Stefan König: CEO of George Medicines

BioBoss host John Simboli speaks with Stefan König , CEO of George Medicines, headquartered in London. Hear Stefan’s thoughts about leadership in biopharma and how George Medicines is working to extend and improve the lives of people suffering from the world’s leading causes of death and disability—including hypertension, cardiovascular disease and type 2 diabetes

Transcript

John Simboli  0:00  
Today I'm speaking with Stefan König, CEO at George Medicines, headquartered in London. Welcome to BioBoss, Stefan.

Stefan König  0:07  
Hi, John. It's a pleasure to be here. Thanks for having me. I Look forward to our conversation today.

John Simboli  0:12  
What led you to your role as CEO at George Medicines,

Stefan König  0:15  
I have to say I never really had planned out my career to become CEO. At some point, it was probably just before the pandemic, or maybe during the first part of the pandemic, that I realized that I'm halfway through my life, I'm mid 40 right now, halfway through my career. And I spent the first 20 years of my career working for big organizations and big pharmaceutical companies. But I also spent a significant part of that career living in emerging markets. What we call emerging markets, so countries that have a developing economy, countries that have part of the population living in poverty. And I've seen how inequalities, inequalities truly affect people, they affect the lifespan of the people they affect, you know, what people are striving for, what people are dreaming about. And I felt it was time for me to make a step-change in my career and in my life and really focus, what I think is the second part of my career now, to work on jointly with a group of people to make these inequalities better, to make the world a better place, and to offer solutions that would be equally accessible and equally affordable for people around the globe. So this is really what drove me to go over to George Medicines. And it was the desire to build an organization embedded in a different stakeholder network, because any pharmaceutical, any big pharmaceutical company, as far as I know,, they have to have a very embedded stakeholder and shareholder network, and they have to deliver to certain goals, just like we have, but we have shareholders and stakeholders that have different goals that have the goal of, you know, evening, these inequalities that exist. And they have also the goal to just bring up many low and middle-income countries to the same standards of basic health care that we enjoy in some of the more mature markets. And I could immediately identify with that. And it was also, you know, after having built within global companies, teams and organizations and local, regional, global business units, it was an opportunity again, from almost scratch to build an organization, fill it with the energy and the spirit to fight for that, I think, noble goal.

John Simboli  2:31  
In that moment, that realization that this was your calling, this was your next step. had you considered either the other, you know, big categories of starting something from scratch, absolutely, from scratch, rather than going through the George framework, or taking it to a very traditional large pharmaceutical company? Had either of those options been serious possibilities?

Stefan König  2:55  
Both of them went through my mind. In fact, I was almost about to join another big, big pharmaceutical company, when the opportunity opened up a Georgia Medicines. And there were not a lot of sleepless nights ahead. In order to trade-off between these two opportunities. It was pretty obvious that I wanted to have a step change in my career. And on the first opportunity that you mentioned, did I ever think about starting a business on my own? A lot. But I have to say it needs to come with the right set of foundation of opportunity, of having the background of having an idea to start something. I had plenty of friends who taught me we have to start at some point, a business. But it was always like, what around do we want to build a business? And I suddenly myself in front of the George Institute and their willingness to build a commercial arm of commercializing, and finding an application for the inventions, the research of the George Institute. And here we go.

John Simboli  4:00  
Would you tell us just a little bit more about the George Institute as you found it, and I know that you've helped to create something that's a new aspect of it, or variation on it. But as you found it, what was the attraction about the George Institute in particular?

