Latest / The BioHub - by Avetix / Episode 172 - Jonathan Sadeh - EVP, Head of R&D and CMO of Bausch Health

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Episode 172 - Jonathan Sadeh - EVP, Head of R&D and CMO of Bausch Health · The BioHub - by Avetix

• 0:06
  So welcome back to another episode of the Bio Hub and
• 0:09
  Avetics podcast. Today, I'm joined by Dr.
• 0:12
  Jonathan Sade, EVP, Chief Medical Officer and Head of R&D
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  at Bosch Health. Jonathan is a physician
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  scientist with more than two decades of experience leading
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  drug development across some of the biggest companies in our
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  industry, including Sanofi, AstraZeneca, Schering, Plough
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  and most recently BMS. He oversaw some major global
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  programs in respiratory, immunology, cardiovascular and
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  neuroscience. So in today in this
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  conversation, we dive into his journey through Big Pharma, how
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  he thinks about progressing within large organisations, the
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  evolution of R&D and why he chose Bosch as his next
• 0:52
  opportunity. So let's get into it.
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  How are you, Jonathan? Great, thank you Max for
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  inviting me. Excited to chat about my career
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  and other topics. It's a pleasure to have you
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  honestly, and I think it definitely makes sense to talk
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  about your journey first, you know, 20 plus years across some
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  of those biggest names in pharma.
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  Like I said, what what originally drew you out of
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  academia and then instruct development?
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  Yeah, I think, I think there was an evolution there.
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  I I started my career as a pulmonary and critical care
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  physician. I, I trained in a, you know,
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  prestigious medical academic institution in Boston and
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  thought I've made it in the world.
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  I'm going to, I'm going to stay in academia.
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  This is great. This is what I always wanted to
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  do and I, and I did kind of progress that career path.
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  I, I got more into research by getting another master's degree
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  in, in clinical research. And, you know, it was clear that
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  my path was going to be in, in academia as I got more and more
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  into the pulmonary and critical care career academic path, I, I
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  realize that to be successful in academia, you need to be really,
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  really focused and be a super special, be super specialized in
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  one area. That's how you, you know,
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  publish, get more grants, advance your career by being
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  really, really focused. And I, I realized very early on
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  that I'm very interested in a lot of different areas.
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  I got into pulmonary and critical care because I thought
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  there was a lot of different things that I could do there.
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  There are a lot of areas that I could research, but, but I
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  couldn't really do it in an academic Medical Center because
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  I had to be so, so focused. And so over time, I think I, I
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  realized that by interacting with people in industry, meeting
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  people in industry, first of all, that there was such a path
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  as, you know, physician scientists, This could be in an
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  industry I didn't even know that existed, existed.
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  One, once I met people and saw how their career evolved, what
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  they were doing, I realized that that could be a much better path
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  for me. I could work in multiple
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  different areas. I, I was really excited about
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  the idea that I can work in respiratory, but maybe I'll work
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  in other areas as well. And I'm working in respiratory.
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  I can work on various different things within respiratory.
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  And, and that was, that was really exciting for me.
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  I and like, I realized how diverse my career would be in
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  industry when I got into it, but I guess in, in retrospect now 20
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  plus years after I, I, I realized it was, it was a great
• 3:34
  choice for me and I, and I'm really happy I made that move.
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  Yeah, I mean amazing. And you've spent most of your
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  career inside large global farmer organizations.
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  And then we talk about Bosch as well.
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  So why didn't you make that move to a smaller company earlier?
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  You know what? What kept you in Big Pharma?
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  Yeah, You know, I I started my career or, or before I even
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  joined industry, I thought being in a small company would
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  actually be a better fit for me. I was in Boston at the time and
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  you know, this is 25 years ago. There are actually not that many
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  big farmers. There was all small companies.
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  So I started talking to small companies and I thought it would
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  be a really good fit for me to get to be in a in a company
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  where I could get to know everybody have a big impact and
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  a small organization. But, but it became clear that if
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  I want to train and learn how to do drug development, I need to
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  be in a large organization where you do you, you do research and
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  you know, and a massive scale and you can learn how to do drug
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  development the right way. And so very quickly I realized I
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  need to go to a large company and, and the first company I
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  joined was, was sharing Plough. I needed to move to New Jersey
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  for that. And, and I think big pharma has
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  been a great training ground for me.
