Interview with Judith Love, General Manager, Oncology Nordics

Judit LoveThe importance of patient power is being recognised across healthcare, including the pharmaceutical industry. In this interview, Judith Love, General Manager for Novartis Oncology Nordics, explains what a patient focus means for development of cancer care. She also discusses how to provide safe patient access to Car-T cell treatments and what the company is doing to increase access to cancer treatment in regions where resources are scarce.

"There are two aspects to patient involvement, internally how we operate as an organization, and externally how we enable a better experience for patients and their families through working to make healthcare more accessible. I think the pharmaceutical industry in general can go a long way in improving the perception people have of us as an industry, in some ways we need to re-write our contract with society. At Novartis, we have a commitment to become more patient focused across the organization; it is part of our vision of re-imagining medicine. That means we need to make it real and alive in our everyday actions.

We have a new Novartis commitment to patients and to caregivers so that we can make a bigger impact on patients at the end. This commitment was co-created with patients’ input so that we focused on what was important to them. We worked with 40 patient organizations, representing over 200 million patients, so it is a good start.

From an outside societal perspective, we need to find ways to address the gap between available infrastructure and the technological advances that enable better screening, diagnosis and treatment. This will allow treating patients with the right drug at the right time. The technology is moving faster than the regulations and policies and in my view, from the pharmaceutical perspective, the gap just keeps growing. There is a massive disconnect between the two. We got to shorten that timeline."

In August 2017, the U.S. FDA approved the first Car-T cell treatment to treat children and young adults suffering from acute lymphoblastic leukaemia (ALL). The treatment is not yet approved in Europe, and healthcare is aware that though the treatment may save lives, it is not an easy treatment to give, nor to receive.

How is Novartis collaborating with healthcare to develop safe patient access?

"Car-T cell treatment is a real breakthrough; it is trail blazing and requires that we work together with the healthcare system. It is not a drug; instead, it is a completely novel therapeutic process that enables the patient’s own T-cells to be re-engineered via a unique manufacturing process to be reinfused into the patient.

We started collaborating with University of Pennsylvania in 2012. Thanks to that collaboration, we now have a very good understanding of what it takes to successfully launch, manufacture and establish a network of certified treatment centres that are able to actually carry out this therapeutic procedure in a way that is safe for the patient. We need a rigorous approval system to ensure that we have the right medical centres to treat these patients. We also need to develop novel pricing and access schemes that are outcome- and value-based.

Novartis has never walked down this path before – nor has the healthcare system, so this is our opportunity to sit together and find ways to bring this exciting treatment to the patient. What is required at a hospital level, from pricing and from policy? It is a unique opportunity to work together, but of course that is also where many of the challenges lies. Industry working along-side health professionals – imagine if we get this right, and what it could mean for other novel therapies."

The majority of new cancer cases are projected to occur in low-and middle-income countries the next twenty years. Can you tell us something how you can contribute to developing care in these regions?

"Novartis collaborates with the Max Foundation on a broad initiative that is very patient focused in that we are working with an NGO for the treatment and support at no cost for the individual patient. We do this with the explicit goal of assisting people living with Chronic 51

Myeloid Leukaemia and to ensure that they receive hands-on support, not just providing the drug like many other projects would do.

This is more of a closed loop that entails four key steps which includes donating the medicine, funding the Max Foundation which then delivers the medicine to the health centres where physicians provide the medicine. The last step is the Max Foundation providing continued psycho-social support and education through their local advocacy organization.

We plan to invest more than 29 million into this collaboration and provide 315 million doses of medicines over the next four years. We have 34 000 patients currently in the programme in 70 countries across 4 continents, that involves 1 400 trained physicians and 450 treatment centres. So, it is more than a donation, it’s more of a sustainable footprint that enables the system to be educated at the same time"

What are your expectations for Uppsala Health Summit?

"I hope that there will be a lot of really constructive dialogue on the issues that count. It is about understanding each of our perspectives and working together with a shared view to transform cancer. We only need to do it on a small scale to begin with, just pick small projects to collaborate together on, give it a go and then see how we can work together and scale it further. We all need to have the courage to try to work together on mutual challenges!"