Stefan König  4:16  
The Georgia Institute, as an institution, I believe, has the key theme of helping societies and helping the world to strive for equal opportunities and equal access and driving research in areas that benefit people. Again, equality across the globe. And whilst I'm painting with my hands here, the picture of the world, I do realize that this is a huge goal. But the institution, since its foundation two decades ago, has been really successful to drive meaningful research in that area. Any equal health care across the world. exists of this triage of three different key items. It is the quality of care, which means the physicians and non-physician care that you have access to. And then it's the treatments and the ease and simplicity and the quality and strength of these treatments. And then lastly is, can I actually access that in the part of the world, or in the part of a country or region that I'm living to? And all these three needs to come together. So I think ultimately, the Georgia Institute realized that with all the good research, with all the good care and the capacity and capability building that the Institute has done, they won't be able to drive that unless they're taking this last step in terms of really offering and, if you want, commercializing, although I don't like that term, commercializing wisely. Clearly, as commercialization, we make the drug available through known distribution at some new distribution channels, they realized they couldn't get there without the asset. And this is why we are here. And this is how I would define the mission of George Medicines. And all of that is built on novel and proprietary both technology and research. So I want to strengthen that. So it's not just that we go on and copy-paste things. But we really strive for using the latest in research. And we do have an IP strategy that lies behind that. And we do have a proprietary manufacturing strategy. So all of that comes along with the research that comes out of the institute.

John Simboli  6:38  
How did you decide you wanted to lead a biopharma company as opposed to be an important member of a biopharma company? Leading one is a big step.

Stefan König  6:46  
I've been in leadership roles before. I've ed country organizations with a couple of hundred employees, I've led, as I said, global business units. But then at the end of the day, you always realize that forming part of a bigger organization was, it provides a certain comfort level, you always have to adhere to the rules of that organization. And I spoke about the shareholder and the stakeholder framework that this organization lies in. So I think it is really important once you realize that, and you realize that you want to step out of that, you can only do that meaningfully, once you lead your own business. Again, you will have a board to report to, you'll have shareholders and people will provide the finances that you have to satisfy, in inverted commas, if you know what I mean. But it is yet different. Because you can work with these people, you can compose board members, and you can just ensure that the company gets a different steer. I think what I'm telling you is, I guess you have more liberty to do that. And once you realize that for fulfilling a certain purpose, you want that liberty, it's a little step to say, from being an a leader of an important part of an organization to becoming an enterprise leader. I guess you'll have to take that step.

John Simboli  8:06  
What were you hoping to achieve that could be done at George Medicines and not at another company?

Stefan König  8:13  
I think what we share at the Georgia Institute and the George Medicines is that we believe there is a big and huge unmet need. And we found a way. And we found the means to improve that. While that is not so dissimilar from any big pharmaceutical or care organization. I think what is novel, at George Medicines, is that we have this connection with academia, with early and late-stage research with other pharmaceutical enterprises. So I see it as almost sitting in the middle and having discussions and being able to pull different levers and pull in people. And sitting with these diverse teams around the table, and ideating these solutions. I find that very different than working in a more classic pharmaceutical environment. So I do think there's a very unique and novel aspect about it. And it ties back to what we think and what we believe our mission is, which is extending and improving the lives of millions of people suffering from the world's leading causes of death and disability. And we want to do that through affordable medicines and through affordable care. And I guess that's the key difference. We don't have to fulfill any shareholder expectations in the sense of ideas that are dilutive to the revenues, are diluted to the profit of the company. But you can do that with a more free and more open mindset. And this academic angle that we come from provides us optimal, unbiased insights without having to take care of many of the other aspects. And also bigger organizations have to take care of. I think also, a lot of the value of our organization lies and its very nimble and lean size, and that we decided, on purpose, to partner out certain items of our business,

John Simboli  10:27  
To what degree is the single pill aspect, maybe there's a better term, a key to making this idea work?

