Introduction

The pharmaceutical industry has been changing rapidly over the past 20 years, and that change has been accelerated due to COVID-19. With the rise of information technology, pharmaceutical treatments are being developed faster, cheaper, and more personalized. In this Insight, we interviewed Dominique Côté, founder of pharmaceutical consultancy Cosawi, to discuss the current transformation efforts underway and where the industry is headed.

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Interview with Dominique Côté

Van: Thank you for joining us. I just wanted to share a little bit about our past relationship and about how we've worked together and really spend some time getting some insights from you about the pharmaceutical industry and where it's going, and generally how... Really how it's transforming and how change management can support it. You had a pretty significant initiative with one of your clients that we were able to support in program management initiatives and some change management. One reason that I wanted to talk with you was because it kind of gave us a little bit more of a taste in the pharma space that we hadn't had before, and I was hoping maybe you could just tell us a little bit more about you and your company, Cosawi and your background. And we have a few questions for you.

Dominique: Thank you, Van, it's such a pleasure to see you again. I'm French-Canadian of origin. I come from Montreal, Canada, my academic background is in research in microbiology and biotechnology, and then I moved to do a little bit of research in genetics and oncology before the DNA sequencing. So it's dating me and quickly realized that that was not my purpose and I was missing out on the business world, so I moved to the pharma industry and interestingly enough, spent my career on the commercial side, never on the research side, but always was a connector between the two. So increasing responsibility in sales, in marketing, in general management, and I've worked with organization like Roche, Novartis before the merger, Searle Pharmacia and Pfizer which was the gist of my career, and then after the integration of Pharmacia into Pfizer, I had the opportunity to have a global role reporting to HQ in New York, and after that I moved to Belgium.

Dominique: I had the opportunity to move to Belgium to lead the commercial operation, what we used to call emerging markets, a group of 70 market, and I had teams in more than 36 countries, which was really an amazing opportunity of learning about culture, different ways of working in different healthcare, to be honest. I had the opportunity to do the spin off of Pfizer Animal Health, so building the commercial operation for what became Zoetis.

Dominique: Did that for three years, and then joined UCB for a couple of years, which is a biotech. After all of these years, 30 years of career in the pharma, mostly on the commercial side and leading commercial operations, one of the red threads of my career was key account management or strategic account management. For me, strategic account management is the way to really achieve patient-centricity and customer-centricity, so that's really my purpose, so after having all those years, I wanted to give back a little bit so I created my own company, which is called Cosawi, where I do consulting with organizations, not only the life science, because this is a bit broader than life science, it can be transferable, but what I do is I help organizations with business transformation from the strategy to the voice of the customer, helping them to really engage differently and change their mindset to a more outside-in mindset and be able to execute on it. So that's what I do now with Cosawi, it's been five years.

Van: And you mentioned the strategic account management, you're also part of an organization specifically about that.

‍Dominique: I've been on the board of SAMA for about 10 years now. SAMA means Strategic Account Management Association. It's an association that is global, and based in Chicago, we've helped for 60 years, organizations really transform into becoming more customer-centric by providing strategic account management mindset, process and skill set. I started working with SAMA in fact when I was in the corporate world to try to see if I could bring a bit of that transformation into Pfizer at that time. And at that time, there was not a lot of life science at SAMA , but a lot of different industries. What I like about SAMA is that it's across all industries. It's a great community, it's also a huge resource for organizations who are wanting to do that, a lot of thought leadership exchange, and I think it was part also of my passion and why I developed Strategic Account Management and in customer-centricity.

Van: Before we met I was not familiar with your organization, so I did wanna just cover that, because I think some of our audience aren't, but it's actually really interesting and great that there's actually an organization specifically for that.

Dominique: It's a community that is really willing to engage, to exchange, to share best practice, what's working, what's not working, and across industry, and I'm a strong believer that independent on the industry, you can always learn from the others sometimes and see how you can adapt to your own industry, and sometimes it's kind of disruptive a little bit to hear how others are doing it, so that's the beauty of SAMA, really.

