A Novel Therapeutic To Cure Dry Eye Disease with Dr. Jeffrey Nau, CEO, Oyster Point Pharma, Inc.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there’s one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That’s why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

: Welcome back once again to the outcomes rocket podcast where we chat with today’s most successful and inspiring health leaders. I thank you for tuning in again because we have a wonderful guest today. His name is Dr. Jeffrey Nau. He’s the CEO of Oyster Point pharmaceuticals. Doctor now has been building his career and developing novel innovative therapies for a disease of the eye. With over 15 years of experience working with biotech pharma and med device companies. Most recently he was V.P. of clinical medical affairs at Optotech. Prior to that he was mad science director at Genentech working on the development of Lucentis to transformative drug for retinal disease. And Dr now has raised more than 150 million in equity for startups such as Janiero corporation, Acuity pharmaceuticals and Neo Vista inc.. He has numerous patents in the space as well as peer reviewed publications and I’m so excited to welcome Jeff to the podcast. Welcome.

: Well thanks Saul. Thanks for having me on.

: It’s a pleasure to have you Jeff. Now what is it that got you into health care to begin with?

: Yeah it’s a good question. So I started out really I think as most young college students do you know heading down the premed path and wanting to go into medicine just based on my my love for science and I loved learning about the human body was very sports growing up and I loved all the exercise physiology and just learning about the you know muscles and bones and things and so I ended up taking a little bit of an odd path from that. I had a small class that had an elective in my undergrad which was intrinsic biology and I end up working in the medical examiner’s office and within a couple of weeks, I found myself doing autopsies and really being into the sort of I would say elbows deep into medicine and learning about the human body from a different aspect and that ultimately translated into some work that I did while I was in school and sort of paid my way through school working with the organ transplant team that was often in there and really was into the surgical aspect of medicine. And then when I went off to school never really thought about the pharmaceutical space or the Medtech space and all always very focused on the clinical piece of it. And for a whole host of reasons that we could probably spend a whole another podcast on, ended up deciding to veer off and head down that pharmaceutical path and first I think it was kind of a patch to figure out where it was going and it just snowballed. And I’ve been here ever since and you know I really love being at the forefront and cutting edge of developing either drugs or devices and found myself in ophthalmology for almost my entire career.

: Amazing what a winding road but always very focused on health care. So fast forward to today, Jeff you’re working on this exciting project at Oyster. What do you think today is a hot topic that needs to be on every medical leaders agenda and how are you guys addressing it over there?

: Yeah I think one of the things that’s going to be it’s really important because we are kind of in a time right now and I think there’s probably a cycle to it if you were to look back through the annals of medicine where we have these bursts of innovation where things really move forward fast. You know we have karty therapy we have CRISPR technology. On the oncology side of things, things are moving so fast it’s really exciting. Usually that followed by some period you know some cooling off period where things kind of slowed down a little bit and then we have another burst of innovation. And I think one of the things that I think is really important to keep in mind is we have to continue to be innovative and we have to continue to think outside the box. You know one of the nice things about Oyster Point you know we’re a venture stage startup pharmaceutical company focused on treating Dry Eye Disease and it’s through a real novel pathway. So for years and years we’ve had therapies that treat Dry Eye Disease whether it’s over-the-counter or prescription eye drops. We’re very focused on the topical aspect of delivering medication. What oyster has done is really transformative in the sense that we’re treating the disease and going through the intranasal route. So a very what I would say disruptive and novel approach where we’re actually leveraging the body’s own parasympathetic nervous system and we’re still doing pharmacological stimulation of the nerves inside the nose which then ultimately result in tearfoam formation. So fascinating things like these where for years and years we’ve had sort of a stagnation and we’ve been very focused on attacking a disease in one particular way and then all of a sudden something changes through innovation. And now the whole field shifts you know and if you think back to a decade ago, harnessing the body’s immune system to go after cancer was always a thought we always had these ideas. I remember learning about it when I was an undergrad but until recently the terms CRSPR and carti have not been on everybody’s tongue like they are today and so I think fostering innovation always looking for new approaches to go after a disease are very important. And I think it’s just evidenced by the exciting kind that we’re in where now really the treatment is just really blowing up right now.

: Super fascinating. Thanks for walking us through that Jeff and what keeps your innovation juices flowing?

