Implement new payment models and policies to help improve patient access to medicines — We must continue to partner with payers, governments, and other stakeholders to align incentives and commit to delivering healthcare that provides value to patientsand keeps pace with innovation while controlling costs for payers.
I had the pleasure of interviewing Susan Sweeney.
Susan Sweeney is Senior Vice President, Global Marketing, Access & Capabilities (GMAC) at Amgen. Susan has dedicated her career to providing commercial leadership across all stages of the product lifecycle, with diverse experience ranging from business development and alliance management to sales, market access, and brand marketing. With 25 years of experience across a range of therapeutic areas, full lifecycle management, and almost all facets of drug commercialization, Susan has great knowledge and depth of the intricacies of the healthcare system.
Susan leads a diverse group of teams within GMAC that work to further embed commercial and access requirements early in the development lifecycle with the goal of reducing the total cost of care, improving access to medicines, and enhancing the patient experience. She ensures industry-leading commercial and digital capabilities, including “beyond the drug” solutions, are leveraged to maximize value across Amgen’s portfolio for patients, partners, and health systems.
Susan is a passionate leader in supporting women in leadership and is a recognized role model within the industry. Her efforts to advance and empower women in the workplace earned her recognition on Modern Healthcare’s Top 25 Women Leaders list in 2019 and FiercePharma’s 2018 Fiercest Women in Life Sciences.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
The dramatic ability of biopharma to impact patients and population health keeps me excited and motivated every day. Amgen’s mission is to serve patients. I try to embody this aspiration through my work and contributions.
Can you share the most interesting story that happened to you since you began leading your company?
I learned about a woman who was diagnosed with heart failure (HF) in her 40s. She is a cancer survivor who was just starting to get on the medications she needed for HF when she was struck by a bus. Fortunately, she survived and is now managing her disease. In fact, she was her cardiologist’s first telehealth patient in the earliest days of the COVID-19 pandemic, which serves as a testament to her ability to take action and manage her health as an early adopter. I often think about her positive attitude and outlook on life even after a series of incredibly difficult circumstances. I think it is important that everyone in the healthcare industry listens to patient stories to understand their experiences and how significant advancements in treatments can change lives; patients are waiting for more options. No time to slow down!
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
One of the most unexpected, challenging day-to-day aspects about working in this industry, and across disparate and complicated disease areas, are the acronyms! I have even seen “NAZ” on the bottom of a slide and had to ask what that meant: No Acronym Zone. Although humorous, the complexity and scientific vernacular underscores the importance to tell simple stories with understandable content. I am a long way off from learning the 100+ pages of abbreviations and that is with over 25 years in the industry. I can only imagine the potential confusion for patients who deserve clear and digestible information, a task I tackle everyday.
What do you think makes your company stand out? Can you share a story?
I came to Amgen because of what I heard about the great people here, the focus on patients along with innovative treatments and the promise of the pipeline — and across all fronts I’m so glad I joined. Just six months into my tenure, the COVID-19 pandemic started and completely changed how we all work. I found there was a lot to adjust to: how do I maintain a connection with my team? How to minimize background noise? Where is the strongest Wi-Fi signal in my house? The list goes on and on. What stood out and continues to motivate me every day is our organization’s unrelenting prioritization to advance medicines for patients and their families. The resilience and dedication of my colleagues along with the support of one another in these trying times is truly special.
Additionally, I am proud of our efforts to collaborate with other companies across the industry, be it to advance public health goals, scientific breakthroughs, or value-based partnerships. For instance, Amgen is a member of the COVID R&D Alliance to promote the power of cross-industry collaboration and leverage the use of an adaptive platform clinical trial design to accelerate research to combat the current global pandemic. Alongside over 20 leading life sciences companies, we’re working together in real-time to identify and accelerate promising treatment options for COVID-19.
Finally, I have enjoyed being immersed in Amgen’s inclusive environment, which focuses on building a culture of diversity that fosters innovation and drives our ability to serve patients. With 52% of our global workforce being female and recognition in STEM Workforce Diversity magazine as well as our inclusion in Forbes’ Best Employer’s for Diversity 2020 list, Amgen is a leader in building a culture that I identify with and support.
What advice would you give to other healthcare leaders to help their team to thrive?
Focus on the unique qualities each of your team members brings to the table and understand how best to harness their diversity and different skillsets. I sometimes think about the concept of multidisciplinary tumor boards and the collaborative approach they bring to cancer care by leveraging the strengths of multiple experts. Much like having representation from radiology, oncology, surgery, and palliative care, I care deeply about leveraging the expertise of my team from different backgrounds that bring fresh insights and methods for tackling problems. Empowering and harnessing these strengths is crucial, and I constantly look to provide bold challenges and opportunities for our people to learn and gain new perspectives as they advance their careers.
According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
According to a Commonwealth report from 2020, while the United States spends more on healthcare than any other country, we are not achieving comparable performance as seen through poorer health outcomes such as low life expectancy, a higher chronic disease burden, and high rates of avoidable mortality because people aren’t receiving timely, high-quality care. Our healthcare payment delivery system itself remains antiquated, inefficient, and often contains misaligned incentives despite the advances in technology and science available to treat patients. This brings a few issues to the forefront for me.
