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Leaders Reinventing Japan's Medical and Healthcare Industries - Why Major Pharmaceutical Manufacturers Are Joining Hands

Innovation Infusion Japan, i2.JP is a healthcare innovation engine that aims to realize a "patient-centric" business model. The Japanese subsidiary of global pharma AstraZeneca launched this open innovation community in November last year with the belief that "there must be much more we can do beyond drug”. More than 115 companies and organizations that share the vision are participating in the community, and the number is increasing every day (September 2021).

TOMORUBA is featuring actions under i2.JP as part of a series of articles titled " Challenges to Healthcare Innovation ". Through the voices of the founding members and participating partners of i2.JP, we will consider and deep dive into the future of healthcare at its best. For the third article, we interviewed four key persons from leading companies in the medical and healthcare industries, who are working hand in hand with i2.JP despite their rivalry.

We want to create a new "voice" that represents the voice of patients――.

That's what Torsten Kanisch of AstraZeneca, the founder of i2.JP, says. In this article, we will introduce the idea behind the establishment of i2.JP, the reasons why three major pharmaceutical companies and a consulting firm are working together to achieve patient centricity, and the industry trends and future prospects as seen by leaders in the medical and healthcare industry.

Leaders from diverse backgrounds who have been working around the world

――First, tell us about your career to date and your current mission.

Kanisch AstraZeneca(Kanisch): I have more than 20 years of experience in the pharmaceutical industry in Japan. I am currently serving as Executive Officer for AstraZeneca Japan, and leading Commercial Excellence as Vice President. This department is supporting all business units in Japan, including CVRM(Cardiovascular, Renal and Metabolism), Respiratory & Immunology and Oncology.

In addition to this, I am also responsible for driving innovation. Our innovation initiatives are based on two pillars: the first is Omni-Channel Marketing, which aims to provide a consistent content experience to healthcare professionals; the second is Patient Centric and Patient Innovation, which aims to move Japan's healthcare system to a more "patient-centric" approach.

Proano Bayer(Proano): I am the Head of Strategy and DX at Bayer in Japan. Originally from Ecuador in South America, I have worked for Novartis in Switzerland and also for McKinsey in Japan. Five years ago, I moved to Bayer Yakuhin (Bayer's Japanese subsidiary), where I am now.

My team is in charge of introducing our “New Commercial Model”, a new way to go to market enabled by Data Science and Information Technologies. We focus on 3 areas of opportunity (1) enhancing our customer engagement by capitalizing on the value of omni channels, (2) helping our people make smarter decisions thanks to the power of Data Science and (3) reducing the amount of time our people spend on manual, low value, tasks by capitalizing on automation and digitalization technologies.

Iida Eli Lilly(Iida):I worked for P&G for about 20 years. After managing various areas such as the U.S., Australia and Singapore, I moved to Eli Lilly 6 years ago. At Eli Lilly, we say "Patient Centricity", and at P&G, they say "Consumer is Boss". Eli Lilly and P&G have a similar way of thinking, and that was one of the reasons why I joined this company.

Currently, I am leading Consumer Experience Team. This team is responsible for providing solutions for patients and consumers to all business units. I also have a role in Next Generation Customer Strategy. In this team, we are working on activities that put the patient at the center and engage healthcare professionals, based on the premise that digital technology is transforming the world.

Boettcher Deloitte(Boettcher): I work in the life science field at Deloitte Tohmatsu Consulting in Japan. My main responsibility is to promote DX in collaboration with pharma companies, medtech and medical device manufacturers. We are also working with governments such as Chiba City and Toyota City on projects to improve access to healthcare.

Japan's healthcare system is riddled with problems. Especially in depopulated areas, there are not enough physicians and not many specialists. We are making proposals to our clients to improve these situations by utilizing digital technology. I believe that this is exactly the kind of initiative that will instill patient centricity.

The idea for i2.JP came from a lunch meeting hosted by the ACCJ

――Currently, four companies are holding regular meetings, but how did you first meet?

