Brian Hilberdink and Douglas Maslin on LEO Pharma

Fred Goldstein 00:02
Hello and welcome to the AMCP Podcast Series - Listen Up as we take a deep dive into the challenges, trends and opportunities in managed care pharmacy. Follow the show's social hashtag at #AMCPListenUp and to learn more about AMCP, visit amcp.org I'm your host, Fred Goldstein. On today's episode, my guests from LEO Pharma are Brian Hilberdink, Inc, President and Executive Vice President North America, and Douglas Maslin, MD, Global Principal Medical Advisor. They'll be discussing LEO Pharma and their involvement with AMCP. Brian. Why don't we begin with you with an introduction and your background? 

Brian Hilberdink 00:40 
Yeah. Thank you very much for having me on this podcast. Happy to be here at AMCP, representing LEO Pharma. So LEO Pharma is a dedicated medical dermatology company. We have a history that actually dates back 115 years, headquartered out of the Copenhagen, Denmark area. We've been in the United States since 2010 and our whole kind of reason for being is we want to be a company that prioritizes medical dermatology, really looking at underserved patients, looking at hard to treat dermatological conditions. In many cases, disease states that are currently not being treated, and hopefully bring solutions to the marketplace. We've been privately held for this whole 115 year journey through a foundation, and then we did bring in a minority owner. That's a private equity group called Nordic Capital, and we have a potential to take this very old company public in the coming years in an IPO. So that's a pretty exciting development for the journey of this, you know, very historic company. 

Fred Goldstein 01:48 
Yeah, it's really a fantastic journey. And Douglas, why don't you tell us about you recently joined? What made you decide to come and work for the company? 

Douglas Maslin 01:55 
Thank you. So I'm a dermatologist based in the UK. I'm working at Adam Brooks Hospital in Cambridge, doing clinics there on Fridays and sometimes on the weekends. And then I joined LEO Pharma about a year ago. Now, I think there are a few reasons for that. Firstly, thinking of LEO itself, they have a real company mission, which is to improve the lives of patients with skin disease. And I guess as a dermatologist, that's also my aim in practice. So it feels like that is aligned very nicely. And then LEO is a company that's very well known in the UK, so practicing within dermatology, I think dermatologists are very familiar with LEO as a strong history, as Brian just mentioned, in terms of topical products initially, and then moving into the biologic space. So as a company I was very aware of and was already interacting with, but I saw there are probably two main areas where I thought I could have an impact, and perhaps we'll get a chance to talk about those more. But one was with the biologic that they were using and are using now in atopic dermatitis, I felt like I could really help communicate the data that was out there on that. And then secondly, LEO was moving into new areas in skin disease, some diseases that other companies weren't targeting so I thought that was a great opportunity to help in those areas. 

Fred Goldstein 03:05 
Yeah, it's really fascinating. Can you sort of cover what areas you work in in dermatology and what sort of conditions? 

Brian Hilberdink 03:10
Yeah, so as Douglas stated, We're currently have a biologic for moderate to severe atopic dermatitis. However, we've recently filed a product for a disease state called Chronic Hand Eczema. Now Chronic Hand Eczema is not a very well defined disease state here in the United States, it's better understood in Europe and Canada and other places around the world, and perhaps Dr. Maslin can speak to that in more detail, but effectively, what you're talking about is a debilitating condition where patients have hands that are so badly cracked and scaled that they effectively can't use their hands. And if you think about not being able to use your hands and how limiting that is from an occupation standpoint, we've also really come to learn that there's massive psychological impact. Our hands are so vital in communication. Think about that person you meet, and here at AMCP, I'm shaking a lot of hands. Think about that, you know, extending your hand if you have Chronic Hand Eczema, and just waiting for that person to cringe as they touch your hand and they feel how scaly it is, and then you have to maybe apologize for it, or you have that awkward let's do the, you know, the elbow bump instead of the handshake. So that opportunity to bring the very first FDA approved treatment for something that is specifically targeting a disease state like Chronic Hand Eczema is exactly the kind of company that we want to be. 

Fred Goldstein 03:16
Anything you like to add Douglas? 

