Tony Estrella 00:03
Welcome to Digital Health Today, Asia Pacific Edition, your go-to podcast to learn about the transformation of healthcare in a region with over 4.5 billion people across more than 40 countries. I’m your host, Tony Estrella.
Tony Estrella 00:16
Today, I’d like to introduce Farid Bidgoli. He is a well-respected leader at Roche Pharmaceuticals in Asia Pacific. As we’ll hear, he oversees a healthcare business in transition within Southeast Asia, looking beyond the challenges of a pharma-only business. With a career which has immersed him in digital health, he understands the challenges and opportunities within a broader ecosystem, including new roles required for Roche, especially within the countries he oversees as a general manager. Welcome Farid, to our show.
Farid Bidgoli 00:44
Good morning, Tony. Thank you for inviting me to your show. It’s a pleasure to be with you this morning.
Tony Estrella 00:49
Oh, great. Great. So to get us started, what brought you into the world of healthcare? How did you start your journey in tackling some of the challenges that we see in this complex environment around us?
Farid Bidgoli 01:01
Yeah, so the truth is, that I’m a little bit of a science geek by background. So I loved science as a child and went through university, so to pharmacy school chemistry. And actually, whilst I love the science, I didn’t love the laboratory work. So then I was thinking, well, how can I combine my love for science, but also my love for people, and interacting with people, and therefore, I joined the pharmaceutical company, in 2001, join the industry. And then yeah, I’ve never really looked back since. So that was my first step into healthcare. But if you were to really ask me when I was really passionate about health care, I would have to confess that say, you know, it was only really when I was starting to have more of a market access responsibility than really understanding some of the challenges and barriers to access to innovation, that took a genuine interest in terms of how health care systems develop, how they value innovation. And also, then my broader view on working in different markets gave me different perspectives and how we should look at healthcare.
Tony Estrella 02:06
Yeah, it’s a fascinating industry, as you said, multiple layers that can challenge our thinking and many, many difficult problems to solve. And we’ve spoken together on panels before both internal to Roche and externally. And you know, one of the things that I think is fascinating about your current area of focus is that you sit across as General Manager, multiple countries in Southeast Asia, can you tell us a bit more about which countries are under your remit?
Farid Bidgoli 02:32
Yeah, so I have great diversity, which I absolutely love. So I have Thailand under my responsibility, which, you know, if we take that in the ASEAN context, then Thailand is an emerging economy. It’s been renowned for developing a universal health care system, and it is going to face challenges in terms of delivering and continues to deliver on that promise, but is seen as a big success. But then I look after other markets like Myanmar, Cambodia, Laos, where health is a luxury, unfortunately, and those health care systems are developing. And therefore I have a leadership role and to play into how I can help support the development of healthcare infrastructure in those markets. And the challenge is really, really vastly different versus, you know, somewhere in Laos we, you know, you have a lack of human health care resource and the capacity in the healthcare system. Myanmar whilst you have the resources, you don’t necessarily have the finance to really bring health care to life. So there’s many different challenges across the different markets and the diversity is something I really love.
Tony Estrella 03:39
For some of our listeners, they may be only experienced in working in developed environments where everything is already existing, and they’re trying to tackle a very complicated problem, but maybe more narrow in focus relative to what you’re describing. It sounds like you’ll have to pave the road as you’re literally driving on it in terms of trying to get all the pieces in place to focus not just on healthcare delivery, but just even the basics of healthcare.
