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The Rugged Biopharma/Tech Topography: What Alliance Managers Need to Know (Part 1)

Posted By Cynthia B. Hanson, Wednesday, September 26, 2018

Business partnering today requires know-how to negotiate nontraditional collaborations for purposes that are different from those of classical business development and licensing (BD&L) alliances. The partnering landscape for biopharma firms is evolving to include a variety of these new kinds of collaborations, according to the session “Non-traditional Partnerships:  The Changing BioPharma Alliance Landscape and the Implications for the Alliance Professional and Alliance Management Community,” led by Stuart Kliman, CA-AM, and Ben Siddall, both of whom are partners at Cambridge, Massachusetts-based Vantage Partners. The two took to the floor at the 2018 ASAP BioPharma Conference to provide key insights on the value and challenges these partnerships bring, especially in the area of biopharma/tech collaborations, which are resulting in very different business models. I had the opportunity to talk with Stu Kliman before the session. Here are some of the insights he provided on this hot topic.

ASAP Media: What is the impetus for your session?

Stuart Kliman: This session is about this ongoing theme of new types of collaborations happening in the healthcare ecosystem. It’s really all about how biopharma and tech are doing more and more together—so new and different kinds of relationships. Those relationships have different purposes. They might differentiate the value proposition of a product or a drug or support outcomes-based deals within the healthcare system. Or they might provide real world evidence and value-based pricing models. This session is about some of the differences between pharma and tech and the different kinds of challenges that organizations need to deal with. About the upstream, how do you start to think about creating these kinds of relationships and the key success factors for doing so? This also raises the question about if and how classic business development and licensing-type alliance groups need to evolve to deal with the changed environment.

We can see from the lineup at this year’s ASAP BioPharma Conference that the biopharma/tech partnering relationship is a very hot topic. How pervasive is the interest on the tech side?

Every tech company that’s out there is trying to figure out how to get into healthcare. It’s this world of FitBit. It’s this whole world of software, hardware, and device companies exploring the healthcare world.

This session is an extension of some of the topics you’ve been discussing and advising on for some time.  What’s different in this session?

There is a lot of focus on understanding the healthcare landscape, defining the problems that the healthcare landscape is creating.  For example, there might be things related to better data, trial efficiency, or the context of a specific therapy, or the need to track value. The first thing you need to do is make sure you have thought through what the different problems are, what capabilities you need to partner with, consider different kinds of players that are out there, and be thinking about the right kind of business model to work with them, and how to design overall relationship around that shared vision.  We will spend more time talking about this notion of problem definition and think through tentative problem types. Does that lead to something that feels like an innovative alliance relationship or a more traditional one?

Stay tuned for more of the ASAP Media team’s coverage of this and other sessions at the 2018 ASAP BioPharma Conference. 

Tags:  alliance  Ben Siddall  healthcare landscape  licensing-type alliance groups  partnering  pharma  Stu Kliman  tech  Vantage Partners 

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‘It’s All about Med Adherence’: Atrius Health’s Dr. Steven Strongwater Discusses Accelerating Change in Healthcare—and Cracking the Code on Improved Care at Reduced Cost (Part 2)

Posted By John W. DeWitt, Wednesday, September 26, 2018

“A lot of non-value-adding costs need to be cut out of the chain,” asserted Steven Strongwater, MD, CEO of Atrius Health, in his thoughtful and data-packed presentation during the ASAP Leadership Forum meeting on opening day of the September 24-26, 2018 ASAP BioPharma Conference in Boston. When it comes to prescription drugs, for example, “it’s all about med adherence. The problem is very practical. In New York, there are ten thousand homeless children. How compliant are they going to be with their asthma meds? Instead they go to the emergency rooms.”

The urgency of reducing soaring US healthcare costs while improving outcomes is a constant mantra for Strongwater and Atrius Health, which serves 720,000 patients in the state of Massachusetts with 1,300 clinicians and 825 physicians across 32 clinical sites in over 50 specialties. The non-profit accountable care organization (ACO) generates about $2.1 billion in revenue and is the top-ranked ACO for quality of care in both New England and nationally.

Regarding the challenge of prescription and therapeutic adherence, there are of course many factors and interdependencies involved, from drug costs and prescription protocols to care models and patient behavior, all of which means you need to ask, “What’s the full delivery chain?” His ask of the biopharma partnering execs in the room was specific: “How will you not only sell [pharmaceuticals that help patients], but also help us manage down the total cost of care?”

