By Business & Finance 
Peter Keeling, CEO Diaceutics, talks us through precision testing, linking all business avenues to help patients more efficiently and technological and cultural challenges facing the business/industry.
Q. What are your main priorities and goals in your role?
Our vision is that better patient testing will drive better patient impact. This segment, namely helping pharma integrate precision medicine, has become the fastest-growing area in healthcare services. As CEO, my primary focus is hiring precision medicine leaders, expanding geographically into the top ten global pharma markets and continuing to innovate by managing big data sets and partnering with the leading clinical testing labs around the world.
Q. What are your biggest challenges as a CEO?
Firstly, I’ll explain the problem we solve for our clients. Precision testing to enable the launch and roll-out of breakthrough, targeted therapies is highly complex and increasingly competitive. Getting the test right for patients and doctors means that patients will live better and longer lives, but failing to integrate better testing can impact a therapy brand for years. Today the pharma industry is investing, on average, $1 billion to $1.5 billion to discover, develop and commercialise targeted therapies, yet when they come to market, these same drugs can be dependent upon getting anywhere from 40,000 to 400,000 patients tested quickly and correctly across ten countries within the first 18 months of launch. The disruption to the health system that this entails requires hands-on management at every step. My greatest challenge has been to build the team which confronts that complexity and clinical urgency, and support them with structured and innovative solutions which ensure the right patient gets the right test at the right time.
Q. How do you keep your team/staff motivated?
Communication, transparency and a shared vision have become the cornerstones of our business culture. I think people join us because they believe in better precision testing, but I think they stay with us because they see for themselves how we are building something special which impacts patients’ lives and supports the world’s leading pharmaceutical companies. At Diaceutics we are transparent about our successes and challenges – and will continue to be, regardless of size – since this alone acknowledges that the best way to scale the business and maintain our innovation is if each of us carries our own special piece of the company, its culture and mission on our shoulders.
Q. What are the challenges facing your industry going forward?
I think there are two; one technological and one cultural.
On the technology side, precision testing is undergoing radical transformation. Today a test is seen as something performed using blood in a test tube, but increasingly technology is looking at your body at a genetic level, tracking your behaviour or integrating data from multiple information sources like your watch or car steering wheel. This new diagnostic knowledge has the potential to deliver earlier and more precise treatments. Keeping abreast of how and where this tsunami of diagnostics can improve treatment choices will be one of the biggest challenges of our age.
On the cultural side, a patient’s diagnostic journey is often still ignored as we race to the treatment decision. Unlike treatment where we have a medical term to describe the benefit of treatment or ‘better treatment outcomes’, we do not yet have a medical term to describe the impact of an efficient diagnostic path to that treatment, even though it will have an equivalent or greater impact in the long run on the patient’s health. As a result of what can be a fragmented, emotional and solitary journey, patients may visit their doctor up to ten times over several years before the right tests are conducted and deliver the right result. It’s like we have focused so much on developing the right therapies that we have neglected the challenge of getting to that treatment decision. Whilst radical testing technology can enable better patient care, our lack of focus on improving this prequel to treatment is slowing the overall impact of better testing and treatment. This is no minor issue; our data suggests that up to 50% of cancer patients in the US and EU are missing access to the right drug because we are not adequately focused on the patient’s diagnostic journey.
At Diaceutics we started out focusing only on the first of these challenges but we now think of our bigger mission as enhancing the patient testing journey by integrating technology with the data to highlight the benefits of a greater emphasis on the patient’s diagnostic signature.
Q. What new trends are emerging in your industry?
Aside from technological leaps in precision testing and treatment, there is a parallel leap underway in our gathering and interpretation of testing and biomarker (definition) data. Historically we have gathered information about patients based on their prior health or controlled clinical trials. Today we are gathering real-time data derived from multiple sources. Most relevant to our mission are the trends and inefficiencies in everyday testing, say for lung cancer, rheumatoid arthritis or hepatitis sufferers. Utilising better insights, we can target specific areas of the patient’s diagnostic journey to improve and hopefully accelerate that patient through to the right treatment. Whilst we still have some distance to go, we are highlighting the key areas requiring change. Furthermore, we are helping our clients make evidence-based investment decisions on how and where to disrupt, accelerate, prioritise and improve the patient’s diagnostic journey.
“Unlike treatment where we have a medical term to describe the benefit of treatment or ‘better treatment outcomes’, we do not yet have a medical term to describe the impact of an efficient diagnostic path to that treatment, even though it will have an equivalent or greater impact in the long run on the patient’s health.”