Douglas Maslin 04:40
Yes absolutely. So Chronic Hand Eczema is a condition that I see a lot in clinic back in the UK, and as Brian just mentioned in the US, people aren't so familiar with it clinically. They still see a lot of it, but they're not so familiar with the terminology of it, or perhaps the causes or the different treatments. They're not so many treatments for that available in the US. In fact, no approved FDA treatments. So that's why I took the opportunity to come, is really to help raise the awareness in the US of this disease state, and hopefully bring a new treatment for these patients as well. 

Fred Goldstein 05:11 
Fantastic and I know you're really active with AMCP, so you can talk a little bit about that. Brian, 

Brian Hilberdink 05:17 
Well, we think that AMCP, first off, is a fantastic organization, because we all have a shared interest, and that is to make sure that, you know, we are providing great value to patients and ultimately finding ways that patients can get access to innovative medications. What we find with AMCP is that it's very much a partnership. It's really about let's put the data, let's put the patient, let's put the disease state in the center, and let's try to find that unique value proposition, to make sure that payers fully understand what it is that they're getting the value that it can offer from an economic standpoint, and ultimately be able to ensure that patients have better access. So that's where I think an organization like AMCP, that's, you know, really kind of helping to elucidate that; really puts us in a great position to put our best data forward, and ultimately for payers to make the right decision from both a clinical and economic standpoint. 

Fred Goldstein 06:15 
And I know you've been involved in a number of different ways with them, with their students and things like that. As I understand.

Brian Hilberdink 06:22 
We love having AMCP Students come visit LEO Pharma. We set up what we refer to as a shadow day, so we have a representative from each of the AMCP affiliates come to LEO pharma, and as the name implies, shadow a LEO Pharma employee, kind of understand what's it like in the life of being a medical scientific liaison? What's it like working back office in medical affairs? What's it like, maybe working on the commercial side and preparing dossiers for a submission with with a payor, just to kind of give them that perspective, so as you know, they're considering what their future career is, also being able to have the perspective that working at a smaller or mid sized pharma company, as opposed to, you know, maybe some of the big pharma companies, we just think that that's a valuable kind of paid forward contribution that we can make to a really great organization. 

Fred Goldstein 07:09 
And do you have any thoughts on that, Douglas as to what you're doing?

Douglas Maslin 07:13 
Yeah, I think to add to what Brian said, listening to his answer there, you could hear everything always comes back to the patient. So one of the core values for LEO is patients, and whether that's in the drug development stage, the Medical Affairs stage where I sit, or more commercial on them, or the market access side, it's always thinking, how can we relate this back to the patients? How can we make things better for the patients as a result? So it's great that in you know, in your in your question about AMCP, there Brian's answer, it's always, what can we do to get better access for patients to these medicines. So that's something that really motivates us at LEO in that area. 

Fred Goldstein 07:46 
And can either one of you talk about, sort of the size of the dermatological issues in the United States, etc? I mean, people struggle with those kinds of conditions. 

Brian Hilberdink 07:56 
Yeah. I mean first off, when you take something like atopic dermatitis, that's a fairly common disease, I mean in terms of people living with eczema and then having, you know, kind of more moderate and severe. I think what's really interesting, however, when you look at the number of people living with atopic dermatitis, we know for a fact that right now, only 5, 6% of those patients are using an advanced systemic treatment, like a biologic, in order to treat their condition. So again, going back to the partnership with the AMCP, with the work that needs to be done in order to really define that value proposition for clinicians and payers, is still something that we need to do, because so many patients living with a dermatological condition, whether it's something like atopic dermatitis or psoriasis, which I think we all know somebody living with on those conditions, or something like Chronic Hand Eczema or one of the more rare diseases, I think the biggest challenge that we have is just this inertia of how many patients are dealing with primary care. Primary Care are doing their best, but they're treating them with steroids. We know that there's limitations to using steroids, they can be very effective, but only for a period of time, then getting the patient to a dermatologist. Far too few patients see a dermatologist, and then, when they see a dermatologist, are they best equipped, and do they also have access to the drugs that they want to be able to prescribe? So I would say dermatology, there is still just, you know, so much opportunity to move patients along that clinical continuum and get them into more innovative and advanced treatments. 