One biotech executive immediately responded that “drug companies care a lot about adherence—we talk about it every day.” Dr. Strongwater replied, “We don’t hear it—but if that’s the case, there are 560 ACOs who’d be interested in working on this with you.” (Strongwater describes ACOs as groups of providers that collectively accept responsibility for overall spending and quality outcomes for attributed beneficiaries. There are 561 ACOs nationwide as of May 2018.)

Stuart Kliman, CA-AM, partner at Vantage Parners, introduced Dr. Strongwater and moderated the leadership forum discussion. At this point, he interjected with an example of a company that is taking a holistic approach to adherence, commenting that “we should be thinking about adherence as a total solution—are we in the drug business or the solution business? And what is that [total solution] going to look like?” Which of course begs the money question: Which organizations in the life sciences and healthcare space are going to invest in holistic delivery solutions?

“We on the front lines do not have the R&D budget to study this,” Dr. Strongwater noted. “This is basic lab research funded through grants, mainly NIH [National Institutes of Health]. Operations research around adherence, compliance—there’s no funding stream to do this kind of delivery-at-the-front-end work. And we really do need help.”

Strongwater spent a slide discussing the frontlines challenge of compliance in diabetes—providing another thoughtful illustration of the entangled drivers of rising healthcare costs. He offered a case example of “a 48-year-old woman who weighs 200 pounds, has two children, and works as a medical secretary making $45,000 a year. She has diabetes and hypertension—but can’t afford her insulin on a regular basis.” Atrius has an analytics tool that can predict, with 80 percent accuracy, the likelihood of a high-risk patient requiring hospitalization—but a doctor probably wouldn’t need that tool in this all-too-common scenario for diabetes patients. “About half of diabetics skip care because of the cost of drugs and 45 percent cut back on treatment. Insulin costs spiked eight percent last year,” he added, noting that insulin price has nearly tripled since 2002 and that three manufacturers control the insulin market.

Strongwater then described one way Atrius is tackling the cost challenge for its diabetic patients—“an initiative within Atrius to switch to lower cost test strips.” With 80 percent utilization, this initiative will save Atrius itself nearly a million dollars a year. Patients still pay their usual copay, but get a free new meter and, if they pay out-of-pocket, they will be able to pay less for their strips.

Stay tuned for more about the ASAP Leadership Forum discussion—including Dr. Strongwater’s analysis and recommendations for collaboratively cutting healthcare costs—as well as the ASAP Media team’s onsite coverage of the 2018 ASAP BioPharma Conference. 

Tags:  accountable care organization  Atrius Health  Dr. Steven Strongwater  Healthcare  healthcare reform challenge  improving outcomes  Stuart Kliman  therapeutic adherence 

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‘Swimming in Partner Soup:’ 2018 ASAP BioPharma Keynote Addresses Challenges of Tech Collaboration on Prescription Digital Therapeutics (Part 1)

Posted By Cynthia B. Hanson, Tuesday, September 25, 2018

Dr. Corey McCann is a man who wears many hats—scrubs, academic cap, campaigner, jester, and even hardhat. As the first of two keynote speakers at the 2018 ASAP BioPharma Conference “Creating Value and Innovative Partnerships by Driving the Alliance Mindset,” Sept. 24-26 in Boston, Massachusetts USA, he provided a lively presentation in which he showed the audience how he switches his hats with aplomb. In his captivating talk, “Lost in Translation: Communication, Confusion, and Consensus in Strategic Alliances,” the physician, scientist, entrepreneur, healthcare investor, and founder/CEO of Boston-based Pear Therapeutics, Inc., delved into the timely but tough topic of the alliance management interface between biopharma and tech.

Colleague Brooke Paige, CSAP and vice president of alliance management at Pear Therapeutics, introduced McCann by lauding his many “heroic” accomplishments as founder of several startups, a trained boxer with endless energy, and highly approachable executive whom colleagues nicknamed “Snacks” because he rarely stops for a full meal.

McCann then delivered a clever, sometimes humorous, talk from the C-suite about the small, innovative company’s partnering with big companies in their quest to pioneer prescription digital therapeutics for the treatment of serious diseases, including addictions.  The cognitive behavioral therapy-based treatment is software that comes with a doctor’s prescription. The software responds and morphs over time, according to the needs of the patient. The downloaded product requires an access code from the physician.

“We are swimming in partner soup,” announced McCann as he talked about the challenges of Pear’s ample pipeline, which involves 10 products that require separate approvals from the FDA because of the unique framework of prescription digital therapeutics. “You will see us aggressively partnering across all of these verticals,” he continued, while flashing a slide of Pear’s pipeline.

