Pharma’s Nutritional Value
Nestlé Health Science CEO, Greg Behar on why nutrition could be good for pharma’s health
With previous senior management roles at both Novartis and Boehringer Ingelheim, Greg Behar is a pharma man – or he was. In 2014, he became CEO of Nestlé Health Science, a company whose mission is to place nutrition into a key role in the management of people’s health.
While Nestlé itself is best-known as a manufacturer of confectionary, Nestlé Health Science occupies the space between nutrition and pharma – science-based, personalized nutritional therapies. Behar, who will be speaking at eyeforpharma Barcelona 2017, says the company offers great opportunities to develop “amazing breakthrough approaches to treatment”.
“The first thing I explain to former colleagues is that, in pharma, working on a first-in-class product is perhaps a once-in-a-lifetime opportunity,” he says. “But more than 75% of our pipeline portfolio at Nestlé is first-in-class.”
A new health frontier
The microbiome space alone is one of the most exciting health developments since biologics, he says, offering the potential to change the management of a wide range of health conditions.
Right now, it’s not a priority for pharma. They see this more as a complicating factor in their development path, but as we start to show more success, there will be more people coming in.
Yet, given pharma’s increasing chatter around patient centricity, it is surprising that pharma is not currently beating down Nestlé Health Science’s door for partnership and collaboration opportunities.
“Right now, it’s not a priority for pharma,” he says. “They see this more as a complicating factor in their development path, but as we start to show more success, there will be more people coming in.”
Behar does see openness to collaborate but it comes from biotech, as demonstrated by the company’s investment in US-based Axcella Health and its pipeline of oral and nutritional therapeutics that target imbalances in amino acid profiles. These have underlying roles in neurological, muscle and liver disorders.
Nestlé has also signed an agreement with Seres Therapeutics around its novel class of microbiome therapeutics, Ecobiotics, which could lead to the first worldwide launch of a microbiome therapy. Currently in phase II, SER-109 targets multiple-recurrent Clostridium difficile, while another C. diff and two inflammatory bowel disease (IBD) pipeline candidates are also part of the collaboration, including SER-287 in phase I for IBD.
“These companies are willing to try new things so we believe we are extremely well positioned with our external partnerships and with our internal capabilities,” says Behar. “The entire space of nutrition and health is moving very quickly and we are seeing a lot more venture capital interest to incubate new companies working in the field. It is progressing in an impressive way, which gives us a lot of opportunities to take a really innovative therapeutic approach.”
Prevention and cure
Nestlé Health Sciences’ business model involves both prevention and cure. “Nutrition has an impact in both and we have a balance of the two,” says Behar. “The angle we take in development and investment is rather different because we are realistic with what is needed to show a long-term impact on prevention.”
This collaboration can explore the potential for nutrition science and digital sensor technology to provide new insights into healthy living. We think this can become a life-enriching technology, using the everyday tools of mobile technology to deliver better and more personalized service and advice.
For example, the company is looking at biomarkers to help indicate long-term success in prevention, mostly on the consumer care side. “We have high-quality nutritional supplements that are great additions in the morning, evening or at lunch for people who are having problems absorbing the right quantity of protein. For aging populations, it’s a way of maintaining muscle mass,” he says.
On the ‘cure’ side, nutrition is an often-overlooked factor in treatment, says Behar, pointing to work done in patients with Alzheimer’s disease that suggest a role for nutrition in the onset and progression of dementia. However, dementia is not the only therapy area where nutrition may make a difference, and Behar believes pharma could learn from Nestlé’s work.
“When you’re in pharma, you recognize the importance of nutrition in health but it stops there,” he adds, pushing pharma to go a step further and develop holistic solutions. “Medicines today are developed as if patients are taking that product and nothing else and that’s too basic. We talk a lot about real-world data but if you’re able to embed a strong nutrition component into a solution, I’m completely convinced it would change outcomes.”