Farid Bidgoli 04:05
Yeah, that’s a great analogy. And actually, before that, I think you have to even before you even pay the road and drive on it, you have to kind of show them where the road could go to and could lead to. And that’s a big challenge. But it’s also a big privilege. And I’ve worked in mature markets throughout my career was in the UK, currently, the majority of it and then works in the US, worked in China. And I think there are lots of learnings you can take from those mature markets into the, you know, the developing markets, but I think one of the things is around when we think about today’s healthcare systems, and what we learn what I see in many of those markets, such as Cambodia, Laos, and Myanmar is they try and so follow the tested path. Yeah. So in laying the road, they want to lay like everyone else has laid it. And when we think about the technology and the disruption that technology brings us, I think that they don’t have to follow those paths. I think they can, you know, build runways and bridges. And really think about how they can reimagine healthcare in its entirety and how it gets delivered. And, and, you know, I tried to bring that thought leadership to those markets, to challenge the status quo in the way that they could arguably develop a lot faster in their evolution.
Tony Estrella 05:15
That’s fantastic. And for our audience who may not know about Roche’s ambitions, and also its proof points in the market, you do a lot more than focus on your solutions and your therapeutic interventions. Can you tell us a bit more about the broader ambition for Roche, say, for the next 10 years and what you want to accomplish as a company?
Farid Bidgoli 05:35
Yeah, thanks, Tony. And I think I’ll start with the pharmaceutical industry, I think pharmaceutical industry, in general, has always been seen as maybe in healthcare as part of the problem. And we need to really think about how it can be part of the solution. And we need to look broader beyond and accept the challenges that health care is facing in the fact that we have, you know, aging populations, which demand more resource, more financing, and then we have limited finances in health care. And therefore something has to give, and unless we really understand that healthcare can’t be delivered at the scale and at the pace that it once was because of limited budgets, because populations are becoming increasingly unwell, we need to solve for the same challenge. And at Roche, our 10-year vision is how do we bring three to five times more medical advances to society at 50% less than the cost and that 50% or less of the cost is important because that talks about increased efficiencies not only in our business in the way we operate, but it talks about how do we enable others to have better efficiencies in health care, so they can invest in the right things and make the biggest impact to population health, and also to personalize healthcare as well.
Tony Estrella 06:53
So it’s a very ecosystem driven approach, as opposed to just focusing on Roche’s direct challenges ahead of you. And that’s a great lead in to a conversation on your vision of where digital health or health tech could go in the future and how they can be collaborators or partners in achieving this broader vision. Can you tell us a bit more about what is your vision for where digital health fits in?
Farid Bidgoli 07:15
So I honestly believe that if I was to be Head of the Ministry of Health now for Cambodia, or Laos, and Myanmar, I would say stop building hospitals, I would say, let’s move to 5G as fast as possible, as speak to the Minister of Education and say, can we introduce digital literacy curriculum please, in our educational curriculum? Can we please think about how we train our medical physicians, and ask them to introduce digital health curriculums and telemedicine curriculums into the way that we practice medicine? Because in countries where there is a lack of infrastructure – physical infrastructure, hospitals, clinics – where there’s a lack of human resource in terms of pharmacists, pathologists, physicians, nurses, if we go down the tested route in those markets and develop those countries, the way that traditionally we’ve seen other markets developed, then the promise of equitable, affordable health care, at scale for populations is at least two decades away, in my opinion. So if we were to embrace digital and really think about digital as the infrastructure and the architecture, to enable health and to support clinical decision making, harnessing AI, harnessing clinical decision support, harnessing the ability of connectivity, and consultation virtually, we could do so much more. And therefore, we would be able to accelerate those emerging markets to a scale and within an affordability envelope, that would make a truly meaningful difference in society. And that, to me, would be the vision of where I would like digital to play a role in healthcare.
Tony Estrella 08:59
Fantastic vision. As you know, I enjoy writing and telling narratives as both a fiction writer and also writing nonfiction about where we’re going. And that’s a future I would love to see be made into a reality. I think it’s the use of technology first to overcome some of the structural challenges. Makes a lot of sense. So when you look at the countries you’re in – maybe Thailand is a good example of this with some of the most innovative hospitals out there, like Bumrungrad – where are you seeing that vision that you’ve painted start to become more real? Can you tell us a story of one or two examples of where you’re excited about what’s happening in the market or even perhaps where you’re engaged and involved as Roche in making that difference?
