[EN] - Price vs. value: the affordability crisis in pharmaceutical innovation

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Pharma faces constant pressure,

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patient access,

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public system sustainability,

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and corporate viability.

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Since this interview,

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Benoit Escoffier has become Head of Access Europe at Daiichi Sankyo,

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which makes this conversation even more relevant.

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The question is no longer theoretical.

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It's about how to balance societal expectations with the economic reality of innovation.

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What responsibility do pharmaceutical companies have in maintaining this balance?

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We discuss this in this video.

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This episode was recorded with the generous support of Daiichi Sankyo.

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There's an extremely strong focus on price,

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not so much on value.

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We're obsessed with price and we don't work much on value.

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The business models of pharmaceutical groups will evolve.

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They must.

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That means we certainly need to think about other ways of evaluating medications.

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Today,

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I have the chance to be with Benoit Escoffier.

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Hello,

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Benoit.

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Hello,

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Nathalie.

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Benoit is the head of Daiichi Sankyo in France.

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I'm delighted to be able to welcome him today because I feel like he has an atypical profile who will talk to us about science,

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innovation,

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leadership.

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And well,

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how do we go about tackling these subjects that are super cross-functional and still manage to have an impact with perhaps simplicity?

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In any case,

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I'm super happy to be able to have this discussion.

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I think we're going to have a slightly different perspective,

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someone who has well traveled the world and who can also bring us

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Well,

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the mission of Pharma Today.

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I'm super happy.

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Well,

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me too.

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I really hope so.

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So to begin with,

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I would like us to take a moment to talk a little bit about you and your experiences when you first arrived at Daiichi Sankyo.

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Could you tell me what exactly was it that truly fascinated you at that time?

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Was it perhaps something along the lines of basically a breakthrough innovation or a revolutionary new approach?

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specifically in the field of oncology,

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what was it that really caught your attention?

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Was there a particular moment or idea that stood out to you?

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Yes,

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actually,

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it was what we might call a kind of second wave of innovation,

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really.

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Right,

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yeah.

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It was the monoclonal antibody drug conjugates,

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which had existed for some time,

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especially in breast cancer,

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and which had demonstrated extremely positive efficacy.

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And there,

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in fact,

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the Japanese researchers...

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Because one of the peculiarities of Daiichi Sankyo is that they really have in-house research that is very,

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very strong.

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The Japanese researchers,

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who are actually very strong in technology,

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more than in chemistry or biology,

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managed to develop an element which is quite important in ADCs,

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which is the linker,

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the one that connects the monoclonal antibody to the chemotherapy,

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basically,

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which is an element of stability.

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We managed to develop a second generation of that specific element,

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which meant that we managed to develop and offer to healthcare professionals and patients products that are even more effective than those that were on the market.

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And we are in this dynamic today,

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very focused on these molecules that we call ADCs.

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But in the future,

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we also have research and development on other techniques of production,

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which...

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I hope and I am certain will be.

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Can you explain a bit what does it revolutionize in the field?

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Why do you actually decide to take on these kinds of fights?

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Well,

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what I'd like to answer to your question is what is a revolution actually?

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I think the interest we have in the pharmaceutical industry is to bring innovations.

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And besides,

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I don't know if we all have the same definition of what an innovation is.

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We talk a lot about innovation.

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We talk a lot about the values of innovation.

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Yeah,

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there's disruptive,

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there's incremental.

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But we don't know.

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In the end,

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I am quite deeply convinced that whether it's the members of,

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well,

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those who work in the pharma industry or even the health authorities,

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they should always put themselves in the shoes of the citizen,

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the patient and the citizen,

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because we are all that first.

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Yes,

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that's how we decide.

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Before being,

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I am a citizen before being there to decide what needs to be done.

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For me,

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well,

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for me and for my team,

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because we worked on it,

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an innovation.

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Today,

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it can be characterized by three things.

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Either it prevents the disease,

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overall vaccine or other things,

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or it cures,

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or it allows one to live longer in better conditions.

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These are the three elements that could determine an innovation.

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So you could have a product that technically is not revolutionary,

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meaning it doesn't have

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a way of being produced that is absolutely new,

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but which meets one of these three innovation criteria and which will therefore improve the lives of patients and so on.

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So for me,

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it's more that which interests me.

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It's to say to myself,

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and what interested me in the portfolio,

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in development,

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in research and development at Daiichi Sankyo.

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What are the molecules that potentially will bring innovations?

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And it's on the basis of this discussion that I had with people who knew about it at the time,

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much better than me in oncology,

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and who told me,

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yes,

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there's something very promising in terms of innovation in this lab.

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So go for it.

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And so that's what I did.

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Yeah,

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yeah.

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And today then you're in charge of the French subsidiary,

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but you also have a global role actually managing the upcoming portfolios.

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Well,

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I was very interested in getting some R&D experience because overall,

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we operational structures aren't much without the researchers who find the molecules and bring them to us.

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And I really wanted to understand how that worked.

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And so we have a future product that's an ADC as well,

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but it targets another receptor called MUC1,

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which it binds to and which is present in many cancers.

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And there are groups that are very far upstream from the launches working on these molecules.

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It's early development,

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early stage,

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well,

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which I asked to work in.

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And so I work as what's called global commercial lead in that group for this molecule,

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which is a quite promising molecule.

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And that allowed me personally to learn a lot about all the stages of development,

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research and development,

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and also about the decision-making processes used at...

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that point.

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And then I think that my experience,

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which is more operational,

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more focused on sales elements,

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finance,

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and the probabilities of also contributed to helping us make choices,

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which isn't always easy when you're so,

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so far along in the development.

