Novartis Oncology Head: from Medicine to Management
Emanuele Ostuni, currently Novartis Head of Cell and Gene Therapy in Europe, has seen patients up close since he was a boy in southern Italy. He is now living his dream job helping patients as Europe Head, Cell and Gene Therapy at Novartis Oncology.
The interview, by Jill Donahue
As a young boy, Emanuele’s father, a surgeon, took him to the hospital regularly. Emanuele knew all the nurses by name. He also worked in his dad’s private practice. “My dad never turned anyone away,” said Emanuele. Even on vacation, he remembers acting as nurse on their sailboat helping a fellow boater who was in trouble. He followed him on house visits and saw in his father a man who did anything necessary to help patients.
This was a conundrum for the young boy. He too wanted to help patients but was wary of becoming overwhelmed by the responsibility. At Georgetown in a pre-med program, he was volunteering in the neurology department where he saw patients not progressing. He thought that maybe by going into research he could help people for whom there was currently no help. At Harvard he got a PhD in chemistry and collaborated with researchers at Harvard Medical School and MIT, developing new material surfaces and approaches to controlling single cells.
The technology was interesting and he joined a startup that would commercialize it. He loved understanding the science and soon realized he was also fascinated by taking a product to market. This was the test of whether your discoveries really made a difference.
To get a grounding in business and strategy, he spent four years at McKinsey. “They had the guts,” Emanuele said, “to take people with PhDs and teach them the basics of business and send them out working with clients.” It was like getting an MBA through real world experience.
Eventually, wanting a more hands on impact, he went back to Boston and became VP of Business Development at Nano Terra, another startup. While there, he started a biotech, Enumeral Biomedical Holdings, with a former colleague who became a professor at MIT.
But there was still a bigger picture he wanted to see, the process from discovery through manufacturing, approval, sales and marketing.
So he started talking to Sandoz, a generics company. Against the advice of colleagues and friends, he was convinced that it was the right business for him to join. The cycle times were fast, so he could see very quickly how products were developed and sold. He oversaw many launches globally and learned how to run branded and generic pharmaceuticals businesses as Head of Specialty and Hospital Franchises and Head of Business Unit Rx and Regional Alliance Manager. He worked in Eastern Europe, managing growth and expansion strategies in the backdrop of highly volatile markets – important skills for what was to come.
DREAM COME TRUE
That’s when the opportunity with CAR-T arose. It was a dream come true role for Emanuele when he joined Novartis in 2017. He had been watching the area develop from a distance and was amazed by the impact the therapies were delivering to patients. He moved his family to Basel to build a team to deliver Kymriah broadly across Europe. It was completely unique, because they had to find a way to deliver a living product. The infrastructure needed is new for the industry, requiring direct links to physicians who may prescribe. His team had to develop services to support hospital readiness, service and logistics. In addition, they had to build teams in all countries and develop approaches for sustainable reimbursement and market access. In addition, new payment models are necessary to allow countries to access the product. It’s a new and complex approach.
WHAT SURPRISED HIM THE MOST?
Emanuele said he didn’t realize how complex it would be. Such a new, transformative product brings out the best and the worst in people and processes. The systems are not completely ready. Physicians are excited while at the same time their experience with this kind of product is limited. Healthcare systems, hospitals, and payers are not ready for a product that is given once and can have lasting effects over several years. Most healthcare systems are used to treating patients on a chronic, regular basis. Patient organizations have also been overwhelmed by the availability of these new approaches. It’s great, he says, seeing amazing collaboration among market participants, but also frustrating when all those things don’t work.
WHAT DRIVES HIM TO FIGURE OUT HOW TO MAKE THE SYSTEM WORK?
“I am very close to patients now. If there is something that makes me not stop, it’s figuring out how to get a patient access to the product, knowing it could be life-changing for them,” explained Emanuele. “The thrill of solving a problem to improve someone’s life, to have that real impact, that drives me,” he added. “Sometimes we can’t help. It’s a fact of life. I have to feel positive that I and my team did our best.”
PATIENT ACCESS IS THE PRIMARY POINT
It starts with some major and minor signals that all add up, he explained. “We focus the team on one target of patients identified for treatment– not country specific – we think of one regional number – one common objective. This results in greater collaboration.” His first point in his communications when discussing performance is not on sales, it’s on how many patients were identified to receive the therapy in a given period. The technicality of how they recognize revenues is secondary to how many patients they can impact. “Can we give access to the product to patients within label? That’s our focus,” explained Emanuele confidently.
They ask every person “If you were a patient, would you want this, would this be ok with you? And if you were a physician, would you want this? Are you OK with a patient passing away while waiting for a product?”
He has seen that with this approach the light bulbs go off. “When it really clicks, he said, you see real change in behavior. It’s almost a militancy.” People realize we should change anything that gets in the way of that patient access.
LOVE AND LIQUID NITROGEN
Emanuele is quick to point out that nothing happens without a strong team. With his leadership team, early on, they worked to define their long term vision and the key principles behind it to make sure that “we could always check ourselves against them to stay on track.” The vision was given the name “Love and Liquid Nitrogen.” “We wanted to reflect the passion we have for patients and for supporting each other while connecting that to the task of delivering our product, which is shipped in liquid nitrogen.” Beyond the leadership team, which meets frequently, they organized an all hands meeting to ensure all colleagues made the vision theirs and that they could learn from each other and connect. “We recognize the importance and the gravitas of what we do, and at the same time, we want to have fun together while doing it.”
THE FIRST CHILD TREATED WITH KYMRIAH
Looking back, Emanuele remembers his first realization of mortality. “I remember some house calls with my dad and realizing the patient was just on palliative care – they weren’t going to get out of bed,” he reflected. He saw patient care at its best and at its limit – when there was nothing else that could be done. “Now, I’m working in a place where something can be done,” he added with pride. “There is a small group of patients, with these two cancers, that now have more options than before.
“I am exactly where I want to be. I’ve been training to be here for a long time,” Emanuele explained. He still has the bracelet he made with a Swedish patient group on the day he met Emily Whitehead – the first child treated with Kymriah at age 7 who is alive 7 years later. “That was a big day for my team and me. My team ask me why I wear this bracelet. It’s my inspiration,” he said, then added, “My role was announced on May 10, 2017. I didn’t think of anything of the date. That afternoon the media lit up like a Christmas tree about Emily Whitehead – it was her 5-year anniversary of being cancer-free. It still gives me goose bumps. I feel very connected to my purpose.”
When I asked Emanuele what he wanted from this article. He said “I’m proud of my story. I want my story to help others find their own story and make a difference. If there can be more leaders driven by purpose, we as an industry can do better for patients. Sometimes people are so far removed from the patient that it is embarrassing. I want to build a bigger community focused on what makes a difference and what makes the world better for patients.” Thank you, Emanuele for your inspirational story. You made a difference sharing it.
To learn more about Emanuele, enjoy the video interview where he answers questions like:
What are you most excited about regarding new treatments for cancer?
How important is patient centricity to collaboration and to creating effective digital tools?
Where should patient centricity sit in the organization?
How do you measure success?
How do you help your team connect with what patient centricity means to them? •
Author, Engage Rx: The 3 Keys to Patient-focused Growth
Co–founder, The Aurora Project
Jill, HBa, MAdEd, is a keynote speaker, author and thought leader who has authored two books on Influencing in patient-focused ways and co-founded The Aurora Project, a global patient-centricity group. She also serves as Associate Editor of Healthcare Sales & Marketing.