WEBVTT 1 00:00:00.000 --> 00:00:03.417 (rhythmic ambient music) 2 00:00:08.760 --> 00:00:09.900 Hello, everyone. 3 00:00:09.900 --> 00:00:12.030 Thank you for joining us here at the conclusion 4 00:00:12.030 --> 00:00:14.490 of the JP Morgan Healthcare Conference. 5 00:00:14.490 --> 00:00:17.178 We're excited to have with us two great CEOs 6 00:00:17.178 --> 00:00:19.050 in the healthcare industry 7 00:00:19.050 --> 00:00:22.650 and more broadly across the business community with us today 8 00:00:22.650 --> 00:00:25.860 to share their reflections from this week's conference 9 00:00:25.860 --> 00:00:28.440 and their perspectives for the year ahead. 10 00:00:28.440 --> 00:00:31.170 So now let's get to introducing our guests. 11 00:00:31.170 --> 00:00:35.220 Tom Polen from BD and Dave Ricks from Eli Lilly. 12 00:00:35.220 --> 00:00:37.560 First, I'm honored to introduce Tom Polen, 13 00:00:37.560 --> 00:00:40.350 the chairman and CEO and president of BD. 14 00:00:40.350 --> 00:00:43.410 The $19 billion global MedTech company. 15 00:00:43.410 --> 00:00:45.300 It's my pleasure to introduce Dave. 16 00:00:45.300 --> 00:00:48.900 Dave is a Eli Lilly veteran of more than 25 years. 17 00:00:48.900 --> 00:00:50.970 Dave became CEO and chair of the 18 00:00:50.970 --> 00:00:54.570 company's board of directors in 2017. 19 00:00:54.570 --> 00:00:55.860 After he joined Lilly 20 00:00:55.860 --> 00:00:59.460 as a business development associate 25 years ago, 21 00:00:59.460 --> 00:01:02.035 he has had various international leadership positions 22 00:01:02.035 --> 00:01:05.798 across the world in Canada, China, and the US. 23 00:01:05.798 --> 00:01:09.300 (upbeat bright music) 24 00:01:09.300 --> 00:01:12.810 The talk of JPM was GLP-1s, right? 25 00:01:12.810 --> 00:01:15.150 And we know in addition to their ability 26 00:01:15.150 --> 00:01:16.710 to manage diabetes, obesity, 27 00:01:16.710 --> 00:01:19.050 they've also been shown to help heart disease 28 00:01:19.050 --> 00:01:21.029 and they're being tested for a wide range 29 00:01:21.029 --> 00:01:23.940 of cardiometabolic conditions. 30 00:01:23.940 --> 00:01:26.228 How should the healthcare system, the providers, 31 00:01:26.228 --> 00:01:29.154 the insurers, patients, physicians, 32 00:01:29.154 --> 00:01:33.270 how should they think about this class of drugs? 33 00:01:33.270 --> 00:01:36.480 What we call is incretin super family GLP-1s, 34 00:01:36.480 --> 00:01:38.850 it's been going on for a while. 35 00:01:38.850 --> 00:01:42.060 But we have moved to this 36 00:01:42.060 --> 00:01:45.300 kind of hyperbolic inflection point, 37 00:01:45.300 --> 00:01:47.670 I think, for three reasons that make this super unique. 38 00:01:47.670 --> 00:01:52.500 One, excess body weight, which we know 39 00:01:52.500 --> 00:01:54.630 because for almost all adult diseases, 40 00:01:54.630 --> 00:01:57.600 the first line of therapy is, 41 00:01:57.600 --> 00:01:59.520 oh yeah, lose some weight. 42 00:01:59.520 --> 00:02:02.400 Whether it be lot of cardiovascular conditions, 43 00:02:02.400 --> 00:02:07.400 even autoimmune conditions, reproductive problems. 44 00:02:07.742 --> 00:02:12.719 What we hadn't known until really the last couple years 45 00:02:12.719 --> 00:02:14.160 was a couple things. 46 00:02:14.160 --> 00:02:17.130 One, we could augment weight successfully 47 00:02:17.130 --> 00:02:19.500 and safely at pretty big scale. 