: I think the thing that really keeps me going is you know I started out going into medicine wanting to help people. You know I love the patient contact aspect of it. If I was to say the one thing that I’d miss being an industry versus being on the clinical side is I loved interacting with patients and being able to help a patient whether it be just through consultation or whether it be actually delivering a treatment. I really enjoyed that. And so I think that staying on the cutting edge of innovation, you have to keep that patient peace in mind and that patient interaction piece and you always have to remember that if you’re doing the right thing for the patient, not only from the standpoint of bringing these novel treatments to the forefront but also thinking through all the form factors that go into therapy and how patients are receiving health care today, how patients may or may not like whatever therapeutic option you’re bringing to the table because of the way that they’re going to either attain it or ultimately utilize it. And so I think there’s ways to innovate around a lot of different aspects of medicine not just if you’re focusing on the actual treatment itself but how are these patients getting these treatments and how are we keeping them on these treatments and so I just think that there are so many opportunities to really keep yourself patient-centric focused and innovate around that sort of holistic idea and that that’s really what keeps me going is working in companies you mentioned in my past that I had worked at Genentech and I worked on this amazing drug who sent us that literally stopped people from going blind. And so to be able to see that type of innovation come to fruition and see the impact that it has on people take you back to when you were in the clinic and you were you could do something to help someone and that just feels great. And that’s really what keeps me going.

: That’s awesome Jeff. And no doubt it you guys are doing it yet again here with oyster not sure what detail you do go into it but maybe if you can dive into some of the things that you’ve seen early on with this new approach at Oyster for dried eyes.

: Well so dry eye disease is becoming a little bit more I would say at the forefront of people’s minds. One of the things that Oyster has benefited from with the most recent drug approval in the space is Shire’s Xiidra™ and they’ve launched an eyelove™ campaign which is really all over the TV and radio ads and people have seen Jennifer Aniston talk about her eyes. And many of your listeners have probably seen these commercials. And so you know the concept of Dry Eye Disease and just eye health in general is really taking a big step forward by all of this marketing that’s going on now and this market is really massive. So there’s a few markets in the pharmaceutical space where you have 34 million patients that are out there with Dry Eye Disease. You have about 20 million of them that have a diagnosis of Dry Eye Disease. So there’s a huge number of patients that just are not seeing in eye care provider. And then of those 22 million or so that have a diagnosis there is literally about less than 2 million patients on prescription medications. And there’s a whole host of reasons behind that but it’s just a giant unmet market where there’s opportunity for a really good therapy to come to the table. So what we’re trying to do is really bring the therapy to the table that gets at the root cause of the disease and really impact the disease early on in its existence. And the whole concept of Oyster Point is really by putting healthy tear film onto the eye on a regular basis. So as you and I sit here and we’re just sort of breathing in and out of our nose that airflow going across our nasal cavity causes basal secretion of tear film and so when we have things like stuffed up noses we often get dry eyes. The whole host of other things that can cause it. But the one thing that is keep in mind is really the reason that you and I don’t have Dry Eye Disease although I’m not a hundred percent sure you don’t have dry eye disease is have healthy tear film. And so having that healthy tear film is really the key to not progressing down this slope of inflammation and sort of a chronic dry eye disease state. So what we’re doing here is pharmacological stimulation of the trigeminal nerve that causes tear film formation and we think that by keeping these patients moist with regards to their cornea over time will alleviate many of the problems that we see with patients with Dry Eye Disease. And so it’s a disruptive approach. No one else has ever gone through the nose to try and treat with a pharmaceutical and it just makes sense from a biological perspective because we’re really we’re sort of harnessing the person pathetic nervous system to do our work.

: That’s fascinating. And how are the results coming out. Are you seeing that it’s working?

: Yeah. So we had some early studies that gave us a glimpse at how well it worked and it was eye opening. No pun intended but it was it really was exciting for us to see that we actually have completed a 160 patient Phase 2 trial that will be presenting in July. And although I won’t give away the results I will tell you that the results are pretty amazing and we’re super excited to present it. We think it’s going to be a game changer. Really excited about the opportunity to bring another therapy to this patient population because it’s just growing. You and I are both sitting here right now probably looking at a phone or looking at a screen. The screen time is going up you know Dry Eye Disease is not going away anytime soon. And so there is a real need in this marketplace for another therapeutic option.

: That’s awesome. That’s so great. Thanks for walking us through that Jeff. And really neat that you’ve taken on this approach and as the market sits today, is this something that is also reimbursed by insurance providers?

