Christi Shaw, Sr. Vice President, Lilly and President, Lilly Bio-Medicines, on her unconventional path to success
Perhaps the most poignant comment Christi Shaw has made about her career is that, after thirty years in the industry, Fortune mentioned her for the first time in 2016 when she resigned as U.S. president of Novartis to take care of her ailing sister. Despite her many significant accomplishments, this was the decision that made headlines, largely because it was such an unusual move in the midst of a vibrant career. She’s working to ensure that this kind of necessary and understandable choice is not “news” in the corporate world, but a more common and acceptable one.
Throughout her career, there have been two main drivers of her passion and success. One, of course, is a dedication to the companies and brands she has worked for, propelling them in the marketplace. The other, which goes hand-in-hand with the first, is an unwavering focus on the patients and the people she has worked with.
She explains that this grew out of her upbringing. With a father who was a businessman, and a mother who devoted herself to philanthropic organizations, Christi borrowed some of both personas and brought them together in a career that has been driven, successful and people-oriented. She explains it as a perfect way to combine philanthropy and business, by helping hundreds of thousands of patients at a time.
TRANSLATING MEANING INTO MANAGING
When Christi joined Novartis, she made a mental journey through her career in order to determine the most important leadership policies she could institute. Why were certain teams successful and others not? What led to realizing the potential of products and people? What gave patients longer and fuller lives?
She got it down to three main data points on a single slide (see above). The key determinants she settled on were Focus Externally, Create Possibilities, and Be One Team.
The External Focus portion was a way of re-directing the company’s thinking to consider those it served. It resulted in exercises that would help everyone understand the patient journey. Beyond whether a treatment was working properly, what did it contribute to quality of life? A patient’s daily life should not be dominated by details about medication and an obsession with the disease state. How could the company help doctors assist in this process? How can the company help them get access? How do price and value figure into the equation? Dealing with these questions led to solutions that were about outcomes for the patient.
To help executives understand the patient journey, she conducted exercises in what it’s like to be a heart failure patient
For instance, she conducted exercises in which executives experienced what it’s like to be a heart failure patient: breathing through straws, walking with weights in their shoes, checking into a mock hospital, having to choose between paying for follow-up medications and groceries. It was important that everyone understand what the world is like for their patients. When they had to put medicines in a two-week pouch, only 25% of them got it right—and these were people who weren’t struggling with a life-threatening disease. It was a demonstration of how big a task it is to find solutions for patients, rather than just providing medications. She has participated in a similar exercise at Lilly, simulating the experience of people with rheumatoid arthritis.
Christi also changed the financial slides that reported progress, stating success in terms of how many patients were helped rather than how many dollars were earned. In board meetings, executives would discuss how patients might like Novartis to be directing its energies. The result? Expenditures were scrutinized more carefully, and financial expectations were surpassed.
Another program she championed was “Signature,” a leading edge way to match new oncologic therapies to genetic alterations in patient tumors. And consistent with her dedication to inclusion, Christi’s leadership team was made up of 60% women and 40% minorities.
Create Possibilities, Christi says, is about excellence. What are all the ways we can help? How do we work with partners—payers, the government and others? Rather than try to find the one “perfect” solution, she encouraged staff to develop multiple solutions and share them. That way, you create more potential, because there’s rarely just one right answer to a problem. In this culture of innovation, all the options are considered. “It’s about options, not absolutes, and excellence, not perfection.”
Christi points out that people and companies are often mired in the customary models they’re used to, while technological and other kinds of disruption are happening all around. When patients can get an EKG and other indicators on their cell phones, companies need to be aware of and connected to that new world. “At Eli Lilly, we discovered that 20% of Alzheimer’s diagnoses were wrong. As a result, some of the prescribed treatments may actually be making the dementia worse. The industry has to catch up to the reality,” she says. “That’s why it’s important to look at all possible solutions.”
“It’s about options, not absolutes, and excellence, not perfection.”
