So welcome back to another episode of the Biohub and Avetix podcast. Today I'm joined by Dr. Jonathan Sade, EVP, Chief Medical Officer and Head of R&D at Bosch Health. Jonathan is a physician scientist with more than two decades of experience leading drug development across some of the biggest companies in our industry, including Sanofi, AstraZeneca, Shearing Plough, and most recently, BMS. He oversaw some major global programs in respiratory, immunology, cardiovascular, and neuroscience. So in today, in this conversation, we dive into his journey through Big Pharma, how he thinks about progressing within large organizations, the evolution of R&D, and why chose Bosch as his next opportunity. So let's get into it. How are you, Jonathan? Great. Thank you, Max, for inviting me. Excited to chat about my career and other topics. It's a pleasure to have you, honestly. And I think it definitely makes sense to talk about your journey first. You know, 20 plus years across some of those biggest names in pharma, like I said, what originally drew you out of academia and then into drug development? Yeah, I think there was an evolution there. I started my career as a pulmonary and critical care physician. I trained in a prestigious medical academic institution in Boston and thought, ah, I've made it in the world. I'm going to stay in academia. This is great. This is what I always wanted to do. And I did progress that career path. I got more into research by getting another master's degree in clinical research. And it was clear that my path was going to be in academia. As I got more and more into the pulmonary and critical care career academic path, I realized that to be successful in academia, you need to be really, really focused and be super specialized in one area. That's how you publish, get more grants, advance your career by being really, really focused. And I realized very early on that I'm very interested in a lot of different areas. I got into pulmonary and critical care because I thought there was a lot of different things that I could do there. There are a lot of areas that I could research, but I couldn't really do it in an academic medical center because I had to be so focused. And so over time, I think I realized that by interacting with people in industry, meeting people in industry, first of all, that there was such a path as, you know, physician scientists could be in industry. I didn't even know that existed. Once I met people and saw how their career evolved, what they were doing, I realized that that could be a much better path for me. I could work in multiple different areas. I was really excited about the idea that I can work in respiratory, but maybe I'll work in other areas as well. And if I'm working in respiratory, I can work on various different things within respiratory. And that was really exciting for me. I think I realized how diverse my career would be in industry when I got into it. But I guess in retrospect now, 20 plus years after, I realized it was a great choice for me. And I'm really happy I made that move. Yeah. I mean, amazing. And you've spent most of your career inside large global farmer organizations. And then we talk about Bosch as well. So why didn't you make that move to a smaller company earlier? You know, what kept you in big pharma? Yeah, you know, I started my career or before I even joined industry, I thought being in a small company would actually be a better fit for me. I was in Boston at the time. And, you know, this is 25 years ago. There are actually not that many big pharmas. There was all small companies. So I started talking to small companies and I thought it would be a really good fit for me to get to be in a company where I could get to know everybody, have a big impact in a small organization. But it became clear that if I want to train and learn how to do drug development, I need to be in a large organization where you do research on a massive scale and you can learn how to do drug development the right way. And so very quickly I realized I need to go to a large company. And the first company I joined was Sharing Plow. I needed to move to New Jersey for that. And I think big pharma has been a great training ground for me. Initially, it was just a training ground, a place to learn how to do drug development, to do research, to learn how to do it right, because you've got all the resources you need in big pharma. But then over the years, I think what kept me in big companies is that there's a lot of opportunities, uh, back to why I moved into industry. I thought that there was, there were going to be a lot of opportunities to work in different areas. And, and that's exactly what happened in big pharma. You, you work in, you know, asthma and then somebody says, well, you should work in COPD and you should work on coughing. You should work on respiratory infections. And so you get a lot of opportunities and, uh, uh, and that's, that's really what, uh, what was really exciting for me. And, and I think the end of the day, I always kept like, I'm, I always felt like I'm getting really good opportunities. I'm advancing in my career and I'm really doing exactly what I thought I would be doing when I, when I went to medical school, really, which is doing research, advancing science, helping patients. That was exactly what I was doing in, in, uh, in big pharma. So I was really excited about it and don't regret a minute of staying in big pharma. I mean, yeah, you kind of talk about those new opportunities and what you've got. I think a lot of people want to know how you actually progress with inside the companies. You know, you talk about like there was those opportunities, but how do you kind of take it by the scruff of the neck and, you know, progress into those? And then also, you know, what have you learned about navigating big pharma and building influence? Yeah, no, that's a great question. I think that the big pharma beast