Dreams to Reality
Dr William N. Hait
Where will we be in five years?
Dr William N. Hait; Global Head, Research & Development Janssen, Pharmaceutical Companies of Johnson & Johnson

In recent years, the biopharmaceutical industry has made exciting progress. We have furthered our understanding of complex biological processes, harnessed the power of technology to advance drug discovery and development, and generated critical data, both clinical and real-world, that will continue to improve patients’ lives and propel innovation in the life sciences.

This progress lays the foundation for our industry to change how we approach disease understanding, management and treatment. It will no longer be enough for pharmaceutical companies to research and develop therapeutics that address the symptoms of illness. Successful pharmaceutical companies of the future will have instituted programmes to identify early signals of disease and predict and pre-empt the disease-causing process from progressing to disease before they ever get sick.

My predecessor and colleague, Dr Paul Stoffels, Chief Scientific Officer, Johnson & Johnson, projected five years ago that: “We are beginning to experience a paradigm shift in the challenges that clinical research is addressing. No longer are we relying on the old model of investigating diseases of high unmet needs; we are now confronting many of the more difficult and debilitating chronic diseases that require a different approach.”

The Janssen Pharmaceutical Companies of Johnson & Johnson then imagined and have since set into motion a “different approach” to achieve this paradigm shift for patients, and drastically change the way healthcare is managed in the future. We have established three dedicated research platforms to focus on disease prevention, disease interception and the human microbiome – areas of transformational medical innovation that are poised to change the healthcare landscape. Janssen is approaching prevention with programmes aimed at both infectious and noncommunicable diseases (NCDs) that exist within the general population, while our efforts in interception will require specificity in the identification and targeting of at-risk populations to deliver solutions that stop or reverse progression to disease. Our exploration of the human microbiome will foster key learnings for these groups, as well as drug discovery and development efforts across the five Janssen Therapeutic Areas (TAs) – Cardiovascular & Metabolism, Immunology, Infectious Diseases & Vaccines, Oncology and Neuroscience.

In its focus on the prevention of chronic NCDs, the Janssen Prevention Center will explore new approaches to disease prevention in major areas of unmet medical need such as Alzheimer’s disease, heart disease, cancer and autoimmune diseases, which continue to increase and burden healthcare systems globally. The goal is to identify and discover innovative solutions to extend people’s healthy life span and compress morbidity, through world-class vaccine discovery expertise and capabilities. To that end, the JPC has coined the term ‘Immorbidity’ to capture this audacious vision.

The Disease Interception Accelerator (DIA) aims to predict and pre-empt select diseases, such as type 1 diabetes (T1D), presbyopia and cataracts, postpartum depression and other conditions by intervening earlier than today’s clinically accepted point of diagnosis and treatment; rather, we will be seeking solutions that inhibit progression to disease and preserve wellness. In the case of T1D, the DIA is building on the knowledge that T1D begins before insulin dependence to identify pathways and targets where interventions will halt progress of the disease before autoimmunity disables insulin-producing cells. The efforts of the DIA will utilise the rapidly emerging science of immune diagnostics and precision intervention to aid in its pursuit of intercepting T1D, a disease that 1.25 million Americans are living with today including about 200,000 under 20 years of age; which is responsible for 40,000 new cases diagnosed annually and more than $14 billion annual healthcare expenditures in the US alone1.

Striving to more fully understand the microbiome – the diverse population of bacteria living in and on the human body – the Janssen Human Microbiome Institute (JHMI) is gaining a deeper understanding of the role of the microbiome in health and disease, and finding new forms of therapies to address autoimmune diseases and other conditions for which no sufficiently effective treatment options exist today. While our Immunology TA has been active in the microbiome field, the JHMI will serve to connect internal expertise with external innovators to advance the potential of microbiome-based science and strategies across all of the Janssen TAs. Like each of these new research platforms, the JHMI will leverage the Johnson & Johnson Innovation global infrastructure including our Innovation Centers in London, Boston, California and Asia Pacific, and our J-Lab incubators to access compelling external science.

Innovating for the future
While prevention, interception and greater understanding of the human microbiome will drive the future of our industry, we will maintain focus on our existing strategy and research and development priorities. As a leading healthcare company, it is our responsibility to propel innovation and make a difference in the lives of people today, and for years to come. Janssen has formed these new research platforms to interact closely with our Therapeutic Areas as well as engage external partners, to further fundamental research in these areas of promising opportunity that we can begin to translate into effective healthcare solutions. We believe the positive impact of this paradigm shift on people, communities, governments, medicine and the global economy will be dramatic and far-reaching.

Industry-wide collaboration will be key
As Paul Stoffels so eloquently phrased it five years ago, “as an industry, if we are to take the next giant step towards improving patient outcomes around the world with costs that are manageable and acceptable, we must combine our expertise and best practices among industry, academia, biotech and government with collaborations for truly innovative development and discovery.” This sentiment lies at the core of our strategy and culture today – collaboration is an imperative in striving to preserve health and develop transformational medical treatments for those suffering with disease. While Janssen works to pioneer disease interception and advance disease prevention and the human microbiome, we hope to inspire other groups to work with us to find much-needed solutions. In order to create a true paradigm shift, we all, together, play an important role.

Five years from now
When we look ahead again in five years, our industry can expect to have examples to share that illustrate where we have together harnessed cutting-edge science, novel therapeutics, precision diagnostics and new business models to intercept diseases. We hope to have succeeded in:

l Encouraging a broader shift in how the industry, regulators, payors and physicians accommodate advances that interrupt the progression from health to disease.

l Energising, attracting and connecting with the world’s leading visionaries and brightest scientific minds.

l Focusing on personalised health as opposed to personalised medicine, which ensures wellness of all individuals.

We sit at the brink of an exciting future for healthcare where we will progress approaches to “make disease history” and move towards a time in which people are no longer patients, but empowered individuals proactively managing their health versus dealing with disease.

JDRF. General Diabetes Facts. http://jdrf.org/aboutjdrf/ fact-sheets/general-diabetes-facts/. Accessed on June 15, 2015.