Another area needing attention, she believes, is healthcare policy and legislation. Lilly is currently working with payers on policy reforms such as fostering more effective conversations between pharma and payers before a product is approved. This is part of a larger effort around pricing reform.
The Be One Team part of her chart is about overcoming politics in favor of recognizing strengths and improving impact. The overriding goal should be to leveraging the wisdom of each member and supporting the strength of a team that works well together, rather than letting individual agendas take over. She says that many people have insights to contribute, even from areas not directly under sales or marketing. Some are good idea people, others are good coaches.
“When you create that dynamic, it’s really phenomenal,” she says. “If some are not achieving their goals, others should be supporting them to improve their efforts.” For instance, top performing reps can ride with those who aren’t doing as well, to model certain behaviors and tactics.
In the board room, Christi often doesn’t sit at the head of the table. This creates a more democratic atmosphere. “Middle management shouldn’t have to ask permission all the time, but just be able to offer ideas on an equal basis with everyone else,” she says. “The biggest ideas don’t always come from senior management or the brand leader. They often come from the people closest to the customer.” This is why she spends time in field talking to reps and reimbursement managers. At her town halls she brings in the field people to explain their tactics and successes.
Transparency is also part of this process. Once, when a compliance issue over an off-label request was handled incorrectly, rather than hiding the incident, she decided to share it with others. It helped uncover the motivation, and discover what the right way would have been. The motivation to help the patient was the right thing. It was only the process that was wrong.
Through this model, the team is better able to serve the larger purpose, the mission of the company. “We are able to examine where we’re going, and ask if we should challenge our own guidelines.”
PUTTING POLICY INTO PRACTICE
Christi recalled one product launch that didn’t go well. She was a district sales manager at the time, and called a meeting of her team. She drew on all the strengths and suggestions of the team members in asking how they could best promote the brand, and whether everyone truly believed in it. Some people were good at messaging, others at science. After the meeting, people were on the phone, sending voicemails and emails, practicing messages, role-playing. They explored various tactics and created peer-to-peer programs. Eventually, her team became number one in the country, and she was asked as a leader to help replicate her strategy nationwide.
In another instance of learning from mistakes, a mature brand she worked on was passed within six months by a me-too product new to the marketplace. What was the differentiation? “They knew the docs, they knew the patients. They understood that there was an arduous process for patients, who had to go to three places to complete their tests. They focused on flow, and made things more efficient for the patients. That’s understanding the customer.”
“When we focus on patient needs, success follows.”
Many decisions involve a complex process. During the launch year of a new medicine, they gave away the drug for compassionate use, because many patients were desperate for any hope. But down the road this hurt the company’s chances of getting reimbursement. Christi had to work with patient advocacy groups and motivate patients to lobby the government to straighten out the situation. “Patient demand often carries more weight than our efforts,” she says. Working beyond the narrow corporate realm was another example of her focus on patient-centricity. The sum of it is that “When we focus on patient needs, success follows.”
MAKING THE RIGHT PERSONAL DECISION
We mentioned above that Christi left Novartis at the height of her career to care for her older sister, who was in critical condition, suffering from multiple myeloma. Although she was deteriorating, she had been accepted to a promising new clinical study. But having a full-time caretaker was a condition of the study. A younger third sister was in the midst of preparing for her wedding, so Christi felt that it was her turn to take responsibility.
Christi decided to resign from Novartis, which for her was not a difficult choice. Surprised colleagues, though, encouraged her to consider taking a leave of absence. But Christi didn’t think that would be the right decision for the company. They needed a full-time, long-term person to guide them through a growth period, and Christi couldn’t predict how long her sister’s care would take. For most people, questions about reentering the industry, lost earning potential and other issues would have given them pause. But Christi didn’t hesitate.
