Saturday, November 16, 2024

‘The UK is at the back of the race of turtles’: Sanofi’s boss on the need to develop new medicines

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Paul Hudson, the Briton who leads the French drug firm Sanofi, is “immensely” proud to have carried the torch at the recent Paralympics opening ceremony along with fellow employees, as the firm was one of the sponsors of both sets of Paris games.

“It was more emotional for people carrying the torch than they realised, perhaps even than I realised,” Hudson says, recalling how the Paralympics grew out of the Stoke Mandeville hospital in Buckinghamshire, a spinal injuries centre where German-born neurologist Prof Sir Ludwig Guttmann organised the first competition for wheelchair athletes in 1948.

Hudson has been running Sanofi for five years, and is seeking to turn the €130bn (£108bn) company, which was founded in 1973 and grew through 300 acquisitions, into a drug discovery powerhouse. Amid plans to split off its €15bn consumer healthcare business, Opella – whose brands include Cenovis vitamins, Dulcolax constipation relief and Icy Hot pain relief gel – the firm revealed on Friday it was in talks to sell a 50% controlling stake in the division to the US private equity house Clayton Dubilier & Rice.

The French government made clear on Monday that it wants Opella to keep its headquarters, investment and research in France, and is considering taking a public stake through the state-owned investment bank BPIfrance.

Investors bristled at Hudson’s decision last year to ditch the firm’s profit margin target to ramp up spending on research and development (R&D), triggering a 19% drop in its share price. The stock has since recovered, hitting an all-time closing high of €105.76 in early September.

Despite being a major vaccine maker, the company was late in the race to develop a Covid-19 jab. It has done better on RSV, a virus that causes serious respiratory illness in infants, by striking a partnership with AstraZeneca to develop and market Beyfortus, a one-time injection of antibodies. In Spain, Beyfortus reduced RSV hospitalisations by 82% in babies less than six months old, according to results from the first RSV season last winter, after the drug’s launch.

‘Immensely proud’: Paul Hudson with the Olympic torch. Photograph: Emeric Fohlen

Hudson argues that Beyfortus should be considered instead of a vaccine invented by US rival Pfizer, which is given to pregnant women who then develop antibodies that protect the baby. There are no studies evaluating effectiveness of one versus the other, but he notes that “maternal vaccines have a very low uptake”.

The UK has become the first country in the world to develop a national vaccination programme for RSV, which he applauds. However, the government opted for the cheaper Pfizer jab. “It’s a financial choice,” Hudson says. “If you’re choosing for a clinical benefit, you would choose Beyfortus.”

He sees this as emblematic of a wider problem. “I’ve been campaigning for years to try to get the UK government to understand the threat and the opportunity of how the NHS is being run. There is a massive opportunity, but sadly, it’s being squandered.”

Investment in UK life sciences dropped by nearly 60% between 2021 and 2023, according to government figures. The UK has also fallen far behind other countries in conducting clinical trials where new medicines are tested on volunteers. The number of trials rose slightly to 411 in 2022 but was well below the 2015 peak of 690, while the average time taken to set up a trial fell from 305 days to 194 days, according to the Association of the British Pharmaceutical Industry.

To speed up research, the UK recently announced public-private investment of up to £400m in clinical trials and the creation of 18 clinical trial hubs.

Hudson says he told Keir Starmer, however, that the key issue was NHS reimbursement of new medicines – which are often not offered to NHS patients because they are deemed too expensive. He believes this is short-sighted, as patients lose out and international drug firms will invest less in Britain.

For example, the UK’s health regulator in August rejected lecanemab, a drug that can slow the progression of Alzheimer’s, saying its benefits were too small to justify the cost of the therapy for use on the NHS.

Hudson argues that more new medicines need to be made available on the NHS because this incentivises pharma companies to conduct clinical trials and invest in the UK. He notes that of the £400m programme, only 5% was allocated to access to new medicines. The government is aware of the issues, Hudson says, “but it’s a systemic overhaul that’s needed”.

Tellingly, Sanofi only spends €20m a year on R&D in the UK, while it invested €3.6bn in research and manufacturing in Europe over the past two years. Last month, Hudson invited the French president, Emmanuel Macron, to open Sanofi’s new factory, Modulus, in Neuville-sur-Saône in the east of France, which can make up to four different vaccines or biological medicines simultaneously.

“The UK is at the back of the race of turtles,” says Hudson. “In Europe, they’ve now identified the problem … The clock is ticking on how fast the US is moving, how fast China is moving.”

Mario Draghi, the former European Central Bank president, economist and academic, agrees. Presenting his report on the future of European competitiveness last month, he said the once-thriving European pharma sector had been struggling due to low investment in research and a complex regulatory framework, and needed to reform. Artificial intelligence (AI) would revolutionise healthcare, he said, but the EU was not spending enough on it, lagging behind the US and China.

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“Do this, or it will be a slow agony,” Draghi warned, recommending greater access to health data for AI development and targeted public investment in cell and gene therapies.

Hudson is hopeful that this will be a wake-up call to Europe. “Draghi is a respected voice,” he says.”

The chief executive, who previously worked for Swiss firm Novartis and the UK’s AstraZeneca, where he led the US business, is a big believer in the potential of AI.

Sanofi has a partnership with Barts Health NHS trust in London, which covers 2.5 million people and is using AI to identify patients at risk of the rare genetic disorder Gaucher’s disease. So far about 200 people at risk have been identified.

AI can speed up diagnosis of rare diseases dramatically, from 12 to three years. “By the time you’ve reached your fifth doctor, there’s enough evidence in the data for an algorithm to say you’re more likely to have this and to enable the physician to say, well, let’s check.”

Hudson, who used to ride around Paris on a trottinette (electric scooter), jokes that his French is “flawless in restaurants”, admitting he was never good at the language at school. A fervent Manchester United fan and season ticket holder, he talks in football metaphors, aiming for “more shots on goal” with his R&D programme.

Speaking on the day that Sanofi released trial data on a new treatment for multiple sclerosis, which delayed worsening of a progressive form of the disease by 31%, Hudson says the company is working on new asthma drugs, vaccines for E coli, chlamydia and acne, and expanding use of its blockbuster eczema and asthma drug Dupixent to treat ulcerative colitis and other illnesses.

When he graduated in 1990 with an economics degree from what was then Manchester Polytechnic, most people went into banking, consulting or retail – but he chose healthcare. “One of my family members is a doctor, and he was saying, you might really enjoy being in and around health. I thought quite a lot about it, ‘yeah, this could be really interesting for me’.

CV

Age 57
Family Three children.
Education Economics degree at Manchester Metropolitan University.
Pay €11m total package.
Last holiday South of France in the Nice region.
Best advice he’s been given To treat other people as you wish to be treated yourself.
Biggest career mistake “Too many to mention … but that is how you learn!”
Word he overuses “Of late, it is ‘all in’.”
How he relaxes “It often revolves around three things: family, food, and football.”

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