Van: I do wanna dig into that a little bit, actually, 'cause I've been curious about a lot of the cross-pollination between... 'cause pharma is such a unique industry, and I've been just very curious about some of the cross-pollination between other industries and that. So I definitely wanna talk about that in a little bit. One thing that's been on my mind as we work, because we work across many industries, and many were impacted by the events over the last year and a half or so, over the next few years what major transformations do you see coming in to the pharma industry.

Dominique: Even not thinking about COVID and the pandemic, I think the pharma industry is one of the most disrupted ones, and research shows that because of a couple of things, first of all, the integration of the healthcare systems, but also the technology.Technology is really disrupting the way that all our healthcare system are working, and there's also a big shift in terms of value, so all the things we hear about value-based pricing, also those value contracting, value proposition and all of these things. And the last is, I think for me, I've seen an increase, which is again, close to my heart, but an increase in the weight of the decision-making from the patient perspective, so I think the patient have more and more weight into the decision making, including defining themselves, what does health means. So I can relate to... I can maybe give an an example, even in oncology.

Dominique: I remember when I started working in oncology, obviously this a devastating diagnosis to get, and you count on your physician for sure to get the treatment and to get... What do I need to do? But more and more with education, with the information, with everything that's kind of going, and the patient have also a place to be part of their treatment decision, I would say, and making a decision what they're willing to do, especially when you're in the late stage,we've seen certainly an acceleration in the healthcare impact with all the telehealth, so technology has really, really increased, boomed into the healthcare systems, including telehealth. Our healthcare services got a lot of stress from COVID, obviously, and it was about managing that, but a lot of shift and acceleration of about 10 years of the telehealth implementation and execution happened because of Covid.

Dominique: I think we're gonna to see now and what's next, because post-COVID, we're gonna realize that some medical areas, or therapeutic areas have been a backlogged, so how are we gonna be treating all that and catching up. The big data is another one, the insight... When I talk about technology, it's also the data piece so big data and how all of this is also providing help in terms of diagnostic and help creating insight. So both on the healthcare itself, but also the pharma company in terms of data insight supported by machine learning and all these things. Obviously, that's going to accelerate. For me, I have the hope, that all of this is gonna bring more time for a healthcare practitioner to spend time on the more holistic view of the patient, because the support of diagnostic making.

Van: Some industries are able to leverage big data for very individualized experiences, of course. Probably the biggest example, people think of is like Facebook, where every single person who interacts with Facebook is seeing a completely different world personalized to them specifically. We work a lot with hospitality, for example, and that's an industry, by the way, that has been impacted severely a little bit for very different reasons, but they have got personalization down, they take data and they will present you with deals and with their guest experiences and things like that, they're very, very specific to you, and they're leveraging a lot of big data to do that.

Van: And I was actually reading an article in The Economist recently about how Roche is actually taking some big data and using it to do personalized cancer treatments. And I think that's fascinating, and you mentioned about how there's a trend to put a little bit more power in the hands of the patient. And I'm wondering if maybe that does play into that, that we now have... We can now start leveraging big data better, we can start presenting something specific to the patient, actionable information specific to the patient, and perhaps that's a way to give the patient more power, is that... Is my thinking correct there?

Dominique: I look at it as two angles, when you look at big data and healthcare in general, there's the impact on the healthcare itself, so how it can help to personalize... To your point, years ago, and I'm coming back to the oncology topic, I was on the forefront, when we started to have those genetic testing, you could have, for example, breast cancer HER2 positive or negative, and it started to evolve the treatment, and I would say less general, more personalized. We're moving to what I call, the individualized treatment, because as we continue with the DNA sequencing, that took about 10 years for the first one to be fully done and about billions of dollars now is being done in hours and much more affordable. So we're gonna really start to use that DNA imprint of ourselves to be able to personalize treatment of medication, so that's one area.

