OR_Sempre Health_ Kati Sadiwnyk: Audio automatically transcribed by Sonix

OR_Sempre Health_ Kati Sadiwnyk: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kyle Wildnauer-Haigney:
Hey everyone! Welcome back to the Outcomes Rocket Pharma podcast sponsored by Sempre Health. I’m your host, Kyle Wildnauer-Haigney, and today, I’m excited to introduce you to Kati Sadiwnyk. Kati is head of Lantus and Biosimilars for Sanofi. Kati also manages Sanofi’s Insulin Affordability Programs and Partnerships and is a key contributor to the US General Medicine’s Digital health strategy. She has been in the industry for 11 years with experiences across market access, marketing, and operations. Kati started her career at Zitter Health Insights, building a large team focused on primary and secondary research on payer management controls for in-line and pipeline specialty products, devices, and retail products. Following this, Kati worked for Precision for Value before transitioning to Sanofi. Kati has a passion for problem-solving, talent development, and simplifying the complex. Kati received a Bachelor of Arts in Mathematics and Statistics from the College of New Jersey and recently completed an MBA at Rutgers University. Kati lives in New Jersey with her husband Alec, and two boys, Egan and Toren. Well, thank you, Kati, for joining the show.

Kati Sadiwnyk:
Thanks so much for having me.

Kyle Wildnauer-Haigney:
So maybe to kick it off, I’d love to hear what inspires your work in healthcare.

Kati Sadiwnyk:
Yeah, so there’s two reasons, really. One is, I love problem-solving, I love puzzles, and I think, no, I think we can all agree on our healthcare industry being very complex and flawed and messy, so that’s something that I really like, but really it’s more personal. And I’ve been acutely aware of the power of healthcare for my whole life, I’m a twin. We were born 12 weeks early. My sister was born with cerebral palsy and had a number of health issues growing up, and she actually went through a period of years where she had debilitating migraines every day due to a misdiagnosis, malfunction, and a shunt she had in her brain to drain fluid, and this was in middle school, this was in high school. She’d missed huge chunks of school because of the migraines, and when she went, she could barely lift their head up. And when we were 16, the issue was properly diagnosed. We found a doctor in New York, and they had an experimental brain surgery that had a 40% success rate that it could fix the problem, had a whole bunch of other risks too that could have happened, and my mom basically turned to my sister and said, it’s your choice, and this is at 16. That’s your choice to decide on this surgery, which I look back now, I’m like, wow, that was kind of an amazing thing that my mom did. And my sister chose to get it because she had been dealing with this for so long and actually ended up being successful and changed the course of her whole life. And that just taught me so much about the importance of patient advocacy and finding the right doctor, doing the research, finding the right accommodations around you, and just the toll that the health issue can have on the person, on families, and also just the criticality of innovation, which is what was really important in the end for her. So that’s really what has kept me in this space and what drew me to it naturally once I graduated.

Kyle Wildnauer-Haigney:
You know, we all have those personal stories of being a patient or being a caregiver or supporter to someone who is going through their own health challenges. Just in that one story, it’s wild to see the complexity of the healthcare system, but also the power of innovation and of that new treatment and the profound impact that it had on your sister.

Kati Sadiwnyk:
Yeah, absolutely.

Kyle Wildnauer-Haigney:
And so maybe shifting to kind of what you’re working on today, I’d love to get an understanding for the audience of kind of how, what you are doing and then also how Sanofi is adding value to the overall healthcare ecosystem.