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Yeah,

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yeah.

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And is it,

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do you want to tell us about that?

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Maybe about basically just the perspective of how a lab thinks five years before a launch,

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what it looks at?

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Because later,

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well,

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there might be people in administration listening who think,

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oh.

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Well,

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I'm going to have to validate that or not.

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And so actually,

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is that taken into account?

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I mean,

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on what criteria are these things that you,

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how do you anticipate them knowing that,

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well,

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you have your eye perhaps a bit sharpened on France,

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but you're not just dealing with France?

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No,

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no.

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And I've worked on many regions,

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but I think it would actually be interesting.

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It's a good.

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It would be interesting,

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in fact,

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if perhaps the authorities could,

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or if there could be exchanges with the authorities upstream,

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only of phase threes,

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which are essentially the phases that actually allow for registration.

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Now,

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there can be exceptions or whatever,

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but there could be discussions upstream,

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particularly on protocol designs.

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Overall,

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the authorities on the very upstream part today...

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Yeah,

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they're not there.

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No,

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it's not.

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They don't have the time.

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Yeah,

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yeah.

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That's for sure.

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But the decision-making modes,

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first,

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there's a capitalistic decision-making mode,

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meaning these are huge investments.

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And so they can,

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to have,

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either you have deep enough pockets and you can do it all by yourself,

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or you decide to go and do it with a partner who can help you.

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That's what we did with AstraZeneca on one side and then with MSD on the other.

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So there's a decision already there.

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Then there's the part,

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let's say,

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very scientific and clinical,

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meaning the efficacy of the drug on various elements very early on to see if there's an activity that works or not.

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And then after that,

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we get into the logic of phase one,

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phase two,

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with a very strong driver nonetheless,

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which is scientific.

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Does it work or does it not work on which we must apply feasibility filters at some point?

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And that's where I come in is to say,

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yes,

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okay,

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it's scientifically or clinically,

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we see there's an activity.

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But overall,

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the market is already completely saturated,

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for example.

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So it will be hard to bring value compared to that where the target is so small that in terms of development costs compared to potentially what we could have in sales,

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it doesn't work.

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And so there are many decisions that come into play.

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based on a clinical activity relative to a feasibility to then move towards phases two,

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phase three and others.

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It's quite complex.

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And it's not the right time to talk about that,

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because

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I'm going to ask you to talk about a stable world.

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But that means there's also,

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well,

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looking perhaps at the final market and what there will be in such a country to know how it's going to go.

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And they're the weight of each country.

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How do you...

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Look at it.

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Because while it's true that often health authorities naturally have a French perspective,

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they find it hard to consider that there are other countries,

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or even consider that other countries are there basically to pay.

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to pay for what happens in Europe?

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Well,

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that's somewhat what happens in practice since the United States represents

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50% of sales and almost 60%

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of profits,

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at least for specialty products,

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for 2%

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to 3%

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of the population.

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So there is something today,

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and I think it's one of the reasons,

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even if it's done in a somewhat brutal way,

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for which the

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American president is putting pressure on the pharmaceutical industry.

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So yes,

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I...

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I think we're at an extremely important moment where the business models of pharmaceutical groups will evolve.

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They will evolve and they must evolve.

271
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And that means we certainly need to think about other ways of evaluating medicines.

272
00:10:47.981 --> 00:10:49.742
I was talking about innovation.

273
00:10:50.082 --> 00:10:50.463
Exactly.

274
00:10:50.583 --> 00:10:52.084
First thing is what is an innovation?

275
00:10:52.184 --> 00:10:54.686
And then second thing is what value we give to innovation.

276
00:10:54.687 --> 00:10:55.486
Yeah.

277
00:10:55.487 --> 00:10:56.087
And that today.

278
00:10:56.347 --> 00:10:57.008
For society,

279
00:10:57.068 --> 00:10:57.808
meaning not just for.

280
00:10:58.168 --> 00:10:58.329
Well,

281
00:10:58.369 --> 00:10:58.809
exactly.

282
00:10:59.165 --> 00:10:59.405
I mean,

283
00:10:59.445 --> 00:10:59.865
basically,

284
00:10:59.925 --> 00:11:03.686
if our mission is to improve the quality of life for society in general,

285
00:11:03.826 --> 00:11:08.368
then our innovation must enable this improvement in quality of life.

286
00:11:08.908 --> 00:11:09.168
Today,

287
00:11:09.208 --> 00:11:13.789
we're still using the same evaluation criteria that we've had for quite some time,

288
00:11:13.829 --> 00:11:14.889
especially in oncology.

289
00:11:16.510 --> 00:11:23.972
And there are certainly things to contribute to work on regarding more comprehensive aspects of quality of life,

290
00:11:24.032 --> 00:11:24.672
for instance,

291
00:11:24.772 --> 00:11:27.453
improving quality of life across many more factors.

292
00:11:29.157 --> 00:11:33.038
where we target the populations we want to bring our innovations to,

293
00:11:33.638 --> 00:11:36.479
so that the effect is truly positive and not diluted.

294
00:11:36.899 --> 00:11:39.020
So there are things that we absolutely need to work on,

295
00:11:40.260 --> 00:11:40.500
well,

296
00:11:40.980 --> 00:11:42.201
to hope that this industry,

297
00:11:42.481 --> 00:11:42.841
which is,

298
00:11:43.361 --> 00:11:43.861
in my view,

299
00:11:43.901 --> 00:11:45.582
the most essential industry today,

300
00:11:45.662 --> 00:11:49.123
because it's the one that brings the most benefits to citizens,

301
00:11:49.223 --> 00:11:50.123
not many others do,

302
00:11:51.223 --> 00:11:52.484
at least in terms of industry,

303
00:11:53.644 --> 00:11:53.824
well,

304
00:11:53.904 --> 00:11:57.565
can continue to have a business model that rewards the risk taken.