Stefan König  10:34  
The single pill in combination, drug therapy is the vehicle that we've identified John, in order to achieve what I just described as the vision. The single pill offers many benefits in terms of adherence and compliance. But more importantly, it offers a very important efficacy and safety benefit compared to existing therapies at standard dose, the opportunity that you have is with the single pills and through the combination, through a smart combination of different pharmaceutical ingredients into one pill, you can go in with a much lower, if you want, starting dose, we call that an ultra low dose formulation or a low dose formulation, which usually starts with a quarter of the normal standard dose. And if you combine, for example, in our lead candidate, three of the quarter standard doses of three active ingredients—they are well known and well studied or best in class—then you actually have a very important efficacy and potentially important safety benefit for patients that take that single-agent versus a regular standard dose. But overall, what it does, it offers simplicity, for the treating physician and for the healthcare system that is deciding to use these drugs, because by offering more efficacy at a similar or better safety level, it avoids the cycling between the patient and the physician, going back and forth on finding the right drug or finding the right strength. And it just gets much earlier to efficacious outcomes for the patient. And we also know by just looking at the figures, for example, in terms of how hypertension is treated, that oftentimes this cycling back and forth, this patient-physician dialog is broken and doesn't happen. And that is true for mature markets, with good health care systems as it is true for emerging countries with immature or incomplete healthcare systems.

John Simboli  11:43  
And that tactic, that path, that mechanism for realizing that vision that you just described, a single dose, was that clear to you coming in as CEO that this was going to be the means to do it? Or is that something that evolved?

Stefan Konig  12:57  
It was already there, John, when I joined, this idea of polypharmacy and poly medication, and by the right combination, achieving what I just described—a simplistic, more efficacious, and potentially safer approach to treatment. And I think what you will see is that this will evolve over the years as well, at George Medicines. All of our products at this moment that are in clinical-stage development, or that are in the pipeline, are based on that approach. So it's quite fundamental to what we do at this moment. But as I said, it's a vehicle for me. In the future, I'm not excluding that you'll find different vehicles that are equally as paradigm-changing as this combination product theory at a low dose and ultra-low dose that I was just describing. For now and for the foreseeable future, it is certainly where George Medicines' heritage is built on and I think this is also how we are going to deliver on key aspects of our vision and mission

John Simboli  13:04  
As the CEO of a company, what do you do?

Stefan Konig  14:07  
I want to provide a platform so that people can ask the questions they need to ask. I want to provide a platform for having diverse thoughts and diverse opinions and diverse access to different sources of information so people can excel in living their dreams iving their thoughts. And then, at the same time, once I provide that platform, I provide as part of the platform, the guardrails that keep people within a certain frame that sometimes can be wider and sometimes it can be narrower. It keeps people within that framework of ensuring that we deliver to the end result, which is the vision and the mission that we have as a company of providing accessible combination products for improving noncommunicable diseases and how these diseases are being treated around the world. So it's a platform for people to live out their ideas. And I think what really motivates people is that they see they can own something, they have a baby, they can develop that further within these guardrails. And this gives you the ultimate sort of motivation and impact from people. And especially when you speak about academic scientists, these people are all driven by an idea. And if you fit these people within this platform in this framework, I think that's what we ultimately do as leaders of a company if you provide both the diversity, the chaos, but you also provide the guardrails in order to make this chaos a useful and meaningful chaos for society.

John Simboli  15:56  
How do you go about being collegial and still making the decisions you have to make?

Stefan König  16:01  
I oftentimes am not the subject matter expert so I'm oftentimes not the right person to take a specific decision. Oftentimes, you need experts, you need teams, you need people who look at things from diverse viewpoints. So what I want to do is I see myself as a facilitator. I see myself chairing these conversations, who's leading these conversations so that people can actually express their ideas and I can get the best expertise out of people. And in many occasions, surprisingly, you actually arrive, not always at a consensus, but you arrive at a very clear path forward when you facilitate these conversations right. So I see myself as a facilitator, in the day-to-day, of these conversations that allow us to come up with a decision. Rarely, I mean, there's certainly a few key decisions, and, you know, sometimes the buck just stops with a CEO, I know that. But on the flip side, I don't these are the most important, strategically the most important decisions. But these are oftentimes operative decisions that you have to take, be it a salary raise or be it, you know, be it something else that is more tactical in nature. But I think on the big strategic decisions, it is truly the facilitation of a dialogue of experts that have me and have the organization arrive at a certain decision point.