Kanisch:We first met around February 2019. The Leaders of Bayer Yakuhin, Eli Lilly Japan, and AstraZeneca Japan attended a luncheon hosted by the American Chamber of Commerce in Japan (ACCJ). It was there that I first met Francisco from Bayer and Mr. Iida from Eli Lilly. As I recall, our leaders gave us an agenda and we discussed it together with the ACCJ leaders.

As we had a deep discussion, I realized that the first thing we need to do in Japan is to collaborate. Although these three companies are focusing on different therapeutic areas, we compete in some areas and complement each other in others. Under these circumstances, what we always agreed on was that we had to do our best for patients. We came to the conclusion that there is still a lot we can do to improve the environment for patients.

The following year, in 2020, we had another round of discussions and the initiative started to take off. Christian from Deloitte joined us at that time, and the current team was formed. So the four of us started working together in the summer of 2020.

――When the three major pharmaceutical companies, which are competing with each other, joined forces, was there any opposition from within the company?

Iida:Not really. I think it was because we felt that the healthcare reform that was about to begin could not be achieved by one company alone. I imagine that the reason why our Leaders got together to discuss the issue was because they felt the need to collaborate. I believe that this collaboration started because of this timing, and if it were five years ago, this framework would not have emerged.

――So there was a need of the times. Did the discussion go smoothly?

Proano:We spent a lot of time discussing how we can collaborate to create an eco-system of innovation. We knew we wanted to do something that ultimately helps Japanese patients, but we did not know how to implement it. It took us several weeks to figure it out. When I look back, it was a very interesting process, it took us long conversations to align on the approach; we did not agree right away and had several differences in perspective. However, now, we work really well as a team and we value very much leveraging the skills and perspective each member brings to the table.

――Mr. Boettcher, what were your impressions and expectations when joining this team?

Boettcher:I've been part of this team since 2020, and we've seen so many startups emerge since then. Some of them have great ideas. This year, we have several themes, all of which are for patients in Japan. I think we're more focused than we were at the beginning.

Not only pharmaceutical companies, but also consulting firms like us, IT companies, and insurance companies are trying to get involved in healthcare. So, I think a very exciting time is just around the corner. I'm very excited to see what we can do this year.

Recent trends in the medical and healthcare industry

――Next, I would like to ask you about recent trends and issues in the medical and healthcare industry. How do you see these trends emerging in Japan and overseas?

Kanisch: I think one of the biggest trends is the availability of data and the way it is analyzed and utilized. There is a lot of progress being made around the world in using data to improve the long-term health of patients and to cure them faster.

For example, in Israel, when you are born as an Israeli, you are given an individual ID. With that ID, you can track your health information. From birth to death, all your health information is linked to your ID. This means that you can have a longitudinal view of your health data. By combining this data, you can examine the effectiveness of treatments and determine whether or not your health is at risk.

This means that a patient is in control of his or her own health. The point is that patients are responsible for their own health. However, without the data at hand, this will not be possible even if we are in a good medical environment. There are many developed countries that leave the control to patients. I think there is room for Japan to evolve a little more in this area.

――This is about "Who and in what way should manage and make use of personal health data?” What are your thoughts on this, Mr. Iida?

Iida:Healthcare in Japan is a "hybrid" of the American model, which focuses on the commercial side, and the European model, which focuses on the public side. If it works well, it is a good mix, but COVID-19 has brought to light the fact that it may be a bad mix.

More broadly, there is no clear vision of what kind of country we want to become. Without a clear vision, there is not always productive in talking about things such as NHI prices, is there? I think that is the issue in Japan today.

――You are saying that the leaders need to discuss and present the "big vision/policy".

Iida:Yes. Also, in Japan, it is hard for patients to tell doctors their opinions. In Europe, on the other hand, as far as I understand, this is not the case. In Europe, doctors are supposed to be working under the system.

In Japan, even if patients have many things they want to say, they will not voice their opinions and requests when they enter the examination room and go in front of a doctor in a white coat. There is a habit of setting up a hierarchy. Of course, there is a hierarchy to some extent in every country, but I think it is more prevalent in Japan. I think this is another challenge unique to Japan.

――It may be true that in Japan, doctors and patients are not in a collegial relationship.

Boettcher:The relationship between doctors and patients in Japan is not quite equal, but I think it has changed significantly compared to 10 years ago. Patients are now able to gather a variety of information on the Internet. It is no longer one-way. I also feel that patients in Japan are becoming more demanding.

