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Digital (health) can create new options for helping patients get better therapy, and helping doctors take care of their patients better: Dr Michael Devoy

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On the sidelines of Bayer’s virtual Pharma Media Day, Dr Michael Devoy, Executive Vice President, Medical Affairs and Pharmacovigilance, Bayer Pharmaceuticals had a freewheeling conversation with Viveka Roychowdhury on the company’s recent collaboration with CureVac for a COVID-19 vaccine, and how digital health fits into its business strategy, along with investments and partnerships in relatively new age health solutions like cell and gene therapy, which are very different from the chemistry-based expertise that the 150-year plus group is traditionally known for. Excerpts from the conversation …

On the recent deal Bayer has signed with CureVac, could you explain from a R&D and medical science perspective what is Bayer’s role? Bayer is also doing a lot in digital health. How do these new modalities- digital health, AI – play into making healthcare systems more sustainable in the mid and long term? This is the conversation going on in India – how do we rebuild our healthcare systems so they are more sustainable, going beyond COVID-19 as well.

Sustainability has come to the forefront. It was important before, but COVID-19 has brought this question more urgently into focus. We need to consider how we take our healthcare systems forward in the future and how we make them more sustainable and patient-centric.

We are also very pleased about our collaboration with CureVac. As we entered the pandemic, as a company, we adopted three guiding principles to guide us through these difficult times. First, to protect our employees- Bayer made sure to do the most we could in terms of ensuring a home office for those who could work from home. Even in regards to our employees with jobs on-site such as in R&D, we put safety procedures in place.

Second, we provide life-saving, critical products and we ensured the continuity of supply in this case, especially in the early days in particular, across healthcare and agriculture. We’re proud to say we kept up production across all our areas of business.

Third, helping fight the pandemic which we did in a number of ways- such as at a community level, ensuring resources such as financial resources- we moved quickly and accelerated procedures for donations so we could respond quickly. We looked into our own portfolio to see if any of our drugs or products could help with the pandemic either in our research pipeline or in markets, for instance like Xarelto, with thrombosis being one of the critical complications coming from the virus. We have a number of studies and collaborations on this.

Bayer doesn’t have a history or heritage in the vaccine area, but we were approached and agreed to support CureVac, a German-based biotech company and one of the early pioneers in the area of mRNA technology. This technology has proven to be very effective for developing vaccines for COVID-19already- the first two approved vaccines (in US and Europe) use this mRNA technology. CureVac has a vaccine similarly based on mRNA, and they started the last phase study in December. Bayer has agreed to support in terms of clinical operations of studies, the country footprint Bayer has around the world, along with regulatory activities, pharmacovigilance and safety, logistics along with other topics and operations. In other words, Bayer, as a company with extensive experience bringing products to the market is working with a company that has an important technology to collectively bring another vaccine through.

The only way out of the pandemic is to achieve a high level of immunisation as a society, and we need as many options as possible. The bigger picture is that this is a part of Bayer’s overall commitment to play a role in society to help fight this pandemic.

In terms of digital health solutions, how does that play into the whole business strategy of Bayer as a company?

We look at digital as something which can have an important impact across our entire value chain, and as something that can help us do our research better, identify targets faster, and speed up development studies. We have been more active in having clinical trials using models where data is being collected by patients and transmitted via devices such that we deliver drugs straight to their door, and therefore reduce the amount of travel time for patients to and from hospitals, which is helpful at this time.

We also see how digital can create new options for helping patients get better therapy, and helping doctors take care of their patients better. Bayer last year established a formal collaboration with One Drop. The founder is a diabetic himself, and was looking for how he could benefit from and take care of his diabetes. That resulted in a digital solution to help diabetes patients manage their condition, with data collection undertaken about disease control and lifestyle and treatment, and how these come together.

We partnered with One Drop because we believe that such an approach has the ability to be replicated for other chronic diseases where you have to continuously take care of the disease and your lifestyle, treatment and advice from the doctor. The more you can monitor these factors, the better your outcomes can be.

With chronic diseases such as diabetes and kidney disease, they create a tremendous burden on the healthcare systems in every way, in terms of hospital time and treatments. By helping reduce that burden and helping patients, this will help ensure greater sustainability.

Adjunct to another part of the business as well as our core pharmaceutical therapeutic research, in the future Bayer will support developing these options and make these available for patients and physicians to use.

Today, for instance they might prescribe an anti-diabetic drug, but then in the future along with it, they will also prescribe an anti-diabetic digital solution to help you take care of yourself and ensure better outcomes.

One of the techniques that will support this is the use of Artificial Intelligence (AI), which will help one look at the data provided and guide patients to make better decisions around their health, such as with their drugs, diet, exercise and lifestyle. Well-designed digital solutions will make these things work better, more easily, and in a more integrated fashion.