First, given that access to and the cost of medication remains a concern to many patients, greater attention should be placed on reducing healthcare costs and increasing patient access. For instance, a recent report from IQVIA, a data science firm, found that patients continue to pay more out-of-pocket for prescription medicines in total, and cost is one of the primary reasons patients will abandon their prescriptions. Patients must be able to access the medicines they need.
Second, healthcare spending in the U.S. continues to increase, so we need to incentivize the system to deliver care that brings value and increases efficiencies. The Centers for Medicare & Medicaid Services said national health spending is projected to grow at an average rate of 5.5% per year for 2018–27, reaching nearly $6.0 trillion by 2027. However, one study found that between $760 billion to $935 billion of annual healthcare spending in the U.S. can be attributed to wasteful care. Value-based programs and collaborations, including the use of value-based contracts, can reduce costs and improve patient access to medicines. Still, more robust implementation of these types of arrangements will require changes to current policy as well as greater alignment on the definition of “value” among stakeholders.
Third, a rapidly aging population is facing our economy, leading to a dramatic rise in the number of people suffering from serious, age-related illnesses like cancer, cardiovascular disease, dementia, and osteoporosis. Increasing prevalence of chronic disease remains the biggest threat to society in the 21st century and requires medical innovation and biotechnology to be part of the solution.
Finally, we must improve the use of real-world data and real-world evidence. Insights drawn from real-world data can help better understand the effectiveness of medicines outside of a clinical setting and holistically understand a patient’s health and health outcomes, as patients spend most of their time outside of a doctor’s office. This will help us design better alternative payment models and improve patient outcomes.
You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
That’s a good question. I’d say that no one stakeholder can bring about change on their own. To create system-wide changes with novel solutions, we must collaborate in the following ways:
1 . Implement new payment models and policies to help improve patient access to medicines — We must continue to partner with payers, governments, and other stakeholders to align incentives and commit to delivering healthcare that provides value to patients and keeps pace with innovation while controlling costs for payers. One way of doing this is through alternative payment models such as value-based contracts. We recently entered into a value-based contract with a state Medicaid program, signing an agreement with the Oklahoma Health Care Authority and Pharmacy Management Consultants for one of our biologic medicines. This contract reflects our larger commitment to partner with payers on contracts where we share risk and accountability for health outcomes to better ensure patient access.
Additionally, policies that would tie patient cost-sharing to the discounted net price of a drug rather than the undiscounted list price would enable patients to directly benefit from the substantial, negotiated discounts that free market competition brings to the healthcare system in the form of reduced out-of-pocket costs at the pharmacy counter.
2 . Embrace a healthcare system that focuses on predicting and preventing disease — The current healthcare system focuses on reactively treating health events and disease, as opposed to preventing these events from happening in the first place, which can keep costs high for patients. The COVID-19 pandemic, dwindling Medicare and Medicaid reserves, and a global economic crisis have shown us that we cannot continue spending healthcare dollars on care that does not deliver value to our patients and systems. To revamp our healthcare system and deliver more affordable care, we need to co-create solutions that leverage the strengths of multiple stakeholders (e.g., biopharmaceutical companies, payers, practitioners) such as value-based partnerships.
We believe engaging in value-based partnerships with stakeholders is an important way to identify mutually beneficial opportunities to reduce costs, improve care and enhance patient experiences worldwide. For example, Amgen partnered with Fairview, a leading academic integrated delivery network, to understand febrile neutropenia (FN), a complication of cancer treatment. Amgen extracted data and demonstrated feasibility to track and monitor FN in a real-world sample of cancer patients. The project unlocked the information needed to try and improve patient outcomes and potentially decrease healthcare resource utilization through quality-improvement activities.
3 . Invest in and leverage technological and digital solutions — Digital health solutions are paramount in linking patients and providers within and outside of typical healthcare settings. This has been evident with the exponential rise in telehealth during the COVID-19 pandemic. Emerging digital solutions can also help unlock new insights to bring novel therapies to patients and decentralize clinical trials, allowing patients to participate remotely. We launched a digital health monitoring study in collaboration with major academic groups and healthcare providers that uses wearable devices to help assess whether making real-time data available to physicians will improve treatment decisions for patients with heart failure. If successful, this study could serve as a model to help improve access to clinically effective and evidence-based care.
As you can tell, digital health solutions, including real-world data, can create a more connected, agile, personalized health ecosystem — bringing providers and patients closer together.
4 . Pursue and apply precision medicine and personalized treatments — It’s crucial we continue to invest in scientific breakthroughs that balance patient and population health needs of today and tomorrow. Advancing precision medicine and personalized treatments can better match patients with specific treatments, improve R&D efficiency, expand access to human data, address access and use at all stages of drug development, and more. To accomplish this, we are applying expertise and investing in R&D, drug discovery, and enhancing the application of real-world evidence to support better decision-making. For example, we’ve invested in Aetion, whose analytics platform helps biopharmaceutical companies and payers better understand how drugs work in the real world.