Dominique: The other area is in terms of the healthcare and using all the machine learning, the AI and all the big data to be able to provide better support, diagnostic and technology in general, to be able to treat patients. On the pharma part, I think that obviously, we don't use data the same way, there's a lot of regulation, a lot of limitation for good reasons of data privacy and all that and how you use patient data, but there is a lot of data that, again, we're right now leveraging in terms of research, how can we accelerate the research. On the commercial side, it's also how can you, I would say, leverage because those organizations are big. How can you leverage all the big data to be able to provide more insight to your customer. And because there's so much available, you don't know what is valuable, and how to sometimes transfer this data information to something that's actionable.

Dominique: The way that we work with organizations right now is looking at that, how can we leverage data and commercial enabling function like business intelligence to be able to take data, translate into something that's about trends, about actionable insight that they can use and then help their customer do something with it. I think there's a different angle. I think the pharma certainly is gonna be impacted as anyone else with big data, the question is, how do you harness it and make something of it and do something valuable with it.

I think there's a acceleration in pharma right now, moving from a more transactional model of what I used to call the marketing billboard, and then really pushing out what we have to offer to move to a strategic account management model, which requires a different organization

Van: Of course, of course. Yeah, that makes sense. And I think being able to effectively use that data and figure out what's relevant and decide what you can and can't access, that is one challenge. Another challenge, I'm assuming that exists is more on the business side. So the availability of this data and a personalized treatments seems like it also impacts the business models and how you sell within pharma. And I'm wondering what kind of challenges you see coming up over the next several years in respect to transformation around that.

Dominique: So I think it's not only big data, but it's also a convergence of some of the things in terms of, yes, the technology, the speed, the data and everything that's accessible that also is changing the way we do it. The digital transformation is something also that's impacting. For example, I hear a lot of people talking about marketing or digital marketing. For me, there is no digital marketing. Marketing should be digital in our new era. So it's part of how we evolve marketing. And then in terms of commercial, there's also all the integration, first of all, of the healthcare systems that is impacted. So the archetype of how and where the decision-making is being made, the value-based negotiation, pricing, value-based offering are also impacting. COVID has impacted also, because, if I may, there's a few research, I think from McKenzie that were showing that in the life science sector, the healthcare professional want to engage, and when they're gonna be able to do it again , they want to re-engage face-to-face but the hybrid models will stay. So, they want to re-engage to a lower rate. They want to re-engage with people who are gonna bring value.

Dominique: There’s a real trend in today's environment that people want to engage with business people, and people that bring value to them. If I spend an hour with you, what's the value for me? And I think that is the big impact. We see a lot of model, and I think there's a acceleration in pharma right now, moving from a more transactional model of what I used to call the marketing billboard, and then really pushing out what we have to offer to move to a strategic account management model, which requires a different organization, and is moving in an environment where everything start with the patient and the account or the customer and the stakeholder. So an outside-in mindset. I think we need to move from the inside out to the outside in. And instead of pushing, really understand the needs, and then those organization and pharma have a lot of value beyond product they can bring in those partnership.

Dominique: So I hope that, again, we're moving towards partnering even more than we see today. We saw great partnership during COVID. So how can we partner as pharma industry even more in terms of bringing solution to the big problems as organization, because the rest is gonna come. And as we help organization and we partner, well, part of that are the product and everything else. But I think there's a broader value that needs to be brought to the table, and can be brought by the pharma industry as well.

Van: For the sake of our audience, there's a couple of things you mentioned, but that I'm not sure everyone understands exactly from a pharma perspective. What would be a customer... What would be a strategic account from the pharma industry specifically? Could you just explain a couple of those terms for us?

Dominique: Yes. the customer is gonna be the healthcare... Either the healthcare system or the integrated health network that you see, or it could be the health group professional. Customer is a broader terminology to say who you're actually interacting with. But in pharma, we often say key opinion leaders or stakeholders. It depends on who. But these are terms that we use, and it's just to define who are you engaging with. So sometimes you can engage with a whole account, for example, an integrated health network you would engage with the whole account as a group. And strategic account management is about, for example, if you look at a pharma organization that's gonna have different BUs, and different therapeutic area having different commercial people going to see the same account for different therapeutic areas, you end up having so many interactions, that's not where the value is.

