Read the Conversation
EF: What attracted you to Italy, and when you accepted this position, what mission did you set for yourself?
EK: Eli Lilly gave me the opportunity to have not just a career but a purposeful career. I truly had no idea what it meant when I was in my 20s, but it ultimately grew inside of me and today makes up the majority of who I am. Since I spend the majority of my waking hours at work, it is important to work on projects that have a purpose and an impact.
The work in Italy has a distinct quality; to us, Italy is a central manufacturing research facility as well as a commercial office. From our office here in Sesto Fiorentino, we oversee the entire region. Although we have regional offices throughout each of the countries, the Italy hub encompasses 19 countries, including Israel, Italy, and Central and Eastern Europe. The primary reason I was drawn to the position was my desire to assist patients, and being in a large area with a diverse population and culture gives me the chance to do so. The Italian team's reputation for being very innovative, motivated, and dedicated to their job is the second consideration. You are always drawn to working with a highly capable group of people who have a solid reputation. I, therefore, seized the opportunity as soon as it became available. I have been in the position for about five months, and thus far, it has not let me down. That is the reason I am drawn to Lily in Italy.
EF: What are the top priorities that you have set for yourself in the market?
EK: We must constantly remember why we do the work that we do. If you concentrate on the challenges, you develop tunnel vision and live in the reality you have created for yourself. Considering that we are a 148-year-old company, we have had numerous self-reinventions. Many people currently believe that our success was accidental; they observe our excellent pipeline and goods, but few realize the factors that contributed to our success. Our success is attributed to our relentless focus on innovation.
When considering our products, notice that we never strive to rank fifth or sixth in the market; we are not a business that pursues commercial activities in that manner. Before we move to either get a first or best in class, we frequently consider the next frontier disease areas that need to be solved. Let me highlight our product lines: we have had the first GLP1 ever, the first weekly GLP1, and now the first GLP1-GIP on the market. The first amyloid PET tracer was developed by Avid, a subsidiary of Lilly, whose invention completely changed the clinical trial environment when it comes to Alzheimer's. We have invested 35 years in that field, which is why we now have a solution for patients with early symptomatic Alzheimer's disease. We have the product that produces the best results for obesity on the market; this enables us to commit to solving a problem like obesity, a disease that can be linked to close to 200 other diseases. I can go on to list our accomplishments in the areas of oncology and immunology. We, therefore, take great care to ensure that our innovation is solving unmet needs for patients who are counting on us.
When I started working for the company about 16 years ago, every pharmaceutical company had a generic division; if they did not, they were starting one. The price of our stock was at its lowest. What was our response? We chose to bet on innovation. The success in the pharmaceutical industry usually predates you by 10-20 years and likely necessitates looking ahead by another 10-20. We are currently in a strong position, and we are focusing on out-innovating ourselves.
Like any market, Italy has its share of challenges. Even if I refer to it as an Italian challenge, the fact that we live in a world where people live long lives makes it effectively a global challenge. That isn't by accident; it's not the result of human evolution. The advancements in medicine, science, and pharmacology have increased life expectancy. The challenge then becomes, "How do you keep investing in this pharmaceutical innovation to give the population a higher expectancy while also improving quality of life?" That is something that every industry player should be discussing. The affordability and sustainability of healthcare systems globally are topics of debate and interaction among various stakeholders. The best way to solve these challenges is by focusing on deploying technology, technology within health systems, and pharmaceutical technologies. For this reason, we are spending a great deal of time collaborating with the Italian and CEE Israeli health systems to address the issues of solving the healthcare sustainability challenge by deploying technology. The industry we work in is difficult but very rewarding because, at the end of the work, there is a patient waiting.
Specifically in Italy, we assist 5 million patients through the hub. If you were a patient today dealing with obesity, type 2 diabetes, or breast cancer, for instance, would you be concerned about the difficulties we, as individuals who work in the healthcare industry, face? The simple answer is no: patients are not interested in hearing about our challenges when navigating the national versus regional systems, interacting with authorities, managing the price environment, etc. They expect us to provide them with innovation that makes their lives better.
EF: You spoke about out-innovating yourself; how can it be done practically?