305
00:11:58.661 --> 00:12:00.722
So is the risk today heavily?

306
00:12:01.983 --> 00:12:04.984
Those are discussions we can have which need to be refined.

307
00:12:05.004 --> 00:12:05.664
But overall,

308
00:12:06.004 --> 00:12:09.186
it's a capital intensive industry with significant risk taking,

309
00:12:09.666 --> 00:12:11.287
more so than in other industries,

310
00:12:12.167 --> 00:12:19.150
and where there must be a suitable return on that risk taking so that people continue to invest in this industry.

311
00:12:19.250 --> 00:12:22.411
But there's going to be a rebalancing in the coming years.

312
00:12:23.071 --> 00:12:24.012
And yes,

313
00:12:24.072 --> 00:12:26.373
does that mean there need to be other sources?

314
00:12:26.733 --> 00:12:28.695
of growth than just the United States.

315
00:12:29.575 --> 00:12:29.995
I think so.

316
00:12:30.116 --> 00:12:31.376
And I think it's a good thing too.

317
00:12:32.657 --> 00:12:32.858
Now,

318
00:12:32.898 --> 00:12:33.038
well,

319
00:12:33.078 --> 00:12:34.419
that's my feeling.

320
00:12:34.439 --> 00:12:35.820
I don't know how it will evolve.

321
00:12:38.942 --> 00:12:39.883
So do you have,

322
00:12:40.403 --> 00:12:40.623
I mean,

323
00:12:40.663 --> 00:12:43.705
basically it means it's not necessarily health innovation paths,

324
00:12:43.765 --> 00:12:45.166
but basically it's paths for,

325
00:12:45.547 --> 00:12:47.488
maybe you can comment on paths for,

326
00:12:48.008 --> 00:12:48.309
actually,

327
00:12:48.369 --> 00:12:48.509
yeah,

328
00:12:48.549 --> 00:12:50.010
what are we not valuing enough today?

329
00:12:50.390 --> 00:12:50.710
Paths,

330
00:12:50.951 --> 00:12:52.211
you mentioned quality of life,

331
00:12:52.311 --> 00:12:52.512
yeah.

332
00:12:52.852 --> 00:12:53.452
For patients,

333
00:12:53.492 --> 00:12:54.033
You mentioned.

334
00:12:56.573 --> 00:12:58.774
I think the feeling I have is that today...

335
00:12:59.394 --> 00:13:00.595
What are we not looking at actually?

336
00:13:01.075 --> 00:13:05.977
What's in the blind spots that that means we're actually a bit off the mark in the sense of everyone,

337
00:13:05.997 --> 00:13:06.257
you know?

338
00:13:08.418 --> 00:13:11.559
I have the feeling today that there's an extremely strong focus on price,

339
00:13:11.919 --> 00:13:12.880
not so much on value.

340
00:13:14.300 --> 00:13:18.182
We're obsessed with price and we don't work much on value.

341
00:13:18.542 --> 00:13:21.763
Maybe at one time it suited everyone not to work on it.

342
00:13:22.564 --> 00:13:22.924
But again,

343
00:13:22.964 --> 00:13:24.965
I think we're at a point where if we...

344
00:13:25.665 --> 00:13:30.127
The industry are proud of what we do and we're confident that what we do really brings something.

345
00:13:30.548 --> 00:13:37.111
We honestly have no real interest in continuing to let the authorities dictate how things should work,

346
00:13:37.571 --> 00:13:39.953
who actually have two main issues.

347
00:13:40.353 --> 00:13:45.356
The first issue is that budgets are becoming more and more restricted and it's not going to get any better.

348
00:13:45.916 --> 00:13:46.456
That's obvious.

349
00:13:47.577 --> 00:13:52.319
And the second is that there's still this old public-private opposition sentiment,

350
00:13:52.399 --> 00:13:53.160
unfortunately,

351
00:13:53.380 --> 00:13:55.201
which means the industry's image is still...

352
00:13:56.021 --> 00:13:56.861
quite negative.

353
00:13:57.222 --> 00:13:57.342
So

354
00:13:58.082 --> 00:13:59.642
I'm personally quite convinced,

355
00:13:59.742 --> 00:14:01.263
and I'm working with my team on this,

356
00:14:01.803 --> 00:14:03.263
that we need to work on value.

357
00:14:03.783 --> 00:14:03.923
Now,

358
00:14:04.003 --> 00:14:07.364
value is once again about the elements I mentioned.

359
00:14:07.645 --> 00:14:08.185
Innovation.

360
00:14:08.445 --> 00:14:08.565
Now,

361
00:14:08.605 --> 00:14:09.525
how do you value them?

362
00:14:09.625 --> 00:14:09.765
Well,

363
00:14:09.825 --> 00:14:11.126
it's certainly not simple.

364
00:14:11.426 --> 00:14:11.546
No,

365
00:14:11.766 --> 00:14:14.126
but surely it was simpler to talk about a list price.

366
00:14:14.527 --> 00:14:14.987
Exactly.

367
00:14:15.227 --> 00:14:16.407
It's certainly not simple.

368
00:14:16.887 --> 00:14:19.608
There are surely several criteria to be integrated into it.

369
00:14:21.349 --> 00:14:21.689
Of course,

370
00:14:21.729 --> 00:14:22.689
quality of life.

