In the latest episode of the Venari Podcast's Chief Commercial Officer Series, Joe Knight, who leads the Commercial Function within the Life Sciences team at Venari Partners, was joined by Everett Crosland, Chief Commercial Officer at Cognito Therapeutics. They discussed building high-performing commercial teams, transitioning to a CCO role from an access perspective, and predicting future commercial trends.
Everett sheds light on Cognito Therapeutics, a late-stage Phase Three company dedicated to tackling Alzheimer's and neurodegenerative diseases. Drawing on his market access background, Everett highlights the need for creative engagement with payers, recognising their increasing influence as gatekeepers in the healthcare industry. He stresses the importance of a cohesive approach that integrates strategies involving physicians, caregivers, and patients.
Everett and Joe also discuss the critical task of building commercial teams ahead of product launches. The timing depends on several factors, including the organisation's financial state, the specific market, and the pace of change within it. Drawing on his own experiences, Everett highlights the challenge of maintaining focus and making strategic decisions with limited data.
He outlines his approach to leadership, emphasising directness, transparency, and authenticity. Everett believes in inspiring and motivating his team by connecting them with the company's long-term vision; it is also crucial to remain adaptable in the face of evolving circumstances.
Looking ahead, Everett expresses enthusiasm for innovative partnerships in commercialisation strategies. These partnerships could involve large provider networks, healthcare delivery systems, and payers, with the aim of developing comprehensive solutions. He acknowledges the challenge of scaling high-value gene therapies within a fee-for-service system and anticipates that early-stage partnerships, characterised by collaborative efforts among stakeholders, would drive future advancements.
Read on for the full transcript of their conversation!
You are currently the Chief Commercial Officer at Cognito Therapeutics. Tell us about the company and how you got there.
We are a late-stage Phase Three company focused in the Alzheimer's space. In particular, we're a medical device company that leverages years, if not decades, of neuroscience coming out of MIT to potentially effect positive changes in Alzheimer's and neurodegenerative diseases more generally. I came into Cognito a couple of years ago, right as the company was really embarking on this later stage in preparation for the market and standing up the Phase Three study. There's often a question of when you bring in your commercial team and commercial leadership. Our product in this space really offers an opportunity to be creative and advance a commercial model that leverages the full attributes of the device against a disease that has long been a challenge for multiple life sciences companies. And so I came in a bit early, but I think it's something that will really pay off as we're building what I hope will be proven as a best-in-class commercial model.
You come to the Chief Commercial Officer role with more of a market access background than traditional, perhaps, sales and marketing backgrounds. Of course, you have strong capabilities there too, but how does that access and government experience influence your strategy as Chief Commercial Officer?
As someone who came up in market access, I think it's a real attribute in this world where payers really are continuing to grow in their influence as gatekeepers. I think for a long time, they've been gatekeepers, but it's been interesting to see as payers have been able to really fully deny coverage for products. And now, in kind of this new world where payers have the option and are able to act as that gatekeeper, we have to be creative in how we work with them. We have to be creative in how we engage with them early and ultimately try to get to a place where we're partnering with them. At the same time, we know that the role of physicians, caregivers, and patients is equally important, and it's a matter of knitting those strategies together so that one is pushing and pulling on the other in a cohesive way.
You were saying earlier about how you're building a commercial team ahead of launch for Cognito Therapeutics. You've done that before at previous employers as well. Getting that timing right is obviously very important. This is something that we spend a lot of time helping our clients with. How do you think about building that organisation? When is the timing right, and how do you go about putting in place the essential parts?
Often the rule of thumb that seems to approximate what works is anywhere between 24 and 36 months pre-launch. I think that in small organisations, it's more difficult to make that judgment call and it's more bespoke to the organisation, to the product, to the financial state of the organisations, and to the market that you're launching into. A market that is changing very rapidly. This is like Cognito’s market, Alzheimer's in particular. That market is changing probably more quickly than any market I've ever launched into. And what's driving that is there are new market entrants. There are new diagnostics coming on, there’re digital components being injected into the marketplace and clinical studies, etc. And that's true for a lot of disease states and a lot of conditions. It seems especially true for the neurodegenerative space right now. And so often those types of factors, the complexity can really inform when you want to bring someone or a team on.
Just thinking about that recent case study with Cognito, is there any lessons that you've learned along the way? Is there anything you’d do differently next time?
Oh yeah. Hindsight, right, you always have pretty clear vision. I think that probably the best approach really is nailing down that area of focus early, having the discipline to stick with it. And discipline is often saying no to things that really look like they could be pivotal to your company. And saying no to opportunities that maybe the company has never been presented with previously because it allows you to continue to allocate the resources. And so when these things come in and you have that opportunity to react, it's not a matter of saying no to everything, but it's a matter of saying no to nearly everything. At Cognito, we've gotten really good at focus faster than I've seen at other companies. But it's always a challenge and it's always something that you have to navigate with as much data, but also understand that you're navigating with limited data at the same time.
So following that, I'd like to talk a little bit more about your role as Chief Commercial Officer. How do you approach leadership? You clearly have responsibility for managing a high-performing commercial team, but how do you go about ensuring that that is a reality and then inspiring your team to actually achieve great things?
In a pre-revenue, kind of pre-commercialisation phase, that starts with identifying people who are a good stage fit, you need the people who are energised, fulfilled by the opportunity to build the strategy, test the strategy. It's the people who really have been launching those products and then either following it into the market or going to the next asset and launching another one. In this stage, it's a lot like the launch stage, which is a lot of hyperbolic ups and downs, you know, a lot of news that means that what you've built changes dramatically. And so being comfortable with that change, embracing it, finding the opportunity in the new information, and then keep them motivated with the longer term vision. And so I think, you know, to boil it down, I really like to operate with directness, and transparency, and authenticity, but really focus on pulling that motivation out from the day-to-day, to focus on the big vision and what we're trying to accomplish, and understanding that that vision is going to adjust over time.
Finally, I'd like to ask you to look towards the future. What trends in commercialisation strategy from both Big Pharma and smaller biotechs do you think we'll see more of this year and way into the future?
I get excited about the potential for kind of innovative partnerships that carry forward into commercialisation. Those can be innovative partnerships with large provider networks and healthcare delivery systems. They can be innovative partnerships with payers as well. That doesn't necessarily need to be a value-based arrangement. If you engage early enough, you can build a service and a solution. I think the solution that I really get excited about is that those that are forcing the various stakeholders together. Like gene therapies, you know, multimillion-dollar gene therapies, just won't scale in a fee-for-service world. However, that doesn't mean that they won't succeed. They provide extraordinary value. Those two together, the challenge of not being able to scale in a fee-for-service world while at the same time providing extraordinary value is a forcing function. And I'm really excited about what's going to come out on the other end of that forcing function. I think it's these really kind of early-stage partnerships where we build together versus sequentially.