Kevin Zou highlights Novartis Oncology’s footprint and priorities in the diverse Asia-Pacific region, the challenges of introducing cutting-edge cell and gene therapies, how the company works with regulators and payers in Singapore and beyond, and why Asian representation in clinical trials is of vital importance moving forward.
Technology has been a huge enabler in democratising access to quality healthcare, and the beauty of it, especially for mobile technologies, is that technology is everywhere. It is not a unique feature of developed countries.
Kevin, could you share a little about your career journey and what led you to Novartis?
I started my career as a bench scientist, and I spent a lot of time in the lab. Following graduate school, I joined SmithKline Beecham, before it became GlaxoSmithKline (GSK). I spent two years there working on the discovery of new drug targets. After two years, I did my MBA at the Stephen M. Ross School of Business at the University of Michigan, after which I joined Novartis, where I have been ever since. Ultimately, I was drawn to the prospect of making a huge impact on the lives of patients. That is where my passion lies.
As head of Asia Pacific for Novartis, you oversee a huge and diverse region. Can you give us an overview of what Novartis Oncology encompasses in Asia Pacific (APAC)? What are the trends in the region?
Certainly, we can look at it from two aspects. On the portfolio side, my team covers the entire oncology portfolio for Novartis, including our innovative CAR-T therapy, radioligand therapies and other innovative therapies. On the geography side, APAC for us comprises 16 markets – every country in the region except China, Japan, Australia, and New Zealand.
The overall healthcare trends in APAC are quite similar to global trends but with some uniqueness. Starting with the similarities, there is an increase in the demand for cancer care. Nearly half the world’s cancer cases are found in APAC. Research suggests that by 2030, the number of people with cancer in APAC is expected to grow by around 35 percent, with the mortality rate rising by another 40 percent. These are huge challenges for patients in this part of the world. On the bright side, the good news is that we are seeing more innovative medicines being approved and reimbursed in our region.
In terms of the specific trends, digitalisation is definitely one of them. COVID-19 has accelerated the adoption of digital healthcare everywhere. In countries hit harder by COVID, for instance, the Philippines, India or Indonesia, the adoption of digital technologies has happened more quickly.
Another trend is the advancement of precision medicine. We are still not entirely there yet for Asia but we are getting closer and closer. Cell and gene therapies are the perfect example of truly individualised therapy, where cells are taken from individual patients, reengineered, and placed back in the same patients.
Technology has been a huge enabler in democratising access to quality healthcare, and the beauty of it, especially for mobile technologies, is that technology is everywhere. It is not a unique feature of developed countries. Patients and consumers in developing countries, for instance, in many parts of Southeast Asia, can also access these technologies.
As one of the global leaders in oncology, what are your portfolio priorities for the APAC region?
Our priorities are very much aligned with Novartis’ global priorities. At the end of the day, our purpose is to reimagine medicine and bring breakthrough therapies to this part of the world to improve and extend the lives of patients.
I believe we are uniquely positioned to bring innovative therapies to this region. We have four advanced therapeutic platforms for cancer therapies, from target therapies, cell and gene therapy, radioligand therapy, and differentiated immunotherapy
We are also working very closely with physicians for clinical trials. We are working with health authorities to speed up regulatory approvals, with reimbursement payers to help patients that need therapies to access them in an affordable manner, and with patient advocacy groups to drive awareness and patient education so that patients feel empowered to manage their diseases in ways that were formerly not possible.
We are committed to building strong partnerships across the healthcare ecosystem, whether they are government agencies, regulators, clinicians, payers, patient advocacy groups and even competitors, so that we can advance our common knowledge of medical practice and to discover new therapies and new innovations for patients.
How well-organised are patient groups in the region?
It varies according to country when it comes to patient groups’ ability to shape policy. But taking a long-term view, patient groups in the region are becoming more and more influential and vocal. They are involved not only in policy discussions but also clinical studies and clinical practice. In that sense, they are becoming more empowered and involved.
Having mentioned clinical trials, one of the hot topics these days is the insufficient ethnic representation in global clinical data. How is Novartis Oncology working on ensuring diversity in its clinical trial operations?
The representation of Asian patients in clinical trials is critical to our clinical development. Over the years, the participation of patients from APAC in global clinical trials has improved significantly, so much so that in some of our most recent clinical trials, APAC was one of the leading regions in terms of patient enrolment. We are advocating strongly with local clinicians and health authorities to ensure fair and adequate representation of Asian patients in our global clinical trials.
In terms of regulatory frameworks, there has not been a lot of regulatory harmonisation in the region. Do you expect more regulatory harmonisation in the future and what role might the Singaporean regulator, the Health Sciences Authority (HSA), play, as one of the most advanced regulators in the region?
APAC is a very diverse region and the healthcare systems and infrastructures are very different from country to country. At the end of the day, they were established to meet local needs, which are very different in each country, so having a one-size-fits-all approach is very difficult. A customised model is very important in order to meet the unique challenges and situation of each market, so establishing partnerships with the local healthcare system and stakeholders are critical.
