Seema Kumar Interviews Andy Plump at BioFuture 2023

Hi Sema, thank you very much for inviting me.

Well, firstly, terrific fireside chat. Thank you very much. I had a lot of fun. I think we did good connection. We had a good connection. And I love the topic, of course. As someone who has grown up curious about science and who treated patients and has seen so many patients die of diseases that we should be able to treat, this idea of shooting for a cure is really what we should all be aspiring to. As the science has evolved, as our understanding of human disease evolves, as our access to this diverse array of modalities has expanded, we absolutely have that potential. I think the only thing that stands in our way is ourselves.

Right, of course digital is and will continue to become a more fundamental part of everything we do. Unfortunately, we're still not going to be able to go into a computer and click a button and have a molecule delivered. That's not going to happen, certainly not in my lifetime. But the applications of digital technology are really profound across our whole value chain. From using tools like AlphaFold, which came almost out of the blue and revolutionized how we think about looking at structures of molecules and how our potential therapies bind, it enables immensely our ability to make decisions and move fast. To the other extreme in development, where one of the biggest challenges we face today is finding and accessing patients for our clinical trials. So having the ability not to go to a trial site and then look for patients, but actually go to the world and find the universe of patients and then identify trial sites near those patients, it really has the potential to transform development.

I'm so glad you brought that up. Unfortunately, we didn't have a chance to take on this topic in the panel, so we can do it here. We've done patients a disservice by not recognizing exactly what you said: the need to study our medicines in diverse populations. And parenthetically, we've done ourselves a disservice because there are a lot of patients in diverse, marginalized populations that could be enrolled in our trials. So there's a win-win here. The opportunities for us are the following: first and foremost, to gain trust, to communicate in ways that everybody can understand, and to be able to access these patients. We talk a lot about digital. One of the great opportunities with digital is doing something called decentralizing our clinical trials, which is moving the trials away from clinical trial sites that often don't have access to these diverse populations, and taking the trials to those patients' homes.

Well, it's there, it's there. I mean, the technology is there. It's actually our ability to implement that technology and change management. It's our willingness to step in. And of course, there are risks, quality risks, and all kinds of uncertainties. We don't like that kind of risk. We don't mind the risk of starting a drug discovery program with a 10% probability of success; we're okay with that risk. But when it's the risk that you're in a trial and you're going to do something a little bit differently that hasn't been done before, it's quite scary for us. But at the end of the day, drug development has stayed the same for a very long time. It is a bit of a slow process, isn't it? Is there a way to accelerate it? Could you create, for example, digital twins where you could study your drugs in digital twins instead of in actual human beings? So, yes, we are very old school. We're like a big barge; it's hard to turn us. There are parts of what we do that you can't accelerate. If you're going to do a toxicology study in an animal model to understand the safety profile of a new molecule, that needs to be nine months. You can't accelerate that. But there is so much of what we do that can be accelerated. You mentioned the use of digital twins to gain better understandings that allow us to test hypotheses in more specific populations, smaller sample sizes. There are so many opportunities for acceleration.

So, the science is really hard. Managing people and changing cultures is even harder. I think part of the problem we often have as scientists is that our training is very technical, and we rely so often on our intellectual prowess and lead with that. But in reality, as leaders, what we need to think about is how we enable and elevate the people in our organization. There are lots of books written on this topic, and they make it sound quite easy, but it's not. It requires a lot of attention and focus. One thing I've learned is that you always have to remember you're dealing with people. You need to be fair to people, respect people, be inclusive, listen, and bring people along. When you have a difficult message, you need to share it with transparency, with logic and the underlying reason. People will be okay with hard messages if you're fair, honest, and transparent.

So I do believe in cure. You and I share an optimism, which is why we're in this business. I certainly believe we have that opportunity. The science is a challenge, but we can overcome that with the tools we have. We have to accelerate what we do, implement new tools rapidly. We have to ensure, because a lot of what we do is regulated and highly politicized. Regulatory agencies that regulate what and how we work are influenced by the political dynamics of the world we live in. Actually, we influence those political dynamics by our reputation. So we have to uphold our regulation, solve problems collectively. We talked a little bit about the IRA in our meeting. The intent of the IRA is good – countries are reeling from healthcare costs, who can argue against affordable healthcare? But how you get to it, unfortunately there are provisions in the IRA that will limit innovation and prevent our ability to go after cures. So we have to work better together to ensure we're working towards the same common goal: to treat and ultimately cure disease. And of course, we want the cures to get to as many people as possible. Access is an important aspect of curing. It's critical. One of my colleagues is Nigerian, a physician scientist with a prominent role in our development organization. His goal is to move towards cures for sickle cell disease. Those cures shouldn't just be made available to patients in the United States; they should be made available in the continent where it's most prevalent, Africa. That's his mission. And that gets us to value-based care. At the end of the day, we need to start thinking about value-based care so that a scientist's biggest reward is to see the breakthrough reach as many people as possible and cure as many people as possible. That requires a change in how the healthcare system reimburses breakthroughs. Right, a lot to solve. But there's a way to do it all. Make innovative medicines that will cure disease, be accessible to patients across the world, and drive profits which are the incentives for reinvesting in the next wave of innovative cures. Everybody can be a winner. And that's what cures are all about.

All right, thank you.