Q. Are there any major changes you would like to see in your sector?
One of the fundamental issues with the diagnostic journey is that it is somewhat orphaned. What I mean is that industry, patient advocacy, the clinical community and the insurance sector do not yet collaborate in any consistent way to change the speed and efficiency of better patient testing. This fragmented health system is not confined to testing, but our data suggests that better patient testing has a disproportionate role in impacting lives and deserves more attention. At Diaceutics we have focused on partnering with the pharmaceutical industry and have demonstrated that a well-informed therapy team with experience pulling multiple stakeholders together will invest and deliver better patient testing. You only have to look at leukemia or lung cancer to see this collaboration starting to work. Over the past five years alone, we have seen the introduction of new types of molecular test and biomarkers; more than ten new treatments; and a research, clinical, laboratory and patient community working to revolutionise patient outcomes. Replicating this across other disease areas is not easy but we are optimistic that precision testing will find its rightful place alongside treatment and education as the agents of change.
Q. As an employer are you finding any skills gaps in the market?
Given the relative newness of precision testing as a concept, finding executives and analysts with a working knowledge of this space is not easy. We address this by bringing together a matrix of skills from the pharmaceutical and diagnostic industries, pathology and haematology, alongside experts in reimbursement, regulation and clinical management, and enabling them to integrate as a cohesive unit with our clients. If you look on LinkedIn today, you will not find anyone with the job title ‘Chief Precision-Testing Officer.’ In five years’ time, this role will be as important as Chief Financial Officer.
Q. How did your strategy develop in the context of the banking crisis and economic crisis?
In any economic crisis, the spotlight turns to value. In our case, the question becomes, “What is the value of investing at this time in better patient testing for our therapies?” We addressed this early on by articulating how our solutions deliver greater return on investment for our pharma clients. Specifically, we harnessed the power of data to show that every $1 invested in better patient testing would deliver between $40-$60 in more therapy revenue and significantly greater numbers of patients on treatment.
Q. How will Brexit affect you, or have you started to feel the effects already?
As a global business, we are more insulated than most from the short-term economic uncertainty of Brexit. As has been said countless times already by others in commerce, all business thrives on predictability and politically-generated uncertainty holds back. We will continue to monitor the situation closely.
We are working with many SMEs as well as Enterprise Ireland clients to support that scenario of planning and enable them with simple mapping tool kits, templates, and guides to ‘go-do’. It will build a more resilient and proactive approach to their end-to-end supply chain and it will give confidence that if ‘worst case’ happens, they have a roadmap of sustainable solutions.
Q. How do you define success and what drives you to succeed?
We use a phrase in Diaceutics: “It’s not just about being different, it’s about making a difference.” For us, making a difference is seeing patients benefit from a change in the way they are being tested and the efficiency of getting the right treatment. To date we estimate that, in collaboration with our clients, we have helped more than half-a-million patients globally. We get a huge lift when we start working with a new client on a new problem-testing area, but we are thrilled when data proves we are making a difference.
Q. What’s the best advice you’ve been given, or would give, in business?
‘Stick to the knitting’ is an old business phrase used to encourage medium-sized companies to focus on what they do best. As a start-up grows into a profitable and growing business, it sometimes takes its eye off the ball or diversifies outside of its core competence. We tell people that we will only ever focus on precision testing. Over the past 12 years, through the ups and downs of economic cycles and the complexity of the field, that focus has made us industry leaders.
Q. What have been your highlights in business over the past year?
Growing at 50% a year, revenue and people-wise over the past three to four years has been exciting, with lots of new faces in the company. We had the opportunity this year to bring our first 50 employees together for an off-site meeting focused on our 2020 vision. During the activities, meetings and an odd visit to the pub (we were on the west coast of Ireland after all), we got to know ourselves just that little bit better. I watched as, one by one, my entire team took ownership of our vision to improve precision testing for patients. In fact, I would call this not only a highlight of the year but of my career to date.
Q. What’s next for your company?
We are expanding our global laboratory partnerships. In many ways, laboratories have been the forgotten stakeholder in precision medicine. However, as the commercial shortcomings of the diagnostic companies are revealed to pharmaceutical commercial teams, there is a realisation that laboratories have the hearts and minds of the prescribing physicians. We think of the ‘laboratory-physician interface’ (LPI) as an unloved channel, even though our data shows it is the most active two-way communication channel in the healthcare universe and is key to better testing. Whilst we have been collaborating with the laboratory community in the US and Europe since 2008, there are still some regions where we want to forge new partnerships.
Q. Where do you want your business/brand to be this time next year?
I would like Diaceutics to be synonymous with precision testing for patients, full stop. I think we have gone a long way to build that reputation in cancer but we have a number of exciting collaborations under way in infectious, autoimmune and metabolic diseases which will illustrate the impact that precision testing will have on patients in those general medicine areas. Whilst I will be the first to admit that this journey will not be completed in one year, you can expect to see some exciting events and data which will contribute to our overall brand equity in the next 12 months.
