Thanks, in part, to the combination of speed and endurance required, the 400 metres hurdles are said to be the most demanding of all the sprint-hurdle races. Someone who knows first-hand the rigorous training required for this ‘very long sprint’ is Sanofi’s head of strategic development Pascale Witz.
A molecular biologist by training – having dreamt of being a researcher since she was a teenager – Pascale’s other passion growing up was sport. It was a passion that saw her compete in the French junior national track and field team in the 400 metres hurdles, even choosing her school based on its proximity to training facilities. “My main focus was being able to do research and being able to train,” she explains.
Pascale’s academic career took her to the beginnings of a PhD and research into cloning and isolating a gene coding for serotonin (5-HT2) receptors in the brains of fruit flies, which she pursued for two years. “I always remained very passionate about the subject. But in all honesty, there was a lack of ‘fit’ – I’m very result-oriented and I’m not very patient. The research was just not going fast enough.”
She adds: “A lot of people have asked me, ‘Do you regret not finishing your PhD?’ And I always answer, ‘I don’t regret not finishing it, but I do not regret having spent these two years in the lab, either’. Because I was also working and learning how organisations work and I loved the subject.”
For the next step in her career sport continued to have some influence. “I passed an interview with Becton Dickinson, which was based in Grenoble. I love skiing and I interviewed there on a Friday afternoon in the middle of the winter, and I came back, and I thought … This is how you make big career decisions when you’re young.”
There followed five years working for Becton Dickinson in its pharmaceutical systems business and a period that saw Pascale quickly move into management positions and get her first real taste for building teams.
Having found herself moving increasingly close to the business side of the company’s operations Pascale then took a year off to do an MBA, before joining GE Healthcare, whose health interests were concentrated in diagnostic imaging.
“Then it grew and expanded, and I grew and expanded,” she explains, self-deprecatingly covering-off an 18-year spell that saw her move from global product manager to several general manager roles, first covering Europe, the Middle East and Africa, before spending four years as president and chief executive officer of GE’s medical diagnostics business.
Then, in 2013, Pascale – who was last year named one of Fortune magazine’s Most Powerful Women of Europe, the Middle East and Africa – joined Sanofi as executive vice-president, global divisions and strategic development, to run its pharmaceutical and consumer healthcare divisions. It’s a role that sees her set the company’s strategic direction and gives her responsibility for more than half of Sanofi’s sales. “I joined because of the opportunity – there was really the unique time that Sanofi was in. We’re really at a very interesting time.”
Launching products is very, very exciting and naturally generates a lot of energy
The race for launch success
What makes this time particularly interesting for Pascale – and industry watchers in general – is Sanofi’s product launch plans. This comes after its former CEO, Chris Viehbacher, last year conceded the company had been rather ‘light’ on launches. In fact, its last really big launch was some 14 years ago in the shape of Lantus (insulin glargine), the diabetes blockbuster that is now Sanofi’s biggest-selling product.
Last year it brought in €6.3bn, or more than 18% of the company’s entire annual sales. So, though there have certainly been instances when pharmaceutical companies have been even more dependent on a single product, the looming threat of biosimilar competition for Lantus must have concentrated Sanofi, and Pascale’s, thoughts on how to work its way through this transition.
The company – its leadership question answered with the recent appointment of Bayer’s Olivier Brandicourt shortly after this interview took place – says it’s now poised to bring six new products to market this year and has a total of 18 new products over the next five years.
The plans are, Pascale notes, massive: “This is not only a huge opportunity to serve millions of patients with new medicine, but it is really a rhythm that I don’t think many big companies have ever done. So there was a need to gear and wire and lead the organisation to be ready to coordinate, organise and deliver that, meanwhile, the business still has to run – a product launch in any company is always an event on top of something else.”
The first of these came in February with the debut of Afrezza, the only inhaled insulin available in the US. The drug-device combination delivers a dry formulation of human insulin via a small and portable inhaler, similar to those associated with asthma. But it didn’t have an easy road to market, with its developer Mannkind having to wait until its third marketing application before receiving approval from the FDA. The companies have already succeeded where ill-fated programmes from Lilly/Alkermes and Novo Nordisk/Aradigm failed, but it must now prove it can do better than Pfizer’s Exubera, launched in 2006 but withdrawn a year later due to lacklustre sales and concerns about the risk of dosing errors with the product’s inhaler device.
Following hot on the heels of Afrezza has been Toujeo (insulin glargine), the new basal insulin that will be crucial to moving away from Sanofi’s dependence on Lantus. Also approved by the FDA in February, Sanofi is working towards launching the product in the US and Europe before July. Looking to the second half of this year and Sanofi is aiming for a Q3 launch for its new PCSK9 cardiovascular disease management drug Praluent (alirocumab), which comes from its collaboration with Regeneron.
Further down the line should come other Regeneron collaborations – first the IL-6 inhibitor sarilumab for rheumatoid arthritis and then dupilumab, which targets the IL-4 pathway that’s responsible for atopic dermatitis, asthma and nasal polyposis – though it’s atopic dermatitis that Sanofi will target first. “So this is exciting,” Pascale says. “I mean, just to bring all this and have all the teams focused on building the future of Sanofi was really an exciting challenge.”