371
00:14:23.209 --> 00:14:24.230
impact on recovery,

372
00:14:24.310 --> 00:14:24.950
for example,

373
00:14:24.970 --> 00:14:25.651
in oncology,

374
00:14:27.132 --> 00:14:31.135
but also what it creates in terms of dynamism for a country and so on.

375
00:14:33.376 --> 00:14:34.837
But I think in any case,

376
00:14:34.857 --> 00:14:37.699
it would be interesting for the industry to spend time working on this.

377
00:14:38.880 --> 00:14:42.683
Because today I don't see what the solution is other than to keep fighting and fighting,

378
00:14:43.083 --> 00:14:43.223
yeah,

379
00:14:43.563 --> 00:14:46.085
and fighting without getting the results we want to have.

380
00:14:46.325 --> 00:14:47.246
Because on top of that,

381
00:14:47.386 --> 00:14:51.569
there's a notion of actually being not disunited.

382
00:14:51.957 --> 00:14:55.922
but being opposing forces when in the end we're all looking,

383
00:14:56.183 --> 00:14:57.825
whether it's the public or private sector,

384
00:14:57.845 --> 00:14:58.266
as you say,

385
00:14:58.706 --> 00:14:59.988
or just the average citizen,

386
00:15:00.048 --> 00:15:02.431
we're all looking to be well cared for.

387
00:15:02.771 --> 00:15:06.016
If there's one thing for sure is that or to have the best care.

388
00:15:06.436 --> 00:15:06.697
Yes.

389
00:15:07.983 --> 00:15:11.464
That's why I think the priority and main effort we all must make,

390
00:15:12.104 --> 00:15:13.545
and especially us in the industry,

391
00:15:13.605 --> 00:15:15.805
is to put ourselves in the citizens'

392
00:15:15.845 --> 00:15:16.145
shoes.

393
00:15:16.245 --> 00:15:17.006
Does the citizen...

394
00:15:17.306 --> 00:15:18.266
Do they want this or not,

395
00:15:18.306 --> 00:15:19.206
this innovation or not?

396
00:15:19.266 --> 00:15:19.666
That's it.

397
00:15:20.046 --> 00:15:23.367
Do they want this innovation and are they ready to fund...

398
00:15:23.787 --> 00:15:23.948
Yeah,

399
00:15:24.208 --> 00:15:24.808
to pay for it.

400
00:15:25.128 --> 00:15:25.948
This innovation,

401
00:15:26.448 --> 00:15:27.449
which is an investment.

402
00:15:27.450 --> 00:15:27.589
Yeah,

403
00:15:27.829 --> 00:15:28.809
yeah.

404
00:15:28.810 --> 00:15:29.949
Not necessarily out of pocket,

405
00:15:29.969 --> 00:15:30.970
but the society...

406
00:15:31.390 --> 00:15:31.830
The cost,

407
00:15:31.890 --> 00:15:32.010
no.

408
00:15:32.250 --> 00:15:33.110
It's an investment.

409
00:15:33.470 --> 00:15:35.511
Are they ready to invest in that?

410
00:15:35.771 --> 00:15:35.991
Yes.

411
00:15:36.427 --> 00:15:36.867
And why?

412
00:15:37.027 --> 00:15:37.468
And you know,

413
00:15:37.628 --> 00:15:38.068
and I mean,

414
00:15:38.308 --> 00:15:39.869
and we really have to put ourselves...

415
00:15:40.329 --> 00:15:43.550
It's a very responsible approach you're asking of a citizen to say,

416
00:15:44.411 --> 00:15:44.791
actually,

417
00:15:45.211 --> 00:15:47.872
it's normal that in certain areas we invest.

418
00:15:47.912 --> 00:15:49.433
It's an approach that's a bit new.

419
00:15:49.773 --> 00:15:50.053
For me,

420
00:15:50.173 --> 00:15:52.655
the point isn't so much asking the citizen to decide,

421
00:15:52.975 --> 00:15:54.716
but for us to put ourselves in the...

422
00:15:55.136 --> 00:15:55.676
Citizen's shoes.

423
00:15:56.076 --> 00:15:56.677
Meaning that I,

424
00:15:56.837 --> 00:15:57.517
as the industry,

425
00:15:58.017 --> 00:15:58.197
okay,

426
00:15:59.818 --> 00:16:01.799
I have financial goals that are obvious.

427
00:16:02.079 --> 00:16:06.301
Our mission is to improve quality of life within a sustainable financial framework.

428
00:16:06.701 --> 00:16:07.001
Yes.

429
00:16:07.262 --> 00:16:07.582
In fact,

430
00:16:07.622 --> 00:16:09.123
you're going to look for something else if...

431
00:16:10.283 --> 00:16:11.264
The health authorities,

432
00:16:11.284 --> 00:16:14.165
their goal today is to ensure that the budget doesn't blow up,

433
00:16:14.225 --> 00:16:14.805
doesn't blow up,

434
00:16:14.845 --> 00:16:15.466
doesn't blow up.

435
00:16:16.686 --> 00:16:19.248
And so we're dealing with two opposing logics.

436
00:16:19.568 --> 00:16:24.650
But there comes a point where at least putting ourselves in each other's shoes and saying,

437
00:16:24.690 --> 00:16:24.930
yes,

438
00:16:25.030 --> 00:16:25.411
on this,

439
00:16:25.611 --> 00:16:26.071
it's clear.

440
00:16:26.563 --> 00:16:30.064
That there's an innovation because it meets the criteria I mentioned,

441
00:16:30.204 --> 00:16:31.284
at least one of the three,

442
00:16:31.524 --> 00:16:33.445
and that it's valued in this way.