John Simboli  17:31  
Can you remember when you were a boy, when you were maybe eight or nine or ten, something like that, and you were working through that process of what do I want to be when I grow up? Which, for most of us, is I wonder what my parents want me to be when I grow up? Can you remember what that image was, and does it have anything to do with what you're doing now?

Stefan König  17:49  
I was quite interested in all kinds of technical solutions and in physics, during my sort of school years, and I always wanted to become an inventor. And I didn't exactly know when an inventor means. Of course, an inventor is not a profession per se. I don't think you can probably even make a living on being just an inventor, some do, but most of them probably don't. But I think what it tells me today, looking back, what this idea of being an inventor or becoming an inventor is actually it's about creating a meaningful solution that is usable for societies at large to improve, or solve a solution, solve a problem. So an inventor, in other words, contributes by solving a challenge. And I think this is what drove me, apart from all the technical aspects that would interest me, but I think this is what really drove me to become an inventor. And in that sense, I don't think this has changed over the course of my career, not now, not on what I did previously working for other companies and other businesses. I think, ultimately, what you do is you try to understand what a problem setting is, what a challenge is, and you try to solve for that in the best possible way. And you try to offer a solution or you try to offer, that may be a product, may be a service that may be, you know, something that helps to overcome that obstacle. I think that's what inventors ultimately do. Sometimes it includes uncovering that there's actually a need, but oftentimes, the need is quite obvious if you look at the datasets from the right perspective or the right angle. And I think this has been driving me since then, probably. And there are different ways, different inventors, I think, as you can be an economist, you can be a physician, a physicist, you could you know, you can have all kinds of different professions that actually are quite inventive, and focus on providing a problem solution.

John Simboli  19:55  
In my experience, there are meetings where you as the CEO can ascribe what the company is about in the same kind of way you're doing with me right now in which a certain percentage of people will understand what you said, and will say, let's talk later, I think there might be a fit. A certain percentage will say, I've understood what you say, we're not just the right ones for you or for each other. The third group will say, I think I've understood what you've said, and you'll realize by what they say, no, that's not what I was going for. They went somewhere else with the concept I was trying to go forward with. And my experience is that can sometimes fall into some categories, some patterns. So that what I'm trying to ask is, when people don't get the story, right, when they bring their own perceptions to and it's not the one you're intending, what do they tend to hear and how do you get them back on track?