Instead, she asked herself “What’s the choice you’ll wish you had made at the end of your life? In corporate America, you are so replaceable. The minute you walk out the door, there is someone to step in for you. Everyone says it. Do you wish you spent more time with your family, or at work?” Nor was it the first time she was faced with this kind of situation. She had taken a month off when her mother had breast cancer, and another three weeks when her father was sick. Both times, the companies she worked for were very understanding. And Christi believes that this kind of on-and-off-ramp policy actually helps companies be more successful, by appreciating their best talent.
There’s a happy ending to the story. In August of 2016, Christi’s older sister was well enough to walk their younger sister down the aisle as matron of honor at her wedding.
KEEPING HER HAND IN
Even while caring for her sister, Christi was still a multi-tasker. She mentored other women often, explaining the factors that led to her decision. She encouraged them to do the thing they won’t regret later. Sometimes that means working out an arrangement with their companies. Other times it may mean a greater sacrifice, but one which is just the right thing to do.
During this period, Christi also started working to create a foundation called “More Moments, More Memories” to help patients and caregivers with expenses like transportation, housing and food when they have to travel distances for clinical trials. This will give people more time with loved ones, what Christi calls “the moments you get that you will have for the rest of your life.”
Christi’s decision to re-join Lilly was based on her view that “there are just so many more patients that I can help if I stay in Big Pharma.”
And Lilly is on an upward trajectory. Its pipelines are healthy, and they’re on track to launch 20 new medicines by 2023. Among the most vital, from the Bio-Medicines unit: Taltz, a psoriasis drug also under FDA review for psoriatic arthritis, and Olumiant for rheumatoid arthritis; two potential migraine medicines; and Tanezumab, a potential non addicting treatment for chronic pain in co-development with Pfizer. Tanezumab now has fast-track status from the FDA. And there are more coming from other Lilly divisions.
Taltz is in competition with Novartis’ highly successful Cosentyx, which Christi also helped launch. So now she’s in the interesting position of going head-to-head with a past achievement.
Diversity and inclusion continue to be on her radar. The first part of this involves helping women and minorities learn how to advance their careers. When Christi was in sales, she spent seven years without getting a promotion. When she asked why, it turned out that the company had the impression she didn’t want to move in order to help her career. That, Christi says, was “a trigger, a sign that I have to be in charge of my own career.” The other part is holding CEOs and boards accountable. “We have to alert them to what they don’t understand, and what they’re missing by overlooking some of the talent they don’t hire.”
“When I came into pharma in 1989, it was a badge of honor to be a rep. Now we rate down with the tobacco industry. It breaks my heart.”
Finally, she sees major issues that have to be resolved in the industry as a whole. Why doesn’t insurance cover the things patients need it to cover? Why are business people making treatment decisions that should be made by physicians? Is too much money being taken out of the equation by the middlemen?
Why can’t we get to outcomes based pricing faster vs per treatment?
Streamlining the industry will also contribute to another major goal: being a trusted partner. “When I came into pharma in 1989, it was a badge of honor to be a rep. Now we rate down with the tobacco industry. It breaks my heart,” she says. “But we can turn this around. We just need to find and get behind the solutions that are available.”
As a member of BIO and other industry organizations, she’s doing her part. “For a long time, we saw our responsibility as creating innovative medicines. Now it’s about so much more. We have to bring everybody to the table and make this again the best healthcare industry in the world. And we can.”
Christi Shaw started her healthcare career at Lilly in 1989 and returned there this April as senior vice president and head of Lilly Bio-Medicines. In-between, she has been an executive in the Janssen and Ethicon divisions of J&J, and head of North America Oncology and U.S. President and country head of Novartis. She has also served on the boards of the Biotechnology Industry Organization (BIO), the Healthcare Leadership Council and the Young Women’s Leadership Network. Christi has been a recipient of eyeforpharma’s prestigious Lifetime Achievement Award, was listed by PharmaVOICE among its 100 Most Inspiring People list, and was recognized by Diversity Journal as one of its Women Worth Watching. She has spoken at numerous industry events and has been featured in Working Mother and Life Science Leader magazines.