48 00:02:19.500 --> 00:02:20.700 Weight loss is weight loss 49 00:02:20.700 --> 00:02:22.800 and all these conditions can improve 50 00:02:22.800 --> 00:02:25.620 if people get into a healthy body weight. 51 00:02:25.620 --> 00:02:27.750 So the impact across the healthcare system 52 00:02:27.750 --> 00:02:30.660 direct offsets and improve quality of life, 53 00:02:30.660 --> 00:02:35.112 and maybe length of life seem possible now. 54 00:02:35.112 --> 00:02:37.182 So in addition to the effectiveness 55 00:02:37.182 --> 00:02:38.818 and safety of the drugs, in addition 56 00:02:38.818 --> 00:02:43.280 to the translation to real, hard health benefits, 57 00:02:43.280 --> 00:02:47.503 you have this consumer poll we probably haven't seen 58 00:02:47.503 --> 00:02:51.390 in a drug class that has this kind of impact. 59 00:02:51.390 --> 00:02:53.370 So big opportunity ahead. 60 00:02:53.370 --> 00:02:55.800 I think we can safely say we will have, 61 00:02:55.800 --> 00:02:59.100 if we can ramp up and use these rationally, 62 00:02:59.100 --> 00:03:00.270 if we can get reimbursement 63 00:03:00.270 --> 00:03:02.400 so there's not the massive health equity problem 64 00:03:02.400 --> 00:03:05.151 that's presenting itself right now, 65 00:03:05.151 --> 00:03:07.193 we could probably change the life expectancy 66 00:03:07.193 --> 00:03:09.420 of Western nations. 67 00:03:09.420 --> 00:03:11.430 So Tom, maybe I should ask you, 68 00:03:11.430 --> 00:03:13.890 obviously you play in this ecosystem too. 69 00:03:13.890 --> 00:03:16.011 What role do you play in the GLP ecosystem? 70 00:03:16.011 --> 00:03:19.980 How is BD making it simpler and safer for patients 71 00:03:19.980 --> 00:03:22.260 and providers to administer these GLP-1s? 72 00:03:22.260 --> 00:03:26.160 Inside every auto-injector is a prefilled syringe 73 00:03:26.160 --> 00:03:28.530 with a pre-attached needle that contains the drug. 74 00:03:28.530 --> 00:03:30.660 And so, we invented that category. 75 00:03:30.660 --> 00:03:33.000 We're investing 1.2 billion 76 00:03:33.000 --> 00:03:35.940 in capacity expansion right now to support growth 77 00:03:35.940 --> 00:03:40.230 of this category and other new biologics and vaccines. 78 00:03:40.230 --> 00:03:42.030 One of the things that I hear most, 79 00:03:42.030 --> 00:03:44.400 and I think it's going to be a ripple effect 80 00:03:44.400 --> 00:03:47.250 of what's happening now in GLP-1s, 81 00:03:47.250 --> 00:03:49.410 and just a huge transformational effect 82 00:03:49.410 --> 00:03:52.770 that it's going to have in chronic disease overall. 83 00:03:52.770 --> 00:03:54.240 So many folks that I talked to 84 00:03:54.240 --> 00:03:57.017 and they started taking GLP-1s, they'll say, 85 00:03:57.017 --> 00:03:58.800 "I was really surprised. 86 00:03:58.800 --> 00:04:00.930 It didn't bleed, it didn't hurt. 87 00:04:00.930 --> 00:04:04.200 It was much easier process to do these injections 88 00:04:04.200 --> 00:04:05.820 than I thought it was going to be." 89 00:04:05.820 --> 00:04:07.260 Our strong belief is that GLP-1s 90 00:04:07.260 --> 00:04:09.165 are going to bring that experience to a scale 91 00:04:09.165 --> 00:04:11.040 that's never been had before. 92 00:04:11.040 --> 00:04:13.710 And this is going to continue to enable broad acceptance 93 00:04:13.710 --> 00:04:16.902 of other biologics that are also coming down the pipeline. 