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  Initially it was just a training ground, a place to learn how to
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  do drug development, to do research, to learn how to do it
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  right because you've got all the resources you, you need and, and
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  big pharma. But then over the years, I, I
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  think what kept me in, in big companies is that there's a lot
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  of opportunities back to why I moved into industry.
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  I thought that there was, there were going to be a lot of
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  opportunities to work in different areas.
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  And, and that's exactly what happened in big pharma.
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  You, you work in, you know, asthma and then there's somebody
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  says, well, you should work in COPD and you should work on
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  cough and you should work on respiratory infections.
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  And so you get a lot of opportunities and, and that's,
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  that's really what, what was really exciting for me.
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  And, and I think the end of the day, I always kept like I'm, I
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  always felt like I'm, I'm getting really good
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  opportunities. I'm advancing in my career and
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  I'm really doing exactly what I thought I would be doing when I,
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  when I went to medical school really, which is was doing
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  research, advancing science, helping patients.
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  That was exactly what I was doing in, in, in big pharma.
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  So I was really excited about it and don't regret a minute of
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  staying in Big Pharma. I mean, yeah, you kind of talk
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  about those new opportunities and what you got.
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  I think a lot of people want to know how you actually progress
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  with inside the companies. You know, you, you talk about
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  like there was those opportunities, but how do you
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  kind of take it by the scruff of the neck and, you know, progress
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  into those? And then also what you know
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  what, what have you learned about navigating big pharma and
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  and building influence? Yeah, I know that's a great
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  question. I think that the big pharma
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  beast can be can be difficult to navigate and, and, and it can be
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  very difficult for for some people.
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  I think if I reflect on what, what are the kind of things that
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  made me successful first time, I'm really a people person.
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  I always like to be around people.
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  And you're in a big institution, doesn't matter if it's farm or
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  any other industry, if, if you connect well with people that
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  that helps you a lot. And I think in, in, in R&D and
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  in the pharmaceutical Pharmaceutical industry, I think
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  to be very collaborative and kind of engage with all the
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  different functions within an organization is really, really
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  important. As opposed to, you know, in
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  academia you need to be, I mean, there's collaboration, of
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  course, but, but you're really working individually and you
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  want to, you know, you want to find the, the next discovery,
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  write it, you know, publish it first.
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  Whereas in, in industry you can only succeed if you are working
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  really well with a cross functional team.
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  So, you know, I can be really good at coming up with clinical
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  trials and, and coming up with ideas for the next, next
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  discovery that we make. But I have to sit down with the
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  regulatory and commercial and CMC and, and, and medical
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  affairs, all these different functions.
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  So, so I have to be in that mindset that I'm just one part
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  of a bigger organization. And once you have that mindset
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  and that you have to collaborate with people, that's, that's a
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  big, a big step forward. And I think, you know, being a
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  people person helped me, helped me a lot.
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  I think wanting to take, take on more responsibilities is always
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  was always a great advantage for me In the first few years of my
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  career. I was, I was really lucky that a
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  lot of people were retiring at the time.
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  So I just took on more and more responsibility.
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  And, you know, I, I got to do a lot of projects at some point,
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  you know, it was, I was kind of the go to person.
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  We've got a new project. Let's ask Jonathan to do it.
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  Somebody's retiring, let's ask Jonathan to take his portfolio.
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  And I, I loved it. It was great for me.
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  I love doing it. And so that's, you know, that
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  that really helped a lot in my career.
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  And then I, I think influence is something that comes along with
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  it. Once you build credibility and
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  people and trust and people realize that you're doing things
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  for the right reasons, meaning your, your focus is, you know,
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  advancing our portfolio, finding new innovation, thinking about
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  patients and how we can impact and, you know, positively impact
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  patient care, helps science help, helps you know, the, the,
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  the area that we're researching and helps the company, of
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  course. And so it's a win, win, win.
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  And, and so that, that builds a lot of credibility, trust and,
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  and they, that's an, an influence.