――I see. How do you see the recent trend, Mr. Proano?

Proano:we live in very interesting times, innovation in the healthcare industry is faster than ever before, driven by technology, connectivity and data science. On the technology side we have new equipment that is able to sequence and decode the building blocks of biology and matter as we never could do before, and this is producing a lot of new data describing the composition of our world. In addition to this, we have now new nano-technology that is enabling miniature sensors and wearables that are helping us track and understand the health of each individual person real time; this is also generating massive amounts of data. On the connectivity side, we have huge capability and capacity gains driven by wireless and cloud data centers, enabling us to gather and make available all the new data that is being generated by new technologies. Finally, we have data science (i.e.: machine learning) which is allowing us to make sense of all the data we have at hand. The combination of this -technology, connectivity and data science- will enable unprecedented advances in our ability to (1) understand the human body and the causes of disease, (2) develop new drugs that cure diseases that were never thought possible and (3) prevent disease with personalized therapies or life-style-recommendations tailored to the unique situation of each individual.

――Our understanding of life is being enhanced by the use of cutting-edge technology. What do you think about this, Mr. Boettcher?

Boettcher:As he said, the development of wearables is very active these days, and the Japanese government and local governments are trying to take advantage of this trend. However, the speed is not fast enough.

For example, Apple Watch now has an EKG (electrocardiogram) function. In the U.S., it took about 6 months to introduce it, but in Japan, it has not been approved yet. Japan needs to pick up the pace a little more and take advantage of new technologies. Therefore, our role is to encourage the government. I believe we need to help that progress by supporting the ecosystem.

From Japan to the world, open innovation initiatives are gaining momentum among companies

――Next, I would like to ask you about the "open innovation initiatives" in each company.

Proano: At Bayer, we have Open Innovation Centers in San Francisco, Boston, Berlin, Singapore, Beijing and Osaka. The team in Japan is focused on two areas: the first is “digital innovation”, which includes transforming R&D processes and open innovation, and the second is focused specifically on “drug discovery innovation", which scouts science and technology breakthroughs from leading academia or corporations in Japan in order to form partnership.

As examples of some of the activities of the Open Innovation Center in Japan, I can cite the following: "CoLaborator Kobe", this is an initiative of Bayer in partnership with the Kobe City government that provide office space and laboratories to enable the next generation of entrepreneurs to create their new breakthroughs. We also have "G4A", an open innovation program, where Bayer poses specific challenges to startups and invite them to solve them sot that we can explore the formation of potential partnerships and collaborations. In terms of our scientific drug discovery collaborations, I can cite our partnership with Kyoto University as well as PeptiDream.

▲「CoLaborator Kobe」Webサイトより

Iida:In Eli Lilly, the U.S. headquarters plays a central role in the medical side, so unfortunately we have not so many opportunities in a position to take the lead in Japan. Japan is mainly responsible for the commercial side of the business, so I think it is important to expand the scope of our activities with external parties by participating in i2.JP and the ACCJ's HEALTHCARE X DIGITAL.

Kanisch:In fact, AstraZeneca is in a very similar situation to Eli Lilly. Our company was formed from the merger of Astra and Zeneca, so our R&D team is based in both Gothenburg (Sweden) and Cambridge (UK). In recent years, we have been focusing on the Chinese market, and established a research site in Shanghai. With the acquisition of Alexion this year, we have also acquired a research site in Boston (USA). In this way, we have our sites all over the world.

However, what about in Japan? There are many great drugs being invented in Kyoto and other parts of Japan. We would like to utilize these inventions, but it is not easy to do so because AG Global is responsible for operations. That is why we are now participating in Shonan iPark, an existing ecosystem operated by Takeda Pharmaceutical Company Limited.

Because of this situation in our medical function, I thought about what we could do on the commercial side. As a result, we came up with the "i2.JP" concept. First, we focus on innovation for patients and create a movement. However, of course, we have not forgotten about the pharmaceutical element. i2.JP is not just about digital and devices, but we aim for something beyond that. We would like to expand our initiative not only in Japan but also globally. We are currently working on a drug discovery technology initiative in Japan, which has the potential for global collaboration.