What is the timeline on the release of any solutions on this front?

We are very actively working on this and have been for some time. The One Drop diabetes tool is available already and is up and running. We would hope through the next few months and certainly within the next year or so, we will have started to develop some solutions which work with their platform, but also take care of other disease areas.

This is a clear priority for us and one of our executives has a direct responsibility for it, since digital health solutions are a separate focus area outside of our drug and therapeutics focus areas. That’s also one of the reasons it was a topic of focus during our Bayer Pharma Media Day presentations. It is a key area of activity where we see innovation and value addition.

And what about cell and gene therapy? How does that fit into your traditional portfolio of medicines?

Bayer has been in existence as a company for over 150 years globally and 120 years in India. Our expertise and history lend to us being a very strong company using chemistry to make molecules to treat diseases, which we believe remains an important skillset going forward. For instance, with the product Finerenone, a drug for diabetes disease, and with new products through the acquisition of KaNDy Therapeutics which is set to start phase III development.

We are not forsaking the importance of the traditional area. But, we also believe that innovation drives value and better treatments, and we see cell and gene therapy as an exciting area of scientific development and innovation and as a science-led company, we want to retain a presence here.

We have taken clear steps in that direction, such as with the acquisition of BlueRock Therapeutics and Ask Bio, along with other companies. We want to participate in this direction and bring such solutions to society, and that is why we have focused on building partnerships and made investments in cell and gene therapy.

It’s going to be a critical part of the future of healthcare, not only for single gene diseases but also for more complex, multi-genetic diseases as well.

On the cell therapy side, BlueRock just announced that they will, for the first time, study stem-cell derived dopaminergic neurons in patients with Parkinson’s- essentially offering cell replacement treatment for severe Parkinson’s disease. With their Investigational New Drug Application approved by the US FDA, they will be ready to start very soon and will be able to start treating those patients.

 A lot of these diseases are going to finally culminate in the ageing process. How is Bayer set to engage and prepare the consumer or patient in the decade of ‘healthy ageing’?

I’ve been one of the people from Bayer actively involved in discussions on healthy ageing. Bayer has an active collaboration with the Global Coalition of Ageing, which came additionally because of our work related to age-related macular degeneration.

As populations age, what that does to disease but also in terms of the societal impacts of ageing are factors we keep in mind when we are working on this. There are diseases that are more common as we grow older, such as cancer. This is also the case for heart disease and diabetes.

This is one of the key themes that underpin our strategic thinking, taking into account what’s happening with ageing. We aim to increase the healthy lifestyle of people- the time you can spend living healthy, without the burden of chronic disease or having to spend a lot of time in hospitals or with doctors.

We are very passionate about it, and will participate in this conversation governments and stakeholders looking to make society better for the ageing population, which is impacting virtually every society in the world. India is probably one of the younger societies in terms of demographics, but ageing is impacting people everywhere.

India currently does not have a social fabric or a healthcare system that protects everyone. We have taken the first steps towards universal healthcare in terms of having Ayushman Bharat, which is being expanded. But there is a middle portion that remains uncovered, even as the top of the pyramid takes care of itself. Insurance penetration is still quite low. Coming back to the issue of sustainability- what are your views on that? How can these solutions go from the lab to patients’ bedsides in a more sustainable manner? What are Bayer and other pharma companies doing on that front?

This is a critical topic for our society. In 2019, I had the privilege to attend a conference on ageing in Finland, supported by the Finnish Central Bank. Finland has one of the most rapidly ageing populations. There were healthcare companies, technology companies as well as stakeholders from other parts of civil society deliberating on what this means.

Coming back to digital health, that is going to be critical. If we take advantage of it and deploy it well, it will be a tool to keep people healthy longer and ensure lesser suffering from complications. Diabetes, for instance, is unfortunately common in India and the more we can do to help people with regards to the preventive aspects of that, the more it can keep them away from complications. There are significant implications for sustainability.

In the Q&A at the Bayer Pharma Media Day Event, we had a very interesting discussion around this topic on how digital can support this journey and eventually become a preventive tool, helping people avoid getting chronic diseases and delaying complications, simplifying care and allowing medical systems to focus on the most severe cases. Digital health can thus be sustainable in that sense and help reduce the volume of burden that comes in.

There are many societal aspects too, including how we take care of people as they age. In Europe, young people often have trouble accessing housing or residency, and older people need care and social interaction; so you have interesting models where they can live together and they can have mutual benefits, as well as for society. It is one of the most pressing issues for governments and societies and Bayer and pharma companies are proud to have been at the forefront of this trend, by helping find solutions. The area is very important and interesting, and the topic goes well beyond pharmaceuticals or health, touching upon every aspect of how we live.

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