can be difficult to navigate and it can be very difficult for some people. I think if I reflect on what are the kind of things that made me successful, first, I'm really a people person. I always like to be around people and you're in a big institution. It doesn't matter if it's pharma or any other industry. If you connect well with people that that helps you a lot and i think in in uh in r&d and in the pharmaceutical pharmaceutical industry i think to uh be very collaborative and kind of um engage with all the different functions within an organization is really really important as opposed to you know in academia you need to be I mean there collaboration of course but you're really working individually, and you want to, you know, you want to find the next discovery, write it, you know, publish it first, whereas in an industry, you can only succeed if you are working really well with a cross-functional team. So, you know, I can be really good at coming up with clinical trials and coming up with ideas for the next discovery that we make, but I have to sit down with the regulatory and commercial and CMC and medical affairs, all these different functions. So I have to be in that mindset that I'm just one part of a bigger organization. And once you have that mindset and that you have to collaborate with people, that's a big step forward. And I think being a people person helped me a lot. I think wanting to take on more responsibilities was always a great advantage for me in the first few years of my career. I was really lucky that a lot of people were retiring at the time. So I just took on more more responsibility and you know i i got to do a lot of projects at some point you know it was i was kind of the go-to person we've got a new project let's ask jonathan to do it somebody's retiring let's ask jonathan to take his portfolio and i i loved it it was great for me i love doing it uh and so that's you know that that really helped a lot in my career and then i i think influence is something that comes along with it. Once you build credibility and people and trust and people realize that you're doing things for the right reasons, meaning your focus is, you know, advancing our portfolio, finding new innovation, thinking about patients and how we can impact and, you know, positively impact patient care, helps science, helps, you know, the area that we're researching and helps the company, of course. And so it's a win-win-win. And so that builds a lot of credibility, trust, and I think that's an influence, of course. People believe you, want to work with you, want to listen to you. They come up to you and ask you for your opinion. That's how you kind of advance in your career and people want to give you more opportunities. And I was very, very fortunate that that's what happened to me over the years. Yeah. I always find it really interesting when people talk about how fortunate they were, but there must be an element of just working hard. And you say like taking on this extra, you know, this extra responsibility, there must've been an element in sacrifice in doing that. Well, certainly I've reflected on that quite a bit, on the sacrifice of, I suspect any job that I don't think it would have been terribly different if I was in academia or in private practice or anywhere else. Your dedication to your work and how strongly you believe in it. I mean, I could do my job, but work probably half as much and still do a good job. but I feel very passionate. I'm really passionate about what I do. The impact makes, and the reason I went to medical school, to kind of advance science, advance patient care, I really feel passionately about that. And so that requires, that's more than an eight-hour day. It requires many hours and nights and weekends. And I was happy to do it, although it certainly does sacrifice some of your, you have to sacrifice some of your, your personal, uh, personal life, but you know, you have to find a good balance in, uh, work and, uh, in personal life. And I think I've, I've, I've found it. I hope my wife agrees with me. Yeah. And we talked about like the breadth of, you know, experience you've had. And I mean, in my introduction, I talked about immunology, neuro, cardio, respiratory, even dermatology. Very few leaders have that kind of breath. How does that shape the way you work and approach R&D? Yeah, no, that's a really great question because I said that I started in pulmonary and respiratory diseases. How did I get to work in, you know, dermatology? I think that Very early on in my career, I realized that once you learn how to do clinical trials, research effectively, and how to make decisions effectively, you can extrapolate that into many other areas. So, you know, understanding the science, designing trials in an effective way and being data driven. You know, you're not influenced by what people want the results to be, but what the data really shows you, being objective and making data driven decisions. Those are really, really important concepts. They seem trivial, but we don't always use them. But once you do and once you learn how to do that effectively, I think developing a drug for asthma becomes very, very similar to developing a drug for alcohol-associated hepatitis or psoriasis or atopic dermatitis. And that's how my career evolved. I learned how to do that, and then I said, well, let me see. I'm working on respiratory. but that's very, very similar to what we're doing in rheumatoid arthritis, which is actually the next area I worked on. And there's a lot of similarities there. And I was able to pivot and start working on those areas. And so that is what's really guided me over the years. I believe I'm science. I make my decisions based on science, data, and I make decisions quickly and effectively, if I follow those principles, I can actually continue and work on any therapeutic area. And I've been really fortunate to be able to work on many, many