Alliance management at Pear must bridge two distinctive worlds. Pear’s team is “half and half,” he explained: pharma is based in the Boston area; tech is based in the San Francisco Bay area. “We brought these two very disparate sets of people together” in one company—but to do that required a lot of effort to enable tech and pharma to understand the lingo of each’s area of work.   

“One of the things I would like to interweave into this talk is this idea of communication between alliance partners, and nonverbal cues, and how we are productive or nonproductive,” he said, while providing the example of etiquette surrounding the exchange of business card. “Even for those of us who think we have a handle on this very basic skill—this handing of paper to another human being—there is ambiguity.”

“How do entirely different disciplines communicate?” he asked the audience.  “There is an interface between tech and biotech. How tech people communicate with one another is very different than how biotech people communicate with each other.”

People in the two industries dress differently, he then explained. A person in the Bay area might “eat avocado toast and ride a scooter to work. … If I’m interacting with the tech team, I make sure to pet their dogs they bring to the office,” he explained in a sea of laughter from the audience. “One of my personal favorite examples is this issue of language. When pulling Pear together, we used the acronym API—which means Application Program Interface in tech, but for biotech, it means something different”—Active Pharmaceutical Ingredient.

It actually took a while for the two teams to figure out this discrepancy, he explained, again as the audience rippled with laughter. But in the end, the two industries found the glue that holds them together: “Impacting the patient. That is the rallying cry for us. That is how we approach partnership—through good and bad.”

Stay tuned for more of ASAP Media’s coverage of Pear CEO Corey McCann’s keynote and other sessions at the 2018 ASAP BioPharma Conference.  

Tags:  2018 ASAP BioPharma Conference  Alliance management  Alliance Mindset  biopharma  Brooke Paige  cognitive behavioral therapy  creating value  C-suite  Dr. Corey McCann  partnering  Pear Therapeutics  prescription digital therapeutics  software  Strategic Alliances  tech 

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‘We’ve Already Transitioned to Value-Based Care’: Atrius Health’s Dr. Steven Strongwater Discusses Accelerating Change in Healthcare—and Cracking the Code on Improved Care at Reduced Cost (Part 1)

Posted By John W. DeWitt, Tuesday, September 25, 2018

What’s on the leadership agenda today for biopharmaceutical alliance executives? How about collaborating to reduce drug costs, suggested Steven Strongwater, MD, to a group of about 20 life sciences alliance executives who participated in an ASAP Leadership Forum meeting and workshop session facilitated by Stuart Kliman, CA-AM, partner at Vantage Partners. The group met in a closed-door session the first afternoon of the September 24-26, 2018 ASAP BioPharma Conference in Boston.

Healthcare spending in the US is “something like $3.3 trillion, or $10,000-plus per person per year. It’s approaching 18%, and heading north of 20%, of GDP [gross domestic product]. A lot of this is driven by drug costs,” said Dr. Strongwater, who is president and CEO of Atrius Health, a non-profit accountable care organization (ACO) that employs 6,800 medical professionals and serves 720,000 patients in eastern Massachusetts. Atrius, with 1,300 clinicians and 825 physicians across 32 clinical sites in over 50 specialties, generates about $2.1 billion in revenue and is the top-ranked ACO for quality of care in both New England and nationally.

“Things are in rapid, accelerated transition right now, with all of these vertical and horizontal mergers like CVS-Aetna, Cigna and Express Scripts, WalMart and Humana. … Digital health is a major transformational force,” he added, flashing a chart showing the explosion, in number and size, of digital health deals since 2011. (Average deal size today approaches $18 million, and 2018 likely will see nearly 700 digital health deals worth a cumulative $8 billion, according to the Rock Health Funding Database.)

“There’s so much money in the healthcare space. Everybody wants in because it’s almost 20% of the economy, and costs are continuing to rise,” said Dr. Strongwater in setting the stage for his discussion of reform strategies and cost-reduction collaborations.

Today, “it’s a terrible disadvantage to be in a fixed model [of reimbursement],” he continued. “I would argue that we’ve already transitioned to value-based care.” He cited a comment by Troy Brennan, CVS’s chief medical officer who will remain on board after the merger. “He says 80% of what is offered at the primary care office will be offered at CVS. Companies like CVS believe they can disrupt the doctor-patient space. They are a serious competitor—with free parking too,” Dr. Strongwater noted to chuckles around the room.

Patients seeking better care at a lower cost are the core change driver—a “consumerism explosion,” said Dr. Strongwater, adding that “patients are looking for more empowerment” and “at the end of the day, consumers will always win.” Today, “patients are booking office appointments like airline seats” using digital solutions. “They want faster quicker access for less money,” he added, citing as an example the emergence of “clearinghouses for cheap MRIs” and rapidly growing demands by Massachusetts and other state governments for pricing transparency.