94 00:04:16.902 --> 00:04:20.100 (bright upbeat music) 95 00:04:20.100 --> 00:04:21.810 Tom, you see M&A right now. 96 00:04:21.810 --> 00:04:24.960 And how do you see it specific to the MedTech industry 97 00:04:24.960 --> 00:04:27.720 versus the mood a year or two ago? 98 00:04:27.720 --> 00:04:30.690 Balance sheets are much stronger now post-COVID. 99 00:04:30.690 --> 00:04:33.270 People have cash, they're very active. 100 00:04:33.270 --> 00:04:35.520 There's been a lot of spinouts in MedTech 101 00:04:35.520 --> 00:04:36.930 over the last several years. 102 00:04:36.930 --> 00:04:39.549 You're seeing greater appetite for the add-ins 103 00:04:39.549 --> 00:04:42.030 in the portfolio that are getting people, again, 104 00:04:42.030 --> 00:04:43.950 back in those core markets that they want to be into 105 00:04:43.950 --> 00:04:46.230 with higher growth-adjacent spaces. 106 00:04:46.230 --> 00:04:47.677 We've done about 19 acquisitions 107 00:04:47.677 --> 00:04:50.763 over the last three or four years, 108 00:04:51.690 --> 00:04:54.531 and our last one was our largest of those, 109 00:04:54.531 --> 00:04:57.360 which was in the pharmaceutical automation space, 110 00:04:57.360 --> 00:04:58.830 and put us as the world's leader 111 00:04:58.830 --> 00:05:01.350 in pharmacy, robotics, and automation now 112 00:05:01.350 --> 00:05:03.300 with about a $700 million business. 113 00:05:03.300 --> 00:05:05.640 Growing nice teams in that category. 114 00:05:05.640 --> 00:05:07.890 Most importantly of all is this is being spurred 115 00:05:07.890 --> 00:05:10.320 by what is unprecedented innovation 116 00:05:10.320 --> 00:05:12.060 that's happening within the MedTech sector. 117 00:05:12.060 --> 00:05:14.733 We're looking at broad healthcare process efficiency. 118 00:05:16.050 --> 00:05:18.660 No pharmacists should be counting pills anymore, right? 119 00:05:18.660 --> 00:05:20.820 That's all being done by robots now. 120 00:05:20.820 --> 00:05:23.040 And there's shortages of pharmacists, 121 00:05:23.040 --> 00:05:25.380 all of that is transforming now. 122 00:05:25.380 --> 00:05:27.150 It's fueling growth in the space. 123 00:05:27.150 --> 00:05:30.270 There's true technology shifts that are happening right now 124 00:05:30.270 --> 00:05:33.270 and enabled by some really exciting science 125 00:05:33.270 --> 00:05:35.160 on the AI side, on the automation side, 126 00:05:35.160 --> 00:05:38.050 on the biomaterials side that 127 00:05:39.360 --> 00:05:40.680 create tremendous opportunities, 128 00:05:40.680 --> 00:05:41.850 make a difference for patients, 129 00:05:41.850 --> 00:05:45.227 and drive new value creation in the industry. 130 00:05:45.227 --> 00:05:48.109 (gentle upbeat music) 131 00:05:48.109 --> 00:05:50.790 Dave, you are active in the industry-wide dialogue 132 00:05:50.790 --> 00:05:53.640 on how the US healthcare sector 133 00:05:53.640 --> 00:05:55.620 needs to evolve more broadly, 134 00:05:55.620 --> 00:05:57.600 both to deliver cost effectiveness 135 00:05:57.600 --> 00:05:59.850 and to deliver good patient outcomes. 136 00:05:59.850 --> 00:06:02.460 How do you see that happening? 137 00:06:02.460 --> 00:06:04.920 And are there transformative changes coming along? 138 00:06:04.920 --> 00:06:08.087 And how do we get to both an affordable system 139 00:06:08.087 --> 00:06:11.040 and one that is delivering health outcomes 140 00:06:11.040 --> 00:06:12.840 for our whole population? 141 00:06:12.840 --> 00:06:17.790 For the last 20 years, I think the policy debate 142 00:06:17.790 --> 00:06:20.760 mostly has been about expanding insurance coverage 143 00:06:20.760 --> 00:06:22.050 in the United States. 