Transcript of Full Interview with John Kutz
December 2022
I was fortunate to have John Kutz on the ScaleHealth Podcast and benefit from his insights and experience around pharma, MedTech and digital health. To hear the interview with John, listen to the Pharma/MedTech episode of the ScaleHealth podcast.
John is a Managing Director at Eversana Consulting – the consulting division of the giant life sciences services company. Eversana is the leading provider of global commercial services to the life sciences industry and serves more than 670 organizations, including innovative start-ups and established pharmaceutical companies.
What follows is the complete transcript of our conversation.
Adam: I'm, super excited to be here with John Kutz from Eversana. Welcome, please tell us a little bit about yourself and a little bit about Eversana.
John: Eversana is an organization that's really setting itself up to provide the complete roster of services for pharma companies, young companies - to really do all things commercial. I grew up serving clients over at Deloitte and came over to Eversana a year and a half ago. I have been working around all things digital and with a great, balanced portfolio of clients that are either younger companies with their first product and with other kind of titans in the industry.
Adam: We're so fortunate to have an expert that works directly both with pharma and med tech companies as well as many digital medicine companies who are taking a, a pharma or med tech approach. Maybe, first John, could you say a little bit about traditional pharma and med tech and how they interact with other sectors of healthcare?
John: The best analogy that I have for it is, if you think about a family where you're the child the, mom is like the provider - the ones who are concerned and always there for them. The pharma companies and the med tech companies to a lesser extent, are kinda like that rich uncle who probably has the money to solve the problem, but is usually a little bit aloof and perceived as being a little disconnected. So the pharma companies are really trying to overcome this perception by trying to adopt policies and other things that make them very patient centered - outcomes for the patients.
And on the surface there's a lot of animosity between the payers, the providers, the pharma companies and med tech companies, but if you look below the surface, there are lots of areas where they are actively collaborating and really working together. And some of those areas are things like patient-oriented admissions, social determinants of health. As the pharma companies call it marketing and a lot of awareness raising education around different therapeutic areas. And the med tech companies they function a little bit like the pharma companies, but they just have less resources. They're not as profitable. They're more embedded with the providers so they tend to have a better relationship with the provider sector, but they often struggle to find enough resources.
If you look at the pattern of innovation, the pharma companies are really concerned with their brands, the products that they sell. And so all of their efforts in terms of research and development, marketing, brand building are really focused at that level, which is why you see that they're really more about their brands than they're even about building their own corporate reputations. The med tech companies tend to be a little different cause they need a much more rapid cycle of innovation because they're trying to make sure they always have a little bit better product to justify a price increase when they're interacting with the provider sector.
Adam: I love that metaphor of the rich uncle. You hit a little bit on it, but maybe you could double click a bit more about the structure of these companies between commercial and R&D and other areas, for those of us who don't know it as well. So they can understand how they actually function.
John: Those are the two predominant divisions - the research and development, so the science side and then the commercial side. But they tend to organize themselves when they have a portfolio or a roster, products around therapeutic areas. For example, you would have a big business within Abbvie around neurology, which is where their migraine, head headache, Botox therapeutics, and things like that would be housed. They tend to manage themselves at the level of the therapeutic area and that's where you find brand leaders and the people with power within the organization. But then they do bifurcate pretty neatly between R&D and the science and then the commercial.
Adam: And any advice for innovators who are thinking about selling to or working with pharma or med tech - whether it's points of call, key priorities; you know, scars that we all have?
John: I think it is a challenging thing. I think the best way to think about it is to think about a pharma company as a potential partner, but also a potential customer. I know that there are a lot of young companies I've seen who have gone out and really found a deep, profound connection between their product and one of the existing brands. Or even more importantly, maybe a brand that is about to be launched. So, I would say really pay attention to the announcements, the pipeline reports that a lot of these pharma companies have, and try to make that connection between your product and what they're about to launch. A lot of these pharma companies will have an innovation team, a digital team, and a team that's doing wacky doodle cool stuff. Those can be interesting conversations, but they can often be a waste of time because they don't really have the resources, the power to really fund a really innovative pilot project or to really make anything happen.