therapeutic areas over the years and hope to continue to do that because I do, at core, see myself as a physician scientist, not a pulmonologist only. I'm a physician with background and experience in many different areas. I'm trained initially as an internal medicine doctor, so I feel like I can legitimately work on any therapeutic area and hope that by the end of my career, I will work on pretty much every therapeutic area. Yeah. So you'd recommend that to people coming through the industry to try and work in any kind of therapeutic area they can You know I think it really important to start your career The advice I give to people early on in their career is that you want to start in the area that you're really good at. And I came in and worked for the first, I don't know, probably seven, eight years of my career in pulmonary medicine. I was highly specialized, highly trained in that area. I knew the area very well. I knew experts in the area. I could call anybody and ask for, you know, feedback, advice in pulmonary medicine. And so it was a perfect area for me to start. And I think that's what I recommend others to do. But, you know, there's, I think at some point you need to make a decision. Do I want to continue and be very, very highly specialized in that area and continue to work just on that? or should I expand? And I think if you're in academia, as I said before, you need to and you have to stay specialized and work only in that area. I think the advantage we have in industry is that we can extrapolate and move into other areas. And I think the way the industry is evolving, I think it's very advantageous for people to do that because the science is evolving so fast. You don't know what's going to be the next big thing. And once that big thing comes on, you should be ready to pivot to that. I mean, 10 years ago, I don't think anybody would have predicted that weight loss and GLP once would be the biggest area in clinical and drug development and research. Now it is. And so pivoting to that, learning how to work in that area, one example, is really, really important for people in this industry. So that is the advice I give to most people. Not everybody loves that. They want to continue to specialize, and that's okay, too. Yeah. I mean, my next question was actually around the future of the industry. I was talking about how it has changed over the last decade. You talked about the change to obesity, but I was going to mention just general new modalities, AI, regulatory shifts. just generally what are the biggest changes lead for leaders to adapt is the brep side that you've just spoke about as well yeah no there's there's a few things i think you're touching on a on a few really important uh points i think the first thing the first point i'd make is that the science uh science and clinical uh our understanding of of pathophysiology of disease is evolving extraordinarily fast. It always evolved, right? I mean, every year we learn some new things, but the pace of our understanding of basic science and pathophysiology of disease, in my opinion, has changed dramatically over the past few years, I'd say even five years. And that's really, really important to realize. Things like, you know, I worked a lot in immunology, resetting the immune system was like a dream that people would talk about in the past, but never really understood how you do that or what the impact of that could be. Now we actually know how to reset the immune system and prevent autoantibodies from developing in people with certain autoimmune diseases. That actually is changing the way we may be treating these patients in the future and how we develop drugs for these conditions dramatically. So, and I think that level of innovation is going to continue. So that's one really important change in the industry. I think the other you pointed to AI, I think that's, and machine learning, I think, is really, really important and impactful. Our ability to analyze large databases and find, say, subsets of patients who are more or less likely to benefit from an intervention or a new drug is really changing the way we are working. And I think putting it all together, I mean, being able to adapt quickly and continuously learn is going to be really important. We can't talk about, you know, this is how we did it, you know, 20 years ago, 30 years ago, and so we should stay, continue to do that. That's not going to work. You need to be really comfortable with changes, learn every day about new areas of innovation and how you should adapt to them, and be comfortable with continuous changes, which can be difficult for some people, but I think that is the way our industry is moving, and to be successful in it, I think you need to have those capabilities. Oh, yeah. 100%. I think that's really good advice. I mean, talking about changes as well, you stepped into Bosh at a pretty fascinating moment where a global business was undergoing a pretty big transformation. What excited you most about joining and then also just that general project of transformation? Yeah, I think, as I said initially, I always wanted to be in a smaller company. I started my career thinking that I should be in a small company. It took me 20 years to get to a small company, but I'm really happy I made that change for a few reasons, general reasons related to Bausch. I think that being in a small company, clearly my ability to impact where the ship is going is much, much larger. And I felt that from day one. I can really direct the areas that we go into or not go into very, very quickly. And I think Bausch has the advantage of being a small enough company that I can make these. We can pivot and go in different directions quickly. But it's large enough that you have resources to run big programs and make really impactful programs that will change the way patients are treated out there. And so I feel like it's a good balance of not too small, but