Farid Bidgoli 09:40
Yes. So obviously, when we think about the pandemic, the pandemic has been a burning platform to help, let’s say release the potential we’ve all seen in telemedicine, telehealth. And I think that we see that specifically in hospitals like for Bumrungrad and the BDMS and the private hospitals, but then we’re also seeing it in the public sector as well, in terms of how they’re engaging with patients. One of the things I also like is that they are also using technology around how to improve the patient experience, which is something we shouldn’t neglect when we look at digital technology. We think this is a way of delivering care. Actually, it’s also a way of delivering a better experience. So for example, in my hospital called Siriraj, it is a university hospital, they allow people to book online, and then when people go for their appointments, if they’re running late, they will get notifications, they’ll tell them, go and have a coffee. And that’s great. Now is something very simple, you know that a patient’s about to attend an appointment, but you’re running late, rather than sitting in a chair for 30 minutes getting frustrated, you’ve given them the option to do what they want and inform them. So I think there’s the patient experience element as well when we look at digital health. That’s just one example.
Farid Bidgoli 10:54
On the extremes, then, I think ophthalmology is a great example in Thailand, where there’s been partnerships between Google and Nikon and ophthalmologists around using artificial intelligence to really look at looking at wrestle images to predict things like diabetic retinopathy, and certain diseases as well. And using AI rather than just clinicians. And that’s really important, specifically, when you look at Thailand, and it’s, you know, an aging population, the number of people with diabetes and where people will have age-related macular degeneration will increase. So I think that’s a great step.
Farid Bidgoli 11:32
And then, in fact, you asked me about what we’re doing. In fact, we want to do something ophthalmology. We’ve partnered with a UK startup called Give Vision. And they have an amazing device called SightPlus™, which is a headset visual device which improves visual acuity. But actually, what we’re trying to do here in Thailand is, take the fact that it improves visual acuity, and the study from Moorfields Hospital shows that people with different eye diseases spend about four to five hours a day using this device, so highly sticky. Yeah? But with that, then we’re seeing if we can, let’s say expand the use of that and actually move this away from just a visual aid. But actually, can we also do visual acuity tests? So could we actually, you know, do visual acuity tests in real-time? Based on the fact that this is a degenerative disease. So, could we track how degenerative diseases of the eyes over time, could we pick up those signals as well using AI? And can we, for example, you know, replace the need to go to an ophthalmologist for an eye test, you know, every six months? So that’s really exciting as well, because, again, you’re bringing personalized medicine to patients in ophthalmology, when we only think we could bring personalized medicine to maybe you know cancer today. It will improve the patient experience. But arguably, we could reduce the resources and demands on healthcare systems and ophthalmologists doing eye tests which are arguably low value in terms of their clinical expertise. So I think, there’s amazing things happening in general in the ecosystem that I’m seeing which, you know, is great. I love the experimentation, I just would love to see it at scale.
Tony Estrella 13:11
Now to hear you describe that I think probably gets our audience or entrepreneurs very excited about the fact that you’re speaking their language. You’re describing, you know, the way that you can be problem led in helping individuals achieve better health care outcomes, talking about the experience. And you know, one of the things that from a Roche perspective that I think has been very exciting to see from an industry perspective, is that you have technology infused into your DNA as a company with your investments in acquisitions of companies like Flatiron Health and Foundation Medicine and mySugr. And I think the future holds has a lot of promise if leaders like you who are embedded not only within Roche, but other pharmaceutical organizations are taking that view that helped to be very ecosystem driven. So thank you for being a leader in that space.
Tony Estrella 13:58
What do you see that as Roche overall, you have a pharma business, you have a diagnostics business, you focus on various therapeutic areas, if you look at the countries that are in charge of trying to transform healthcare within which area, which therapeutic area is your priority right now? Or if it’s more than one, what are those areas?