This is why the company is “taking our own destiny in our hands” by looking at cancer, mapping the needs and gaps for some patients, for example in head, neck, and breast, cancer, to provide better, targeted nutrition therapies. Much more can be done, says Behar. “With immunotherapy, patients do better if they are stronger when they commence therapy or during therapy.”
There are particularly strong possibilities in nutritional/pharmaceutical combinations. “There is a lot of potential but pharma has been pretty shy in doing true partnerships, so we do it ourselves,” he says, citing a combination therapy with mesalamine, the standard of care for Crohn’s disease.
It is also vital that they embed technology into their products, as seen in an agreement between Nestlé and DBV Technologies which is fuelling the development of an advanced patch for allergy desensitization. “We took the technology and reframed it as a diagnostic tool for cow’s milk protein allergy in infants – a very quick 48-hour diagnostic,” he explains. “With such a service, you shorten the diagnostic and open up added services in terms of advice, behavior change and recommendations about solutions and their delivery. It can become a much more holistic solution.”
Nestlé has also announced a new collaboration with Samsung. “We have the number one nutrition, health and wellness company partnering with the largest technology provider in the digital space,” says Behar. “This collaboration can explore the potential for nutrition science and digital sensor technology to provide new insights into healthy living. We think this can become a life-enriching technology, using the everyday tools of mobile technology to deliver better and more personalized service and advice.”
Currently, the two companies are doing this on an ‘open platform’ basis, so that other companies can make use of the services and technology. “It’s a start, but very promising,” he says.
Nutrition gaining recognition as core component
Among the many battles to be fought is getting nutrition recognized by consumers, health professionals, regulators and payers as a core component of the prevention and treatment of disease, says Behar. “This is a long-term journey, although the situation with healthcare providers and consumers is evolving much quicker than regulators and payers.” The latter comes from continuing dialogue with regulatory authorities: “For example, we are shaping a new scientific and evidence-based approach for a medical food product approval in IBD and Crohn’s disease with the FDA and EMA.”
This medicinal food is the first product of its kind submitted in the US, now in Phase III. “It’s not like any drug so there’s a lot happening. The first step is with regulatory authorities. The second is to make sure we embed payers’ requirements into evidence development, which we are doing, a key step so HCPs and consumers use our product as they see fit but in a competitive situation with other products that may be reimbursed but may not necessarily be first line. It’s going to take time but I’m hopeful we’ll see a positive response from payers. Some of our products are now being reimbursed more broadly and that’s a positive sign.
“We have a clear path to how we want to advance the role of nutrition, in the way we want to impact consumers and patients to manage their health. We believe it’s a cornerstone of what we do and that we are the company that is able to bring this world-leading nutritional therapy to people,” he says.
There will undoubtedly be evolution of the model, he accepts. “We are focusing on really implementing the strategy and gaining traction in the three businesses we’ve built – consumer care, medical nutrition and novel therapeutic nutrition – as well as getting partnerships that allow us to bring success in our pipeline so that we can have an impact for our patients and consumers.”
Keeping it simple and focused
Comparing his new role to this previous experience in pharma, Behar focuses on innovation. “In pharma you have the good, the bad and the ugly, and I like companies that are very focused and innovative. We focus on innovation as it brings excitement for the future. Risk-wise, we are smartly balanced as we are in consumer care and medical nutrition, so the risk profile is much lower than in pharma. Novel therapeutic nutrition has a similar risk profile but also faster development.”
Speed is important but so too is an entrepreneurial culture. “One of our key guidelines is to keep it simple and focused,” he says. “That component, plus the digital space, makes our job very exciting. I am extremely excited by breakthrough innovation and, in the next five years, we’ll see some very exciting new approaches to health.”
Pharma, he believes, “is going to be excited to be part of this game-changing climate”, while biotechs already seem to agree. It remains to be seen whether larger pharma companies consider nutrition to be good for their health.