Kati Sadiwnyk:
Yeah, so I’m really lucky because I have a role that covers a lot of different areas. I have managed traditional drug marketing, managing a couple of our insulins, but then I also get to touch pay negotiations. I work on all of our affordability programs, co-pay programs, for-good programs, and partnerships, and then also get to work with our advocacy groups on different health equity initiatives. And I think there’s a lot of really good work that’s taking place in the industry within these buckets, especially for me, one thing I look at a lot is insulin affordability and how we can help create programs for the uninsured and commercial population paired with some work that’s been done in Medicare to reduce out-of-pocket to 35 to really help create more predictable copays for people using insulin. I think one of the biggest challenges we have is, there’s a lot of programs that are out there, there’s a huge gap in awareness, and there should never be a patient that can’t take insulin because of cost. So that’s a big area that I’m focused on and really passionate about. But there’s two other areas where I see value being added to the system as a whole. First, we’re testing new ways to reduce the burdens of disease management by partnering with companies that are focused on behavioral modification to really support patients in their journey to be more adherent, eat better, to have a better lifestyle, and manage their mental health. And when we think about a drug company or a biologics company, we think about our products, really they’re only as good as they are used, and the barriers to managing health are so much deeper than things like drug reminders, and sometimes we oversimplify those things. And, you know, I take medication every day, if I miss a couple of doses, I guarantee you it’s not because I forgot about it, but because there’s some other issue going on that may be affecting my mental or emotional ability to manage my care. And what I’m really excited about is seeing digital therapeutics like DarioHealth, which is a company that Sanofi is in a co-promotion with, to see what they can do to address some of these invisible barriers while, at the same time, we find other ways to limit out-of-pocket costs as a hurdle. So that’s something that is, I think, something that can add value overall for the system. And then for us, for my role, one thing that I’m striving to do, my team striving to do is really to be the connectors in the marketplace of all of these different organizations by having transparent conversations and finding shared priorities, whether I’m talking to, say, a PBM or a wholesaler or a health system or an affordability program company, we all need to work together to make the system better. Nothing is really going to get fixed by each of us individually operating in our areas, and I think we’re at a place now where we can have more open dialogue. And as we get into ’23, what I’m most excited about is seeing how some of the work we’ve been building on in ’22 can really be put into outcomes in the future for patients.

Kyle Wildnauer-Haigney:
Absolutely, I think in the last, how long, like several decades, right, it’s kind of been a very siloed experience for patients, we all feel it, but kind of going from each of these entities. And I’m really excited to hear about how you’re working with PBMs and other stakeholders to really support patients and drive up outcomes. I think one thing I’d love you to, just, maybe explain for the audience, you mentioned in the beginning kind of patient affordability, advocacy programs, some of the work you’re doing in Medicare, maybe you could just double-click that and explain the different types of programs that Sanofi is working on. I think that’d be very helpful for everyone listening.

Kati Sadiwnyk:
Yeah, so we have a number of different programs that we’re working on, some tied to affordability, which I’ll go into deeper, and then maybe I’ll talk a little later about some of the things we’re doing around health equity. But most insulin manufacturers, I won’t even say just Sanofi specifically because this is something we’re all trying to do in the industry, have a number of programs available to help buy down the cost of medication for the patient at the point of sale. So whether a patient is uninsured, underinsured, has commercial insurance, or has some other type of income requirement, we have programs in place to help manage those costs. And actually, in July, we announced that any uninsured individual can get all of their insulin needs for a 30-day supply net for $35. So patients that are using, say, a basal insulin or a rapid insulin, they can get their 30-day supply of both together for $35. So we’re really excited about that, we have seen the use of that program go up, and we know that with the Medicare plans next year, offering insulin for all beneficiaries for $35 for their supply, that hopefully challenges with cost issues, with costs tied to issues with adherence tied to cost start to go down. And then we also work with other partners in the marketplace, like Sempre Health, like Optum Store, to continue to find other ways to get these cost savings passed through directly to the patient, so really, really excited about those. Continue to see any gaps that are in the marketplace where patients either don’t know about these programs or aren’t utilizing them in the optimal way.

Kyle Wildnauer-Haigney:
And it’s so interesting because I think a lot of the conversation right now within the pharmaceutical value chain is really focused on affordability and cost, but these are, many programs sponsored by the manufacturer that are really trying to address the price that the patient pays, right, out of pocket and addressing affordability and ensuring that patient can not just afford their medication, but also stay on treatment for a longer time period. I had one question. You know, you mentioned DarioHealth. I’d love it if you could maybe explain some of the work that you’re doing there, what does a co-promote really look like, and what you could see this partnership expanding into?

