Evolution of Pharmaceutical Innovation. Digital Health Interviews: Amir Lahav

Hello everyone! Welcome to the latest episode of Digital Health Interviews. We would like to remind you to subscribe to the channel and comment under the videos to provide more feedback about the content. And of course, we’re very excited to introduce the guest for today’s episode. His name is Amir Lahav. Amir has been actively involved in the intersection of pharma and digital health. He has over 15 years of experience in healthcare, academic research, and clinical data science, and has held positions at Pfizer, Harvard University, and Mitsubishi Tanabe Pharma Holding America.

A Symphony of Innovation: Amir Lahav’s Journey

Amir Lahav’s journey is a testament to the interconnectedness of life’s pursuits. His career began in the realm of music, where he aspired to widespread fame with his songs. However, he soon realized the dichotomy that often exists between artistic fulfillment and financial stability, noting, “It’s either you make music or you make money: you have to choose.” His diverse interests didn’t end there; he was also an avid volleyball player and fitness enthusiast during his college years. These experiences were pivotal in shaping his character, exposing him to various people and scenarios that fostered a mindset conducive to thinking outside the box.

His creative inclinations later found a place in the field of digital health and artificial intelligence. Lahav’s academic tenure at Harvard Medical School and his role as an advisor at Digital Health Innovation laid the groundwork for his current position as an advisor. He actively assists these companies in achieving success and offers consultancy services to major pharmaceutical firms.

Lahav’s approach to problem-solving is unique; he doesn’t claim to have all the answers but instead facilitates the process of discovery, which he finds immensely gratifying. Currently, he serves on the Advisory Boards of approximately twelve companies, each at varying stages of development, which suits his dynamic nature and attention-diverse tendencies.

The Paradox of Progress

Amir Lahav has navigated the complex landscape of the pharmaceutical industry, experiencing its highs and lows firsthand. His tenure in the sector has been both enriching and challenging, providing him with valuable lessons, including those learned from his missteps. Lahav describes the pharmaceutical industry as a “unique animal,” likening it to a unicorn in its singularity and mythical status. The industry professes a love for the concept of “innovation,” yet, according to Lahav, there’s a disconnect between the idea and its implementation. He explains, “They like the word ‘innovation,’ but when you tell them ‘innovation’ what they hear is ‘change.’”

This perception often triggers a fear response, as change implies departing from long-established practices. Lahav empathizes with the industry’s cautious stance, recognizing that it operates under the weight of immense responsibility and is inherently risk-averse. He observes that a staggering 99% of decisions in pharmaceuticals are driven by the need to avoid, minimize, and manage risks, a reflection of the delicate nature of their work. Despite the challenges, Lahav remains engaged with the industry, helping to navigate the delicate balance between preserving tried-and-true methods and embracing the new possibilities that innovation brings.

Pharma’s Evolution in Patient Care

Amir Lahav acknowledges the inherent risks in the pharmaceutical industry, particularly the stark reality that a vast majority of drugs fail during development. This failure rate translates into significant financial losses, yet the industry remains cautious, often operating at a pace Lahav likens to a “snail operation.”

Despite the conservative nature of pharma, Lahav has observed a shift towards openness, especially in the wake of the digital revolution. The ubiquity of smartphones has transformed them into almost an extension of the human body, a change that has not gone unnoticed by the industry. Recognizing the potential of digital accessibility, pharmaceutical companies are investing in tools and technologies that leverage mobile devices for health monitoring and patient engagement. The COVID-19 pandemic catalyzed this transformation, forcing the industry to embrace remote patient monitoring as clinical trials were disrupted.

Then Amir Lahav delves into the pharmaceutical industry’s recent epiphany regarding remote digital monitoring and decentralized healthcare methods. The necessity to adapt during challenging times led to a rapid shift in perspective. Lahav notes the newfound appreciation within pharma for the benefits of remote patient monitoring, stating, “Not only do you get more frequent and continuous data but you may get very accurate and very powerful data.”

Lahav highlights the irony of clinging to outdated practices when technology offers superior alternatives. He draws a parallel between the reluctance to abandon old methods and the absurdity of preferring faxes over emails in an age of digital communication. The industry’s willingness to embrace smartphones as a medium to extend care beyond clinical trials signifies a major transformation. Pharma companies are now able to directly engage with patients in the real world, offering companion apps that accompany specific medications. These digital tools not only aid in disease management but also provide pharmaceutical companies with invaluable data on drug performance across diverse patient populations.

Lahav concludes with an optimistic view of the pharmaceutical industry’s adaptability and eagerness to learn. He believes that while the industry may be slow and risk-averse, it is open to embracing new opportunities, provided the communication is effective.

The Pragmatic Approach of Pharma Partnerships

Amir Lahav and our host Alex Koshykov discuss the challenges faced by startup founders in the pharmaceutical industry, highlighting the reluctance of large pharma companies to collaborate with startups. Alex observes that pharma companies prefer to replicate solutions in-house rather than partner with startups, which often present themselves as too premature for collaboration.

Lahav points out that the pharmaceutical industry’s hesitance is rooted in risk management. Given the high failure rate among startups, pharma companies are cautious and conduct thorough due diligence before committing to partnerships. He emphasizes the importance of communication and transparency in these potential collaborations.

A recurring mistake Lahav noted is the tendency of young CEOs to overpromise the capabilities of their startups. He says, “Pharma is allergic to sales pitch. They don’t like it; they like and appreciate young startups that come to them and say ‘We have preliminary data. We think there’s a promise here, there’s a potential.’” Lahav criticizes the practice of overselling without substantial scientific backing, which often leads to a lack of sustainable relationships with pharma companies.