: Yeah so the two products that are out there right now which are topical drops are reimbursed. We expect that our product once it gets the market will be reimbursed as well.

: In the same way?

: Yeah.

: Got it. Very cool. Very cool and very innovative to think about this. And folks take a note from Dr now here and the things that him and his team have done, there’s another way. When you thought that the only way was topical, they found a different pathway to have the same result or even better. And so think about what you could do to approach your problems in a different way and use this episode as inspiration to do just that. What would you say a time when you maybe had a setback it could be at oyster, it could be at one of your previous roles and something that you learned from that setback?

: Yeah. One of the examples that I always tell people is we started a company back in the early 2000 timeframe called Neo Visto which was a therapy that was brachytherapy so we use a very small strontium 90 pellet that was on an applicator and this applicator was placed through a surgical incision into the eye and held over a neo vascular lesion for patients with Criddle new vascularization due to age related macular degeneration. The surgeon would hold this applicator over the lesion for a number of minutes. We deliver a very focused dose of radiation and then they take the applicator out and we close the patient up when we were starting that process. First of all, this was pretty 9/11 before we had a lot of safeguards in place for how radiation traveled throughout the world. But I think we also went into this study as mostly pharmaceutical and medical device folks with no real radiation experience and so we very quickly underestimated how hard it was to a transport radiation and radioactive material throughout the world to do clinical trials. All the people that needed to be involved. I had never heard of a radiation physicist before and I quickly figured out who those guys are and what they do. And I think without really understanding what we were getting into we were pushing forward so fast that we didn’t know all the players that had to be pulled together. So we got ourselves into a situation where just to start a clinical trial rather than getting one physician under contract we had a RETNA surgeon, a radiation oncologist, a medical physicist, a surgical suite, a hospital, the local authority who oversaw radioactivity in the area. You were over your head in just contracts for one cent there let alone doing a massive multicenter Phase 3 trials throughout the world. So I think where we failed there or where we made a mistake there is we just didn’t get to know all of the intricacies of that particular technology fast enough or really enough to be able to be proactive in plan. So it probably caused us some some delays once the machine started moving forward we got pretty good at getting all those sites up and running and how they were going to work. But I would say if if we had a lot more institutional knowledge beforehand things would’ve went a lot smoother, moving forward.

: That’s fascinating. And now you sort of build those learnings into what you’re doing at Oyster and I’m sure the level of due diligence you took it even to the next level.

: Yeah.

: Now that’s really great Jeff. Thanks for sharing that. And how about the other side of the coin. Right. That was a setback. Tell us about one of the proudest leadership experiences you’ve had to date?

: Yes. I think one of the one of the other things that I touched a little bit on the forward was that I feel very passionate about the patient aspect of developing new therapies and making sure that you’re always doing what’s in the best interest and what’s right for the patient. And if you sort of lives live by those rules and when you have big questions that you have to answer, if that’s always the basis for how you’re going to answer those questions, you’ll you’ll likely make the right choice. So one of the things that when I was a Genentech when we were developing sent us there was a cry to use the drug and infants that were born with this condition called Retinopathy of Prematurity where they have a blinding condition when they’re born and without receiving therapy such as Anti-VEGF therapy immediately their retina can be basically damaged for the rest of their lives and in many cases these patients, these very young patients are just going to be blind for the rest of their life. And so the physicians out in the field were using drugs off label to treat these patients with maybe not the best safety profile behind it, but they were doing the best that they could to help these babies. And we had this drug Lucentis that we knew could help and has the potential to help. But it certainly wasn’t approved and it was very risky for the company to go down that pathway as you can imagine. So I’m going to tell you that one of my proudest moments from a medical leadership perspective ultimately ended in failure. But it successfully took proposals up to the very highest level within that organization to allow for these babies to get access to the medication. And unfortunately for you can imagine legal reasons and some risk tolerance reasons it didn’t move forward but we were very, very close. It almost happened and that was a proud moment for me and the team there really sort of pushing through when we knew that we were going to face them adversity and trying to get that approved. But trying to do the right thing anyway.

: That’s pretty cool. Jeff you were sort of at that juncture of your passion for patients and also your passion for innovation and pushing the envelope and you’re just kind of in-between both then even though it didn’t come to fruition. You were pretty darn close and the outcome was the right outcome even though it didn’t work out as giving them access to that.