Kati Sadiwnyk:
Yeah, yeah, so we have a really interesting model with DarioHealth and the core to that model is that each company is using the areas of expertise that we have in a combined way to deliver the best care to the patient. So for Sanofi, a big part of what our value is it’s understanding disease states, understanding patient and physician challenges, navigating the complex reimbursement system, generating evidence, right? These are things that are really core to the way that we operate in the market, and for Dario, it’s building an engaging, user-centric platform, it’s understanding behavioral health, it’s empowering people through coaching, basically taking our core capabilities and bringing them together through a co-promote where we help support Dario getting to market, through contracting with payers, we also are helping to actually develop new resources to be used on the platform and generate evidence. And then, of course, Dario brings their expertise and development to this partnership. And ultimately, I think what’s exciting about this is not just the way we’ve come together, but also that this is a long-term arrangement. And when I look at work that’s been done in the industry in the past between manufacturers and digital companies, a lot of it is short-term or there’s kind of almost like a passive type of partnership, but this is a situation where there’s been an investment in Dario, and we’re committed to really making something great over time, building on it over time, and making sure that it’s also commercially viable and supported, which is where our infrastructure as a company really comes into play. And this structure requires the type of agreement, this type of partnership, it requires a certain amount of humility and focus where we’ve had to clearly define on both sides what we’re great at and where we’re not, which is, it’s kind of hard for companies to do. And we also have had to figure out how to not necessarily operate like a large pharma company, which is like the classic trope in these areas, is, you know, we’re the cruise ship trying to work with the speed boat, and it’s harder for big organizations to be agile and try new things. And this happens all the time where the bureaucracy of large organizations stifles innovation, and we’re just so conscious of that and making sure that we’re not stifling the incredible work that’s being done, that has been done, and is being done by Dario, and that we have the right operating systems in place and just the flexibility in the way that we think to try out this new way of working. And I think, while there’s a lot of other collaborations in the marketplace, I think this one stands out a bit because of the way that we’ve approached it and really jumped fully into this partnership.

Kyle Wildnauer-Haigney:
You know, I think moving beyond the pill has been a theme that’s been discussed within pharma for quite some time, but it sounds like you guys are taking a very thoughtful approach to how to create the structure relationship and really understand what we’re both good at, to not just make it a marketing kind of headline or press release, but really to drive patient impact overall.

Kati Sadiwnyk:
Right, I mean, at the end of the day, with any digital therapeutic, do you want to be reimbursed? You have to get to a place where you can show a reduction in total cost of care. And I come from market access, my backbone, my background is firmly steeped in market access, so I am very aware of what payers need to see and what their challenges are, that they have to navigate and what their bottom lines are driven by. So part of our assessment when we looked at this solution is this is something that’s going to actually resonate with the payer market and is it going to ultimately show what we need to show, which is a reduction of total cost of care. And what I was hugely impressed with was the level of evidence and data that has been already generated, combined with what we can do in the future to really show that this has value in that members are not just interested or accidentally opening the app, right, but they’re truly deeply engaged in the tool, which is just, it’s just really cool. It’s really cool to think about where that can go in the future.

Kyle Wildnauer-Haigney:
And maybe to double-click on that, I’d love to understand kind of how your role, how that relationship with DarioHealth has really improved the outcomes, and some of that evidence that’s generated to, not just improve the patient health and overall kind of outcomes, but also Sanofi’s business.