EK: You find areas where needs aren't being served, use the resources at your disposal, assemble the greatest scientists and expertise to tackle the issues, and make the decision to solve them. For instance, we have been in Alzheimer’s disease research for 35 years and have spent $8 billion on research and development. Many scientists retired from Lilly before they could find a cure. We have had many failures, and every failure got us closer to a positive signal… The important thing is that we stayed the course and listened to the voices around us. Lilly is one of the few biopharmaceutical companies of our size that has had uninterrupted efforts in Alzheimer's disease. Everybody else enters and exits, and many only invest when there is a positive signal. Focus, consistency, and commitment give an advantage. We believed that patients depended on us, and we committed and persevered.
That is what it means to "out-innovate yourself," meaning to seek out more innovation rather than merely copying what others are doing.
EF: Why is an investment of one euro in Italy preferable to one made elsewhere? What health-related potential does the Italian market offer?
EK: Lilly makes investments in various parts of the world. We have been operating in Italy for 65 years, and our site in Sesto Fiorentino has had multiple investments. In the last 20 years, we made the decision to transform the site from a site that was dedicated to antibiotics manufacturing (a business we used to be in, to a biotechnology manufacturing site. The latest investment we made in Italy was 750 million dollars, focused on increasing our production capacity throughout the network. As it stands, our site in Sesto Fiorentino is a key site for the enterprise that serves the needs of over 9 million patients across 60 nations. We are very proud of our team in Italy and the accomplishments they have been able to score over the course of our existence in Italy, and they continue to prove that they are the key ingredient to our success.
One aspect to highlight is Lilly’s presence is not only centered around manufacturing; we have made a significant investment in clinical trials in Italy and . currently rank fourth in the country for clinical trials conducted, which indicates that we are providing high-quality medical care from physicians and matching it with both national clinical trials and production. Hence, we handle every aspect of manufacturing, clinical studies, and commercialization.
Every single person who works here is proud of this place. In addition, as I previously indicated, we oversee 19 distinct countries; we do not just concentrate on one market. You can only imagine the amount of investment we are making in human capital by equipping managers with the tools they need to manage globally and concentrate on the healthcare issues that affect not just one but nineteen different countries. Of course, there are large hubs here in Sesto Fiorentino, but not everything is managed from a command center; autonomy exists.
EF: Given that you oversee a center of 19 countries, how do you manage success?
EK: First and foremost, it's critical to consistently prioritize employing the greatest candidates. The values that Eli Lilly upholds typically draw in candidates to work here. It is a little-known fact that Eli Lilly and Company has been around for nearly 150 years. We did not change the company's name nor add a new name to the company’s name; it is still known as Eli Lilly and Company. We have not merged; instead, we have stayed independent and have made strategic acquisitions. Thus, the company's core values—respect for people, ethics, and excellence—are incredibly strong. These principles appeal to every individual who works at Eli Lilly because they are congruent with their own. Since values are learned at home, no company will ever teach them to you. The values of the organization must align with yours when you start working there.
We have worked out a method for finding individuals who share these values and are motivated to improve human health. They seek to make a lasting impact on human health, and we give them a platform to accomplish this. Our employees in Italy are dedicated to Eli Lilly's objective, just as this is the case worldwide for the company. The investment made in Eli Lilly Italy was made because it was worthwhile, and it was valuable because of the employees.
Many individuals who work in the field and comprehend the implications of foreign direct investment for businesses recognize that such investments carry a responsibility because they can have a positive social and economic impact on a country, and they do not take this lightly. Thus, they exert every effort to ensure that, upon reflecting on that investment, the company would recognize that it was the right decision. The employees at Eli Lilly Italy, however, are very clear that this job is not just about a salary but also about making a difference for patients and the country that we operate in, and they do a fantastic job in ensuring that we deliver. Of course, the remaining portion is to continuously persuade the authorities about the value of that investment and ways to continue making us feel welcomed as investors.
EF: We know the potential of AI in healthcare, but in practice, how can we ensure that AI is integrated in a way that benefits the patient?
