Lundbeck’s Charl van Zyl on a new era in neurology

Thank you, Isabelle. Thanks for having me. Doing really well today, thank you.

Yeah, thank you for that question. Of course, it's an amazing journey in a way where I've been through, had the fortune of course working in a number of countries and it took me around the world. But I think the thing that draws me to the industry is the difference we can make to the lives of patients, or allowing them to live the life they would like to live. That's the ultimate promise and sort of the reason or the purpose of why we work in life sciences. And I feel that's something that has been with me through my journey, but also one of the main reasons why I really came to Lundbeck.

Yeah, my interest has always been in the sciences. Even through my school and university time, I was drawn to the curiosity of science and understanding. And of course, as you get deeper into a topic, it unlocks more questions. So I was really drawn to the science, and it felt like the industry was a way to practice that in a way that makes a real impact on people and society. Having worked from a science background and then adding leadership skills and experiences over time, it really becomes a natural fit to be in the industry and combine these two things and lead an organization towards making this impact on society.

It starts out often more broadly. Sometimes we start with larger companies who work in a number of therapeutic areas. And then as the journey continues, we sometimes work in very specific areas. My journey entered into neuroscience a little bit more in maybe the last eight or nine years with a company I worked for prior to joining Lundbeck. The severity of the diseases—neurological conditions are often lifelong, severely impacting patients but also families and caregivers. It is one of those areas where we are increasingly understanding the science, but there's still a high unmet need. That's what drawn me to the difficult challenges of neuroscience, and I like these challenges and these ambitious opportunities.

Yeah, and to build on that point, there's been this sense that we are in the decade of the brain, where there's a greater understanding of brain diseases. The advances in understanding human genetics have significantly advanced the ability to find solutions for diseases that we didn't really know how to solve. That has seen an advancement into more rare diseases as well, where there's often a very clear genetic component. But it is still an area that requires a lot of courage to remain in neuroscience and take bold steps towards finding solutions for brain diseases. We still don't fully understand the brain, and it's a journey of learning more about that.

I would say with any type of new position like this, I still see it as a privilege to lead a company like Lundbeck—a company with a long history, more than 100 years in existence. There's a strong golden thread through the company of the purpose of why employees work for the things we do, trying to address these unmet needs for patients. I found that very much an inspiration when I joined Lundbeck. In any role like this, it's important that I listen and learn in the beginning and understand the history—where are we, what have we done, and how do we build in that future. My priority in the beginning was very much around understanding the history, the journey, but also mapping out what could we look like in the next decade. How do we solve the work we are doing now that will impact the next decade for the company? In life sciences, we often deal with a discovery of a new molecule but it takes probably 10 years to get to the market and be available to patients. So we always have to think long-term. A lot of my initial focus was to set a clear strategy or framework of where we would like to go and build a roadmap together with the leadership team on how we could prepare Lundbeck for the next generation and for the long-term success of the company.

One of the fundamental things that we have changed—this is prior to my arrival but it's certainly part of my vision as well—is that we target diseases by understanding first of all the biology. We really need to understand the science: what is going wrong in the disease pathway, and is there a specific target or intervention that we can achieve to modulate the disease or address the symptoms. That's the foundation of everything we do. We need to truly understand the pathobiology, and that is what is driving us now towards areas where we can understand the biology, then design a molecule or therapy to address that target, and then test it in patients to see if it has the clinical effect we would like. Building in there the understanding of what is the unmet need that patients have today and is our treatment going to solve unmet need. We're not there to address things that are me-too or similar to what is standard of care. We're always addressing the ambition of what is an improvement over standard of care. That leads us at Lundbeck towards diseases where there is high unmet need—often rare diseases in neuroscience, but also populations of chronic diseases where there's a specialized intervention. We're moving more to spaces where we are treating maybe 10,000 patients in the world or a few thousand patients, because it's not as prevalent a disease but it's a huge burden. Our science is leading us towards these spaces where there is high unmet need.

That's a great question, and that's one that we keep evolving ourselves on. For a company like us dealing with lifelong conditions with very severe impact on patients' lives and also on caregivers, the first question we ask ourselves is: do we truly understand the journey the patient is going through to get to the right treatment? It often can take very long, or there's a misunderstanding of the disease because it's not so prevalent. Our journey in the company is very much around a mission which is every patient counts—every patient is an individual that we would like to serve. Understanding the journey, how do we reduce the friction points for the patient to get them to the right treatments and the best solutions for them. Our model is shifting a lot more to be more patient-centric. It's truly important that we understand how do we ensure early awareness, are we working with patient associations, are we working with experts in the field to truly understand what patients need. And then when our treatment is available on the market and approved, we also need to work on ensuring that patients have access—reimbursement with healthcare authorities. It is really a journey that is lifelong, and after that it's education and any other services we need to support patients with. We see that as a collective journey. We are only one player in that space—we're providing the medicine but we need to work with healthcare authorities, with all the caregivers and support services around that. It's often a partnership that solves that for us.

No, not at all. In the space of mental health, of course there is still a large part of the science that is not fully understood. We do not fully understand all of the brain diseases, the more central diseases. This is an area of ongoing need for funding of basic research, continuing to understand how we can support and understand these diseases to be able to target them more effectively. To your point about the journey for companies in life sciences, it is very much around making sure that we connect the value of the medicine that we provide not only to the impact of the individual patient but what does it mean to society. The value of a patient being able to function more or require less healthcare services, or could even take employment—is essentially the contribution of the value of that to society. I think this is not just for Lundbeck but for life sciences—the impact we make on society is often misunderstood. It might only be judged through the price of the medicine or the price of the innovation, but not on the value of what we bring. This is part of our mission: to connect our work also to the impact it has on the broader society.

Yeah, no, this is very true. I don't propose that I have a solution for this, but I think the ambition we need to set is that the more we can connect the value and understanding what our medicines are doing and the impact it has—the health economics of our activity—is something that we all have to continue to work together on. Working with governments, with those who support patient reimbursement, that this is really the value that we connect to the impact we can make, of course.

There's generally a convergence in my mind between biotech and health tech. There is increasingly the technology or the way to measure real-world evidence, or the impact of different diagnostics that would inform patients and healthcare professionals if the medicine is working—is a patient doing better. The sort of real touch points, so that it's not based on consultation with your doctor and then six weeks later another one, so that what happens in between is really what we need to try and understand. I think there's a strong role for health tech, and the advance of digital health is important. As a company, I think we need to remain focused on what we're good at, which is discovering medicine. But we are very open to partner with companies who are providing more the digital solutions. I think it's a collaboration in our world. Digital or health tech can certainly measure more real-world impact of patients. For example, in diseases like Parkinson's, we could measure the functionality of a patient—being able to move more, being able to walk to the supermarket to buy something. The real functionality can be measured through digital tools, through movement, through many different ways. So there's definitely a role to play for this partnership between biotech and health tech.

Thank you for that question. We all have different ways of how we decompress or have time to reflect. I use sports, so I am quite active—different things, swimming, biking, those types of things. In my journey through life, I have always been active in triathlons, so this is something that I try and do. It becomes less easy to do these days given the time, but I find that as a way for me to digest sometimes ideas, thoughts. Spending time with others, doing sports really is a way to kind of reset, regenerate. I use that a lot, of course. But I also love having a great dinner with a glass of red wine. So I have a wide spectrum of things I get involved in. I've learned over time it's so important to balance and have that regeneration, because we're running a marathon—we're not in a sprint. We want to pace ourselves well.

Thank you, Isabelle.