443
00:16:33.665 --> 00:16:34.645
That could be interesting.

444
00:16:35.025 --> 00:16:35.265
Right.

445
00:16:35.726 --> 00:16:36.406
Thank you very much.

446
00:16:36.426 --> 00:16:39.067
I appreciate your willingness to share your experiences.

447
00:16:39.467 --> 00:16:45.708
I'd really like to hear you talk a bit more in detail about things that are perhaps a bit more concrete and specific in your daily work today.

448
00:16:46.189 --> 00:16:47.709
So as I understand it,

449
00:16:47.729 --> 00:16:49.429
you took over an existing subsidiary,

450
00:16:49.890 --> 00:16:52.950
but it was one that had to be completely transformed from the ground up.

451
00:16:53.291 --> 00:16:54.591
What was going through your mind?

452
00:16:54.851 --> 00:16:55.431
At that time,

453
00:16:55.471 --> 00:16:56.531
what were you thinking about?

454
00:16:56.612 --> 00:16:59.192
What did you want to achieve and what were your goals?

455
00:16:59.732 --> 00:17:00.893
What did you want to achieve?

456
00:17:01.153 --> 00:17:02.233
I was very lucky because,

457
00:17:02.273 --> 00:17:02.513
yes,

458
00:17:02.593 --> 00:17:05.954
I took over the Daiichi Sankyo France subsidiary in 2019.

459
00:17:06.414 --> 00:17:11.436
There were just under 20 employees who we still had a cardio portfolio,

460
00:17:11.516 --> 00:17:13.256
but mainly for export markets.

461
00:17:13.316 --> 00:17:16.697
So they still had to maintain a minimum level of activity there.

462
00:17:17.257 --> 00:17:19.598
So today we're at over 90,

463
00:17:20.298 --> 00:17:23.379
which is absolutely very interesting and remarkable.

464
00:17:24.796 --> 00:17:25.256
And for me,

465
00:17:26.336 --> 00:17:26.497
well,

466
00:17:26.537 --> 00:17:27.457
that was the challenge.

467
00:17:27.458 --> 00:17:33.981
It was the challenge of rebuilding a subsidiary with an existing team and a team I was going to build and create.

468
00:17:34.941 --> 00:17:46.228
With my own personal ideas and desires that Daiichi Sankyo really allowed me to develop more of a startup mindset with a lot of collective intelligence,

469
00:17:46.308 --> 00:17:47.648
with a lot of empowerment,

470
00:17:47.748 --> 00:17:49.970
with a lot of decentralized decision making,

471
00:17:50.490 --> 00:17:52.151
with a lot of work on oneself.

472
00:17:53.531 --> 00:17:54.271
Because once again,

473
00:17:54.331 --> 00:17:57.192
I think it's starting to be perfectly understood and known.

474
00:17:57.372 --> 00:17:57.652
I mean,

475
00:17:57.732 --> 00:17:59.993
a happy employee is an engaged employee.

476
00:18:00.773 --> 00:18:01.733
And overall,

477
00:18:02.934 --> 00:18:04.114
your mission will be achieved,

478
00:18:04.434 --> 00:18:05.594
or at least your goals,

479
00:18:05.694 --> 00:18:06.295
your ambition.

480
00:18:06.775 --> 00:18:07.235
So for me,

481
00:18:07.555 --> 00:18:08.115
all my work,

482
00:18:08.615 --> 00:18:10.456
besides defining a vision and a plan,

483
00:18:10.916 --> 00:18:14.137
is to recruit people who share this kind of mindset,

484
00:18:14.157 --> 00:18:17.778
who are truly committed to building teams that genuinely want to work together,

485
00:18:18.198 --> 00:18:21.719
and then to ensure throughout the entire year that overall,

486
00:18:21.999 --> 00:18:22.559
as a group,

487
00:18:23.259 --> 00:18:28.122
they continue to be fulfilled and satisfied in doing what we do together as a team.

488
00:18:28.922 --> 00:18:29.102
Well,

489
00:18:29.142 --> 00:18:38.347
I think that perhaps one of my main qualities is quite precisely the ability to simplify complex things and make them easier to understand things.

490
00:18:38.467 --> 00:18:39.228
And in any case,

491
00:18:39.268 --> 00:18:45.611
to express those thoughts and feelings to my teams in a way that is truly authentic and genuine,

492
00:18:46.292 --> 00:18:49.674
but not in a way that comes across as pessimistic or negative,

493
00:18:50.154 --> 00:18:50.734
because there are,

494
00:18:50.754 --> 00:18:51.174
of course,

495
00:18:51.235 --> 00:18:51.915
always things

496
00:18:52.291 --> 00:18:53.132
that are complicated.

497
00:18:53.172 --> 00:18:54.073
There are things that are,

498
00:18:54.913 --> 00:18:57.235
it's certain that Donald Trump's policy today,

499
00:18:57.435 --> 00:18:59.857
or at least the threats that he indeed,

500
00:19:00.818 --> 00:19:06.083
but I honestly think that there are always opportunities to be found in every threat.

501
00:19:07.203 --> 00:19:09.565
I believe there's a significant opportunity for Europe,

502
00:19:09.605 --> 00:19:13.249
especially when the United States stops investing in science.

503
00:19:13.769 --> 00:19:17.332
And so what I try to do is tell myself,

504
00:19:17.892 --> 00:19:18.093
look,

505
00:19:18.573 --> 00:19:20.014
what we see as a difficulty,

506
00:19:20.755 --> 00:19:20.935
what...