Stefan König  20:45  
One misconception that we have often when I speak to people is Oh, you are the polypill maker, the polypill maker. And you may have heard about the polypill, is a probably now 10-year old concept of combining different antihypertensives, anti blood-clotting agents, and statins for controlling lipids into one single pill. It was thought to be a treatment that could potentially extend people's lives, as well as it could improve the quality of years that people have to live. But it was thought of as a preventative therapy. So the only indication that was really out there for the polypill was age. And it's a concept that was tested academically. And in many studies, it actually proved to be successful, but it never turned out to be successful in a commercial or even non-commercial setting. And whilst the academic results have been widely accepted by the community, there was never any net benefit or never any net effect in healthcare systems using the polypill approach. And that is for two reasons. One is the polypill didn't really work on changing the dosing regimens of the ingredients. And then secondly, the polypill wasn't really targeted towards solving an actual health problem. It was just a preventative medicine. And this idea of prevention in medicine is something that is very difficult and very hard to transmit. What I'm always telling people is we are not the polypill company when they're going down that path. I think this was where you were heading to—we are not a polypill company in the sense of, you're not trying to combine just different ingredients that are well known in order to prevent the onset of health problems What we are trying to do is to find best in class ingredients that by a combination of best in class ingredients, achieve a certain desired health outcome for a specific disease problem or for a specific disease challenge. And this is how we've developed, for example, our lead product candidate, which is a pill of antihypertensive medications, targeted to resolve very specific blood pressure challenges. So one category is George Medicines as a polypill company. Another one is saying, oh, George Medicines is an emerging market company, who intend to be selling and marketing their drugs in low and middle-income countries to ensure that these patients get access to medicines into health care as well. Also not true because we have the vision and the idea and the means to play equally in mature markets, as well as in emerging markets. Because it's utterly wrong to say that, for example, the care of hypertension is well controlled and is well placed in mature markets versus emerging markets. If you just look at the US, for example, over half of the people who know that they have hypertension, live with the disease and they have not that disease under control. Half of the US patients don't have well-controlled blood pressure, who know that they have a blood pressure problem. And then if you look at the inequalities, even within the US or you could go to the UK, just for changing the setting, you have from one postcode of a city, let's take London for example, to the other end of London or maybe to the center of London, you have a difference in life expectancy driven by cardiovascular disease of about 10 years within the same country under the same NHS, health care broad circumstances you have 10 years difference in life expert expectancy of people just by looking at patient records from zip code, a postcode perspective. So our treatments are equally important for emerging countries, who oftentimes have a need to move faster and more decisively than mature markets. But the inequalities exist in mature markets and the challenges exist equally in the mature markets as they exist in emerging countries for cardiovascular diseases. So that's one of the sort of biggest learnings I think we are just uncovering as a society as we speak about that. We've just had a few days back, World Heart Day, and at World Heart Day we covered, every year, we observe World Heart Day, we uncover a wealth of new information. And we uncover a wealth of new challenges, as you look into data sets better with artificial intelligence, with digital means, we uncover every day more, in terms of what we need to get right to treat what is still the biggest killer of people, it's not cancer, it's actually cardiovascular diseases. There's a multitude of factors in there, of course, John, there is education, which oftentimes, you know, higher education levels oftentimes leads to different lifestyles, that leads to different checkups, and, you know, patient-physician conversation to that and leads to better adherence and compliance. So there's a multitude of things in there. And I'm acutely aware we can only, with our treatments that we offer, try to solve for parts of these, but then we are part of a bigger stakeholder network, where I said this triage of the three different elements that make good health care, you know, you want to be part of, of a team, and we want to be a team player, working with institutions that help to measure, to access, to treat patients adequately,

John Simboli  26:52  
How does the pipeline express the vision that you have for the company?

Stefan König  26:57  
So the pipeline that we are building is focusing on trying to understand what are the biggest health issues that we observe as a global society. And when I say global society, I truly mean this as a global society. So we really take this step back, we look across countries and continents, in order to understand what are the biggest health challenges that we have? Which are the health challenges that are evolving and developing and growing, and which are ultimately the biggest ones that need to be tackled? This has led us in our first drug candidate to tackling cardiovascular disease, one specific aspect of cardiovascular disease, which is hypertension, uncontrolled hypertension, which has many, many facets to it. So we ultimately, when we do that, and we prioritize, and we've just gone through a big pipeline prioritization process over at George Medicines, is we try to understand what's the impact observed? And we use other measures like patient-years of life impacted. What's the impact that we can have to a global society with therapy, X versus therapy Y versus therapy Z? So that is key for us, and has almost become a hurdle. If you don't meet a certain threshold it's almost as if we're not going further on a given idea. I think this is also what makes us different over at George Medicines is that we ask ourselves the question first, what are the biggest problems to address? Not where's the most money that we could be making? What are the biggest problems that we want to address, versus where do we have the best solution that we can offer? And then we go deeper and we try to understand what are the academic research that we have available for a given outcome?

John Simboli  28:59  
What's new at George Medicines?

Stefan König  29:01  
What is new is that for the first time, we've had an opportunity based on the financing from a venture capitalist, to run that global phase three trial that is targeting the FDA submission. What is also new is that we have, for the first time, really gone through a rigid process of pipeline prioritization, where we had an opportunity to look and try to figure out which are our most promising product ideas, where we have the best global impact to healthier societies, true to our vision, and which are the next candidates that deserve to go through a similar development pathway?

John Simboli  29:45  
Do you allow yourself at this point to think, if this comes along the way I hope that it will we're actually going to change people's lives in a profound way?