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  Of course. People believe you want to work
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  with you want to listen to you, they come up to you and ask you
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  for your opinion. That's how you kind of advance
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  in your in your career and and people want to give you more
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  opportunities and I was very, very fortunate that that's what
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  happened to me over the years. Yeah, I always find it really
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  interesting when people talk about how fortunate they were.
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  But there must be an element of just working hard and you say
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  like taking on this extra, you know, this extra responsibility.
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  There must have been a element in sacrifice in in doing that.
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  Well, certainly I, I, I've reflected on that quite a bit on
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  the sacrifice of I, I suspect any, any job that I, I don't
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  think it would have been terribly different if I was in
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  academia or in private practice or, or anywhere else.
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  Your dedication to your work and, and how strongly you
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  believe in it. I mean, I, I could, I could do
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  my job, but work probably half as much but and still do do a
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  good job. But, but I feel very passionate.
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  I'm really passionate about what I do.
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  The impact makes in on reason I went to medical school to kind
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  of advanced science, advanced patient care.
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  I really feel passionately about about that.
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  And so that requires that that's that's more than an 8 hour day
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  requires many hours and nights and weekends.
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  And I was happy to do it, although it it certainly does
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  sacrifice some of your you have to sacrifice some of your your
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  personal, personal life, but you know, you have to find a good
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  balance. I mean work and in personal life
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  and I think I've, I've, I've found it.
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  I I hope my wife agrees with me. Yeah.
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  And we're talking about like the the breadth of, you know,
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  experience you've had. And I mean, in my introduction,
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  I talked about immunology, neurocardio, respiratory, even
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  dermatology. Very, very few leaders have that
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  kind of breath. How does that shape the way you
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  work and approach R&D? Yeah, I know that's a that's a
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  really great question because I, I said that I started in
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  pulmonary and respiratory diseases.
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  How did I get to work in, you know, dermatology?
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  I think that I very early, very early on in my career, I
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  realized that that once you learn how to do clinical trials
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  research effectively and how to make decisions effectively, you
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  can extrapolate that into into many other areas.
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  So you know, understanding the science, designing trials and in
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  an effective way and being data-driven.
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  You know, you're not influenced, but put by what people want the
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  results to be by what by but what the data really shows you
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  being objective and making data-driven decisions.
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  Those are really, really important concepts.
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  They seem trivial, but, but we don't always use them.
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  But once, once you do, and once you learn how to do that
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  effectively, I think developing a drug for asthma becomes very,
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  very similar to developing a drug, a drug for, you know,
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  alcohol, alcohol associated hepatitis or, or psoriasis or
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  atopic dermatitis. And, and that's, that's how my
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  career evolved. I've learned how to do that.
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  And then I said, well, let me, let me see.
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  I'm, I'm working on, on respiratory, but that's very,
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  very similar to what we're doing in rheumatoid arthritis, which
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  is actually the next area I, I worked on.
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  And there's a lot of similarities there.
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  And I was able to pivot and, and, and start working on, on
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  those areas. And so those that is what's
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  really guided me over the years. I'm in AII believe I'm, I'm
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  science like I make my decisions based on science data and and I
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  make decisions quickly and effectively.
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  Once I, if I follow those principles, I can actually
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  continue and work, work on on any therapeutic area.
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  And I've been really fortunate to be able to work on many, many
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  therapeutic areas over, over the years and, and hope to continue
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  to do that because I do at course see myself as, as a
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  physician scientist, not a pulmonologist only.
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  I'm a physician with, with background and experience in, in
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  many different areas. I'm trained as an, in, you know,
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  initially as an internal medicine doctor.
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  So I, I feel like I can legitimately work on any
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  therapeutic area and and hope that by the end of my career I,
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  I would have, I will work on pretty much every therapeutic
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  area. But yeah, would you, so you'd
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  recommend that to people coming through the industry to try and,
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  you know, work in any, any kind of therapeutic area they can?
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  No, I think, I think it's really important to start your career.
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  The advice I give to people early on in their careers that
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  you, you want to start in the area that you're really good at.
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  And I came in and worked for the first, I don't know, probably
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  7-8 years of of my career in pulmonary, pulmonary medicine.