Dominique: But those very important and most important account are customers. It's the opportunity to bring a team together. So how can we really understand what is their strategic imperative, what do they care about, what's important to them, and then look at, what we have which part of it are product and services, but also value enablers, and how can we help them achieve their own objective. Which goes a lot further. At the end of the day, for me, it's how can we help these healthcare system or healthcare groups to be able to achieve their objective by also providing a better outcome for the patient. So it comes back to patient centricity. Does that help?

Van: It does. And I think one question I have, and this may just be my ignorance from coming outside the industry, as we've talked about big data and about patient-centricity, and it seems like from an outside perspective that as you make treatments more specific to an individual patient, that seems like it's going to change a little bit exactly how you manage those strategic accounts, because it seems like the focus is a little bit less on the actual healthcare organization and more on the patient specifically, because you now have the power to do that, whereas before, you couldn't necessarily rely on very patient-specific data. Is my assessment true that that's presenting a little bit of a challenge for pharma, or are they really just able to just deliver more patient-centered products through the same type of cycles?

Dominique: I think the biggest difference on how the pharma has evolved is that you've had years of what we call in the pharma world, blockbuster. Which are those product that, again, in disease areas like cholesterol or heart disease, you had a huge pool of patients where you could provide the same thing. I think that it's not a question of becoming more patient-centric, necessarily, but I think going to the more individualized diagnostic and treatment, first of all is gonna reduce hopefully side effect, it's gonna be better suited and all that. The challenge it because you need to do research and develop research for a smaller pool of patients.

I think as the patient voice is increasing in decision-making, it's question that we have to ask ourselves, do we want our healthcare system to reimburse prevention? Lifestyles? Or do we want them to really focus on things that are life-threatening, and curing cancer? It's gonna be an interesting debate, Van, To see how we move in that direction of having more individualized, more personalized medicine

 Dominique: So, as you know, I'm a strong believer that there is a place for pharma to provide patient value. I'm not sure the press has always been good with pharma. If I put myself back into the years of being in the pharma, some of that bad press was deserved. Again, the way we communicate, and a lot of the things that were done, they were a mistakes. But to really become patient-centric, one of the issues is that you also are not a non-for-profit, so you end up having very small group of patients, and having to develop medication for them. And I think for this, big data again, and all the technology is gonna help in accelerating that R&D period of 10, 15 years that we've seen. Again, the investment costs has been huge, so it's all about how can we reduce the cost and speed to treatment

Dominique: At the same time, I think as the patient voice is increasing in all those decision-making, it's question that we have to ask ourselves, do we want our healthcare system to reimburse prevention? Lifestyles? Or do we want them to really focus on things that are life-threatening, and curing cancer? It's gonna be an interesting debate, Van, To see how we move in that direction of having more individualized, more personalized medicine and being able, having the ability maybe to treat some of the disease, but again what is the cost of the disease and where do we spend our budget in this? And I think that's a bit beyond what I do, but this is always great discussions to have.

Van: I'm gonna take us back out to a slightly higher level for a second. What are some of the challenges that you see internally within pharmaceutical companies in actually adapting to transformation? Every big organization has huge challenges with transformation, every big organization has challenges with change management. Is there anything specific, or any stories or experiences you can share of times when transformation has been difficult or will be difficult? Or has been especially good? If you have any thoughts.

Dominique: Looking at business transformations, what I like is that there is not two business transformations that are the same. Even sometimes if you wanna have a similar objective of maybe re-organizing and being more focused on how you can partner differently and bring more value to the account, or the customer, or to the patient. There is never one way of doing it... None of the projects are the same. Which is why I love what I do. I think some of the challenge are gonna be very variable. I see organizations that are doing amazing things. And most of them are, but often it's not on the whole journey. Those business transformations, including strategic account management, are not a sales model, they are a business transformation, it's a cultural shift, and it's a journey.

Dominique: There are different ways of getting at it. Usually what we do is that we look at the organization and do a diagnostic of the organization to understand. Some of the things that are harder and that I see, are coming, first of all, the executive sponsorship and leadership as one key thing. Again, it's about the mindset and business transformation that is not a sales process, this is not a sales organization, this is really a business transformation. And it needs to break the internal silos and bring the different department around the table, to look at what can we offer to those strategic accounts. The leadership is key, measuring the impact, and bringing the voice of the customer inside to transform.