5 . Increasing diversity and inclusion in clinical trials — Clinical trials are an integral part of the drug development process. Patient participation is crucial to the successful completion of a trial. Yet, many clinical trials cannot enroll as many patients as desired and the patients that do enroll are not necessarily fully representative of the population the drug will serve. With this as background, Amgen has supported an important effort to increase the enrollment and diversity of patients who participate in clinical trials. In 2018, Amgen provided a $2 million corporate donation to the Lazarex Cancer Foundation’s, a non-profit organization focused on improving patient access to cancer clinical trials, IMPACT (Improving Patient Access to Cancer Clinical Trials) program. The results of the pilot program with Massachusetts General Hospital saw minority participation in cancer clinical trials double and a 29% increase in overall participation.
Amgen has also invested in Science 37, a company that has developed a decentralized framework offering end-to-end clinical trial services without geographic limitations. More patients can participate in trials from anywhere, even without access to major medical institutions and clinical sites. This is a classic win-win because sponsors can access a more diverse patient population and patients can participate in cutting-edge research.
What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Collaboration, coordination, and co-creation across healthcare is the driving force to achieve success. Our solutions and “concrete steps” need to span patient access along with lower cost treatment options, transformative treatments and technologies.
In terms of increased patient access, it’s crucial that biopharmaceutical companies not only price medicines responsibly, but also work with payers, pharmacy benefit managers, and other stakeholders to align on value and develop value-based approaches that offer system stakeholders greater budget predictability and risk-sharing. We also need to develop robust patient support programs to deliver broad access to novel therapies to appropriate patients and continue investing in lower cost treatment options, such as biosimilars.
Second, I believe that we must collaborate with others and invest in technologies and approaches that transform care delivery to focus on more precise, personalized solutions. We need to continue to apply and expand our expertise in areas such as R&D and data analytics while investing in digital health solutions.
We need to ensure we’re co-creating a stronger healthcare system. Biopharmaceutical companies can work with payers, pharmacy benefit managers, and health plans to improve patient access by implementing value-based programs, partnerships, and solutions. The goal here is to align incentives and help shift the system towards more proactive, predictive and preventive care.
I also believe that leaders, communities, biopharmaceutical companies, and healthcare practitioners play an important role in elevating and including the patient voice. It’s crucial we keep the patient voice and the industry’s shared goal of improved patient outcomes at the forefront of every decision. From providing robust patient assistance programs to leveraging new digital solutions to pushing for more innovative legislation, every healthcare stakeholder has their part to play.
I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
It’s outdated to think of mental/behavioral health and general health as two separate things — we have ample evidence and frameworks, such as the application of social determinants of health, that show these are intertwined. The key here is to promote a healthcare system that evaluates a patient’s health and health outcomes more holistically and beyond the traditional healthcare setting. The use of digital health tools and application of social determinants of health frameworks may help in the coming years with bridging these “tracks.” We’ll also have to invest in companies and approaches looking at novel ways to link mental/behavioral health and general health and continue emphasizing care that focuses on personalized treatments and prevention.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider actively creates a system that brings providers and patients closer together by accounting for patients’ needs and proactively addressing and predicting patient concerns and health risk factors. Excellent healthcare providers take action to solve problems using integrated solutions like new treatments and digital approaches. They approach a patient’s health with a more holistic understanding that accounts for social determinants of health and barriers to accessing quality healthcare. This ultimately advances population health and builds stronger, more resilient health systems for tomorrow’s patients.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Winston Churchill is known for concise communications, and I really enjoy this quote of his: “This Treasury paper, by its very length, defends itself against the risk of being read.” Meeting complexity with complexity often does not add value and detracts from the core message. We work in an industry where we have a responsibility to our patients to provide clear and informative communications on potentially life-transforming medicines. Only by truly understanding the science and data can we distill complexity into something more easily understood.
Are you working on any exciting new projects now? How do you think that will help people?
Amgen is developing a comprehensive, customer-centric capability backbone that enables our commercial teams to deploy flexible, go-to-market models and provide personalized experiences for our customers. This is a highly collaborative effort across functions that ensures we are adapting to the evolving healthcare landscape, preparing for our post-COVID reality, and maximizing access to medicines for patients.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
One of my favorite books is The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg. Understanding why habits exist and ultimately how to break them is very important in the healthcare arena. Throughout my career, I have observed that we often continue doing something in a particular way because of precedence; this is not prudent or innovative. I constantly strive to question how we do things and drive towards fast adoption of innovation.
I would be remiss to not mention my love for crime-oriented podcasts, although these fall squarely into my downtime and relaxation. Maintaining mental health is more important than ever in our busy lives, and activities that provide mental breaks augments my leadership capabilities.
If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?
I would inspire healthcare stakeholders to take risks, disrupt established healthcare silos, and seek opportunities outside the “status quo.” We need to engage in multidisciplinary ways, working with governments, payers, tech companies and others to co-engineer a system that delivers value to patients and prioritizes more proactive, predictive and preventive care. This will help benefit patients and systems through reduced costs, broader access, and improved health outcomes.
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