Otsuka: Keeping an Open Mind

Embrace technology and collaborate with reputable partners to deliver truly patient-centric solutions, says Otsuka USA President, Kabir Nath



Otsuka may not be the world’s biggest pharmaceutical company but it certainly has some big ideas. In recent years, it has grabbed headlines with moves to tackle two important challenges facing pharma – improving patient adherence and gleaning insights from electronic medical records – in collaboration with Proteus Digital Health and IBM Watson.

In fact, when it comes to innovative solutions, there are few ideas the company wouldn’t consider, says Kabir Nath, President, Otsuka America, Inc. North American Pharmaceutical Business. “We will not rule anything out until we have examined and tested it,” he says. “One of the pleasures of working at Otsuka is that we have an incredibly long-term philosophy that is focused on contributing to people’s health – and we define that very broadly through the core pharmaceutical business as well as nutraceuticals, devices and other healthcare businesses. Nothing is ruled out, but it has to be measured on its own merits.”

Part of this drive towards innovative ‘beyond the pill’ solutions lies in the very nature of the therapeutic areas to which Otsuka is committed. “I am a big proponent of value-based care and the conversations people are having about paying for outcomes,” says Nath. “In principle, the idea that we tie what we do more closely to the actual outcome makes a lot of sense, and we can do it for targeted medicines.

“However, one of the unfortunate facts about neuroscience is that, in general, we don’t know which drugs will work for which people, and, quite frankly, we have limited prospects of solving that riddle any time soon based on our current knowledge of  the biology. Hence, our current focus, for instance, on symptoms in Alzheimer’s disease rather than disease modification, where we have two separate phase III programs in agitation. Based on our experience and understanding of psychiatric diseases, we have a better chance for some measure of success with that approach.”

Partnering for holistic solutions

For Nath – and Otsuka – the future for pharma is accepting that we cannot do everything alone. “Many people are talking about holistic solutions and a very important part of this is how we partner with other players in the system to deliver medicines appropriately as part of broader solutions. For example, Otsuka’s interest in digital medicine led us into an alliance with Proteus Digital Health for the ‘chip in a pill’. This is a very interesting experiment – firstly to demonstrate that we can actually measure adherence accurately and, beyond that, to see how we can deliver useful information to patients, caregivers, physicians and payers, in fact, all the people who contribute to improving patient outcomes at an individual level.”

Otsuka’s list of collaborators is a long one. “We are very open to collaboration and innovative thinking; we work with companies and consortia, and we do a lot of work with academia, including projects with Princeton and Harvard, as well as many leading universities and institutes in Japan. We seek the brightest and best talent to help us think about the challenges and develop solutions. We also have many cross-functional and cross-industry committees; for example, we are part of the General Council on Alzheimer’s disease, a consortium of caregivers, HCPs, KOLs and financial institutions that is helping to figure out how to better navigate the Alzheimer’s journey,” he says.

Trust is key

Deep knowledge of the patient experience is essential, says Nath. “What I always return to is, how do we ensure a superior outcome at the patient level? That requires a deep understanding of how an individual patient with a mental health illness or Alzheimer’s disease moves through the system and what the intervention points are that can help make the treatment or therapy more effective. That’s why the Proteus collaboration is so exciting because integrating real adherence data, readings from wearables around sleep and rest activity, etc, and potentially other sources of patient-derived information may lead us to algorithms that can, at least partially, predict a schizophrenic or manic episode, for instance. Our work in behavioral health solutions is also important at a population level, helping payers to predict how patients move through the healthcare system and what outcomes they can expect. These are areas that are going to be really important.”  

Nath points to the possibility that they may soon launch the first drugs to treat agitation and aggression in Alzheimer’s disease, depending on research outcomes and regulatory approval. “This behavior has a huge impact on the lives of both the patient and caregiver. Through research, we know that aggression is one of the leading causes of institutionalization of patients with dementia, so we have to collaborate with advocacy groups, physicians and long-term care to improve outcomes for patients by treating aggression in a non-sedating way.”

Alliances and collaborations can also bolster pharma’s image among patients and the public, he says. “As an industry, for whatever reason, we have forfeited trust, and the idea that we can rebuild trust on our own is frankly unrealistic, and would be extraordinarily hard. As we’ve seen more than ever over the past few months, a lot of the information available to patients is fake or misleading, which in healthcare is downright dangerous. In theory, at least, industry websites are accurate and unbiased, but nobody believes them. Branded websites at the product or company level are not the places people primarily go to for information, so we have to establish trust through the collaborations. I really cannot see any other way for us to do it.”


Kabir Nath will be speaking at the upcoming Philadelphia Summit, 20-21 April, 2017


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