Kati Sadiwnyk:
Yeah, so I mean, we’re in the earlier stages of this partnership, we launched earlier this year. So I think there’s still a lot to be uncovered in figuring out where the overall performance will land, but I mean, I will say just in these first couple of months in terms of improvements for Sanofi, this has allowed Sanofi to have much deeper conversations with our customers, whether it’s health plans, PBMs, health systems, and even just in the broader community that go way beyond transactional discussions to those that are much more transformational. And a lot of our, call it, say three years ago, most of our conversations with these external stakeholders would very much be about rebates, right? And we’re at a place now where there is an interest in the market and having different conversations and talking about health equity and talking about specific gaps in care and talking about affordability among different member populations. And this fits in so perfectly within those conversations and is really a tool that the market can utilize to really address some of those bigger gaps in care that may be affecting plan performance, and that’s what, I think it’s a really nice bridge to getting into deeper collaborations even within the payer space. So that’s what I’ve seen right away. I think the other piece of this is that it gives us a chance to really help shape a market, because right now the overall digital therapeutic marketplace, especially when you look at, say, reimbursement or activation of solutions, it’s completely all over the board for how, for what plans understand about this market, just the level of expertise, the ability to implement. I mean, there’s some organizations that are very well-versed in this space, and there’s some that are incredibly, they have incredible gaps in their knowledge. So we have the ability to come in and help really define what this marketplace could look like, to pick out what the best practices are that we see across the industry, and bring those forward to help the market evolve faster than it could do on its own. So that’s been really great to be a part of, to really start to educate more broadly on what’s coming and how we can all move along to get to a place where we’re managing care in a more sophisticated way.

Kyle Wildnauer-Haigney:
Do you think partnerships like this one with DarioHealth could lead to proliferation of value-based contracts, or how do you see that playing out? I know that’s a very hot topic right now.

Kati Sadiwnyk:
So I’m always torn on the value-based contract concept, just having come from the drug side and having tried to do these and just knowing the challenges with measurement of value-based contracts, you know, on the drug side, there’s always issues with sample size and finding the right metrics and the time period to measure. I think on the digital side, there are some differences just in the sheer volume of data that is transmitted back and forth and more of a real-time fashion, I think that makes a huge difference. And just the scale of outcomes that you could actually assess is completely wide-ranging versus anything that we would do on the drug, but I think the core challenges that we see on the drug side have to be considered on this side as well, right, keep things as simple as possible, measure your outcomes in a time frame that actually makes sense based on the plans’ typical turnover rate, right? I think we’ve looked at different contracts that have three-year results and that’s just not going to fly for a plan. And I guess, you know, don’t try to oversimplify even some of your engagement metrics, and I know there’s solutions out there that pay on a per-member basis. There’s some that pay on a per-member basis, and some consider engagement to be something very passive. And then there’s some that get a bit more sophisticated in defining what an engaged member means. And I think to the extent that plans feel like they’re paying for something, the value that they’re paying for something for the right population, and that population is actually using it in a defined way that they can stand behind. Then, I think there’s a clear case to be made for the solution, and if that’s done through some type of VPC where there’s some risk there, even if it gets to a place of being shared risk, that could be pretty interesting in this marketplace. So I always have hesitation and I think every plan that you talk to will have the same hesitation, but I think this has to be shaped up in a slightly different way based on the type of data that is available.

Kyle Wildnauer-Haigney:
And I think you just outlaid some of the key challenges with taking on risk or more deeply collaborating with all the stakeholders and in the ecosystem, and so I’m sure all the entrepreneurs or startup individuals listening in will probably be reaching out to you in the coming weeks, asking to pick your brain a little bit. Maybe shifting slightly, it sounds like you and also Sanofi overall has been doing a lot of work in this area and really experimenting with a number of different initiatives to try to improve overall outcomes in the business. I’d love to understand what are the biggest setbacks that you have experienced and some of the learnings that came from it.