Farid Bidgoli 14:18
Yeah, so one of the challenges actually at Roche right now is we have a fantastic pipeline, and the pipeline in the future is highly diverse. And I always find this a personal challenge as a leader now of a pharmaceutical company in Thailand, or irrespective of where I am in the world, is that idea of prioritizing? Yeah. Because then you’re asking me to choose certain people with certain diseases over the other people with other diseases. And I think that’s something as leaders we really struggle to do. So we try to, for example, look at how we can bring the science and medical advances, we can shape policy in different ways. Roche obviously today would be largely known as an oncology company. But when we look at our pipeline, we have an emerging rare disease pipeline, we have a really exciting ophthalmology portfolio. And then we have a history in nephrology and transplantation. All of those plates, we have to spin, because, you know, I was on a call the other day, and we were talking about our, our subject portfolio, and meaning that products were, you know, maybe an hour of patent, but still very highly relevant. And we’re interviewing somebody, and they gave me a great answer. We said, Well, you know, how would you handle these products that aren’t very sexy anymore? Yeah? And his answer was brilliant. He said, Well, they might not be sexy for us, because it’s not new innovation. It’s not new science. But if you ask the patient who’s just about to go through kidney transplantation, ask them, is this drug that’s about to help you not reject your new organ, sexy? He said, I think they’d say it’s really sexy. You know, I thought it was a great answer. And so, you know, for me, it really is difficult when we think about prophesizing, the innovation that we bring to people all over the world.
Tony Estrella 16:05
So in other words, it’s being very individual-centric, consumer-centric in the mindset, and following where their needs are. And I think that’s a fantastic view of how to operate, it’s very much the way that we need to operate as an overall industry. And that’s what brings ecosystems and partners together in a collaborative way when you can solve common problems that are led by the individual first. So that’s great to hear. And as you think about the challenges ahead, where do you see the biggest roadblocks that prevent you today from achieving your goals? And what are you working on to try to overcome those challenges?
Farid Bidgoli 16:42
So as we think beyond, let’s say, the pandemic that we’re currently in, I think that health care is highly relevant. I think it’s highly relevant politically. And I think that amongst society, it’s something that I think we’ve paid a lot of focus and attention to, rightly so. And it’s something that we value. We value our health, we value the health of others, which is great. My concern would be as we look forward, as we move away from a healthcare crisis, we start really looking at the price we paid for that economically. And my worry is that health care and governments could go one of two ways. They could look to say this is an area where we need to invest and support. In R&D and strengthen healthcare systems. Or they could say this is an area now where we need to cut costs, we look at this in a silo way. Yeah? Not in an ecosystem way, not in a health of a nation way. And I’m hoping that we look at the former, we look at that healthcare is an investment. And I’ll give you a great example actually, if we look at the human capital index that’s published by the World Bank, then it would rank Thailand, for example, behind countries like Malaysia and Vietnam. And that’s because, you know, for the first time in 2018, Thailand became an aging society. By 2040, Thailand will have a third of its population over the age of 65. And when you put that into economic context, and healthcare context, it means two very simple things to me. It means that we’re going to have a higher number of people who are dependent, and a workforce that they rely on to keep them healthy. And we need to keep that workforce healthy. So investing in health is investing in our economy. And I’m hoping that a country like Thailand realizes that. And I hope that other countries around the world realize that also.
Tony Estrella 18:37
To put that in context it’s about 70 million people in Thailand. So yeah, pretty significant number of individuals. So as you look at the initiatives that are impactful to you, one of the newsworthy items that came up recently is that through FutureProofing Healthcare, there’s now an APAC index that helps to measure advancements towards and current status towards personalized health care. Tell us a bit more about that.
Farid Bidgoli 19:03
To me, it was a fantastic way of really thinking around the future of healthcare and personalized healthcare, and how we deliver that. And a big element actually, of that research was looking at digital technology, was looking at artificial intelligence, was looking at the access to telemedicine/telehealth, was looking at the access to or the use of wearables, and biosensors as well. And I’m glad that they included that and looked at personalized health care from a digital landscape as well as where we would think from a traditional diagnostics and therapeutic landscape. And it also looks at things like the policy context. Do we have really strong policies and a strong political will behind personalized health care? And they ranked countries against that, against their policies.
