Garth Sundem   00:00

Welcome to this episode of the Medical Affairs Professional Society podcast series: “Elevate”. I’m your host, Garth Sundem, Communications Director at MAPS. And today we’re speaking about health equity with Ariel Katz, CEO of H1. This episode is sponsored by H1, whose platform helps life sciences companies, hospitals, academic medical centers and health systems, connect with providers, find clinical research, locate industry experts, and benchmark their organizations. So, Ariel, it’s good to speak with you again. And I am excited because I don’t think we have on this podcast series spoken much about the role of Medical Affairs in health equity. So, let’s just start with the open-ended question of what in the world is the role of Medical Affairs in promoting health equity?

Ariel Katz   00:59

Yeah, so I’m excited to be here, again, it’s good to chat with you. When I think about health equity, it is the job of everybody in healthcare to work on this directly or indirectly. And so, including H1, it is our responsibility to do so when I think about Medical Affairs and clinical development, specifically Medical Affairs, we need to engage with patient advocacy groups that represent minorities with certain conditions, we didn’t make sure that clinical trials have right protocols, and design and eligibility criteria to make sure it’s inclusive of everyone in the world for everyone, in the US wherever the clinical trials taking place. And work as hard as possible to make sure that individuals that have socio economic barriers to participate in clinical trials can still participate if the condition affects them. And so, there’s a lot that Medical Affairs can do and needs to do to promote health equity, because it has to be the future and Medical Affairs. There’s like every other function and life sciences and every other function. healthcare needs to take responsibility and accountability for understanding, communicating educating all these disparities that do exist, and filling that gap with education, which is what we’re the best at. So that’s how I think about how Medical Affairs should fit into this puzzle.

Garth Sundem   02:15

Well, that’s a heck of an overview. And I think that you mentioned about six places that Medical Affairs can intervene to promote health equity. So maybe we should start at the beginning. And you talked about designing treatments with the patient in mind. So how does Medical Affairs help to do that? You mentioned engaging with patient advocacy organizations? How does Medical Affairs help the industry design treatments with the patient in mind?

Ariel Katz   02:48

So, when I think about Medical Affairs, we’re the closest to the frontlines in terms of engaging with advocacy groups, caretakers, physicians, nurse practitioners, and we’re bringing that, all that back to our organizations every day with insights with Intel, and everything. And it is our job to partner with our clinical colleagues, as they are trying to design clinical studies that are inclusive, that have a diverse patient population, diverse physician population, and it is our responsibility as Medical Affairs to own that piece, and bring that back to our organization, and stand up for the voice of everyone who won’t have a voice otherwise. And we need to make sure that when we’re engaging with physicians, we’re engaging with a diverse set of physicians that see a diverse set of patients, and we’re engaging with patient advocacy groups. Don’t just go to ASCO. I mean time to go to ASCO, we all do that. Make sure you’re hitting other advocacy groups, societies but make sure for advocacy groups, you’re getting ones that represent minorities with cancer. And so really making sure that you’re engaging with everyone in the community to help take a chip at this problem.

Garth Sundem   03:55

We you know, we think about diversity in clinical trials, you’re talking about diversity in the people we engage with who are running clinical trials as well. That’s an interesting perspective.

Ariel Katz   04:05

You need to. We are unbiased. We are like unconsciously have these biases in who we’re engaging with. If you Google, if you just go to the top academic medical centers, and are just engaging with the top key opinion leaders at those top academic medical centers, do you think that’s representative of the country or the people with that condition? And so, it’s pretty biased? I don’t think it’s malicious. I think it’s like unconscious biases, and how we operate. But Medical Affairs should take a stance to make sure they are engaging with a diverse set of individuals.

Garth Sundem   04:40

Right. And maybe the leaders today grew through a system, you know, that’s 30 years old at this point. And is it just that the industry and industry models and industry mechanics, and academia models and academia, mechanics need to catch up with to new reality or, you know, as Medical Affairs professionals, do we need to be driving toward this future of inclusion and diversity not just in clinical trials, but in the development lifecycle?