: Yeah. And then I think that that’s it’s important. I think it’s important for a lot of people to understand the people who work and in this industry by and large, they’re the same folks that live in your neighborhoods and they have the same level of commitment and concern about really improving people’s lives. And you know I think there’s there’s times when the farm industry gets a bad rap for being very focused on profits and finances and things of that nature. But I would say by and large throughout my career, I just always run into people that really just want to do the right thing and really want to bring something to the table for patients and the ones that are most successful are the ones that really live and breathe that mantra and are focused on that line of thinking.

: It’s a great message. I agree. You know I do feel like pharma does tend to get that bad rap but it’s great to hear from folks like you Jeff to level set and give people an opportunity to revisit that paradigm. I too have I’ve met tons of great people in pharma. I would agree with you. Now tell us obviously oyster is your exciting project. So rather than dive into that deeper maybe you could just give the listeners some ideas so that they could continue in their innovative pursuits.

: Yeah so I think the one piece of advice that I would give to people is never stop thinking about what’s next or how you can move forward and prove something. I don’t you could put a price on momentum. I’m kind of always in awe of some of these folks that are serial entrepreneurs and how they just have that momentum and drive to move forward despite any obstacles that get in their way and they’re always thinking about innovative ways of tackling a problem. So the people are the most successful of also probably had the most setbacks and the most adversity. So I think the biggest piece of advice I would give is just continue with that momentum and keep going forward. And you know I often tell my staff you know when we have certain little setbacks whether we have comments from the FDA or we have some interesting data that might make us pause for a second that look, these are the bumps along the road and the end of the day people look back at most of these projects with 20 20 hindsight and just think it just happened and it was just organic the way it happened but it really is momentum moving forward, overcoming some of these hard times really embracing the times when you’re successful. Just don’t stop innovating. We need a lot of really smart minds out there to continue doing what they’re doing and bringing new things to the table. You know I just read an article the other day that was sort of the history of the CRISPR technology and I was around when there were some setbacks in gene therapy in Philadelphia where a young boy had passed away. I was developing a drug that was a small interfering RNA at that time. So we we felt that pain. But look where the industry is now and there was a setback there but we’re about to go through sort of an amazing and transformational period in medicine.

: That’s amazing yeah. What a great message Dr. Nau. And I always think of momentum as well. And you either have forward moving momentum or backward momentum. There really is no plateau. I am a firm believer that plateaus are they don’t exist you’re either moving forward or back. And this advice you’ve given all of us here will definitely serve as inspiration to keep moving ahead. Let’s pretend you and I are building a medical leadership course and what it takes to be successful in medicine. It’s the 101 of Dr. Jeff Nau. And so we’re going to write out a syllabus lightning round style with four questions followed by a book that you recommend to the listeners. You ready?

: Sure.

: Awesome. Let’s do this. What’s the best way to improve health care outcomes?

: I think the best way to improve healthcare outcomes. And again this is this translates into all areas of life is to go out and build relationships and build relationships with your target audience whether those be patients or physicians. Good relationships with those that you do business with. Make sure that you’re networking. Make sure that you’re building relationships where others trust you. You’d be amazed at how many innovative projects come out of two people sitting down and having a coffee and talking about something completely innocuous and then all of a sudden some transformational breakthrough comes into one or the other person’s mind. So build these relationships, foster them, make sure that you’re talking about things that you’re thinking about with others to the point that you can. But I think the way that we improve healthcare outcomes really is it is not single individuals but it is a massive team of people moving forward and I benefit from thousands of other people out that have either come before me or are moving in tandem with me. So there’s holing up in your office is certainly not going to move the needle not for the patients and certainly not for your company.

: It’s a great message. What would you say the biggest mistake or pitfall to avoid is?

: I think this is another one that translates to areas outside of medicine which is make sure that you’re listening. And you know we’re told often from a very young age like our mothers that you need to listen but that’s not the type of listening that I’m referring to. I’m referring to the step back. Allow the people in your organization, allow the patients, allow people to have a voice where they can contribute. They feel like their message is heard before you interject and give your opinion and allow that team approach to happen by learning how better to just sit back and listen and then to contribute after you’ve allowed the rest of the group to come to the table. And so I think one of the biggest mistakes or pitfalls to avoid is really to stifle that process and to as a leader to be able to step in and say here’s what I think we should do. What do you guys think. That’s one of the biggest mistakes I think anyone can make because they’re not listening and taking the other inputs and then disseminating those back to the team in a way that you know is going to drive things to move forward. So I would say you know not listening is one of the biggest mistakes or pitfalls to avoid.

