Guest Column | December 20, 2019

Rebels Vs. Clones: Constructive Dissent In The Pharma Industry

By Martin Lush, VP of Health Sciences, NSF International

The pharma industry is in the middle of an identity crisis, but not in the way you may think. Rather than a period of uncertainty and confusion typically brought on by a change in role or expectations, this crisis is far more insidious. It’s brought on by a mind-set in which industry leaders believe they know exactly what the industry should be doing.

Many companies have lost sight of the human element — the people who develop the products we create and the patients for whom innovation is essential for health and well-being. Pharma is suffering from institutional blindness, a misplaced perception that what we did 10 years ago will work in the future.

There’s genuine risk in the development of this kind of hive mind for both the industry and especially for the patients it serves. If thought conformity is on the rise, then patient safety is on the decline. Strides in patient safety always ensue from those willing to question the status quo. Once we stop rebelling against the existing level of safety and stop demanding constant improvement, we begin thinking that the current state is the best people deserve. That’s wrong. “Good enough” is never good enough.

Meanwhile, we have the worst drug shortages in decades. A combination of factors contributes to the problem, including the 2008 recession and the resulting Indian and Chinese outsourcing trends. Not only are supply chains incredibly complex, but they are also very fragile. Even a minor disruption can lead to supply difficulties. Industry’s failure to develop and retain talent has also been a chief factor.

I have noticed this alarming trend and liken it to the essential belief system conflict in a popular movie series you may have heard about over the past 45 years or so: clones vs. rebels. Clones approach innovation from a risk-averse perspective. They approach solutions from a product-first mind-set and downplay the role that disruptive human creativity can play.  What they want to hear is how a new product will support their financial growth and stability. What they don’t want to hear is how a new idea will require investment of time, treasure, and talent to improve care while keeping patient safety at the forefront. These are the kind of leaders who apply the same self-deluding mind-set Paul Simon wrote about in The Boxer: “A man hears what he wants to hear and disregards the rest.”

Our industry still has dominant hierarchies, overwhelming bureaucracies, and siloed structures and thinking, all created by people who think the same way, about the same things. But putting rebels in key positions is not enough. To fix our problems we need to both hire and empower creative disrupters. Rebels without the authority to challenge the system will quickly tire of being leaders in name only and take their talents to other industries that place real value on innovation and industry disruption.

What Is Disruptive Innovation And How Does It Happen?

“Disruptive innovation” gets bandied about a fair bit, so let’s take a moment to be very precise about what it describes. Harvard Business School Professor Clayton Christensen invented the theory of disruptive innovation and since then, it’s been commonly applied to any business where start-ups topple incumbents. But Christensen has emphasized that this definition misses an essential element: “the use of new or innovative technologies … to deliver products or services better suited to the incumbent’s overlooked customers — at a lower price.”1

Disruptive innovation comes from a combination of rebellious thinking and technological savvy.  It identifies a wedge of the market that’s been neglected or left fallow by an industry that allows a combination of dedication to conformity and risk aversion to decide who is worth serving and who gets left behind. True disruptors connect their new tech-driven service with an underserved population and use that as a springboard to eventually expand into the sectors the giants falsely considered safely within their grasp. This is happening in pharma, now, today, with companies like Aprecia, which aims to create individualized 3D printed tablets containing active medication in personalized dosage, size, shape, and even color and flavor.2

Ultimately, it’s a people problem. Pharma has failed to invest in its people. I believe you must make people before you make products. For years, pharma has invested in a products-first mind-set, to the detriment of creative disruption, and products don’t innovate, people do. We’ve built corporate biodomes to encourage like-mindedness out of fear of risk, and there’s a dearth of diverse, disruptive thinkers — rebels — willing to take on the cautious constructs of the clone-mind’s status quo. Pharma is obsessed with BSCs, MSCs, and Ph.D.s. This can lead to blinkered strategies that place people who don’t know what they don’t know in important positions. It’s not their fault. When you put a group of same-thinking people in a room to solve a problem, they all come up with the same solutions because there is no diversity in thinking.

Companies must invest in their own talent, enabling leaders to do the best they can with the limited knowledge they have and seek and encourage new perspectives and ideas. I attend conferences where people are talking about the same problems we were talking about 10 years ago. Our industry is chronically short of diverse thinkers. For the industry to progress, we need rebels. We need some constructive dissenters to challenge the status quo.

Tomorrow’s industry leaders will be those who are willing to focus on why we do things, which is where much-needed innovation will come from. Antibiotics are an excellent example of this issue. In the next 10 years, it’s likely that the risk of dying from infection will be higher than the risk of dying from cancer. Yet, there’s no development in antibiotics because there’s no immediate money in it. Rebels embrace the risk of innovation, because they realize it drives improvement.

Changing that paradigm will require disruption that’s likely to come from an external force (diverse thinkers), like Amazon or Google. It will take radical changes to incentive and repayment structures, and those changes are unlikely to come from within legacy pharma. It might take big tech’s leadership, funding, and influence to incite the pharma industry to speed up development. Diversity in thinking is imperative to create the rebel ideas sorely needed to tackle things differently. What will YOU do to break the clone mind-set in your company?



About The Author:

Martin Lush is VP of health sciences at NSF International, an independent organization whose mission is to improve and protect human health by supporting the development of and adherence to drug and med device manufacturing standards. Lush’s group provides training, consultation, testing, and project-specific support of pharma and medical device companies to help them stay compliant and incite them to think differently to solve chronic problems. If you want some disruptive thinking to prepare you and your business for the future, not for a world that no longer exists, contact Lush at