144 00:06:22.050 --> 00:06:25.260 I don't think that's the main objective anymore. 145 00:06:25.260 --> 00:06:27.268 I think what we need to do is focus 146 00:06:27.268 --> 00:06:29.820 on three other objectives 147 00:06:29.820 --> 00:06:31.830 in terms of how we're delivering healthcare. 148 00:06:31.830 --> 00:06:34.025 You touched on one point, which is 149 00:06:34.025 --> 00:06:37.170 what I'd say is system-level quality. 150 00:06:37.170 --> 00:06:41.430 Another way to think about that is similar outcomes 151 00:06:41.430 --> 00:06:44.940 independent of where you live and what your insurance is. 152 00:06:44.940 --> 00:06:46.530 And that's a health equity issue. 153 00:06:46.530 --> 00:06:48.360 That's what healthcare should want to do. 154 00:06:48.360 --> 00:06:51.060 And we're a really long way from that objective. 155 00:06:51.060 --> 00:06:54.120 Probably the most glaring examples were during COVID 156 00:06:54.120 --> 00:06:56.010 where you can look at mortality rates 157 00:06:56.010 --> 00:06:59.430 by zip code and by insurance type. 158 00:06:59.430 --> 00:07:02.185 The second big problem, it's affordability 159 00:07:02.185 --> 00:07:06.270 in developed markets of the benefit we already have. 160 00:07:06.270 --> 00:07:10.890 The demography of developed markets is changing really fast. 161 00:07:10.890 --> 00:07:14.903 The ratio of taxpayers to beneficiaries is shifting fast 162 00:07:14.903 --> 00:07:19.830 and no one has this math figured out. 163 00:07:19.830 --> 00:07:22.050 So that's got to change 164 00:07:22.050 --> 00:07:24.640 and that's fundamentally a cost issue 165 00:07:25.710 --> 00:07:28.800 because particularly in the US 166 00:07:28.800 --> 00:07:31.128 if we look at the cost of care, 167 00:07:31.128 --> 00:07:36.128 we know the highest in OECD per patient, 168 00:07:36.390 --> 00:07:38.070 the outcomes aren't really different. 169 00:07:38.070 --> 00:07:40.922 The outcomes at the high end of care are different, 170 00:07:40.922 --> 00:07:43.500 but the outcomes at the low end are much worse. 171 00:07:43.500 --> 00:07:45.840 We can work on affordability during the patent life, 172 00:07:45.840 --> 00:07:47.899 but it's probably the one thing 173 00:07:47.899 --> 00:07:49.530 that actually does get cheaper. 174 00:07:49.530 --> 00:07:51.120 Everything else is inflating. 175 00:07:51.120 --> 00:07:53.880 XUS, I would say it's more of a ratio problem. 176 00:07:53.880 --> 00:07:55.500 We have a ratio problem in the US too, 177 00:07:55.500 --> 00:07:57.060 but it's much less pronounced, 178 00:07:57.060 --> 00:07:59.400 which is the vast majority of healthcare costs 179 00:07:59.400 --> 00:08:01.440 are labor and CapEx. 180 00:08:01.440 --> 00:08:06.180 And labor and CapEx inflate and they inflate without an end. 181 00:08:06.180 --> 00:08:09.930 And right now, inflation in developed worlds 182 00:08:09.930 --> 00:08:12.813 for labor and CapEx is mid single digits. 183 00:08:13.680 --> 00:08:15.390 That was OK when the rest of the economy 184 00:08:15.390 --> 00:08:17.160 was doing that in the last few years, 185 00:08:17.160 --> 00:08:19.167 but it's not going to be OK in the long term. 186 00:08:19.167 --> 00:08:20.880 It's totally unaffordable. 187 00:08:20.880 --> 00:08:24.180 So we have to reduce labor. That's an AI opportunity. 188 00:08:24.180 --> 00:08:25.770 And we have to reduce CapEx. 189 00:08:25.770 --> 00:08:27.660 That's a drug treatment opportunity. 