Neil Davie Ph.D., is the Global Therapeutic Area Head of Pulmonary Hypertension at Janssen. He discusses how a chance introduction to pulmonary hypertension set him on the path to specialise in the condition, and how improving the lives of patients is the driving force for him and his team CEO Series: meeting the beating hearts behind the RARE brands
What made you want to move into the world of rare disease, and then Janssen specifically, with a focus on pulmonary hypertension, and what did that journey look like?
During my Human Biology degree and completely by chance, I attended a patient association meeting for pulmonary hypertension (PH). The high unmet medical need combined with the level of collaboration between patient groups and industry, on top of the well-informed patients, was something I hadn’t seen before—I was hooked!
I went on to do my PhD in Pulmonary Pharmacology at Imperial College London where I also met a parent of a child with a rare type of PH, pulmonary arterial hypertension (PAH). This was another anchor to keep me working in the field after my doctorate was finished. Following my PhD, I did a post-doctoral fellowship at the University of Colorado in the field of PH, and then was appointed Assistant Professor of Paediatric Cardiology at the Children’s Hospital in Denver, working in the PH lab.
After moving on from my academic positions, I held a number of leadership roles at several pharmaceutical companies, focusing on strategic pharmaceutical drug development. In 2019 I joined Janssen—one of the easiest decisions of my career—and in 2020, I was proud to be appointed the Global Head of PH, one of Janssen’s six therapeutic areas of focus.
What do you anticipate will be the biggest challenges and opportunities for your organisation in the next two years?
It goes without saying that the biggest challenges will be those connected with COVID-19.
People with all forms of PH are vulnerable but particularly those with a rare form like PAH, so a long-term difficulty that we face is conducting clinical trials during COVID-19 and beyond. Patients are less able to leave their homes and, in some cases and very understandably, they are worried about doing so to access hospital care, and this applies doubly in the case of clinical trials. What this means is we need to find solutions to try to bring the trials to them. We have to reimagine what drug development in PH will look like in the future, and we have to do it now.
Having said that, this unexpected crisis also presents us with the opportunity to innovate. COVID-19 has already expedited many processes within the healthcare and pharmaceutical industries to improve how care is delivered. Healthcare has become more digital, and there has been an increased use of technology which has given doctors greater insights into patient data. Moreover, we are seeing more companies partner with global and local authorities to address immediate and long-term healthcare needs.
What is your proudest moment in your career thus far?
I can’t bring myself to pick a single moment, but my top three are: completing my doctorate and being able to dedicate my thesis to my parents; being made Assistant Professor of Paediatric Cardiology at the Denver Children's Hospital; and also being made Global Head of PH at Janssen.
What and who are your personal and professional inspirations and why?
I have been incredibly fortunate to have met and worked with some hugely talented and passionate people. During my PhD, I had the honor of working alongside Dame Professor Julia Polak, who was a formidable teacher of mine, dedicated to researching PH. Sadly, she was eventually diagnosed with PH herself, 15 years after she began experiencing her first symptoms. She was a true inspiration to me and many others, and her sheer determination for us to find effective treatments drives me to this day.
What advice would you give someone considering working in the rare disease space?
First off, if you’re looking for a steady, nine-to-five job, then rare disease is not for you, especially in drug development. If you do find that rare disease is your passion, gain as much varied experience as possible. Invest in lots of real patient interaction to help you better understand their journeys, work for brilliant businesses with the expertise and motivated teams to inspire you, and find a mentor who can challenge you.
Do you think the government does enough for the rare disease community at a local and central level, and what gaps do you see currently or emerging?
Simply put, there is always more to be done and at all levels, from both governments and the pharma industry, but there have been some successes worth celebrating. Regulators in particular have done a great job in providing guidance to industry on drug development in rare diseases, especially PAH, but we still have a long journey ahead of us.
Currently, one of the major unmet needs in PAH is the significant delay to diagnosis. It can take an average of two years from the onset of symptoms, and often much longer. In such a progressive disease this delay costs lives.
To help address this, we’ve realised that collaboration is key, both internally and externally, with patient associations and external technology providers. We hope to harness solutions such as biomarkers and artificial intelligence to help us identify patients earlier.
What would you say are some of the biggest motivators for your employees?
Patients are at the heart of everything we do and the pandemic has spurred us on even more. COVID-19 has really put into perspective how patients with PAH, for example, must be feeling, dealing with a life-threatening respiratory disease at a time when you’re lucky if you can see family members, let alone your doctor. This has made all of us increasingly determined to do all we can to improve their lives and I’m proud of how resilient and adaptable my colleagues have been.
What are the toughest parts of being a business leader, and conversely what are the most rewarding?
For me, the worst moments are having to make the decision to stop a study, either due to lack of efficacy and safety or for strategic reasons. On the plus side, the greatest feeling in the world is finally getting a drug approved and knowing that it will positively change the lives of thousands of people all over the world.
I’d add that leadership is never easy and balancing authority with understanding is key. If you’re too authoritarian, you won't inspire people, but if you’re too lax, you won’t get results. It’s important to build a consensus and empower, trust and respect your teams.
What would be your one wish for Janssen PH for the year ahead?
In the not too distant future, I would very much like to see us announce some of the early data from our data science partnerships that could ultimately see us cut the average diagnosis time in half. I feel confident that real breakthroughs are on the horizon.
If you weren’t Head of Janssen PH, what was Plan B? What did your 10-year-old self want to do as a job?
My boyhood dream was to score a try like Gareth Edwards did back in 1973, in the All Blacks vs The Barbarians game! When I have a low moment, I still play that video to give me a lift. Another career aspiration growing up was to be a marine biologist, but to be honest, I mostly wanted to be Jacques Cousteau (those of us of a certain age will remember both Jacques and Gareth)!