Dominique: That's one thing that often is missing. I know there's the NPS and all that, but I think there's... The best way... Because organization in big pharma are big, are matrix, are hard to navigate, and often the only way to change it is to get the perspective of our customers. So, voice of customers is certainly one, that I see that there's a good opportunity to improve in many organizations. The pharma industry has been trained to, and not only the pharma, I'm talking about general SAM, so other industry too. We create, we produce products, and then you need to go to market, so you push them out to sell them, and so you have an inside-out mindset. The strategic account management and customer centricity is about changing that mindset to start with the patient, in the case of the healthcare.

Dominique: What do the patient needs? Then what can the organization provide to them? But having that value chain understood. So you start with their needs, to be able to provide value. What it is offering is the broader value of, not only your product, but what are some of the services, some of the capability, the competency sometimes, that are huge in these organizations that can help organizations thrive? For example, I was working with a client lately, and one of the thing they develop is in the area that they're working on , project management was critically needed in time of COVID.They had a whole team doing project management, they have the capability of doing it so they were able to help and train and really own some of the project management piece. Which sounds simple, but it's just something that we don't often think about going beyond product and services and looking at, What else do we have in our organization that can help? What are some of the partnership, the alliance? In those big organization, we have partnership with many groups, sometimes technology groups, could be many thing, we don't think about that. So we're blind to what I call the closet or the cupboards, we don't know what's in our cupboards, so we cannot ever spice up the rice, if I may say because we always used to have the same white rice, and we're missing all those spice to be able to add value and differentiate ourself, and really contribute to a little bit broader value.

Van: I'm glad you mentioned that because it's actually really amazing in my experience how a lot of very mature industries, a lot of very mature companies, will often lack that capacity for project management and program management. It's like an afterthought. It's like, How do you function? But somehow they do. And when you want to be able to change rapidly and when you want to be able to respond, you have to have some of that structure in place.

Dominique: As I do this work, and sometimes... Locally there is one way, again, of doing it, but to your point,when you do those transformation globally to see how can you also look at what's the vision, what's the strategy, what's the organization globally, and then be able to trickle it down to the local organization, you need a solid team. And that's one of the reason I really like when you and your team come on board to be able to help there, because that's a profession for me, and that's something that in those big organizations and big change management we need.

Dominique: The other thing that I have not mentioned in in any big organization is the lack of patience for outcome... I don't think it's only pharma, but let's focus on pharma. We're not patient. We want result now. And we're being held accountable by shareholders and have quarterly reporting and all those things, and earning release, and…. that's great. But then when you look at working on something that's gonna be more mid to long-term and providing what I call an opportunity of portfolio, creating more trust and more partnership, it takes a little bit more time. Often what I see is that you have people changing, and then the project is being shelved, because you cannot have the return on investment as quickly, again not seen as we're traditionally seeing it. That's why you also need to go back to your voice of customer, because quickly they see the difference in how people engage when they engage in this manner.

Van: You're completely correct. That is definitely not specific to pharma, that is pretty much any large organization is facing that, because they are facing similar pressures, right? They are facing their shareholders, they are facing the need to respond to the business environment. It's always a challenge. And sometimes when you come in and try to put in some sort of management framework around that transformation, and you have to give them a realistic view and you say, "I'm sorry, this is actually gonna take you nine months or 18 months," or something like that, it becomes very difficult to explain that. And of course, it ends up taking that long or longer or it never happens, but being the messenger of that bad news is very difficult sometimes [chuckle] when you're in the transformation role.

Dominique: Sometimes we start with something, but then you realize that all the other ones that needs to be done. And what I always tell them is that, "This is a journey. You need to take a step approach; one step at a time. There's no way we can do everything at the same time." But there is a way of having a process, of starting with that vision, that mission, what do we wanna accomplish, and then being able to see the road map, starting with, Which are those key accounts we wanna focus on and start with a few. Then ask What is our business model? And then putting it together with the organization to be able to scale up through people, bringing the team together, getting the voice of customer input. But the road map takes again, a lot of organizations I work with, it's a question of mid to long term. Not at the same intensity, but it's a question of a couple of years, yes.