▲Shonan iPark is equipped with one of the largest research facilities in Japan, providing an environment that accelerates research in terms of both hardware and software. (*The image is from the facility’s website)

――"i2.JP" will expand the scope of its activities to include R&D and overseas in the future. What are the activities at Deloitte Tohmatsu?

Boettcher:We have a global network of innovation hubs. We have several in Tokyo, as well as in Kyoto, Osaka, and Fukuoka. As a patient-focused initiative, we run a platform called "Patient Connect". We are currently using this platform to make healthcare more accessible to patients.

There is also a group that supports startups. The group supports startups to commercialize their ideas. We also collaborate with academia to search for promising ideas, and we have made some very large investments. We are collaborating widely, including with medtech, government agencies, and patient groups.

We want to create a new "voice" that represents the voice of patients

――Finally, please give us your outlook for the future, what you expect from i2.JP, and a message to those who are considering joining i2.JP.

Iida:We would like to make this a place where representatives from each company can bring their leadership and passion to create innovation. This kind of cross-industry, cross-company activity has never happened in Japan before. This is a valuable opportunity, and we would like to do our best to make this activity a success.

Proano:all of us working in the Japanese Healthcare industry want to leave our mark in this world and want to make a difference in the lives of patients. But often, to achieve this objective, we need help from others, we need larger partnerships to make our ideas happen. "i2.JP" is all about this. It is the first truly open platform in Japan to enable organizations with similar ambitions to work together, and join forces to achieve bigger common goals.

Boettcher: I myself have a really strong determination about this. That is why I am seriously thinking about "what we can do with this time”. I am very excited to see all the members with various backgrounds come together and continue to learn together.

Kanisch:I would like to talk about two last things: the first is that we want to create a "voice" for the government and for patients. In order to make our voice heard, we need to expand our scale and presence. Now, in Japan, the pharmaceutical industry, medical institutions, and doctors are all fragmented. However, I think it is possible to create “one voice” by getting together at i2.JP. It is not the voice of AstraZeneca. It is the voice of patients.

Secondly, a wide variety of people are participating in i2.JP. Not only pharmaceutical companies, but also players from other industries and doctors have joined. By sharing our thoughts with society and not just within our own company, we should come up with new ideas and results. This is an initiative that will expand our dreams. We hope to grow i2.JP by inviting a diverse group of people from both the public and private sectors to participate. The network affects the quality of people and discussion. We will improve "i2.JP" every year and make a bigger impact on the society. So, I hope you will be interested and participate in i2.JP.

Postscript

During the hour-long interview, the word "exciting" was used several times, which impressed me. The current influx of cutting-edge technology into the industry, and the current situation where various players are trying to get involved in the industry, may be very "exciting".

"i2.jp” was launched just last year, but the number of participating companies and organizations has exceeded 100. In order to represent the "voices" of patients, they are planning to expand the scale of the project further. If you are a company that would like to work together to realize patient centricity in the medical and healthcare industry, which is currently gaining momentum, please contact us.

In addition, HEALTHCARE X DIGITAL 2021, a pitch event sponsored by the American Chamber of Commerce in Japan (ACCJ) and supported by AstraZeneca, Eli Lilly Japan, Bayer Yakuhin and Deloitte Tohmatsu, is looking for companies to participate (application deadline: October 1, 2021). We hope you will keep an eye on this as well.(Edited by Yukitaka Sanada, Written by Wakako Hayashi)

カニッシュ・トーステン(Torsten Kanisch)
Torsten Kanisch
Executive Officer, Vice President, Commercial Excellence, AstraZeneca K.K.
飯田 康彦(Yasuhiko Iida)
Yasuhiko Iida
Director, Consumer Experience Team and Next Generation Customer Strategy, Eli Lilly Japan K.K.
プロアーノ・フランシスコ(Francisco Proano)
Francisco Proano
Executive Officer, Head of Strategy and Digital Transformation, Bayer Yakuhin
ボッチャー・クリスチャン(Christian Boettcher)
Christian Boettcher
Partner, Executive Officer, Deloitte Tohmatsu Consulting G.K.

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