an analogy. So in, in, in history, there are dark periods of time that are often characterized by war, by pandemic and by social injustice and unrest, and we’re just coming out of one with covid.
If you look back in history, there are many very similar examples that are characterized by that same triad of, of darkness, always. These dark periods are bookended by greatness, and typically that greatness is scientific or technological. You go back to the 19 early 19 hundreds with Albert Einstein, for example, world War I, and then some of the work that came after World War I was Sir Arthur Edington.
Um, you go back to the 1960s with the difficult period. Bookmark by greatness in our in space exploration. And if you come to today, we’ve established a left bar benchmark in my mind of this dark period, and it was the work that came out of Jennifer Doudna and Emmanuel Chappen with crispr. What we can do in terms of genetic manipulation is just amazing, and the potential for disease is just incredible.
I don’t know what the right bookmark of this dark period will be, but the people who are listening to your podcast will be defining it, and I have to imagine it’s gonna relate back somehow to our ability to manipulate our genome and create good.
Naji Gehchan: Well, thank you so much, Andy. It’s such a great way to finish up with an opening on hope for after all the darkness, as you said with the triad we’ve been going through.
Thank you so much again for being with me today. It’s been a privilege. Thank you.
Andy Plump: Thank you very much. Naji.
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