For instance, our Singaporean office recently hosted our inaugural Digital Health Innovation Forum, where we invited healthtech startup partners, clinicians, academics, government agencies and other stakeholders to foster conversation on digital healthcare and deepen the engagement between all of them.
In terms of the role of HSA, it is definitely one of the leaders in technology and innovation in this region, and a leading health authority. It has been deeply involved in working groups related to regulatory harmonisation efforts to build some sort of consensus amongst the different health agencies. Many governments, not just Singapore’s, want to keep their regulation guidelines up-to-date with the newest innovations and trends. For instance, many governments implemented guidelines to approve COVID-related diagnostic kits, therapeutics and vaccines. HSA also recently issued guidance on cell and gene therapies. They are the leading health authority in the region, pioneering in many areas and adapting to new trends while working actively with peer agencies in the region.
How is Novartis Oncology partnering with government authorities like HSA to advance and support the rollout of precision medicine therapies like cell and gene therapies?
This is an important priority for Novartis. We are the first Big Pharma company to significantly invest in pioneering CAR-T research and clinical trials and we have a lot of ongoing research to broaden its impact. We are exploring the use of CAR-T in different types of cancer too.
Partnering with regulators like the HSA is important for cell and gene therapy because it is not the traditional ‘pill’ approach. As an individualised therapy, the existing regulatory framework is not always suitable so we have to support regulators with more information and expertise. For the region, we can leverage our work with regulatory authorities in other regions, such as the US FDA and the EMA. We also build platforms for HSA to interact with other health authorities. In general, regulators are very eager to learn more about such new therapies and how to facilitate their introduction to this region. We see a fantastic window of opportunities to bring industry and government closer so that patients can receive the benefits of these therapies sooner.
At the end of the day, CAR-T therapies fill an important gap in the current treatment options for patients with cancer. As with any innovation, we want to make sure we deliver value to patients and improve their quality of life in a fast, sustainable and safe manner.
Against the current COVID backdrop, and with healthcare systems under strain, public healthcare priorities have focused a lot on the pandemic. How has this affected normal operations and particularly for oncology companies like Novartis Oncology? Has it been difficult to maintain engagement with stakeholders?
When COVID first hit, the world was forced to shut down and work virtually. It disrupted manufacturing and supply chains globally for many industries, not just healthcare. Border closures also overwhelmed many healthcare facilities, and resources were prioritised to treat COVID patients. Cancer patients were generally hesitant to go to hospitals or clinics due to the fear of contagion. Clinical trials were similarly disrupted.
To address all these issues, Novartis worked very closely with health authorities, clinicians, logistics partners and so on to ensure the continuity of our clinical trials, manufacturing and supply chain operations. In Singapore, for instance, the team had to coordinate with various health authorities to implement home delivery of our clinical trial medicines for patients living abroad to ensure that these patients could continue their clinical trial participation despite border closures.
You are also country president for Novartis in Singapore, the regional hub. What is the significance of Singapore within global operations?
Singapore is a very important strategic market for Novartis. Novartis has the largest number of clinical trials in Singapore out of all the pharma companies present here. The healthcare infrastructure here is extremely efficient and conducive for testing and studying innovative breakthrough therapies.
Novartis has implemented a very significant cultural transformation within the global organisation, with its ‘unbossed’ culture. How have you incorporated it and learnt from it as a leader?
This transformation began about three years ago, with a focus on being ‘unbossed’, ‘curious, and ‘inspired’. It has fundamentally changed how we work as an organisation. We have to be purposeful and inspired to deliver innovative medicines to patients. We have to be curious in order to move forward despite setbacks and challenges.
For me, personally, the questions I asked myself change over time. Initially, I wondered if ‘unbossed’ meant there were no longer any bosses! But it has been a tremendously beneficial journey and I have become a better leader over the past three years. ‘Unbossed’ means we see ourselves as a servant of the team to remove obstacles in their paths, to provide clarity in terms of our strategy, priorities and boundaries. I had to start thinking about the vision for the team, and how to inspire the team. As a result, I definitely think I have become a better person and a better leader within the organisation and for my team.
A final message for our audience regarding the potential and future of Novartis Oncology in APAC?
As a leading healthcare company, we have a tremendous opportunity in APAC. We are focused on developing breakthrough treatments addressing the most pressing healthcare challenges in this region, especially cancer. We want to do that by focusing on having the right medicine for the right patient at the right time, such as precision medicine, which will play an increasingly significant role in addressing healthcare challenges in Asia. In order to achieve this, we have to work closely with partners and stakeholders. We will continue to invest across APAC to improve and extend the lives of patients in the region. For instance, we recently opened Biome in Singapore, the first digital innovation hub in the APAC, Middle East and African region for Novartis. It is a dedicated unit to drive and manage partnerships with digital health startups, innovators and thought leaders to deliver better patient outcomes.