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  I, I was highly specialized, highly trained in that area.
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  I knew the area of very well. I knew experts in the area.
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  I could call anybody and ask for, you know, feedback, advice
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  and in, in pulmonary medicine. And so it was a perfect area for
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  me to start. And I think that's what I
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  recommend to others to do. But you know, there's, I think
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  at some point you need to make a decision, do I want to continue
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  and be very, very highly specialized in that area and
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  continue to work just on that or should I expand?
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  And, and I think if you're in academia, as I said before, you,
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  you need to and you have to stay specialized and, and work only
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  in that area. I think the advantage we have an
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  industry is that we can extrapolate and move into other
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  areas. And I think the way the industry
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  is evolving, I think it's, it's very advantageous to people for
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  people to, to do that because, you know, science is evolving so
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  fast. You, you don't know what's going
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  to be the next big thing and but once that big thing comes on,
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  you should be ready to pivot to that.
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  I mean, 10 years ago, I don't think anybody would have
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  predicted that, you know, weight loss in GOP once would be the
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  biggest area in, in clinical and drug development and research.
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  Now it is. And so pivoting to that,
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  learning how to work in that area is one example is really,
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  really important for, for people in the, in this industry.
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  So that's that is the advice I give.
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  I give to most people. Not everybody loves that.
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  They want to continue to specialize in that, and that's
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  OK too. Yeah, I mean, my next question
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  was actually around the the future of the industry.
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  I was talking about, you know, how it has changed over the last
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  decade. You talked about, you know, the
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  change to obesity. But you know, I was going to
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  mention, you know, new, but just general new modalities, AI
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  regulatory shifts, just just generally what what are the
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  biggest changes lead for leaders to adapt is the prep side that
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  you've just spoke about as well. Yeah.
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  There's a, there's a few things I think you're you're touching
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  on a on a few really important points.
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  I think the first thing, the first point I'd make is that the
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  science, science and clinical, our understanding of, of
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  pathophysiology of disease is evolving extraordinarily fast.
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  It always evolved, right? I mean, we, every year we learn
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  some new things, but the pace of, of our understanding of
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  basic science and pathophysiology of disease, in
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  my opinion, has changed dramatically over the past few
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  years, I'd say even five years. And that's really, really
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  important to realize things like, you know, I, I worked a
• 17:54
  lot in, in immunology, resetting the immune system was like a
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  dream that people would talk about in the past, but never
• 18:02
  really understood how you do that or what, what the impact of
• 18:05
  that could be. Now we actually know how to
• 18:08
  reset the immune system and prevent auto antibodies from
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  developing in, in people with certain autoimmune diseases that
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  actually is changing the way we maybe treating these patients in
• 18:22
  the future and how we develop drugs for these conditions
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  dramatically. So.
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  And I and I think that level of innovation is going to continue.
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  So, so that's one really important change in the
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  industry. I think the other you pointed to
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  AII think that's and machine learning I think is is really,
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  really important and impactful. Our ability to analyze large
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  databases and find a subsets of patients who are more or less
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  likely to benefit from from an intervention or a new drug is
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  really changing the way we are working.
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  And I think putting it all together, I mean, being able to
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  adapt quickly and continuously learn is going to be really
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  important. We can't talk about, you know,
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  this is how we did it, you know, 20 years ago, 30 years ago.
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  And so we should stay, continue to do that.
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  That's, that's not going to work.
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  You need to be really comfortable with changes, learn
• 19:23
  everyday about new areas of innovation and how and how you
• 19:28
  should adapt to them. And you know, be, be comfortable
• 19:33
  with, with these, with continuous changes, which is
• 19:36
  which, which can be difficult for some people.
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  But I think that is the way our industry is moving.
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  And to be successful in it, I I think you need to have those
• 19:45
  capabilities. Oh yeah, 100%.
• 19:48
  I think that's pretty good advice.
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  And I mean, talking about changes as well.
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  You you stepped into Boschet, what a pretty fascinating moment
• 19:58
  where a global business was undergoing a pretty big
• 20:01
  transformation, but what excited excited you most about joining
• 20:07
  and then also the just that that general project of
• 20:10
  transformation. Yeah, I think as I said
• 20:14
  initially, I always wanted to be in a smaller, a smaller company.
