Begin with the impact in mind and then build your consortium: an interview with Pierre Meulien

You can listen to the interview podcast here.

I am very thrilled today to be able and honored to interview Pierre Meulien, who is the executive director at the Innovative Medicines Initiative. Prior to that role, he was most notably the president and CEO of Genome Canada. Interestedly, prior to that, he was the chief executive officer of the Dublin Molecular Medicine Center, which is where he was part in some of the initial discussion about the IMI.

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I got to know Pierre really well a few months ago when we did a joint workshop with stakeholders around the value of sharing data where it was a very interesting dynamic as it was about a game that we had created on the project eTRIKS. That was at the EuroScience Open Forum in Toulouse. What really struck me there is Pierre was, despite this great resume and leading this big initiative in Europe, still very down to earth, and very connected and able to connect very well with the different stakeholders that were there. I thought it was a great opportunity, and he agreed to come on the podcast.

Welcome, Pierre.

Thank you very much, Scott, for inviting me. It's a pleasure.

Okay, we'll dive right into it. The very first question, which I ask pretty much everybody, is why do you do what you do?

Great question. As you know, Scott, most of my career I've been between the public and private sectors. I spent 18 years in the private sector either in biotech or big pharma, notably in the vaccine industry. The rest of my time I've been spending in the public sector, mostly in funding agencies, you mentioned Genome Canada and others, or building public-public or public-private partnerships.

What I like about my job is that I'm passionate about interfaces because I think interesting things happen at interfaces. Whether that be the interface between public and private, the interface between research and clinic, the research between clinical research and health delivery, I think all of these interfaces are going through very interesting times and are facilitating progress. They're also breaking down interfaces, and I'm interested in breaking down silos and creating new ecosystems that can be really productive in bringing innovation to patients as quickly as possible.

If you don't mind, I'd like to just touch on that just a bit deeper as to why you think interfaces are so important. Is it that there's a conflict there? Is it that it's bridging new ideas? I don't know if you can dig in a little bit deeper.

I think it's all of those things. I think it's new ideas get created, and very importantly, silos are broken down. I'll just take one example of academia industry. This is a very interesting interface. Traditionally there has been, I would say, a good deal of mistrust between academics and industrial players. This mistrust has been on both sides, loads of misconceptions about how each other works, what drives them, what incentivizes them. Through IMI and other institutions, we can actually break those silos, disperse those misconceptions, and in so doing build very productive consortia.

Of course, in IMI we're lucky to be able to bring in other stakeholders that are very important in what we do like regulators, and health technology assessors, and of course patients, and SMEs. In doing so, we're able to tackle some of the major issues that may be not tackled or possibly tackled by individuals working in academia or individual companies. Together we can make progress. That's what certainly drives me. It's not that everything should be done this way. Absolutely not, but there are certain things or certain big challenges where we really do need to work much more collaboratively in order to advance fields.

I think that's very well put. It pre-empts the next question I was going to ask, but I'll still dive into it a bit. If you were back again starting off as a researcher or you had a small company, a non-profit, for example, a disease foundation, and you wanted to make a real difference for the future of medicine, what would you say the best way to proceed to do that is?

No matter where you sit in the ecosystem, I think you have to have your own strategy of what you want to achieve. If you're a small SME, you might be a spin-out from a university, your specific technology that you believe in, the question I would urge those people to ask would be, what impact would you like to have on whatever? Is it a particular disease? Is it a health system? Is it a particular patient group? What is the impact that you are hoping to achieve?

Then go back from there and say, "In order to get there, who do I need to collaborate? Who do I need to influence? Where can I get funding from?" I think it all derives from that. Really decide up front what the goal is, what impact you'd like to have, and then go back from there. Then I think people will really succeed.

I think that's really a great point because it's one thing that sometimes surprisingly people don't do, right? That gets me to the next question, often in all these consortium projects and all these different particular EU funding, there's a lot of interest in getting small to medium enterprises, the SMEs, involved. Just a direct question. Why should they get involved?