Farid Bidgoli 19:48
And what was interesting is that, for example, for Thailand – and Thailand and Taiwan had what the experts thought was the best policy. Right? The best directional policy that if implemented would deliver utopia in personalized healthcare. But then when you looked at Thailand overall, it ranked seventh. And when you look at some of the reasons behind that, is that, again, lack of investment in research and development, lack of investment in personalized technologies, both digitally, and I guess both pharmaceutical and diagnostic. Also in terms of workforce capacity, as well, in terms of uptake. So these are some of the barriers. And I think, I think it’s quite clear that you can have the greatest policy in the world but then if it’s not supported to be implemented, then you have a big challenge. And that’s in any case, you know? I can have the best business strategy for Thailand, and Cambodia, Laos, and Myanmar, but if my organization that our employees, my colleagues don’t believe in that, or they’re not passionate about it, or they’re not given the support, the resources, the knowledge, the know-how to implement that, it fails. And I think that that also personalized health, some of the findings were really clearly attributed to some of those things as well. And Singapore was our top. So huge congratulations to Singapore, where you are, Tony, I think that again, goes back down to attitudes of individuals, and the investment and the importance that the Singapore government is placing on it as well.
Farid Bidgoli 21:20
I love these indexes, I think it forms a sense of competition, which is healthy, for me. I think we’ve seen this, in many ways where governments don’t like to be the one that’s ranked on the list. And I think it also helps shape policy and shows people where they, if they made some slight, slight adjustments or slight investments, or value things a little bit more, that would have it have a huge impact. So yeah, I’m glad that the reports out. And let’s hope we repeat that in a year’s time, a couple of years time and see how countries have moved on. Now my job as a leader is to really kind of try and raise awareness of that. So we will do that here in Thailand, But I also encourage other leaders, this was something that Roche supported. But I need other people to speak about these things, you know? Like yourself, Tony. We need to raise awareness of this, so we can really make a huge impact.
Tony Estrella 22:12
Yeah, and for full disclosure, I’ve also been involved with this index development and part of the FutureProofing Healthcare initiative in several ways and lots more news to come around what could happen in that, and in future podcasts, I’ll address that. And for our audience, we’ll have links to the FutureProofing Healthcare Index as part of the show notes. We’re coming up on time here. So thank you so much, Farid, for your input. It’s been a fantastic conversation. If our audience wants to get a hold of you, what’s the best way to do that? Is that LinkedIn?
Farid Bidgoli 22:38
Yeah, my pleasure. Yeah, LinkedIn is probably the best way to reach out to me, and yeah, more than happy to connect and share ideas and make new friends.
Tony Estrella 22:48
Great. Well, thank you so much for joining us.
Farid Bidgoli 22:50
Thank you, Tony.
Tony Estrella 22:50
And that’s a wrap on this episode. Farid’s LinkedIn is included in the show notes, along with other relevant links for both Farid and for me. Before I go, here’s how you, our audience, can support us. Please share this podcast with others. And if you subscribe, you’ll get other updates on new episodes and other content. You can read more about my writing on my website at www.tonyestrella.com, where you’ll find links to reach me on LinkedIn, Twitter, and WeChat. Or you can email me at APAC@digitalhealthtoday.com if you have any questions, suggestions, or ideas for future episodes. And finally, please visit our website at digitalhealthtoday.com or on our second home at healthpodcastnetwork.com to hear other episodes from our podcasting team, including Dan Kendall and Eugene Borukhovich. This show was researched and written by Taliossa and produced along with Mission Based Media. The sound and music was by Ivan Juric.
And until next time, I’m Tony Estrella and thank you for listening.