Fred Goldstein 09:29
And I think, as you've talked about Doug, because people struggle with these illnesses, so being able to sort of right the system at each point where it's difficult people are very busy, like you talked about in primary care, or getting to the payer market and saying, here's why this should be approved, etc, is really where you're trying to focus 

Douglas Maslin 09:44 
Absolutely.

Fred Goldstein 09:45
On that whole continuum.

Douglas Maslin 09:46 
And skin diseases we know have such a big impact on patients. So there's been studies looking across all the specialties trying to understand the impact on patients. For gastro, oncology, rheumatology. So actually, other than oncology, dermatology comes out on top. Has impact on these patients lives. So it's really important that we can advance these therapeutics to patients 

Brian Hilberdink 10:05
The largest organ, right?

Fred Goldstein 10:07 
Right.

Brian Hilberdink 10:08
And I think sometimes, you know, I, I spent many years working in cardio metabolic and I came over to LEO just about two and a half years ago. And you know, when I first told people that I'm gonna going to work for a company focused in dermatology right away, you know, you get into this, like Dr pimple.

Douglas Maslin 10:25
Pimple popper.

Brian Hilberdink 10:26 
Pimple Popper, yeah, and, you know, yes, acne, rosacea, those are common diseases that need to be dealt with. But you start realizing just how debilitating something like atop of dermatitis can be, how debilitating chronic hand excema can be and then Douglas, I mean, there are countless rare diseases, skin diseases, that are just horrifying. So again, I think you have some big pharma companies that have big, blockbuster solutions for some disease states. We know that there are just so many else out there. And what we want to do is find solutions in some of those white spaces and bring treatments that wouldn't otherwise exist if it wasn't for a company like LEO. That's really what our mission is all about. 

Douglas Maslin 11:08 
So hopefully, with that, that answers the question of, you know, why did I join? You know, better than I did at the start, I think you can hear that there's so much unmet need in dermatology, there's a broad range of diseases where there aren't really any approved treatments at the moment, so that's why I've joined to try and help in that area. 

Fred Goldstein 11:24 
Well, it's fantastic. It's nice to sort of hear the patient centric that you talk about, and the passion these two Ps put together, really to focus this kind of thing, because you really don't think about it, you know, oh yeah. I'm thinking, My heart, my liver, my lungs, my skin, my skin, you know, as you said, it's the largest organ. Is there anything else you'd like to add?

Brian Hilberdink 11:43 
Just, I think, you know, one of the things that LEO pharma, that we're trying to do is really come up with innovative partnerships with organizations like AMCP, with providers, with patients, because it's been, I have to say, a bit of a humbling experience coming from big pharma to a smaller company. We can't do it with big size and scale. We're not going to be doing, you know, lots of direct to consumer advertising anytime soon. You know, you see all of the ads on TV by some of the big pharma companies. So I really feel that if we truly do take that patient centric approach, and I don't want to sound naive when I say this, I believe the business will follow, and the business has to follow, because ultimately, we need to build a sustainable company. But I can tell you, it has been a humbling experience, because you realize when you don't have size and scale to compete with, you need to say, Okay, what else can we do? We need to pivot and use agility and our ability to partner and really understand dermatology as our competitive advantage. So that's really what we're endeavoring to do. And you know, hopefully that comes off just even in the short podcast. 

Fred Goldstein 12:48 
Well, I'd like to thank you both for joining us. Brian, Douglas, really a pleasure. 

Brian Hilberdink 12:51 
Thank you so much. 

Douglas Maslin 12:52 
Thank you. Thanks for having us 

Fred Goldstein 12:55
and thank you for joining us today. If you like this show, you can find all our episodes at amcp.org/podcast, on our show page at HealthcareNOWradio.com or on your favorite listening platform by searching Healthcare NOW Radio, you can follow our show's social hashtag at #AMCPListenUp and don't forget to share, Like and Follow AMCPorg on LinkedIn, Twitter, Instagram and Facebook. I'm Fred Goldstein for AMCP. Until next time.