Van: Yeah, absolutely.

Dominique: You can ignite the fire a little bit, because obviously you go back to your day-to-day, you're measured. And that's why I was saying measurement is hard, because we are in many of these organization measured on KPIs that are really not lead indicator but more lag indicator, and very, very short term, very revenue-driven. But we're missing a little bit more the mid to long-term KPIs.

Van: Absolutely. So to address some of that in patients, I'm gonna ask you the million dollar question. For faster, positive transformation, do you see any quick win changes in pharma? Are there any best practices that you can think of or any of the "low hanging fruit" that you see in the pharma industry that could be adopted to respond to some of this need to change?

Dominique: I think that what we're seeing right now and what we're seeing as the impact of COVID, is an acceleration of those business transformations. Again, the pharma has been hit, the healthcare has been hit, obviously there's a lot to do. So again, hit differently than the hospitality, for sure, but at the same time it does require companies to pivot and be able to see differently... As I was mentioning that research that even the healthcare professional, they wanna see people that bring value. I think what we're really seeing is that acceleration of transforming the way we engage, and transforming in those SAM road map.

Dominique: Additional trends that I'm seeing is the trend of establishing what I call centers of excellence, or enabling functions, really for the SAM group. What is interesting in those road map is often, we have organization really investing, focusing, developing their road map to that different business model engagement, but then the commercial enabling functions are still focusing on the transactional reps or the ones that are more in volume, but then there's a gap for the strategic account management to get the right support in terms of being able to be agile. The center of excellence can help the road map, being the owner of the road map, helping in navigating the internal, looking at process, looking at competency and all those things that are needed to accelerate the journey. So, center of excellence is a key trend that I see.

Dominique: The other one is account-based marketing, which is something that I'm happy to see because having been myself a CMO, I find that marketing for strategic account management is often not at the table. What we call our strategic account managers or commercial people end up having so much on their shoulder they cannot do everything, and the role of account-based marketers is not to provide brand or to provide only the product and look at the campaign and all that we need all to sit at the table, at the same time and try to shift the mindset to having a marketing outside-in mindset; what does the account, what does the customer needs? And then be able to bring, as part of the offering the product campaign, but be the owner of, what I was saying, the cupboards. They know what is internally available and the value of the organization to create business cases and use cases, and then they can help scaling those business case, and they are the one that can help translating data into actionable insight. So these are some of the role of ABM at the table, and I see more and more organizations saying, "We need ABM at the table, we need account-based marketing at the table with the SAM and the account team."

Van: The people in our audience who may not be familiar. Can you describe a little bit about what account-based marketing looks like?

Dominique: Yeah, Account-based marketing is not brand marketing, it's not product marketing, it's not enterprise marketing. It's a marketer that will come at the account team, because obviously when you work with huge integrated health network or health system in the pharma world, and you wanna provide value, you need to have other people. So the SAM is what I call the orchestrator, and the account-based marketer is, in my mind, the co-orchestrator. I often say it's customer-led but team enabled. And by that, as I mentioned to the customer, and the role of the account-based marketer at the table is knowing, what is available, connecting with the brand and a campaign, and more the, I would say, the product align marketers, but being at the table to see what else can we bring. Having that marketing in mind but representing the whole organization in light of what can we create or what can we offer to the customer in light of their needs.

Dominique: The other thing their role is about is providing insight in terms of those vertical and those trends that are useful to the customer. So it's not only public knowledge, but there's a lot of corporate knowledge and groups that are working on looking at those trends. So providing that. And the third one is also looking at scaling business cases. We're not good in big organizations to share what's going well, and in strategic account management, the account-based marketer can also look at, If something works well, if an offering works well, how can we create it and scale it in other areas? Because they are a bit more internal, so they can help navigate the organization for the SAM. So I would say the SAM is the owner of the relationship, where the ABM is the owner of the cupboards or the closet.