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  I started my career thinking that I I should be in a small
• 20:20
  company. It it took me 20 years to to get
• 20:23
  to a small company. But I'm, I'm really happy I made
• 20:27
  that change for for a few reasons, general reasons and
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  related to Bausch. I think that being, being in a
• 20:35
  small company, clearly my ability to impact a where the
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  ship is going is, is much, much larger.
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  And, and I felt that from from day one, I can really direct the
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  areas that we go into or not go into very, very quickly.
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  And I think Bausch has the advantage of being a, a small,
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  small enough company that I can make these, we can't pivot in
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  and go into, in, in, in different directions quickly,
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  but it's large enough that you have resources to run big
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  programs and, and make really impactful the impactful programs
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  that will change the way patients are, are treated out
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  there. And so I, I feel like it's a
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  good balance of not too small, but not too big.
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  And, and, and I think Bausch is fit the bill for, for me.
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  I think in my, in my first year here, I've been able to make a
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  lot of these, these kind of changes and feel like, like over
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  the next few years, we will drive innovation in a very
• 21:48
  different way. We can continue to grow certain
• 21:51
  areas that we're, we're really good at, but we are going to
• 21:55
  pivot into new areas as I described before, you know,
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  where we see innovation, where we see unmet medical need, we
• 22:04
  pivot there. We, we feel like we can be, I
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  feel like I'm an organization that is agile enough that we can
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  pivot really quickly into areas of unmet need and scientific
• 22:14
  innovation really quickly. And that's very different than
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  what I was able to do in, in a, in a big company.
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  Love loved my years in big pharma, but I, I would always
• 22:24
  joke with CE OS that, that I met the last CEO I met that BMS,
• 22:29
  that even the CEO of a big company can't really make big
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  changes in, in, in, in a large company that it's such a big and
• 22:38
  clunky ship that it takes years and years to move, to move and,
• 22:43
  and and pivot to other, another direction.
• 22:46
  We actually can do that about and, and can be, can be that
• 22:50
  agile. The other, the, the big
• 22:52
  advantage, the other big advantage that we have here is
• 22:54
  that we don't have a research engine.
• 22:57
  We only work on mid, mid stage to late stage development and so
• 23:03
  we don't have to feed that research organization and again
• 23:08
  can focus just on unmet need and scientific innovation.
• 23:12
  Yeah, amazing. Just just generally how, how are
• 23:15
  you thinking about, you know, balancing A diverse portfolio
• 23:21
  with the need to stay focused and competitive?
• 23:24
  I know you talked about that agility, but also having the
• 23:27
  cash behind you as well. But the what?
• 23:29
  What? What's the strategy like in this
• 23:32
  market especially? Yeah, I know what's it's a great
• 23:36
  question. I think we need to you, you
• 23:40
  definitely do need to focus on some areas that you have that
• 23:43
  you feel like you have an advantage and and you're an
• 23:46
  expert in that's that's really important.
• 23:48
  And for us here at at Bausch, it's it's GI, hepatology,
• 23:53
  dermatology. I think we, we, we have a lot of
• 23:55
  experience in those. We've developed a good, you
• 24:00
  know, development organization, commercial organization and,
• 24:06
  and, and outreach to, in, in the, in the community or the
• 24:10
  medical affairs organizations that are really good at GI
• 24:14
  hepatology especially, but also dermatology.
• 24:19
  So we'll continue to grow those because that, that makes sense.
• 24:22
  And we feel like we're, we're leaders in that area, but we can
• 24:27
  easily pivot into other areas. And, and, and that's what we are
• 24:34
  are actually doing in the next year or two.
• 24:36
  We'll we'll, we'll talk more about, about how we grow our
• 24:40
  business into, in, in other areas.
• 24:43
  And going back to the point I made about, you know, we, we
• 24:47
  don't have the big research development and, and, and, and
• 24:52
  commercial organizations that are just focused in, in one
• 24:55
  area. We can easily focus into, into
• 24:58
  an or, or is it easily pivot into a new area, rare diseases,
• 25:02
  neurology areas where we feel like there is very high unmet
• 25:06
  need and significant innovation. We can easily pivot into those.