507
00:19:21.259 --> 00:19:22.619
opportunity can it create?

508
00:19:23.720 --> 00:19:25.120
I don't want to deny the difficulty,

509
00:19:25.180 --> 00:19:27.441
but I'm interested in opening up to the opportunity.

510
00:19:28.842 --> 00:19:30.102
We had time for decisions.

511
00:19:30.482 --> 00:19:32.023
These are long timeframes,

512
00:19:32.024 --> 00:19:33.263
the pharmaceutical industry.

513
00:19:33.603 --> 00:19:33.963
And now,

514
00:19:34.023 --> 00:19:34.423
in fact,

515
00:19:34.523 --> 00:19:37.304
it's an industry that's accelerating on many subjects,

516
00:19:37.764 --> 00:19:40.045
but which nevertheless remains a long-term industry.

517
00:19:41.586 --> 00:19:42.946
So there's a complexity,

518
00:19:43.666 --> 00:19:45.407
another one that's being added.

519
00:19:47.383 --> 00:19:50.867
I'm quite personally convinced that we'll get something positive out of it too,

520
00:19:51.027 --> 00:19:54.010
that we'll manage to evolve our decision-making methods,

521
00:19:54.070 --> 00:19:57.094
that we'll manage to evolve our investment methods.

522
00:19:57.494 --> 00:19:58.075
What's it due to?

523
00:19:58.195 --> 00:19:59.056
Can you give us a bit,

524
00:19:59.176 --> 00:19:59.636
explain?

525
00:20:00.537 --> 00:20:02.059
What's this acceleration due to?

526
00:20:03.606 --> 00:20:04.386
I think it's due to,

527
00:20:04.846 --> 00:20:06.147
there are different subjects.

528
00:20:06.607 --> 00:20:09.248
There are all the geopolitical elements we talked about,

529
00:20:09.328 --> 00:20:13.529
which mean that suddenly we can no longer not have a plan B,

530
00:20:13.689 --> 00:20:16.130
C or D in relation to this instability.

531
00:20:16.550 --> 00:20:16.670
Yeah,

532
00:20:16.790 --> 00:20:18.010
knowing that it'll be plan E.

533
00:20:18.550 --> 00:20:19.010
Exactly,

534
00:20:19.070 --> 00:20:20.131
which is super important.

535
00:20:20.491 --> 00:20:22.571
We can talk about the United States and China,

536
00:20:22.651 --> 00:20:25.972
which are still two drivers today of the industry.

537
00:20:26.452 --> 00:20:27.833
One that wants to stop everything,

538
00:20:27.873 --> 00:20:31.994
that wants to cut prices and then invest much less in science.

539
00:20:32.410 --> 00:20:35.893
and the other that wants to take a major hegemony with Europe in the middle,

540
00:20:35.953 --> 00:20:37.715
battling a bit over things,

541
00:20:38.075 --> 00:20:40.497
it might be time for us to take leadership on other things.

542
00:20:40.537 --> 00:20:43.460
So the geopolitical dimension is important.

543
00:20:43.461 --> 00:20:46.663
The dimension of artificial intelligence will also come,

544
00:20:47.123 --> 00:20:50.106
notably in everything that is the research and development phase,

545
00:20:50.466 --> 00:20:51.967
to revolutionize our way of...

546
00:20:52.347 --> 00:20:52.908
It gives time,

547
00:20:52.988 --> 00:20:53.268
I'd say.

548
00:20:53.609 --> 00:20:54.249
It accelerates,

549
00:20:54.289 --> 00:20:55.050
but it gives time too.

550
00:20:57.378 --> 00:20:58.359
It's going to accelerate.

551
00:20:58.419 --> 00:21:00.940
It's certainly going to increase the number of competitors,

552
00:21:00.960 --> 00:21:03.201
the number of people who will invest in this industry.

553
00:21:04.382 --> 00:21:13.707
So your ability to be on the market as quickly as possible will be an element that will be primordial in the definition of your business model.

554
00:21:13.827 --> 00:21:15.848
That's an element that's also extremely important.

555
00:21:16.229 --> 00:21:16.569
And then,

556
00:21:17.269 --> 00:21:17.729
once again,

557
00:21:18.150 --> 00:21:21.792
budgetary crises will require us to be much more agile,

558
00:21:21.992 --> 00:21:22.972
much more reactive,

559
00:21:23.152 --> 00:21:24.193
and I even think,

560
00:21:24.233 --> 00:21:24.693
above all,

561
00:21:24.773 --> 00:21:25.694
much more proactive.

562
00:21:26.274 --> 00:21:28.695
Because today we're mostly very reactive.

563
00:21:28.916 --> 00:21:37.841
And so these are elements that will impose a strong effort on us to redefine a business model that must continue to reward risk-taking,

564
00:21:38.281 --> 00:21:39.922
but no longer in the same way.

565
00:21:42.563 --> 00:21:42.763
Okay.

566
00:21:42.823 --> 00:21:43.304
In any case,

567
00:21:43.364 --> 00:21:44.384
it's going to be fascinating.

568
00:21:44.444 --> 00:21:45.325
It's going to be great.

569
00:21:45.705 --> 00:21:46.145
It can be,

570
00:21:46.285 --> 00:21:46.445
yeah,

571
00:21:46.706 --> 00:21:47.086
for sure.

572
00:21:47.226 --> 00:21:47.746
Absolutely.

573
00:21:48.186 --> 00:21:49.087
What would make it not be?

574
00:21:49.667 --> 00:21:50.848
That we don't want to go there.