190 00:08:27.660 --> 00:08:29.601 I think Tom mentioned actually several good examples 191 00:08:29.601 --> 00:08:32.501 of how we can take people out of infusion chairs 192 00:08:32.501 --> 00:08:34.683 and have them sit in their living room. 193 00:08:35.670 --> 00:08:37.530 So that's all got to happen. 194 00:08:37.530 --> 00:08:41.250 I think actually this is one of the defining political 195 00:08:41.250 --> 00:08:43.050 and policy issues, not just in healthcare, 196 00:08:43.050 --> 00:08:46.410 but at the economic level 197 00:08:46.410 --> 00:08:48.840 in the developed world over the next 10 years. 198 00:08:48.840 --> 00:08:52.200 It's a combination of available technology, 199 00:08:52.200 --> 00:08:57.200 business models, and regulatory support for this, 200 00:08:57.630 --> 00:08:58.950 of which none of, 201 00:08:58.950 --> 00:09:02.700 I'd say, we're probably moving ahead on technology 202 00:09:02.700 --> 00:09:06.640 faster than we're moving ahead on really nailing out 203 00:09:07.710 --> 00:09:09.720 how it's going to work in practice. 204 00:09:09.720 --> 00:09:14.070 And the regulators are moving forward to catch up as well. 205 00:09:14.070 --> 00:09:16.710 There's a huge dialogue over the last several years 206 00:09:16.710 --> 00:09:18.150 around hospital at home. 207 00:09:18.150 --> 00:09:20.373 Everyone's talking about, again, how do you reduce 208 00:09:20.373 --> 00:09:23.850 that big CapEx burden that happens in the hospital? 209 00:09:23.850 --> 00:09:25.980 There's a lot of of piloting going on right now, 210 00:09:25.980 --> 00:09:28.950 but we've got to continue to get other elements 211 00:09:28.950 --> 00:09:32.100 of the system aligned to really bring the force 212 00:09:32.100 --> 00:09:34.872 to impact both equity and costs. 213 00:09:34.872 --> 00:09:38.370 (gentle upbeat music) 214 00:09:38.370 --> 00:09:40.590 GenAI has just been such a theme 215 00:09:40.590 --> 00:09:43.110 on so many discussions I've been a part of in the last, 216 00:09:43.110 --> 00:09:44.730 it goes across sectors. 217 00:09:44.730 --> 00:09:46.770 How are you seeing it for your businesses? 218 00:09:46.770 --> 00:09:50.733 AI has such a transformational potential. 219 00:09:51.870 --> 00:09:54.240 You have to be in AI or you will fall behind. 220 00:09:54.240 --> 00:09:55.230 At the same time, 221 00:09:55.230 --> 00:09:57.630 we are focused on both the efficiency of AI 222 00:09:57.630 --> 00:09:58.890 internally within the company, 223 00:09:58.890 --> 00:10:01.140 as well as the benefits that can have to clinicians. 224 00:10:01.140 --> 00:10:04.449 We've got about 15 different pilots going on in the company 225 00:10:04.449 --> 00:10:06.120 focused on efficiency. 226 00:10:06.120 --> 00:10:07.620 We see tremendous opportunities 227 00:10:07.620 --> 00:10:10.094 to automate many basic processes again, 228 00:10:10.094 --> 00:10:12.870 so that we can double down on solving 229 00:10:12.870 --> 00:10:15.270 the big challenges in healthcare and improving outcomes. 230 00:10:15.270 --> 00:10:16.290 On the innovation side, 231 00:10:16.290 --> 00:10:20.310 we've got a couple 510K FDA cleared AI applications. 232 00:10:20.310 --> 00:10:23.760 So we have software that helps pharmacists compound drugs, 233 00:10:23.760 --> 00:10:25.492 manage all the inventory in the pharmacy, 234 00:10:25.492 --> 00:10:28.560 then deploy the drugs up onto the floor in our Pyxis systems 235 00:10:28.560 --> 00:10:31.230 and then our Alaris system infusing them the patients. 