EK: One of the primary issues is finding solutions for the antimicrobial portion of treating medication resistance, which Eli Lilly is working on alongside Open AI. As previously stated, we locate an unmet need, address it, give it attention, and invest in it. In this instance, we have chosen to collaborate with Open AI. Our long-standing collaboration on the issue of antimicrobial resistance is evidence of our unwavering commitment to it. Reaching 30 million additional individuals in 30 years is our 30 by 30 goal. Therefore, we are undoubtedly addressing that.
Today's market participants utilize artificial intelligence (AI) to quicken the cycle, enhance research accuracy, and guarantee that patient responses are foreseeable before we enter the clinics. I believe there are many uses for AI and data in general. In my opinion, AI will not replace people in the way that some people think. For instance, you will need a machine-like general manager or machine-like head of communications. However, AI will enable us to increase productivity and accomplish more with the same resources. AI will help our business by allowing us to serve a larger patient base.
AI must be viewed as a tool for integrating technology into every step of our processes. Since Sesto Fiorentino is one of the most technologically advanced plants in Europe, artificial intelligence is undoubtedly used in our manufacturing process. Artificial intelligence (AI) is utilized in research to ensure that our products get to the clinics quickly, receive responses quickly, and so on. AI is also utilized in our commercial aspect to enable us to get to patients more quickly. That is how we approach artificial intelligence (AI)—we incorporate it into our daily lives rather than expecting a radical paradigm shift. It is comparable to the cell phone in that, although it revolutionized certain aspects of our lives, it was also incorporated into our daily tasks. Today, I can approve an expense report through an app; formerly, I had to log onto a network and a computer. I may now reply to you while I am out and about.
Regarding healthcare systems, Italy and the rest of central and eastern Europe generally use the same formula: 15% of budgets are allocated to pharmaceuticals, while 85% are earmarked for non-pharmaceutical expenses. From a sustainability perspective, discussing the pharmaceutical industry's budgets gets publicity. If someone is motivated by data, then using AI, data, technology, and innovation to solve the 85% seems like the right course of action. Our collaboration with health systems should focus on applying AI and data to solve the 85% challenge, as this assures the sustainability of health systems globally, including in Italy.
EF: Since you recently assumed this role, what legacy do you hope to leave behind in the next four to five years?
EK: Priority should be given to ensuring the sustainability of our investments in Italy, which is derived from ensuring that we are honoring our commitments. In five years, I hope to see breakthroughs in treating obesity, Alzheimer's disease, and type 2 diabetes in Italy, as well as improvements in the care of patients with immunological disorders and the timely diagnosis and treatment of breast cancer patients. There are many items on the list. Having impacted the millions of patients we work to assist is the greatest legacy or accomplishment I will be most proud of. We already provide services to five million people, but in my vision, we will double or triple that number. That would be a worthwhile legacy to leave behind.
The development of the upcoming generation of leaders is the second legacy. I have spent sixteen years here, but I am unsure how long I will be in this role. One day, we will have to pass on the baton, hence the focus on developing the next generation of leaders. A company cannot survive 150 or 65 years in Italy without a generation of leaders who carry on the mission. In conclusion, my legacy would be twofold: first, fulfilling our mission to serve as many people as possible, and second, developing the leaders of tomorrow who will take up the mantle and carry on because we cannot give up on addressing some of the most pressing unmet needs in the healthcare.
EF: Do you have a final message you would like to share?
EK: Innovation is the source of growth, but to implement an innovation, patients must be identified. The drugs of the 1980s and 1990s are no longer available; those times have passed. Thus, it all comes back to our pipeline and the work we are doing, together with individuals who are driven by the organization's objective and devoted to what they want to do. For a company like ours, which has some of the top products in the market that address significant unmet needs and one of the best pipelines, it seems certain that we will continue to be a major player for some time to come. Even with that assurance of remaining a key player, we are focused on collaboration. We aim to collaborate with doctors, patient advocacy organizations, individuals, governments, and regulators. No matter how big the player is, one stakeholder does not solve human health’s challenges.
In my opinion, the COVID-19 pandemic is a prime illustration of how collaboration saved humanity. This idea of collaboration takes center stage.