Van: Anything else that we haven't covered around the commercial engagement model in pharma, or anything in general that, as you see the evolution playing out, any other thoughts or predictions that you have that you wanna share with us?

Dominique: Not sure I have a prediction, but I think it's an exciting time for the healthcare environment and the pharma world, and I think it's a time where the patient are asking to get the the value. There's an increase in transparency, there's all of these trends, and I think COVID has accelerated a lot of them. I think we're gonna see good things coming out. I think we spoke about most of the trends, but I think there's a great opportunity for pharma to really increase, enhance, elevate the way that they provide value, by really creating those partnership and starting from the outside-in. Again, always starting with them first, so the patient and the customer, and then seeing what they can bring, and I think that's the best way to leverage everything they have in terms of capability.

Dominique: I think it's gonna be interesting to see how the COVID, the technology, the digital transformation, and also the start-up, like we're seeing a lot of agility in all those startups and those small biotechs that are booming in the healthcare environment, that are a little bit more agile than the big pharma just because of the size, so they're gonna be pushing also to change all the, I would say the nostalgia of wanting to go back to what we used to do, but seizing the opportunity. I'm a strong believer that we can try to say, "Let's go back to what we knew," but the train has left the station. And if we don't embrace digital transformation, and on the positive side of what it can bring in terms of managing health and providing new product for rare disease that are still today not treatable and have nothing, I think that if you embrace it that's gonna be the ones that are gonna be succeeding in this.

Van: Any start-ups come to mind that are doing something innovative that you can think of?

Dominique: There's many of them, I have to say; not to name, but a few things that are going on. For example, at one point of my career, I was working in transplant, and I was always devastated to see the shortage of organs. You see now with all the technology that we're starting to have tissues being 3D printed. Can you imagine if we could resolve the organ shortage and the immunosuppressive issue for which we need to take medication post transplant to be able to keep the organ from being rejected, "we are going to solve that by 3D printing organs."? There's so many things with all the new technology coming that will accelerate the healthcare environment and benefit patients. Also in epilepsy, there are companies that are looking at being able to predict when you're going to have a seizure by just doing blood pricking, that's a patient's unmet need. For example, in epilepsy, if you're treated and you've been on your treatment, you're comfortable and you're okay with, you know you have the disease, you've gone through the phase and you know that you are an epileptic patient, the only thing that's missing is "How can I know that I'm gonna have a seizure to be able to do something about it ?"

Dominique: I was looking at another small start-up that was able to develop something just for an artist that had Parkinson, and you can imagine for that person not to be able to do what what was her purpose, it was a woman, it was totally devastating. I'm not saying it's not for other patients, but this was, again, very precise, and that small start-up was able to develop a device that was able to stop the shaking. By wearing it, she was able to go back to drawing. It's sound a simple thing, but sometimes having these simple things one at a time are just a way to be able to solve bigger problems. I think sometimes it's just that, for me, I'm fascinated by the energy and the dynamism that you see in those start-up, to say, "Okay, let's solve problems together." And I think that's the mindset. It's like, "Let's look at what's not working. What are the issues, what are the problems? How can we resolve it with everything we have?" And have that mindset of being a bit more outside-in.

Sometimes it's not shifting, it's elevating, it's going to the next level, to be able to thrive and bring even more value to the end user, which is the patient.

‍Van: When I talk about exciting transformation, that's exciting transformation, right?

Dominique: It is, and I think in general, everything is moving in a direction where we need to be a bit more caring about what others cares about. We have the golden rule of, "Treat others as you would like to be treated." For me, there's a platinum rule, which is, "Treat others as they would like to be treated." What I like is people and providing a solution by bringing everything I've done in my 30 years to have impact in helping clients shift to new ways of engaging. Sometimes it's not shifting, it's elevating, it's going to the next level, to be able to thrive and bring even more value to the end user, which is the patient.

Van: Thank you so much for taking the time, and I'm sure we will be talking together soon and hopefully working together again soon.

Dominique: Oh, it's been a pleasure, Van.

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The conversation here expresses the opinions of Dominique Côté and/or Van Goodwin, and does not necessarily imply the position of Cosawi or Van Allen Strategies.

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