• 25:13
  Like we've, we've made some, some changes that we made some
• 25:17
  acquisitions in the areas that we feel we're really good at.
• 25:20
  We we just acquired a company direct that works on, on alcohol
• 25:26
  associated hepatitis and that's a perfect fit for us.
• 25:30
  But next acquisitions could very well be in areas that we we feel
• 25:34
  are totally new to us, but fit fit the the philosophy that we
• 25:40
  have unmet need and scientific innovation.
• 25:44
  Yeah, definitely, definitely. And not.
• 25:47
  Well, we're coming to my final question and it's my usual
• 25:50
  closing question. So I don't know if you thought
• 25:52
  about it, Jonathan, but if you could have dinner with any
• 25:56
  scientist or innovator, past or present, who would it be and
• 26:00
  why? That's it's a great question.
• 26:06
  I, I, I did think about that. And the first, the first person
• 26:13
  that came to mind after dwelling on this for, for a few minutes
• 26:17
  and that was, was really the person I, I, I want to meet.
• 26:22
  And, and would really, I've, I've thought about it quite a
• 26:24
  bit. I, I really would love to, to
• 26:26
  meet this person if they were still alive.
• 26:28
  But Francis Crick is my is my choice, I think for a few
• 26:35
  reasons. Francis Crick, as you, you know,
• 26:39
  was one of the discoverers of the double Helix in DNA.
• 26:45
  And I think that is probably the most important scientific
• 26:49
  innovation in the past century or certainly the past few
• 26:55
  centuries even. I mean, discovering DNA and how
• 26:59
  DNA is translated into RNA and proteins changed the way we
• 27:04
  think about pathophysiology of disease, how we work on
• 27:09
  scientific innovation and, and I think is so impactful that I
• 27:14
  can't think of any other discovery that was bigger than
• 27:17
  that. But, but Francis Crick as a
• 27:19
  person is also somebody I've I've read about in the past and
• 27:23
  I'm really fascinated by who this person was.
• 27:27
  He was clearly really good at science, but also very humble
• 27:35
  person, open to, you know, didn't really respect kind of
• 27:39
  rank and, and, you know, experience ideas.
• 27:43
  He looked for ideas from any junior students, people who were
• 27:47
  around him and and was also able to pivot into different areas.
• 27:53
  The first thing I said is that in academia, it's hard to pivot
• 27:56
  from one area to another. He did it.
• 27:58
  He was a super specialized expert in, in, you know, in, in
• 28:01
  biology, but then pivoted to neuroscience and worked on
• 28:05
  consciousness in the past, the last few years of his career,
• 28:07
  which is just fascinating. And then, and then lastly, I, I
• 28:13
  think he, you know, he spent a lot of time at, at the bar is
• 28:18
  kind of the, the story people, they, they tell the stories
• 28:21
  that, you know, he came up with the idea of the double Helix
• 28:26
  after happy hour with, with some of his colleagues, went back to
• 28:30
  the lab and wrote it down. And, and, and that was the
• 28:33
  beginning of the, you know, the theory of the double Helix.
• 28:38
  I think it always reminds me and I talked to my, my teams here at
• 28:42
  about about how important it still is to actually have face
• 28:46
  to face interactions with people and that we can't do it all on,
• 28:51
  you know, on our laptops and computers.
• 28:53
  We have to actually meet face to face.
• 28:56
  We have to interact. Innovation in the future is
• 28:59
  always going to is, is still going to come through, you know,
• 29:04
  human interactions. And so I, I, I, I thought about,
• 29:07
  I use that example a few times. So anyway, I would love to would
• 29:12
  would have loved to meet Francis Craig, talk about his career,
• 29:16
  his ideas of innovation, how to innovate and how he thought
• 29:20
  about the progression of his career.
• 29:24
  Yeah, I think that's an awesome answer.
• 29:26
  And look, thank you so much for coming on, Jonathan.
• 29:28
  It's been a pleasure. Thank you for having me Max,
• 29:31
  it's been great talking to you.