Ariel Katz   05:15

To develop, it’s the latter. It was. So, when Ken Frazier before he left Merck, he said a really insightful thing. He was like, 10 years ago, people talked about ESG in their board meetings, but didn’t do anything about it. And now you need to, everyone’s environmentally aware, it’s like, companies are created because of that. Five years ago, people started talking about making sure you have diverse patients in your clinical trials. And today, we’re starting to see that shift, just like we saw with ESG, that you need to do it. Like if you don’t like you will be shunned if you don’t, and so they put in place metrics, they hire teams to focus on it. It’s more in the conversation, I think over the next five years, it’s going to be just as important as making sure that companies are carbon neutral like that. You can’t be a company today saying, we are bad for the environment, that just doesn’t work anymore. And I don’t think in five years, you could be a company that doesn’t have really specific metrics and goals around making sure that you’re promoting health equity, diversity, in your studies, and your education and the medicine you’re creating. And I think we’re really at this crazy inflection point. COVID helped accelerate it. Some of the Black Lives Matter movements that happened over the past few years helped accelerate it. Incidents with police helped accelerate it in the US. And so, I really think it all came together. And now we’re seeing this movement, and companies take action finally.

Garth Sundem   06:41

You know, and Medical Affairs, as a whole, talks a lot about demonstrating the value to the organization. And this seems like an area where Medical Affairs can really take the lead, not just executionally, but strategically, in saying, look, we know that we need this broadened perspective of the real world. And look, we are the function that can provide that within the organization.

Ariel Katz   07:06

I think it needs to. Today, if you look at organizations, it feels like a life science company, a pharma company, it’s generally the concept of health equity is either being driven by a health equity department, which are new ones that are being spun up over the past year basically, or by their clinical development teams, since FDA said you need to have diverse patients. People listen, you don’t want your drug to not be approved, because you don’t have diverse patients in your studies. Not as much by the commercial teams today. And with medical, it’s just starting to be spoken about, we hear that one out of every 10 companies we work with. But I think that’s going to change. And I think Medical Affairs is in a critical role, because we’re so much on the front lines, and the medical strategy is so critical to company strategy. So yeah, medical is a big piece of this puzzle.

Garth Sundem   07:55

Also, health equity definitely is at the forefront of people’s minds now, is that the only, well, I don’t want to say the only, but is that the primary reason we’re talking about health equity is because society awareness, society changes, or are there new things that Medical Affairs can do now to actually promote health equity that it couldn’t do before, are there new capabilities, new competencies that allow Medical Affairs to make a difference now, in a way it couldn’t before.

Ariel Katz   08:26

I think now there’s access to more information. And information is power, if you could use it, like you can understand the race and the gender of the patients that a physician is seeing, which is interesting. So, making sure that your MSLs are engaging with the physicians that see a diverse set of patients is critical, critically important. I do think, so that’s new. And maybe that wasn’t here four years ago, three years ago. But I do think this has really come from changes in the world around us and society and trickle down into our industry. And we are really at the forefront of it with COVID and vaccines. The only thing on the newsreel a year and a half ago was, are these vaccines going to be inclusive? Or they, do they have a diverse set of patients that it’s being studied on all you could listen to on CNN, Fox News, whatever it is. So, I do think society is pushed these changes, and now Medical Affairs have the tools and the information to take action, just like their clinical colleagues are.

Garth Sundem   09:30

Well, you bring up the world and you know, the example of COVID vaccine availability is such an interesting one because you have the very macrocosmic take on that and that’s you know, health equity across countries. And then you also have the very microcosmic take on that. And that is, you know, vaccine availability within very specific communities within very specific cities within very specific neighborhoods. So, you know, do you see health equity issues? Globally, I think we have a fairly decent picture of, what are some of the health equity issues that you see more locally or regionally?