575
00:21:51.228 --> 00:21:51.848
We're afraid to go.

576
00:21:52.249 --> 00:21:52.429
Yes,

577
00:21:52.430 --> 00:21:53.169
of course.

578
00:21:53.170 --> 00:21:54.610
But there will be countries that go there.

579
00:21:56.598 --> 00:21:56.858
Here,

580
00:21:56.998 --> 00:21:59.320
I'm mainly talking about the labs and companies.

581
00:22:00.120 --> 00:22:00.540
Basically,

582
00:22:00.600 --> 00:22:01.681
today we have a business.

583
00:22:02.121 --> 00:22:03.182
They don't want to change their...

584
00:22:03.622 --> 00:22:03.842
Well,

585
00:22:04.262 --> 00:22:05.043
it's always the same.

586
00:22:05.103 --> 00:22:06.563
You've seen it in many sectors,

587
00:22:06.624 --> 00:22:06.884
right?

588
00:22:07.224 --> 00:22:07.384
Well,

589
00:22:07.444 --> 00:22:08.284
giving up on Europe,

590
00:22:08.424 --> 00:22:08.845
basically.

591
00:22:09.225 --> 00:22:09.425
Yes,

592
00:22:09.505 --> 00:22:10.586
but it's...

593
00:22:11.686 --> 00:22:12.147
Today,

594
00:22:12.687 --> 00:22:22.212
there are pillars of the definition of our business model that have made this industry wealthy and thus innovation for society for X years that are currently,

595
00:22:22.292 --> 00:22:22.492
well,

596
00:22:22.592 --> 00:22:22.972
shifting.

597
00:22:23.933 --> 00:22:25.774
Either we stay saying to ourselves,

598
00:22:26.490 --> 00:22:26.610
No,

599
00:22:26.670 --> 00:22:27.431
it mustn't stop.

600
00:22:27.471 --> 00:22:28.571
It has to stay like this.

601
00:22:28.831 --> 00:22:31.913
And I fear that won't work or we manage to anticipate,

602
00:22:31.993 --> 00:22:34.754
even if it means anyway to choose is to renounce.

603
00:22:34.834 --> 00:22:35.054
Right.

604
00:22:35.114 --> 00:22:41.777
Even if it means giving up certain things to continue to flourish in a different way of of seeing our industry.

605
00:22:42.297 --> 00:22:43.478
And I think that will work.

606
00:22:43.898 --> 00:22:49.600
Don't you have any models in mind of people who who are already doing it in the pharmaceutical industry?

607
00:22:50.101 --> 00:22:50.321
Well,

608
00:22:50.661 --> 00:22:51.321
I'm not enough,

609
00:22:51.401 --> 00:22:52.882
perhaps today.

610
00:22:53.410 --> 00:23:10.279
uh aware or really in the inner workings of the the big labs or others to know who already has this well is working on it i imagine everyone is actually it's not so much that i think everyone sees it what's harder is making the decision and it's i

611
00:23:10.299 --> 00:23:21.645
think it's a bit like everything the first one who makes the decision we'll have one or we'll have lost that's always the issue it reminds me of the times when we had tons of medical sales networks.

612
00:23:22.206 --> 00:23:22.526
And then...

613
00:23:23.034 --> 00:23:24.675
As soon as one person put one in,

614
00:23:24.695 --> 00:23:25.836
then another would put one in.

615
00:23:26.396 --> 00:23:33.480
And then everyone realized that it was ridiculous and that it destroyed the value relationship with the prescriber as well.

616
00:23:33.920 --> 00:23:34.701
But everyone said,

617
00:23:34.861 --> 00:23:35.041
wait,

618
00:23:35.141 --> 00:23:36.422
if I remove one,

619
00:23:36.482 --> 00:23:36.642
well,

620
00:23:36.702 --> 00:23:38.103
I'm going to lose my share of voice.

621
00:23:38.563 --> 00:23:39.744
So there was this...

622
00:23:40.244 --> 00:23:42.125
So would it be a new lab that's going to do it?

623
00:23:42.445 --> 00:23:42.565
No,

624
00:23:42.685 --> 00:23:43.306
I don't think so.

625
00:23:44.066 --> 00:23:44.186
No,

626
00:23:44.326 --> 00:23:44.446
no,

627
00:23:44.586 --> 00:23:47.608
I think that I think there are leaders who are visionary enough and...

628
00:23:48.268 --> 00:23:49.589
I don't know how to say it politely,

629
00:23:49.689 --> 00:23:50.870
but actually...

630
00:23:51.490 --> 00:23:51.670
well,

631
00:23:51.750 --> 00:23:54.792
an idea is worth nothing until it's been at least executed.

632
00:23:55.112 --> 00:23:56.172
And when it is executed,

633
00:23:56.173 --> 00:23:58.013
the execution will be completely different.

634
00:23:58.513 --> 00:24:01.034
So then we can play for time.

635
00:24:01.714 --> 00:24:02.295
We can wait.

636
00:24:02.375 --> 00:24:02.515
But,

637
00:24:03.495 --> 00:24:03.715
well,

638
00:24:04.075 --> 00:24:05.176
it remains to be invented.

639
00:24:05.216 --> 00:24:07.717
It's like there might be several models,

640
00:24:07.777 --> 00:24:08.077
actually,

641
00:24:08.157 --> 00:24:08.357
even.

642
00:24:08.777 --> 00:24:10.718
I'm even convinced there will be several models.

643
00:24:11.458 --> 00:24:12.119
That's for sure.

644
00:24:12.439 --> 00:24:13.879
Here we're talking about one farmer,

645
00:24:13.959 --> 00:24:16.901
but there may be several formats or models to be decided.