But if you look at what the pharma companies are trying to do, they're trying to figure out how can we more efficiently engage patients so we run better, more efficient clinical trials, and how can we make sure that our products are supported by really patient centered engagement platforms that can, improve adherence or improve compliance for products. Those are things that are really powerful. Being able to go to a pharma company and make the argument - Hey, if you team with us and use our digital therapeutic or our digital offering, your adherence percent will increase significantly. Those are the kind of numbers that get them really.
Adam: Pharma and med tech are a really interesting topic for our audience in the sense that they're, as you're saying, potentially both partners or clients, but also the, the sort of the commercial models of pharma and med tech are something that a lot of digital innovators are looking at. Maybe you could say a little bit about digital therapeutics, SaMD, and how should folks should think about those.
John: Well, this is something that's evolving really rapidly. I know within our work we spend a lot of time with our regulatory colleagues like Marty and you to really understand what is allowed is really allowed.
Software as a medical device, the digital therapeutics, these are all classes of products that I think a lot of the pharma companies find very confusing and also lot of payers find very confusing. And one of the things we've been spending a lot on is trying to get more clarity from payers around how do we get these products not just approved, but get them paid for so that we can take advantage of a similar model to pharma companies. Pharma companies have a model where they get the product approved, get exclusivity, can sell, and then they go. They try to get to peak sales as quickly possible and really reap the benefits of their R&D engine and of the FDA approval.
What we're finding with a lot of these digital therapeutics and a lot of the software as a medical device is that that process of getting approval is very similar to the pharma model, but the process of getting paid by the payers is actually very challenging. We've seen some recent activity of Highmark Health and with a lot of the larger plans starting to put these digital therapeutics and digital offerings on their formularies, which we're really excited about because it means that we think that maybe a year from now, two years from now, that we'll start to build out a more robust, bigger, more profitable sector around digital therapeutics.
Adam: How would you advise an early-stage innovator who has a digital approach to think about whether this is the right pathway for them versus something that might look more like virtual care or even remote patient monitoring.
John: This is a question that we often get. I think right now the mantra is try to have a balanced portfolio with business models. Is there a way that I could partner with the pharma company so I could make payroll? And is there a way that I could do remote patient monitoring, take advantage of existing CPT codes, build out some revenue. Then longer term, how do I position myself so that I do get reimbursed for my product and build it in that traditional pharma, which will be a lot more lucrative.
But again, right now, because that reimbursement pathway is not as clear and open as it really should be yet it's a matter of looking for other ways to make money in the interim and then longer term targeting that pharma pathway.
Adam: John this was great. Thank you so much, especially sitting in an airport about to board a plane. Any last thoughts before we let you go?
John: Yeah -two thoughts. I'll leave you with this. For the pharma companies, there are several moments that matter for them along their commercialization pathway. One of the most important ones is giving their sales reps something to talk about with the physicians and doctors. And one of the things that we've been hypothesizing is could there be a role for these innovative digital approaches to become part of that dialogue between sales rep and a physician, even if it's not directly part of the product - a way where a pharma company could demonstrate their commitment to innovation, their commitment to things that are going on. So one of the things that I would ask myself if I were an entrepreneur right now is - how do I get in the middle of that conversation between a physician and a pharma sales rep? And then also for the larger pharma companies, more and more they're fighting battles against one another with a portfolio of products like with Pfizer buying Biohaven, we see now this clash of titans within headache and migraine between Abbvie and Pfizer. So again, if there's any way for a digital therapeutic, a digital product to be part of that - part of that work between these two companies, the companies would be really keen to promote it, put it in their bag, put it into their sales cycle, and become part of it.
I would say also don't really ignore the larger portfolios within the pharma companies. Ask yourself how could my product make a difference for one of these big pharma in terms of creating greater patient centricity or to get patients moved through of therapy, because that could be a really rich hunting ground.
Adam: Well, thank you, that's great insight. We're fortunate to catch you in this window of time.