not too big. And I think Bausch has fit the bill for me. I think in my first year here, I've been able to make a lot of these kind of changes and feel like over the next few years, we will drive innovation in a very different way. We can continue to grow certain areas that we really good at but we are going to pivot into new areas as I described before where we see innovation where we see unmet medical need we pivot there We feel like we can be I feel like I in an organization that is agile enough that we can pivot really quickly into areas of unmet need and scientific innovation really quickly And that very different than what I was able to do in a big company. Loved my years in big pharma, but I would always joke with CEOs that I met, the last CEO I met at BMS, that even the CEO of a big company can't really make big changes in a large company. It's such a big and clunky ship that it takes years and years to move and pivot to another direction. We actually can do that at Bausch and can be that agile. The other big advantage that we have here is that we don't have a research engine. We only work on mid-stage to late-stage development. And so we don't have to feed that research organization and, again, can focus just on unmet need and scientific innovation. Yeah. Amazing. Just generally, how are you thinking about, you know, balancing a diverse portfolio with the need to stay focused and competitive? I know you talked about that agility, but also having the cash behind you as well. But what's the strategy like in this market, especially? Yeah, no, it's a great question. I think we need to, you definitely do need to focus on some areas that you have, that you feel like you have an advantage and you're an expert in. That's really important. And for us here at Bausch, it's GI, hepatology, dermatology. I think we have a lot of experience in those. We've developed a good, you know, development organization, commercial organization, and outreach to, in the community or the medical affairs organizations that are really good at GI hepatology, especially, but also dermatology. So we'll continue to grow those because that makes sense and we feel like we're leaders in that area. But we can easily pivot into other areas and that's what we are actually doing in the next year or two. We'll talk more about how we grow our business into in other areas. And going back to the point I made about, you know, we don't have the big research development and commercial organizations that are just focused in one area. We can easily focus into or easily pivot into a new area, rare diseases, neurology, areas where we feel like there is very high unmet need and significant innovation. We can easily pivot into those. Like we've made some changes or we made some acquisitions in the areas that we feel we're really good at. We just acquired a company direct that works on alcohol-associated hepatitis, and that's a perfect fit for us. But next acquisitions could very well be in areas that we feel are totally new to us but fit the philosophy that we have. unmet need and scientific innovation yeah definitely definitely and look well we're coming to my final question and it's my usual closing question so i don't know if you thought about it jonathan um but if you could have dinner with any scientist or innovator past or present who would it be and why that's uh it's a great question i uh i uh i did uh think about that And the first person that came to mind after dwelling on this for a few minutes, that was really the person I want to meet and would really, I've thought about it quite a bit. I really would love to meet this person if they were still alive. But Francis Crick is my choice. I think for a few reasons, Francis Crick, as you know, was one of the discoverers of the double helix in DNA. And I think that is probably the most important scientific innovation in the past century or certainly the past few centuries even. I mean, discovering DNA and how DNA is translated into RNA and proteins changed the way we think about pathophysiology of disease, how we work on scientific innovation, and I think is so impactful that I can't think of any other discovery that was bigger than that. But Francis Crick as a person is also somebody I've read about in the past, and I'm really fascinated by who this person was. He was clearly really good at science, but also very humble person, open to, you know, didn't really respect kind of rank and, you know, experience ideas. He looked for ideas from any junior students, people who were around him, and was also able to pivot into different areas. The first thing I said is in academia, it's hard to pivot from one area to another. He did it. He was a super specialized expert in biology, but then pivoted to neuroscience and worked on consciousness in the last few years of his career, which is just fascinating. And then lastly, I think he spent a lot of time at the bar, is kind of the story. People, they tell the stories that he came up with the idea of the double helix after happy hour with some of his colleagues, went back to the lab and wrote it down, and that was the beginning of the theory of the double helix. I think it always reminds me, and I talk to my teams here at Bausch about how important it still is to actually have face-to-face interactions with people and that we can't do it all on our laptops, on computers. We have to actually meet face-to-face. We have to interact. Innovation in the future is still going to come through human interactions. And so I thought about it. I used that example a few times. So anyway, I would love to, would have loved to meet Francis Crick, talk about his career, his ideas of innovation, how to innovate, and how he thought about the progression of his career. Yeah, I think that's an awesome answer. And look, thank you so much for coming on, Jonathan. It's been a pleasure. Thank you for having me, Max. It's been great talking to you.