Yes, and we've seen different types of SMEs being more comfortable than others in some of our consortia in IMI. I'll just explain that a little bit. We have seen that platform-based SMEs, those small biotech companies that are either providing high end service in some secured technology, could be proteomics, it could be DNA sequencing, it could be looking at biomarkers, the validation of these, it could be a lot of different things, but they're providing a service to the project, they love the consortia because they get close to their client base.

They get close to other users that might help them build their networks. Theirs is a real business proposition for them to get into these consortia. It's more tricky for those SMEs who are developing a particular product. I'm building a new vaccine for dengue fever. I'm building the new immunotherapy for cancer. I'm building a new molecule that could be modifying an Alzheimer's disease. For those people, it is admittedly a little more tricky because they're nervous of being eaten up by bigger companies very quickly and that they don't actually get to where they want to get in order to create value in their own enterprise.

I think we have to acknowledge that it's not for everyone maybe. I always say that IMI is certainly not for everyone and not for everything but for certain things where we can get alignment of ideas, alignment of goals, and alignment around objectives. Then we can do magnificent things. Certainly the different types of SMEs would be better off maybe looking at another mechanism of getting funding, and there are plenty of those around. Depending on what you're trying to do, choose the type of funding mechanism that is most in line with your own strategy, with your own product profiles, and your own business model.

I want to maybe extend upon that a bit. I think there's a different type of SME that's emerging now that's, what I would say, people that have transformative technology, in other words, somebody bringing something about digital health, or digital biomarkers, or AI, they're trying to change the future of medicine. They're a mixture of those two types of SMEs. Do you see a role for those kind of companies?

Absolutely. Now we're getting into the realm of what I call technology convergence where we see a huge influx in the digital methodologies, technologies into almost every aspect of drug development, but not only drug development, healthcare practice delivery, electronic health records, big data, how that's analysed, and machine learning, and artificial intelligence, all of this. Of course, as you say, in the digital space now digital therapeutics is a new buzzword. This is going to have great impact in some of the brain disorders that we're dealing with.

These disruptors, I think we really need to bring those in to mingle, if you like, with the traditional companies, whether they be in med tech, or pharma, or whatever. Get a lot of our academics who are building, creating, and generating the latest knowledge, bring all of those together so that we can have a clear path forward and a smooth path forward as to how these technologies are going help each other because the digital people are certainly not used to the stringent regulatory framework that we are used to in medicine, in new medicines development or innovation in medicine in general. We can help them navigate through this, and at the same time we can benefit from this amazing new suite of technologies through the digital informatics space that's creating all of these new opportunities in terms of how we design clinical trials, new regulatory pathways, new real-world data to design these trials and to accelerate the access of innovation to patients.

That's really interesting. Particularly, you mentioned the idea of digital therapeutics and that really working together and not creating more silos that makes a difference.

Yes.

Now what I want to do is go back in time because on the first day at the IMI, you gave an interview. In that interview it was mentioned that you have experience in bringing together partners who may not be used to collaborating. Can you shed some light upon how to get partners to work well together, and what have you seen now that you've been at the IMI for a little bit that works well?

It's true that I have put myself into situations where people have encouraged collaboration among partners who not normally would collaborate together. I think the main thing is you certainly need carrots and maybe a few sticks. The overall thing is an alignment around a particular goal. When I was in the Dublin Molecular Medicine Centre, for example, it was a challenging opportunity to bring the three medical schools in Dublin together and collaborate on certain things. There was a big carrot because the Irish government were providing, with philanthropy as well, providing significant millions of euros, in fact 80 million euro, for them to find ways of collaborating.

At those board meetings, I was always saying, "This isn't to collaborate on everything, because you've spent hundreds of years competing with each other. But maybe what we could do is to choose maybe just three big things that we could achieve together. What would those things be? Let's align around those." Just to give you an example of one of those things, happened to be an opportunity to get a Welcome Trust funded clinical research centre built. This was a significant challenge. Nothing ever like this had happened in Ireland before. Because we worked together with those three medical schools, we managed to win one of those awards, very coveted award. That was a big achievement for Ireland and a huge achievement for the collaboration that had been built.

