New Drug Discovery - Putting Patients First – Asrar Qureshi’s Blog Post #1304

New Drug Discovery – Putting Patients First – Asrar Qureshi’s Blog Post #1304

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1304 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com  for publishing your contributions here.

Credit: Polina Tankilevitch

Preamble

This blogpost takes insights from a McKinsey article. Link at the end.

The Future of Pharma Innovation: What Astellas Teaches Us About Putting Patients First

Pharmaceutical innovation has never been more exciting, or more difficult.

Science is advancing rapidly across targeted therapies, immuno-oncology, genetic regulation, cell and gene therapy, and new drug modalities. At the same time, the industry faces enormous pressure to translate scientific breakthroughs into medicines that genuinely improve patients' lives, while managing rising R&D costs, regulatory complexity, patent expiries and increasingly demanding healthcare systems.

Against this backdrop, the recent conversation between McKinsey and Naoki Okamura, President and CEO of Astellas Pharma, offers a fascinating perspective on how a major pharmaceutical company is attempting to rethink innovation. Astellas is moving beyond traditional therapeutic-area structures and building its innovation strategy around three interconnected elements: biology, modality and disease, while placing the patient at the center of decision-making.

From Therapeutic Areas to the "Innovation Triangle"

For decades, pharmaceutical companies have commonly organized R&D around therapeutic areas: oncology, cardiovascular disease, immunology, diabetes, urology and so forth. Astellas is taking a different approach.

Under Okamura's leadership, the company describes its "focus area" model as an intersection of biology, modality and disease.

The starting point is not necessarily a therapeutic category. Instead, researchers begin with a biological mechanism that has a strong connection to disease. They then ask which therapeutic modality is best suited to address that biology and finally identify the patient population that could benefit. This represents an important shift in thinking. The change may sound subtle, but it can fundamentally alter how opportunities are identified.

Failure Becomes a Source of Strategic Learning

Drug development is inherently uncertain. Most compounds entering research will never become successful commercial medicines. The conventional response to failure can sometimes be to treat the failed program as a loss.

Astellas' model offers a more sophisticated alternative: ask what exactly failed. If the biology remains valid but a particular modality does not work, the underlying insight may be redeployed using another approach. If the biology and modality remain compelling but the original disease indication is not viable, the combination may potentially be explored in another disease. But if the biological hypothesis itself proves invalid, the company is prepared to stop. This distinction is extremely important.

Broad Exploration, Sharp Commitment

Another particularly interesting aspect of Astellas' approach is its philosophy of resource allocation.

Early-stage innovation requires breadth. The company deliberately explores multiple potential areas. But as evidence accumulates, investment becomes more concentrated. Clinical proof of concept becomes an important point at which the organization increases resources behind a promising program and potentially develops follow-on opportunities around the same scientific foundation.

Early development requires experimentation and diversity of ideas. Later development requires concentration and scale. That is very different from allocating resources equally across every promising project.

Breaking the Functional Silo

Perhaps the most significant organizational change described by Okamura is Astellas' decision to shift its primary management axis from functions to patients.

Historically, pharmaceutical organizations have been divided into functions: research, clinical development, regulatory affairs, medical affairs, manufacturing, commercial, finance and others. Functional expertise is essential. But functional structures can also create silos. Each function may optimize its own objectives while nobody feels completely accountable for the entire journey from scientific discovery to patient outcome.

Astellas began moving away from this model in April 2025 by creating cross-functional "asset-maximization teams" with end-to-end accountability for programs. Depending on the stage of development, different functional leaders co-lead the program.

Patient-Centricity Must Become More Than a Slogan

"Patient centricity" has become one of the most frequently used expressions in the pharmaceutical industry. Almost every pharmaceutical company today claims to put patients first. But does the organizational structure actually reflect that promise?

Astellas has been working on patient centricity since 2019, including dedicated patient-centricity structures and efforts to embed patient perspectives into medicines development and organizational culture. Okamura's comments suggest the next stage: patient centricity should influence how resources are allocated, how programs are managed and how employees understand their jobs.

A patient-centric organization is not simply one that conducts patient interviews or includes patient representatives in selected projects. It is one where employees understand the connection between their work and the outcome experienced by a patient.

Technology's Real Value May Be the Data It Creates

Astellas' work with automation provides another intriguing lesson.

The company is using Maholo, a robotic cell-culture system, in an area where consistency and technical expertise are particularly important. But Okamura emphasizes that the primary benefit of automation is not simply that robots can perform tasks continuously. It is data.

Automation can generate large quantities of high-quality, reproducible information. That information can enable continuous process improvement and make it easier to reproduce processes across locations.

Build What You Are Good At – Access What Others Do Better

Astellas also provides an interesting perspective on the internal-versus-external innovation debate.

The company has strong capabilities in small-molecule medicinal chemistry, which makes targeted protein degradation a logical area for internal development. But internal capability does not mean isolation. Astellas continues to collaborate with universities, startups and external technology providers and remains willing to acquire or partner when another organization possesses superior capabilities or assets.

The best pharmaceutical organizations of the future are likely to be neither completely closed nor completely dependent on external innovation. They will be orchestrators of ecosystems.

Preparing for the Patent Cliff

Astellas also illustrates another fundamental reality of pharmaceutical strategy: every successful medicine eventually faces a lifecycle challenge.

XTANDI (enzalutamide – Astellas/Pfizer) has benefited more than 1.5 million patients globally, but its eventual loss of exclusivity is anticipated. Rather than depending indefinitely on a single blockbuster, Astellas is building a portfolio of multiple high-potential strategic brands and expects new pipeline assets to become increasingly important to growth from FY2029.

The strategic lesson is straightforward: A blockbuster is a success. A sustainable innovation engine is a strategy.

Sum Up

Perhaps the most important lesson from Okamura's philosophy is that innovation is not simply about discovering better molecules. It is about building an organization capable of repeatedly converting science into patient value. That requires scientific excellence, but also organizational design.

It requires focus without rigidity, experimentation without waste, collaboration without loss of accountability, technology without technological obsession, and patient centricity that extends beyond corporate slogans. Most importantly, it requires leadership.

The future of pharmaceutical innovation is not just about discovering what science can do.

It is about what can science do for patients, and how can we build organizations capable of delivering it?

Concluded.

Disclaimers: Pictures in these blogs are taken from free resources at Pexels, Pixabay, Unsplash, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, any claim is lodged, it will be acknowledged and duly recognized immediately. 

Reference:

https://www.mckinsey.com/industries/life-sciences/our-insights/putting-innovation-and-patients-in-focus-a-conversation-with-astellas-pharma-ceo-naoki-okamura?stcr=001204AE707B4F5A88F93D2690E982E3&cid=mgp_opr-eml-alt-lfs-mgp-glb--&hlkid=42c35c58244b4b89b94dc1f0293cad7e&hctky=15999472&hdpid=9940ef0d-2613-4ae7-b60e-60bce4f1b969