The role of a CMO “Saying No and Not Saying Too Much?”

CPL Physicians, a Physician staffing specialist based in Boston, ran its 3rd Chief Medical Forum (CMO) at the Harvard, Downtown Club. In the last few years we have noticed a significant rise in CMOs looking to move from Global Pharma to Biotechnology and, on the back drop of this, the key question being asked by many CMOs is: “Are the skills the same for a CMO in a Global Pharma business to that of a growing Biotech?” It is now widely understood that the role of Chief Medical Officer (CMO) is rapidly evolving in response to the requirement of Biopharma companies to apply more ethical and scientific precision to decision making and a growing understanding of how technology such as Artificial Intelligence (AI) is disrupting drug development.

At our previous CMO meeting in Harvard in December 2017, many of the attending CMOs wanted the next forum to offer greater insight and peer-to-peer discussion around the considerations to take on board when contemplating a move from a large structured Pharma business with a lot of resource, to a growing and developing Biotech. We invited Rick Pierce, a Senior Advisor from Bionest Partners, to share his experiences.

Rick offered a number of areas of guidance for CMOs when dealing with business people and financiers as this could be a far more dominant element of the role in a growing Biotech. The job specification of a CMO is not as simple as; the CEO runs the business and a CMO looks after the patients. CMOs, particularly those transitioning from an established company to Biotech, must have a far more in-depth understanding of all of the commercial aspects of running the business whilst remaining hypersensitive to the wider needs of the business. A far more in-depth appreciation of the commercial profile of the product and how a drug is intended to be used by the patient/consumer is key to success.

However, unless you are hiring the very best people to support you on your journey, you could be compromised in a new role. As always, the challenge of “where do we find these great people” comes into question. You could of course engage with an excellent recruitment firm such as CPL Physicians! Whilst you wait for that perfect candidate, you could focus on your current team and utilize your experience as a CMO allowing your current team do their work, observe (assess any skill shortages/enhancements needed), address these and at all times be a team player. Be Socratic with your peers whilst also fostering an environment where they can share what they need to with you in an open and honest manner. It can be said, you get to know your team well when you understand limitations and correct these, whilst pro-actively building in time for error, particularly with patient recruitment. The better trained and developed your own team are, the more productive they become. The CMO group also expressed the view that there should be a firewall between the pre-clinical and clinical stage – each must have its own integrity.

Having clear and well-defined milestones, as well as ensuring these are communicated appropriately, with particular emphasis on investors and any stakeholder with an interest in your business, is key. Often a dashboard can facilitate clear communication, guidelines and make teams stick to and deliver on their milestones. With employees – be open to trust but always verify.

For a forward thinking CMO taking ownership of their own self-development, it can be helpful to build a range of expertise outside of your own specialist therapy area as growing businesses will often need you to expand your remit outside of what you have been trained in. Other indications may become apparent through the drug development process, be ready to develop the knowledge and go onto manage these developments. When it comes to Boards, Executives respect and appreciate a CMO that can say “no” and know when to kill programs. This is not taught in medical school, but at some point you might need to walk into a CEO’s office and tell them it is not working. CEOs don’t like shocks, so ensure you are communicating well and consistently as part of your role.

Ultimately a core competency of an exceptional CMO is the ability and expertise to deal with bad news. In fact, as an absolute, you should have a full operating procedure for the worst thing that could possibly happen; because it might. Transparency is absolute essential. Accept there can be a worst case scenario, particularly if you are at the forefront of something new and radical.

When dealing with finance houses or the FDA, have a script and stick to it, this is not the time to show how much you know or what you have achieved, leave that for job interviews. Ultimately, you need to have absolute clarity regarding what success is, and identify what it is about your company that will attract a big offer from large Pharma or other investors. One of areas of discussion amongst the group focused around Key Opinion Leaders (KOLs) and that we must remain wary. Sometimes there will be biases and conflict through varied loyalties. Be aware that healthcare authorities love clinical trials because they are an excellent source of revenue as well as being committed to finding new cures. Always understand the motivation of these stakeholders.

However, the one area of discussion that seemed to cause the most controversy was tabled by Rick Pierce when he broached the subject of how CMOs transitioned in their career into the CMO role. The group communicated there was a generally hard held belief that the CMO role is a culmination of learnt experience. Rick, however, challenged this and shared his experience of CMOs gaining the role straight from academia. Rick articulated the success that he had firsthand experience of and how this model had proved successful in several of his investments. There were a multitude of objections from the floor around this mode of entering into the role of a CMO. Most pertinently this very talented and industry-renowned group of CMOs felt their more accepted and traditional journey to CMO with their medical training coupled with industry knowledge, was the better route. Rick did openly disagree with this but accepted wholly that the route from academia to CMO would require an incredibly robust and experienced mentoring group.

Our feedback from our first two CMO Forums (Boston and London) was incredibly positive, and the most valuable element of this event was the opportunity to network with peers and also discuss openly the many challenges and changes occurring in industry. Our next Boston event will be held in December 2018.

We would like to thank Rick Pierce for his contribution to our event. Prior to founding FEP Capital in 2007, Rick served as a Senior Finance, Corporate Development and Investor Relations Officer for four publicly traded companies, including Javelin Pharmaceuticals, Inc., which merged with Pfizer, Inc. Rick has been involved in a number of highly successful IPOs, secondary offerings, private placements, mergers and acquisitions, and strategic business development transactions. Rick is involved in several emerging biotechnology companies as a strategic advisor and shareholder.

If you would like more information about the next event please email or you can call the Boston office on (617) 844-1434