You have a degree in medicine... How did you end up in business? I originally wanted to study science and math but my ambitious (and pushy) parents wanted me to go into medicine – so I did. I loved the theory, but I became disillusioned by the clinical realities. I remember diagnosing a little girl with a rare medical condition called Rhett Syndrome. I was proud of myself, and when I told the consultant doctor about my diagnosis he congratulated me. But then he told me that she’d be in a wheelchair by 15 and dead by 20; All we could do was manage the condition. I was totally dissatisfied with that. I decided that I wanted to be involved in getting new medicines to doctors. Naturally, my first thought was research – my father worked at the Wellcome Trust in the UK for 30 years and my mother researched HIV at the UK’s Medicines Research Council. But my parents told me I didn’t have the patience for research, so I went into business. I actually started in strategy, which wasn’t very interesting, so I got into finance. Finance has a bad reputation, but it’s really important. Think of the great scientists and entrepreneurs; the air they all breathe is money. Granted they may have noble intentions, but they also need capital. I learned that when it comes to investing in science, half the battle is finding the right financial structures to make something happen. I spent a lot of time at pharma companies before starting my own company.
What inspired your interest in the cost of clinical trials? The biggest challenge in making medicines isn’t discovering exciting molecules, it’s cost-effectively bringing them to market. Many of the big pharmaceutical companies have an embarrassingly large number of extraordinary, life-changing molecules just sitting on their shelves, but testing them all would be too expensive. I’m not a researcher so I can’t develop a new medicine and save lives, but I realized that if the costs of trials could be reduced, then more trials would be conducted; more medicines would be brought to market – and more lives would be saved! The key? Finding the right investigator, which can be remarkably difficult. We began with that simple concept: making it easier to find good investigators for clinical trials. We developed a sort of ‘LinkedIn’ system where registered investigators could upload their professional history and look for clinical trial opportunities. We discussed the idea in 2008 and by 2011 we had 67,000 registered clinical trial investigators. It turned out to be a very valuable resource – and pharma companies loved it. But is that enough to bring down costs? With our data, we can recruit a full complement of investigators within a week or two – whereas it could take a pharma company months to do the same thing. But that was only the starting point of DrugDev. After the database was launched, someone in pharma told me that he loved what we were doing, but he described it as giving him ‘plumbers’ when he wanted to ‘build a whole house’; we were only fixing one problem in the clinical trial conundrum. What if we could do more?
Lots of small companies have come up with best-in-class solutions to individual problems in clinical trials, but they’ve never reached critical mass. We’ve been bringing these together and integrating them to automate the clinical trial process. For example, you can have software with supporting services that allows a pharmaceutical executive to configure the clinical trials that they want to run, and then at the other end of the system, a person is receiving instructions for how to run the trial. And suddenly everyone comes together like a very efficient army. Automation doesn’t sound very sexy, but automation can halve the cost of clinical trials. In addition, when you collaborate and bring lots of modern solutions together in an efficient way, you start to see new insights, including the potential to almost standardize the clinical trial process. What are your hopes for the future? People often say that nothing ever changes in the industry. There’s some truth in that, but I believe the industry has never been under more pressure than it is now. But there’s so much room for improvement in the clinical trial process. For example, the classic way of communicating with a site and implementing a change at a site is to contact your head of clinical trials, who then contacts your country manager, who contacts your local monitor, who then goes to the site and makes the change – usually feeding back after a few weeks. It can all happen rapidly if everyone logs on to the same computer system. It may sound obvious, but it isn’t happening at the moment. I hope that we will see the emergence of a clinical trial operating system (hopefully from DrugDev – but I’m open to competition!). What’s the most important thing you’ve learned during your career? Good people are the most important aspect of starting a company. You’ve got to get yourself a kick-ass team! And you’ve got to understand what motivates them – and then create the best possible environment.
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