Ariel Katz   10:17

I mean, I think as a country, we failed in terms of health equity when it comes to the vaccine. Think about, think about the individuals and the disparities between people that are taking the vaccine, feel like they have access to the right information. I think we failed. Yeah, like we’re not seeing the uptick, we thought that we would stick around vaccines. And this is a great example where this is Medical Affairs’ role. What is our job to educate? Clearly there is an educational gap in certain communities in the US, to me that’s health equity at its forefront, right, right here in our home. And so yeah, I think that’s a great example where we could have done a better job educating certain communities, and we didn’t do that job upfront. And now we’re paying the price. And this is a law. There’s an aftershock. COVID. And this is years and decades of lack of education and engagement with certain communities. And I don’t think we’re going to be able to continue to operate that way. That’s gonna change in the future.

Garth Sundem   11:15

Well, and again, an opportunity for Medical Affairs to lead, so you bring up education, you bring up engagement, I wonder if there are other activities on this list of how Medical Affairs can work towards healing this issue of lack of, I don’t know what, again, understanding and engagement what else can Medical Affairs do in these communities?

Ariel Katz   11:43

So, I think, when I think it starts with the strategy, and starts with headquarters, and making this a priority, and making it a priority, that you’re not just engaging with the person with the most scientific publication who speaks on the stage at the top medical conference, but the individual, individuals you’re engaging with come from a diverse background, from different communities, different educational backgrounds, see different patient populations. And if you start with that strategy, they’ll start to trickle down to folks in the field. And if your strategy, depending on the individuals, we’re talking to changes from someone who was a top doctor at an academic medical center to someone in more rural community or inner-city community. And so, I just think it starts with the strategy and then trickles down to content that would be useful to different communities, because it’s different depending on who you’re talking to, scientific content, and then comes down to education and persistency around it. And so that’s how I think that, that’s the role that Medical Affairs needs to play. If I had a future ball, like from a Disney movie, I would bet that Medical Affair starts to do this over the next five years.

Garth Sundem   12:51

And that’s interesting that it could be driven by organizational strategy, you know, is the first step for a Medical Affairs team in, in working towards health equity, to create the buy in and thus create the strategy at the organizational level. And then everything flows from there.

Ariel Katz   13:15

Everything, yeah, yes. Short answer is yes, we are seeing the C suite of these large pharma companies make it a top priority, top and you’re, you see them creating websites, different programs, acronyms for it, and hiring teams specifically for it and how they could trickle throughout the organization. But it also needs to come from Medical Affairs leadership, and bring that up.

Garth Sundem   13:40

Up, and I don’t want to say down but at least parallel. Interesting. So okay, that’s where we start. We start with organizational strategy that may be driven by the organization, moving towards Medical Affairs, but we also have Medical Affairs speaking to the organization and saying, this is something we need to do. And what I hear you saying, Ariel, is that once we have that strategic imperative embedded into the organization, that every Medical Affairs activity that we’ve talked about in this conversation flows from that, you know, engagement, education, insights, that allows you to design around a patient population and engage a patient population. It all starts with strategy.

Ariel Katz   14:31

It all starts with Medical Affairs leadership strategy, and then needs to come from that team. Anecdotally, like we work with all the top 10 pharma companies, we’ve probably seen a handful of them, but half of them start to think about this and start to try and take action around it, which is amazing to see. I don’t know where that came from, came from the leadership and the vision or came from someone else at the organization. But we’re starting to see this change. And so, it’s exciting for the world. We’re starting to see some of this change.

Garth Sundem   15:01

Well, and I think if organizations don’t, they’re gonna find themselves in that non carbon neutral position five years from now and realize that they should have done something now. All right, well, let’s, let’s leave it there for today. Thanks, Ariel for joining us today. To learn more about how your organization can partner with H1 to promote health equity from the top down and from Medical Affairs up and all around, visit H1.co. MAPS members, don’t forget to subscribe. And we hope you enjoyed this episode of the Medical Affairs Professional Society podcast series: “Elevate”.