Lahav also advises startups to prioritize transparency and realistic presentations of their products to foster successful partnerships with the pharmaceutical industry. He warns against the unsustainable approach of putting “the wheels before there’s an engine,” which ultimately backfires in the face of investor expectations and industry standards.

Amir Lahav shares his perspective on the interaction between pharmaceutical companies and startups, focusing on those with a B2C model. He clarifies that while startups can manipulate app store systems to boost their product’s visibility, this tactic doesn’t work on pharma companies, which require genuine value to be convinced.

He unveils a tactic that often sways pharma companies: the use of competitive intelligence. During advisory committee meetings, Lahav finds that pharma executives show little interest in digital health products or digital biomarkers until he mentions a competitor’s involvement. At this revelation, “By the way, Novari is doing this,” the executives’ attitudes change dramatically, showcasing their fear of missing out on a competitive edge.

Lahav observes that many pharma companies exhibit emotional responses similar to those of five-year-olds who envy others’ toys. Despite the sarcasm in his analogy, he stresses the importance of competitive intelligence in the industry’s decision-making process. In the end, he points out that patients will gravitate towards treatments that offer more advantages and enhance their experience with disease management, underscoring the significance of patient-centered solutions in a competitive market.

The Middle Ground in Clinical Trials

Amir Lahav shares his current views on the state of clinical trials, particularly the balance between virtual and traditional methods. He believes that the industry has overextended the concept of decentralized, virtual trials. While acknowledging the benefits of remote participation in certain study activities, he insists that not all aspects of clinical trials can or should be virtual.

He explains that flexibility is key and that the FDA and the Decentralized Trials Research Alliance support a hybrid model where patients can engage in some parts of the study remotely. Lahav compares this approach to a GPS advising a U-turn “if possible,” suggesting that remote activities should be integrated into clinical trials when feasible to reduce patient burden.

Lahav emphasizes that this flexibility can lead to a more diverse patient population and cost savings, but warns against the unrealistic expectation of conducting trials entirely virtually. He concludes that a balanced approach, which does not fully abandon in-person clinical settings, is essential for realistic and efficient trial outcomes.

The Future of Remote Patient Monitoring

Amir Lahav expresses his enthusiasm for the advancements in remote patient monitoring, particularly the integration of artificial intelligence (AI) in analyzing data from various devices. He is most excited about devices that can enhance the efficiency and speed of clinical trials.

Lahav highlights the transformative potential of AI and predictive analytics in real-time data monitoring. He explains that this technology enables pharmaceutical companies to adopt a proactive approach to managing clinical trials, a significant shift from the traditional reactive stance where actions are taken only after issues arise.

He emphasizes that a valuable remote patient monitoring tool utilizes AI to provide actionable insights from real-time data. Such tools allow for early intervention, potentially preventing complications and improving trial outcomes. For Lahav, the ability to act on predictive data analytics is a game-changer in the field of clinical research.

Selecting Startups: The Amir Lahav Approach

Amir Lahav, known for his advisory and investment roles in numerous startups, has a straightforward criterion when it comes to choosing a startup to work with. For Lahav, the decision hinges on the people behind the venture. He believes that at the end of the day, what truly matters is the team’s character. “You can work on the coolest invention in the world, but if the CEO is arrogant, it’s not worth it,” Lahav asserts.

He strives to associate himself with individuals who are problem-solvers, those who set their egos aside, and prioritize emotional, social, and interpersonal harmony. Lahav candidly admits, “I like the sound of my footsteps walking away from people that annoy me; I’m addicted to that sound.” This reflects his commitment to surrounding himself with the right people, emphasizing that life is too short for anything less.

When evaluating startups, Lahav looks for those that address significant problems with solutions that can scale. His criteria are clear: the solution must save money, time, or lives. If a startup’s offering fails to meet any of these conditions, it doesn’t pass its initial screening. He seeks evidence that the startup can bring value to its target customers, which then opens the door to further discussions about differentiation, business models, and clinical validity.

Lahav is also mindful of the value he can bring to a startup. He avoids merely being a decorative name on a company’s website. Instead, he focuses on whether his experience can contribute to the startup’s growth and improvement. “I’m also trying to be very respectful of my time and their time,” he explains, ensuring that his involvement is both meaningful and impactful.

Embracing the Future: The DHAI Conference

Amir Lahav is gearing up for a significant event in October, the Digital Health & AI Innovation (DHAI) conference in Boston. With an expected attendance of 400 to 500 people, Lahav is particularly excited about this gathering, which seems to be a convergence of his professional and personal circles. He has extended invitations to friends from diverse sectors such as academia, healthcare, pharma, tech, and even patients.

One of the sessions that Lahav is emotionally invested in will feature real patients sharing their desires and expectations from the development of clinically meaningful solutions. He emphasizes the importance of including the patient’s perspective, stating, “I believe in the power of patient voice to inform a lot of the things we do and how we do them.”

The conference will delve into various topics surrounding artificial intelligence, including its future, the role of humans in an AI-driven world, and the collaborative potential between humans and AI. Lahav dispels the common fear of AI replacing jobs by highlighting that AI enables people to focus on what they are best at, such as patient care, rather than administrative tasks.

Lahav extends an open invitation to the event, promising that it will be fun, entertaining, and educational. He values honesty and encourages speakers to share not only their successes but also their failures. “Don’t try to sugarcoat it,” he advises, advocating for transparency over false success narratives. This philosophy underpins the conference’s ethos and the community it aims to build.

Our previous episode was with Bradley Tusk: Driving Innovation Through Regulation