Building a better health care system: A conversation with Mark Reisenauer, President of Astellas US

Our industry continues to work tirelessly to combat the COVID-19 virus by developing effective therapeutics to treat COVID-19 and vaccines to prevent future infections. As we continue our efforts to bring the pandemic to an end, we should not miss the opportunity to learn from it and use those lessons to build a stronger, more resilient, affordable and equitable health care system.

I had the opportunity to connect with PhRMA board member and Astellas US President Mark Reisenauer about how we can build a better health care system for all Americans.

Steve Ubl (SU): First, I’d like to welcome you to the PhRMA board. I know our industry’s fight against disease is personal to you. Would you mind sharing a bit about your journey in the industry and why you’re so passionate about pursuing treatments and cures?

Mark Reisenauer (MR): Thanks, Steve. It’s a privilege to join the PhRMA board at this important time, when the industry is contributing so much to public health and poised to deliver even more medical and scientific breakthroughs.

For me, it was the opportunity to bring safe and effective treatments to patients that got me hooked on this industry in the first place. I was a political science major, taking a break before law school, when I first went to work as a pharmaceutical sales representative. The role grabbed me, and I never looked back.

I love the constant learning in our industry – understanding disease states and staying on top of new advances so we can share them with health care professionals and, ultimately, having a meaningful impact on people’s health.

I relish the collaboration – few industries demand more active and constant interaction with so many stakeholders, from physicians and patient advocates to insurers and policymakers. And I revere the opportunity to make a fundamental difference in people’s lives – achieving better health, getting diseases under control, and sometimes delivering outright cures. The value created for society is greater than in just about any other industry.

Yet we have much more to do. That became clear to me at a personal level when I lost my father to cancer and more recently when a dear Astellas colleague passed away from pancreatic cancer in the prime of his life. He was one of those people who lights up a room with energy and perseverance, and was all about coaching, developing, and giving back to others. He will remain an inspiration for what we do at Astellas and in this industry.

SU: For patients who are struggling with diseases like cancer, they often face the additional problem of worrying how they’ll be able to afford their care. What are some things we can do as a health care industry to make sure that patients are able to access and afford their medicines?

MR: Worrying about accessing and paying for care is the last thing that a person needs when they’re sick. Battling a serious illness upends every part of a person’s life, and the lives of those caring for them. My family’s own caregiving experience with cancer changed me in that regard, opening my eyes to the challenges people face with our health care system. We can do much better as a nation, and our industry is ready to be a part of the solution.

I’m proud of PhRMA’s proactive agenda to make medicines more affordable. It puts the emphasis on lowering out-of-pocket costs for patients and their families, which have gone up disproportionately in recent years compared to other areas of the health care. In Medicare Part D, for example, that means capping beneficiaries’ out-of-pocket expenses and smoothing costs more evenly over the year. For people on fixed incomes, the financial roller-coaster of various coverage levels during the calendar year is an unnecessary burden.

Benefit designs need to change – guided by enhancing affordability and predictability for patients. No one should have to hold their breath at the pharmacy counter, wondering what it will cost this time. Patients should be the first to see the savings that result from negotiated discounts on medicines that our industry provides, and from cost-sharing assistance.

Of course, getting access to the right care at the right time often involves challenges beyond the cost of medicines. Medical “deserts” and ethnic and racial biases in care must be acknowledged and addressed as well. Too often, the absence of basic services such as transportation to health care facilities is what keeps a person from getting the care that they need. Cross-sector collaboration is the only way that we will get to holistic solutions for such challenges.

Five years ago, Astellas launched what we call the “C3 Prize” – a program that supports big ideas to change cancer care beyond medicine. I’ve had the honor to be centrally involved, and I’m constantly amazed by the resourceful, passionate proposals brought forth to improve the cancer experience by those who are touched by cancer. 

SU: What are some things we should look out for when making changes to our health care system so we can ensure the type of innovation we’ve seen against COVID-19 can continue against other diseases? 

MR: In addition to addressing affordability challenges, I believe a principle taken directly from the practice of medicine should guide us: first, do no harm. Some of the ideas on the table in Washington – on drug costs and intellectual property protections in particular – would put America’s biopharmaceutical innovation engine at grave and needless risk. Our industry’s response to the COVID-19 pandemic demonstrates the tremendous value we deliver to public health and society. Beyond the pandemic, we’re driving significant advances against other difficult-to-treat diseases and conditions, including cancer.

There are lessons to be learned from the creativity and speed exhibited in the development, regulatory review and distribution of COVID-19 vaccines. It would be a tragedy to disregard that evidence now and upend our successful system by letting the government set prices – as provisions in HR 3 would do for many treatments – or make it easier to invalidate foundational drug patents. 

Instead, we should look at what worked so well in the development of COVID-19 vaccines, and identify approaches that build on those lessons. I believe collaboration is key, with companies and other health care organizations partnering to get to solutions more quickly. We showed that clinical trials can be organized, executed, and analyzed much more quickly than we’re used to. Let’s make that the new standard practice! The relationship between industry and regulators during the pandemic also functioned well, and we should find ways to institutionalize the sense of urgency that prevailed, which is just as necessary against cancers and other diseases for which there are few or no treatments.

Above all – and this is a particular priority at Astellas – we should put insights gained from patients at the center of the entire discovery, development, and delivery chain. The pandemic underscores the importance of listening to patients on their risk tolerance and quality-of-life concerns, for example, with an emphasis on equitable access and care.

My passion for this industry is undiminished from the days when I first joined the profession. That’s because the medical and scientific prospects are brighter than ever, with things like cell and gene therapies becoming reality at Astellas and other companies. We’ve made a tremendous impact on many hard-to-treat diseases with limited options. Working collaboratively with all stakeholders will be essential in unlocking this potential. We will succeed by carefully reckoning what works well and what needs improvement in our health care system.