: Beautiful. How do you stay relevant as an organization despite constant change?

: Yeah I think that one of the ways to stay relevant we touched on earlier is really to continue to innovate. And one of the nice things that I really love about Oyster Point and other companies that I’ve been involved in is you know we’re really at the forefront with oyster. One of the beautiful things is it’s just disruptive and very innovative approach that no one else is going down that path. So we’re really at the sort of tip of the spear with regards to leveraging this pathway to treat this disease. And so for us maybe fortuitous that we’re in a really great place to stay relevant and not from that perspective but I think continuing to innovate, continuing to do the right thing for the patient. Continuing to always ask “Is there anything else we need to be thinking about” is how you stay relevant.

: What’s one area of focus that should drive every thing in a health organization?

: I think I already touched on it which was as a leader I think it’s really important we often get tied up in the sort of nuts and bolts of day to day operations but I often think that it’s really a good thing to do which is to take a step back with your team and make them do something that helps them understand the patients that they’re trying to treat, whether that be taking a day off and for us we’re in the ophthalmic industry and so you know we take them to some of these organizations that help people with low vision. Having them understand that there is a person on the other end. So you know I often tell my team look we have a great drug. But now you have a responsibility and your responsibility is to bring this thing to the market and it’s not a responsibility necessarily like in the shareholder responsibility it’s a responsibility because there’s literally millions of people out there that need another therapy.

: That’s a great great piece of advice there so listeners in whatever company you’re in. Or even as providers you’re at the front line of this so the reminders constantly there for you. Take away some time to be able to remind your people and refocus them on the reason why you’re doing this which is the patients. What would you recommend to the listeners.

: I may be slightly boring in that I am not a fiction reader and I think that’s where the science piece comes into play. I’m actually right in the middle of a book called 1491 right now which is about the Americas Before Columbus came to the shores. I would recommend that by an author by the name of Charles Mann and had just finished up reading. I think it’s an older book but I hadn’t seen it when it first came out a book called Guns Germs and Steel by Jared Diamond which is a great read as well.

: Awesome. Some great recommendations listeners you could get all of the shownotes, transcripts, links to the resources discussed. Just go to outcomesrocket.health/oyster and you’ll be able to find all that there. Jeff this has been a blast. Love if you could just share a closing thought with the listeners and then the best place where they could collaborate with you.

: Yes so I think we talked about a lot of different topics here but my thoughts that I would share with everyone or just continue to do innovative things, continue to collaborate even if you have a product where you think or therapy that you think. Okay we just got to get to the finish line. Always keep thinking about you know is there something we’re missing. Is there a different way that we need to do this. Pressure test it, poke out. Because you’d be amazed how many things change through the process and don’t come out at the end the way that they came into the system and so continue to innovate. We need innovation. Continue to work and collaborate with others. And you know last but not least continue to keep that patient-driven focus in mind. Not only when you make decisions but with your company keep them focused on the fact that they have a responsibility to bring these therapies to the patient population that’s out there. And there is a responsibility that you’re not pouring lattes. This is a very important task that you’re working on. I think just within about a week or so we’ll actually have a Twitter feed. We’ll have a LinkedIn page, OysterPointRX. We also have a website, www.oysterpointrx.com. And you can send us a note through our info section on that page there as well.

: Outstanding Jeff. This has been a true privilege to connect with you on this, not only the novel therapy but also your thoughts on leadership and improving outcomes for patients. We wish you guys the biggest success and looking forward to check in again here in the next year or two to see how things are progressing.

: Yeah we were happy to check back in and let you know how things are going Saul and I appreciate you having me on.

Hey Outcomes Rocket friends, thanks for tuning in to the podcast. Once again as a leader in health care you have big ideas great products a story to tell and are looking for ways to improve your reach and scale your business. However there is one tiny problem. Health care is tough to navigate and the typical sale cycle is slow. That’s why you should consider starting your own podcast as part of your sales and marketing strategy at the outcomes rocket, I’ve been able to reach thousands of people every single month that I wouldn’t have otherwise been able to reach if not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That’s outcomesrocket.health/podcast.

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