646
00:24:17.281 --> 00:24:18.021
As I was saying,

647
00:24:19.662 --> 00:24:19.782
the...

648
00:24:20.594 --> 00:24:27.356
the drugs we're going to put on the market won't more and more and more be on a restricted target for which you'll have a specific contribution.

649
00:24:27.836 --> 00:24:31.857
And so that means a different financing logic than what we see today.

650
00:24:32.377 --> 00:24:35.418
There are many different things that will continue to evolve.

651
00:24:35.778 --> 00:24:43.620
My feeling is that we really need to be more proactive in thoughtfully designing this horizon.

652
00:24:44.220 --> 00:24:44.340
Yeah,

653
00:24:44.440 --> 00:24:44.661
yeah,

654
00:24:44.662 --> 00:24:44.861
I know.

655
00:24:45.141 --> 00:24:46.061
But be attentive,

656
00:24:46.481 --> 00:24:49.102
just because there are others out there who aren't really waiting.

657
00:24:49.422 --> 00:24:49.602
Yeah,

658
00:24:49.782 --> 00:24:49.922
yeah.

659
00:24:51.426 --> 00:24:53.088
I'm talking about the industry in general.

660
00:24:53.089 --> 00:24:53.769
Yeah.

661
00:24:53.849 --> 00:25:00.395
I think governments and others at some point face so much pressure from all sides that we have to be a force for proposals.

662
00:25:00.776 --> 00:25:01.376
And once again,

663
00:25:01.516 --> 00:25:02.838
I am deeply convinced of it.

664
00:25:04.034 --> 00:25:06.776
I'm a citizen first before being the GM of Daiichi Sankyo,

665
00:25:06.936 --> 00:25:10.118
which I'm extremely happy about and which takes up a lot of my time.

666
00:25:10.238 --> 00:25:11.159
I'm a citizen first.

667
00:25:11.219 --> 00:25:12.940
I'm first an inhabitant of this world.

668
00:25:13.060 --> 00:25:13.800
Thank you very much,

669
00:25:13.881 --> 00:25:14.241
Benoit,

670
00:25:14.301 --> 00:25:14.681
for this,

671
00:25:14.741 --> 00:25:15.101
I think,

672
00:25:15.261 --> 00:25:16.462
very open discussion.

673
00:25:16.982 --> 00:25:17.603
In any case,

674
00:25:17.643 --> 00:25:18.984
it leads us to reflect,

675
00:25:19.104 --> 00:25:21.085
to feel concerned already by an era,

676
00:25:21.265 --> 00:25:22.005
even if it is,

677
00:25:22.706 --> 00:25:23.767
because even if it's complex,

678
00:25:23.847 --> 00:25:24.327
we are also,

679
00:25:24.487 --> 00:25:24.647
well,

680
00:25:24.667 --> 00:25:24.927
you know,

681
00:25:24.967 --> 00:25:26.548
perhaps also responsible for it.

682
00:25:27.049 --> 00:25:27.549
Absolutely.

683
00:25:27.769 --> 00:25:28.289
Absolutely.

684
00:25:28.590 --> 00:25:29.010
So it's...

685
00:25:29.450 --> 00:25:29.630
Well,

686
00:25:29.830 --> 00:25:33.192
learning to appreciate what we like and to defend it perhaps as well.

687
00:25:33.332 --> 00:25:33.732
Thank you.

688
00:25:35.513 --> 00:25:35.813
Thank you,

689
00:25:35.833 --> 00:25:36.173
Natalie.

690
00:25:37.273 --> 00:25:38.374
Don't hesitate to share,

691
00:25:38.574 --> 00:25:38.754
well,

692
00:25:38.914 --> 00:25:40.155
what you thought of it with Benoit.

693
00:25:40.595 --> 00:25:43.736
Where can people write to you to tell you what they thought of it?

694
00:25:45.897 --> 00:25:46.017
Oh,

695
00:25:46.037 --> 00:25:46.217
well,

696
00:25:46.317 --> 00:25:47.878
on LinkedIn without any problem.

697
00:25:48.298 --> 00:25:50.199
And then later via my email.

698
00:25:50.259 --> 00:25:50.399
Well,

699
00:25:50.459 --> 00:25:52.720
there's no with pleasure even to discuss it.

700
00:25:54.541 --> 00:25:55.161
Thank you very much,

701
00:25:55.221 --> 00:25:55.561
Benoit.

702
00:25:55.661 --> 00:25:56.142
See you soon.

703
00:25:56.382 --> 00:25:56.682
Thank you,

704
00:25:56.702 --> 00:25:57.022
Natalie.

705
00:25:57.914 --> 00:25:59.095
If price reflects value,

706
00:25:59.115 --> 00:26:00.036
who defines value?

707
00:26:00.576 --> 00:26:01.877
Is it the national governments,

708
00:26:02.078 --> 00:26:03.179
the individual patients,

709
00:26:03.319 --> 00:26:04.340
or the healthcare industry?

710
00:26:04.900 --> 00:26:07.983
And what happens when innovation is no longer new but essential?

711
00:26:10.245 --> 00:26:11.265
In the next episode,

712
00:26:11.425 --> 00:26:15.209
we move away from cutting-edge oncology to talk about mature medicines,

713
00:26:15.589 --> 00:26:19.092
where access depends less on price than on the viability of production.

714
00:26:19.632 --> 00:26:20.893
In the comments section below,

715
00:26:21.234 --> 00:26:26.098
I invite you to share your thoughts on who you think should define the criteria for a medicine's value.