Of course, reimbursement lies at the center of the healthcare reform challenge.

“How we are paid for healthcare defines the kind of care that is provided,” Dr. Strongwater said. “I will say that again: how we are paid defines how care is provided.”

Stay tuned for more of the ASAP Media team’s coverage of the ASAP Leadership Forum and other sessions at the 2018 ASAP BioPharma Conference. 

Tags:  Atrius Health  Dr. Steven Strongwater  Healthcare  healthcare reform challenge 

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How Merck and Pfizer Build Alignment and Navigate Complexity: A Transformative Alliance on a Journey of Oncological Discovery

Posted By Genevieve Fraser, Friday, September 21, 2018
Updated: Monday, September 17, 2018

There were some cultural differences to overcome when in 2014 pharmaceutical company Pfizer joined forces with biopharma company Merck, selling its sharing rights to develop an experimental immunotherapy drug to accelerate progress against some of the most difficult-to-treat cancers. The alliance paired an American behemoth, Pfizer, founded in 1849 in Brooklyn, New York, with Merck, a German-based multinational corporation, founded in 1668 (no typo).

 

 To drive alignment in their complex partnership, Pfizer and Merck utilize a “divide-and-conquer” approach, as explained by two of the companies’ alliance leaders during a session at the March 2018 ASAP Global Alliance Summit in Fort Lauderdale, Florida, USA. Discussing their experiences “Navigating and Effectively Managing Complex Alliances between Large Biotech/Pharma Organizations,” Judy Baselice, Pfizer’s director alliance management, and Brian N. Stewart, CA-AM, director alliance management at Merck KGaA, Darmstadt, Germany, described how the Merck-Pfizer partnership uses five main tools for keeping the alliance on the same page.

  • Divide and conquer – Six alliance managers with divide and conquer responsibilities with different alliance committees, working groups, and other activities.
  • Distribute monthly dashboards – Capture everything from development and commercial activities to changes in manufacturing, medical affairs, and a snapshot of competitors; distributed to everyone from senior leadership to project management, so everyone knows what’s going on.
  • Invest in coordination and jointly chair meetings – What are the issues and activities and what’s coming up next? Discuss what was agreed to coming out of the gate.
  • Use available technologies – Exchange information from a review of clinical development to the use of federated calendars (meaning you type in a name and availability shows up).
  • Refer to guidance included in the contract – these are your guidelines for final decisions.

The matrix of what the alliance looks like includes co-administrated studies, co-promotion and co-commercialization agreements, a dedicated alliance management team, reports and global marketing with the alliance general manager, as well as target goals for external partnering. Management tools include a SharePoint site, calendars with a pull-out archive section, and regional groups, all of which added to the complexity of the alliance. Of course, what they needed when they launched was to recruit patients, to get the study readouts, and to receive notifications when there were significant changes.

 

External alliances that were outside of the core alliance involved collaboration agreements. Each involved incremental complexity—three- to four-way agreements, extended research and collaboration agreements within the compound, as well as assets that the teams did due diligence on. There were also alliance and third-party signed agreements to move forward, along with standalone agreements not part of other overall agreements.

 

“These separate agreements add additional layers of complexity with each deal we do,” Baselice stated. “Not every one of these partnerships will look alike. We also declined opportunities and had to determine which molecules were not ready based on a need for additional data.”

 

“We co-funded funded fifty percent of each trial as well as each organization’s legal team review of IP clauses. It can take six to 12 months per project,” Stewart added. “Also, we needed to educate both companies on what to do and what’s at risk which involved the future of our alliance in some respects. Effectively managing the alliance matrix is a matter of life or death for some.”

 

“The important thing is to keep everyone updated,” Baselice said. “It was important to be consistent and to avoid confusion. We needed teams to feel there was no need to horde data. We stressed openness and transparency. We have nothing to hide and the goal is to move it forward, share info and foster the attitude that everyone is there for the project. Of course, there are some things Pfizer can do that Merck can’t and vice versa. For example, Merck can go into countries Pfizer can’t, like Iran.”

 

Read more about the Merck-Pfizer partnership and insights into how the two companies’ partnering leaders manage their complex alliance in the August 2018 issue of eSAM Plus.  

Tags:  agreements  alliance  Brian N. Stewart  co-commercialization agreements  collaboration agreements  Complex Alliances  dashboards  due dillegence  External alliances  Judy Baselice  Large Biotech/Pharma Organizations  Merck KGaA  Pfizer  third-party signed agreements 

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