Stefan König  29:52  
I envisage, together with my teams, daily, almost, in terms of what would happen If that drug finally hits a given market, and how could we change the standard of care in that market as well. Because in medicine, it takes multiple parts and I spoke about the triage of three different elements, at least, that need to happen in health care, which is measuring, treating, caring, and accessing it, finally, if you're going to add that fourth piece on. And we envisage that daily as we go and run clinical trials in country settings, where you compare, for example, a given therapy from George Medicines, versus the standard of care, because what you want to understand is how is our treatment doing, versus a given standard of care, be it in the US be it in the UK, or be it in Nigeria, or be it in Sri Lanka. And we've been able to run some of these studies. For example, we ran a trial in Sri Lanka, versus the local standard of care. And you wouldn't think how good, actually the local standard of care is in Sri Lanka, it's pretty comparable to what we do in the UK. And the standard of care in Nigeria is not so dissimilar to how hypertension is being treated in France. You wouldn't be surprised because most of the treatments in hypertension are widely available, they're off patent at this moment, they are relatively accessible. But still, though, as I discussed, you need a different angle in terms of how to treat hypertension and not only hypertension but other big non-communicable diseases appropriately. So we ask ourselves these questions, I would say, daily. We try to keep very much in touch with prescribers with not only key opinion leaders, but the actual prescribers, which oftentimes, as a primary care physician, we have in our team, a lot of former, and still currently practicing primary care physicians, who sometimes come from these countries, which is a great advantage in working and the broader setup of the Georgia Institute as well, because we have the source our talent from, from these countries, oftentimes, where we want to make the biggest differences. It is not just the US, or not academic institutions in the UK, but it's the lead for our Africa programs come straight from Nigeria, for example, the lead for some of our Southeast Asian programs comes from Sri Lanka. And here we go. I mean, we have these people who've worked as a physician in these countries. And they help us not only to understand, but they do help us to keep us true to our mission as well on what our products can be doing in these kinds of settings. Interestingly, although you would think about, for example, hypertension or diabetes as largely soft problems. They're actually not solved. Whilst the treatments and the solutions may be out there, they're either underused, they're not well understood. So we have to take and bring that to a different level. And we have to offer faster, easier-to-use solutions for adequately tackling these challenges. And I think you're completely right when you say, with the products that George Medicines intends to offer, you can both achieve the magnitude as well as you can achieve the depth of an improvement. But if you think about the global society, as one society for just a moment, going back to understanding what are the biggest, specifically to healthcare, because that's the industry that we play. And these are the solutions that we offer for the challenges that exist, what are the biggest challenges that we face as a global society? And there are many, but there are a few things that impact people on a global scale. And quite honestly, we spoke a lot about these diseases, it's not communicable diseases. You just go through the statistics and you see very easily it is cardiovascular diseases that need to be improved. It is diabetes that needs to be improved. And then for a long time comes nothing. And then there's a few communicable infectious diseases that come on top of that. And I think as a global one society is one world. And it sounds very idealistic, you know, by no means I want to, I want to be as idealistic. But if you really want to understand what the global society, as a whole is suffering from, you need to tackle these things first. And then you need to need to delineate, you need to understand what is driven by inadequate care, what's driven by inadequate treatment, and what is driven by inadequate access. And in each of these things, you will find items that require fundamental step change. Now, we as George Medicines can only do so much and I spoke about the importance of a team of care and about access, which we will be difficult to address all of these but what we can offer is you can offer better therapies that hit on these goals to improve the big challenges that we have as a global society. And we can help a bit, as well, with access because as I said, we are for-profit in mature markets, but we are certain li for nonprofit in the low and middle-income countries but most of our friends of a global society sit. And I think this is where you really want to want to drive a step-change.

John Simboli  35:14  
Thanks for speaking with me today, Stefan.

Stefan König  35:16  
It was a pleasure. Enlightening conversation and I hope we will be able to meet again soon. Thanks for having me.