Training and preparation
But the scale of this challenge, Pascale acknowledges, is not to be underestimated. “Launching one product is a challenge – launching that many … we did have to strengthen and add muscle to our market access team.
“Payers are such a big stakeholder, and this is why having a good market access team is important. What I did when I arrived was to regroup the people that were within the business and R&D under one single team so that we could have a bit more cross-functional expertise sharing. I think we have now a very solid team for market access. Part of my role has been to organise [this focus], lead it, shape it, and make sure that we have the right level of preparation for all these different areas.”
There were still some silos within the company to integrate and Pascale regrouped pricing, value in access strategy, and the health economics and outcomes research functions together.
“I was cautious in the way that I regroup them. Market access is so important for a new product launch that, although, we decided to regroup them, we still have market access people that are focused only on diabetes, and they are fully part of the diabetes product team. It’s a traditional matrix approach, because you need to be part of a function so that you have the leadership and the best of the expertise, but you want to be part of the project team that is going to bring the medicine to market.
“So we still have the regional people in the regions, because that’s efficient, but the world has moved towards a much more networked organisation – it’s not like 30 years ago when you could draw boxes and have clear-cut boundaries. Today, we need to think about how we’re going to consider the physicians, the payers and the patients very early in the development.”
Asked whether these were easy changes to make Pascale says “Big organisations always have inertia. But I came to Sanofi from another big organisation and the way you manage inertia is really running people around the goal. And this is why launching products is very, very exciting and naturally generates a lot of energy.”
It’s everybody’s purpose and goal to be patient-centric
Part of the changes that Pascale has helped usher in at Sanofi has been to make it take a much more patient-centric approach. “I hired a chief patient officer, which was actually a first done by the big pharma companies. Don’t get me wrong, everybody who is working in a pharma company does have the patient in mind, and they mean well for the patient.”
Nevertheless, the appointment of Dr Anne Beal – a paediatrician and public health specialist – was a strong signal of intent. She joined Sanofi a year ago from the Patient Centered Outcomes Research Institute (PCORI) in the US, where she was deputy executive director and chief officer for engagement. Prior to her time at the PCORI, Dr Beal was president of the Aetna Foundation, the independent philanthropic arm of private health insurance firm Aetna.
Pascale explains what qualities she was looking for prior to picking Dr Beal. “It was a very unusual role for pharma, and it was therefore difficult to frame, because roles are quite traditional in the industry. So I wanted somebody who could understand the patient. I didn’t want somebody who was coming from the industry.
“So I was looking for somebody who was close enough to the field. I had said it should be a nurse – or if a physician, then not a hospital physician.
“So Dr Beal is a physician by training, and she’s a conventional paediatrician. She also has worked for a foundation. She has worked for PCORI. She has done a lot of public health. But I was not describing her profile. I was really looking for an individual who would be able to work collaboratively with a lot of different functions and have the ability to influence and lead the group towards a mindset.
“The last thing I wanted was to build a separate entity that would be in charge of the patient-centricity, because the point is, it’s everybody’s purpose and goal to be patient-centric. And that’s why I’m saying that people really embrace it very, very quickly. And now she’s leading by influence through a network of people embedded in the different functions and the different regions.”
Another driver towards changing the company’s complexion is the way it collaborates with others – with its work with US biotech firm Regeneron, “a very driven, very successful company” according to Pascale, of clear pipeline importance. But the nature of collaboration at Sanofi, as across today’s pharma industry, is that it runs far deeper than just working on medicines.
“With the evolution of the technology – digital health sensors etc – it can help building integrated care solutions; however, we are not going to become a sensor manufacturer or device manufacturer. The analogy I very often use is that if you want your blood glucose monitor to seamlessly interface with your Apple iPhone, we’re not going to develop an iPhone. We would be foolish to believe that we could do that. But we need to have enough people in-house who understand what it means to connect with iPhones or with other devices.”
The company has a number of partnerships in place, notably with companion software company Voluntis around its Diabeo diabetes app, though it quietly announced the termination of its drug-device research collaboration with Medtronic recently, commenting that it had been “unable to finalise a formal business partnership” with the firm.
We want people to be competitive with themselves
Maintaining momentum
Back to the company’s launch plans and the topic of how to maintain momentum for Sanofi’s own ‘long sprint’ comes up.
“We’re getting more organised and the excitement comes from the variety of therapeutic area that we are covering,” Pascale explains. “And, while we have an infrastructure, it’s still being built … it’s a rhythm that people enjoy.
“We are very much encouraging collaboration, so we are working on pairing the Toujeo team and the Praluent team, who have common projects to look at the patient, because being patient-centric means that you need to think about your patients that are going to have both diabetes and cardiovascular risk.
“I’m a strong believer in the learnings of one being applied to the other one, and synergies that we can have between teams. So I’m trying to create more connections.
“We want people to be competitive with themselves. Now, maybe I’m coloured by my type of sport, but in track I had my best friend running against me, but I still wanted to win. I was not beating them throughout my race – I was too busy running my own race.”