Thursday, September 15, 2011

Mundel Quits Novartis And Humbly Enters The Gates of Philanthropy

If you'd been slogging away trying to develop drugs for a pharmaceutical giant for the last three years, and one of the world's richest men offered you what is probably the highest-profile job in global health, you'd take it, wouldn't you?

So, apparently, would Trevor Mundel, Novartis' drug development chief, who this week announced he'd be leaving the Swiss group by year-end to become executive director of The Bill & Melinda Gates Foundation's Global Health Program.

It's a chance to do some good, leave behind the profit-motive, get back to basics. Indeed, Mundel declared himself "humbled" and "deeply honored" to take up the post, according to this WSJ piece. He isn't the first of Novartis' R&D chiefs to be attracted by the opportunity to contribute more broadly to global health goals: Paul Herrling, one-time head of global research, moved in 2003 to lead the not-for-profit Novartis Institute for Tropical Diseases in Singapore (although he has made clear his view that such activities do, at least indirectly, make business sense too).

Herrling's influence has since extended beyond Novartis: he was appointed, somewhat controversially, earlier this year to become part of a WHO group evaluating funding for projects in neglected tropical diseases.

As for Mundel: by quitting pharma outright to pursue philanthropic goals, he follows in the footsteps of Tachi Yamada, previously R&D chief at GSK, who retired from his position within the Gates Foundation earlier this year and is returning to pharma (Takeda) as well as a new role in venture capital (at Frazier Healthcare).

Yamada apparently drove the Gates health program through a vigorous expansion phase, to which Mundel is now expected to bring some focus and pick out the winning programs, according to this WSJ story quoting Jeff Raikes, the foundation's chief executive.

So what does Mundel's track record of picking winners look like? Critics may say not great -- under his watch, Ilaris was rejected for gout, Tasigna stumbled in some types of stomach cancer, and COPD drug indacaterol was held up. But Mundel also oversaw the development of multiple sclerosis drug Gilenya, the first significant oral MS therapy to reach the market. He also beat BMS's Sprycel to a first-line therapy indication for Tasigna. Indacaterol (Arcapta Neohaler) got there in the end. And Mundel oversaw a period of industry-beating growth in R&D spend, according to analysts at Sanford Bernstein, although it's unclear how well this has translated into pipeline assets (certainly the Phase III pipeline remains relatively small).

Most importantly perhaps, Mundel introduced into Novartis, upon his arrival in 2003, the concept of translational medicine -- the early assessment of the relevance of lab-based medicine to patients. Indeed, it was this approach that led to Ilaris' resurrection in the first place, following the compound's failure in RA: it came back in 2009 as a drug for a rare genetic disorder called Muckle-Wells syndrome.

And translational medicine was a critical piece of the puzzle for Novartis at the time, shortly after it had appointed academic Mark Fishman to spice up discovery research. As such, Mundel "bridged the gap between Mark [Fishman]'s somewhat esoteric, anti-commercial but very innovative research programs, and the market-focused, number-crunching trials necessary to get Mark's compound on the road to market," notes a former Novartis executive.

Mundel's next challenge will be similar: helping turn research ideas into real drugs to save real lives. But there's rather less money to spend (even Gates' pockets aren't bottomless): the Foundation's $1.5bn-$2bn in annual health research grants is about a quarter of Novartis' burgeoning R&D budget. And there won't be any stock options.

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