236 00:10:31.230 --> 00:10:33.870 I think every one of our businesses has AI 237 00:10:33.870 --> 00:10:38.100 as part of their, of active products in pipeline. 238 00:10:38.100 --> 00:10:41.013 And you're seeing that across the MedTech world. 239 00:10:42.210 --> 00:10:45.210 Translation and conversion of technical information 240 00:10:45.210 --> 00:10:49.860 into words humans can read is something it's good at 241 00:10:49.860 --> 00:10:51.900 and people get bored with. 242 00:10:51.900 --> 00:10:53.850 So it's a big productivity game, 243 00:10:53.850 --> 00:10:57.153 but also allows us to just deploy people on better problems. 244 00:10:59.130 --> 00:11:02.310 Probably the other big generative opportunity 245 00:11:02.310 --> 00:11:04.470 relates to drug discovery. 246 00:11:04.470 --> 00:11:09.360 So here we're talking about machines 247 00:11:09.360 --> 00:11:11.880 looking at the chemical space. 248 00:11:11.880 --> 00:11:14.488 Chemical space is vast and the machines are good 249 00:11:14.488 --> 00:11:17.430 at coming up with interesting new starting points. 250 00:11:17.430 --> 00:11:19.924 For the IP-generating activity, 251 00:11:19.924 --> 00:11:22.860 I mean, every drug company has to be all over this, 252 00:11:22.860 --> 00:11:24.450 but probably the quick win 253 00:11:24.450 --> 00:11:26.700 is more the industry-specific applications 254 00:11:26.700 --> 00:11:29.477 like clinical trial optimization. 255 00:11:29.477 --> 00:11:32.850 (gentle ambient music) 256 00:11:32.850 --> 00:11:35.190 Probably next year we'll reach global parody 257 00:11:35.190 --> 00:11:37.443 at all management levels of women and men. 258 00:11:38.430 --> 00:11:39.780 We've made huge progress 259 00:11:39.780 --> 00:11:41.490 in African-American promotion rates. 260 00:11:41.490 --> 00:11:44.121 It's probably not a coincidence that we've become 261 00:11:44.121 --> 00:11:47.850 a lot more diverse and inclusive in the last decade. 262 00:11:47.850 --> 00:11:51.090 We've also 10Xed our market cap. 263 00:11:51.090 --> 00:11:53.040 We've just gotten to make sure 264 00:11:53.040 --> 00:11:54.630 that we have an equitable culture, 265 00:11:54.630 --> 00:11:56.940 which we're really proud and it's been a long journey. 266 00:11:56.940 --> 00:11:59.542 That the more diversity and inclusion 267 00:11:59.542 --> 00:12:01.350 that we've got in the organization, 268 00:12:01.350 --> 00:12:03.240 the more that we've seen it 269 00:12:03.240 --> 00:12:05.940 really show up in new innovations and opportunities. 270 00:12:05.940 --> 00:12:07.320 And that's been a part of our fuel 271 00:12:07.320 --> 00:12:09.123 of our higher growth rates that we've seen in the company 272 00:12:09.123 --> 00:12:10.530 over the last few years. 273 00:12:10.530 --> 00:12:12.570 What a wonderful way to end this discussion. 274 00:12:12.570 --> 00:12:14.460 Thank you both so much for joining. 275 00:12:14.460 --> 00:12:17.250 From the very beginning where we talked about innovation 276 00:12:17.250 --> 00:12:18.840 to the end where I think 277 00:12:18.840 --> 00:12:21.514 both of your passionate explanations 278 00:12:21.514 --> 00:12:25.530 of why taking on issues of inclusion and diversity 279 00:12:25.530 --> 00:12:28.533 gets to better outcomes, gets to better innovation. 280 00:12:29.699 --> 00:12:32.670 I think it's been really a very powerful 281 00:12:32.670 --> 00:12:34.416 and interesting discussions. 282 00:12:34.416 --> 00:12:37.583 (gentle upbeat music)