That's an example of people who are not used to collaborating can get aligned around a particular goal. Now in IMI, we can see lots of alignment where there is a particular blocking point in either not having medicines for ... Scott, yourself, you've been involved in U-BIOPRED, one of the projects looking at severe asthma, where there was a real blockage of dearth of new medicines, new innovation in this area. But because we were able to bring five of six pharma companies and some of the best brains in academia and SMEs together, and very importantly, patient groups, as you well know, this transformed the field.

 There are extraordinary things that can happen when you get these multidisciplinary, multisector groups together and align yourselves around a particular goal. IMI is lucky to be able to provide some very significant resources and mobilize the brains and expertise in industry to be able to create these consortia with very aligned goals.

I think one of the key factors in these kind of projects is leadership. It's not leadership coming from the IMI office, it's leadership running the project. That notion of co-leadership from the public and private sectors has really worked. We can see that time and time again in our projects. Of course, sometimes it's more challenging than others, and sometimes communications break down, things that are normally in any complex network or even in any complex family. We're there to facilitate those difficult times, to encourage people to stick it out and continue to work together, and continue to produce remarkable results.

That's fantastic. I know your time is limited, so I just want to leave you with one last question, and perhaps it's a big one. What does the future hold for the IMI?

I think there is an immediate future, and people keep on reminding me that my job is to implement this phase of IMI, IMI 2. We still have two years of allocations to run, 2019 and 2020. We have well over 450 million euro to allocate in those two years. That's just the public side, and we will have to match that. We're talking about nearly a billion euro to be allocated, mobilized. Of course, the use of taxpayers' money is always scrutinized, and rightly, so we have to do that correctly. That's the future, lots of things to do.

Within those two years, we want to do a lot of things that I've talked about. We want to bring in these new disruptors. We want to bring in more of the other sectors other than pharma who need to be at the table. We need to increase our engagement with patients. We need to increase our engagement with those who deliver healthcare and pay for the delivery of healthcare because if we can be a little bit self-critical as a community, I would say that we've been remarkably good at pushing technology and trying to tell people how neat some of these things are and that they should be using them. We have been pretty bad at articulating the economic value to systems that some of this innovation brings. We've been very bad at that, and we need to understand how to do that a lot better.

In order to do that, we need to bring in the health economists. I'm talking about not only those who are in HTA bodies around Europe but also in academia, the scholarly health economists who can bring new models to what we do. Also, I would say, social science and humanities to deal with some of the things you talk about, digital and all of the things around data use, the ethics around that, the legal considerations, and the social science and sociology of what we do. I think all of that needs to be brought to bear. There's lots to do in, I would say, the near-term. Of course, after 2020 there'll be a new framework program called Horizon Europe. The decision has not been made yet to recreate another public-private partnership in health, but it's certainly being discussed. I think that irrespective of whether that happens under Horizon Europe or not, I think there will be lots of reasons and good reasons to create public-private partnerships in the health space in the future, if you'd like.

I completely agree. I know that your time is about up, so I just want to take a minute to thank you. It's been really interesting what you've said, added some nice insights. I've learned a lot. Is there anything else you want to mention or comment on?

No, I'd like to just thank you, Scott, for all the efforts that you make in outreach and all the things you do. I'm so happy to contribute to a podcast because I think we need to get the word out there in terms of what we do, why we do it, and what the value is to the European citizen of what we do. Even if the impact on health systems will happen a few years down the line, I think the European citizen needs to know that we're working very hard to bring innovation into their lives.

Well put. Thank you, and have a good day.

Thanks a lot, Scott. Nice talking to you, bye

Scott Wagers

"The Consortium Whisperer" Physician and researcher who has spent the last 12 years engaged in developing biomedical R&D consortia, as well as designing and supporting the delivery of consortium based projects.

No matter who you are, you can, and you should innovate through consortia. They are the only way to make a big difference to the future of medicine. Want to find out how? Get in touch.