It’s challenging to build a pharmaceutical clinical pipeline, as any drug maker would tell you, and Novartis is considered to have one of the deepest in the industry. The company’s R&D head, Mark Fishman , a former Harvard Medical School professor who joined the Swiss drug maker in 2002, stopped by Health Blog HQ today to chat about his approach to Big Pharma R&D. On his arrival at Novartis, Fishman tells the Health Blog, he began to change the culture away from a traditional corporate approach driven largely by financial models and metrics. The philosophy used to be “if you can measure it, you can make it better,” he says. But Fishman, a cardiologist who spent 25 years in academia, says that doesn’t necessarily apply to scientific discovery. He “forbade” his colleagues from bringing up any discussion of financial estimates with him before the experimental compounds showed a benefit in humans, saying it was “silly” to guess at their

value before they demonstrated at least potential clinical utility. Any drug that actually works will have commercial value, even if it’s for a rare disease, says Fishman. Instead, Fishman wanted his 6,000 scientists to focus on unmet medical needs and on diseases that are straightforward enough to take a crack at with a reasonable chance of success — for example, those with a fairly narrowly defined patient population, as is the case with a single gene defect. If a compound works in that group, the lessons learned can potentially be applied to broaden its use to conditions sharing similar mechanisms of action. As a result of this change in philosophy, about 30% of the compounds in the pipeline when Fishman joined Novartis in 2002 were killed. So far its output of new medicines through the early proof-of-concept phase has doubled, says Fishman.

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Don’t Talk to Me About Financials, Says Novartis R&D Head