Kati Sadiwnyk:
Yeah, so I always tell people that I work with that, I’ve made pretty much every mistake possible in my career, and part of this was because I was in a leadership role pretty early on and had to learn on the job, but more recently I think is because I do try a lot of different things in these different areas and you’re going to fail at different points in time, right, for one reason or another, but when I actually when I heard this question, I thought of something personal and wanted to share that. So a couple of years ago, I was in the office. I think this was pre-COVID, so probably four years ago or so, and I was giving a presentation that I had done a bunch of times before, and all of a sudden I was standing there talking and I felt myself getting dizzy and nauseous. I felt like my throat was closing up and I actually had to leave the room in the middle of the presentation to catch my breath and tried to shake it off that day and was just really confused after that. Like, what in the world just happened to me? I’ve never experienced anything like that. This is something I’ve done a bunch of times. And then it kept happening, it kept happening, it happened the next day when I had the presentation. Then it started to happen when I was just talking in a room with my colleagues. Then it started happening when I was just talking to a friend and after this initial incident it was all internal, just the same feeling kept happening over and over. It happened for about three weeks and eventually, I just walked out of the office one day and went directly to the doctor because I just was so confused and frustrated, right? Like why? What is going on? And I had had anxiety in the past, but it always manifested differently. So I was, and I had worked through it a lot in the past and got to a place, five years prior to this, I felt actually really good for a long time. And what I found out at that point was that I was having panic attacks and just not realizing and not really having a clear trigger that I could understand for why they would start, why they happened then. But I just knew that I had to address it, so I, right then and there basically started taking medication and used that to help get me to a place where I could kind of operate more consistent to the behaviors that I had been doing in the past, and it’s something that was one of my biggest setbacks. But honestly, I think I’m still set back from it where it’s something that I still struggle with today, I’m still working through, and I never quite figured out what switch flipped at that moment, but it did, and now I’m kind of working through it. And ultimately, I tell the story because the biggest thing that I learned through this is the importance of vulnerability. And this is a story that I’ve shared at this point with my team with a larger cohort of people within Sanofi, and I do try to speak to this as I talk to different organizations within my company, because what I’ve found is that by me being more vulnerable to my situation and especially to having this situation at a time when I’m in, somewhat of a position of leadership, right, that people can really relate, and a lot of people, especially during COVID, sharing this, a lot of people were dealing with similar things, and I think I learned that it’s important to be open and vulnerable, to be true to yourself, and that by doing so, people can really, really relate to you and you develop a much deeper level of trust with your coworkers, with people around you by doing this. And this is more something I’ve learned as a leader, but this process of being open and transparent is something I take to all of my conversations now, whether it’s internal or even just external, and talking with customers or talking to vendors or partners. So that’s probably my biggest thing.

Kyle Wildnauer-Haigney:
Thank you for sharing that, Kati. I mean, I think oftentimes the traditional models of leadership are somewhat removed and not as vulnerable. And I think many people, there’s tons of resources about leading with your heart and really kind of putting your full self out there creates a powerful dynamic, and thank you for sharing that. I think that was really great.

Kati Sadiwnyk:
And it helps me understand patients too, right, when you can really empathize in that way. So that’s something I try to think about even as we talk about digital health solutions and how we think things may evolve, right? I can empathize more for the experience when you’ve dealt with it.

Kyle Wildnauer-Haigney:
Absolutely, and many of the patients, especially within chronic disease care, it’s not just one issue that they’re challenged with or one disease or, there’s a compounding factor here, right, and it could be anxiety around the treatment, around the drug itself, and being able to empathize. I think that’s spot on. Maybe before we conclude, I’d love if you just share a closing thought and where listeners can get in touch with you.

Kati Sadiwnyk:
Yeah, sure, so I’ve spent a lot of time in different quarters of the business and there’s good and bad that come along with each. And I think, I find there’s a lot of things that can drive you crazy if you let them, but the thing that I try to focus on and keep me grounded is really just thinking about people. And you know, when I say that, I need the patient, but I don’t just mean the patient, right, or the recipient of healthcare, but really more broadly, the people that I work with, external customers, vendors, advocacy groups, and really try to establish healthy relationships so that when we work together, whether it be on the type of work that we’re doing with Dario or some of the insulin affordability programs, that we’re all doing, so with the best intentions and clarity of focus and a lot of the other stuff, a lot of the challenges will kind of melt away if you have the right people around. So that’s something I don’t think I always knew in my workaholic twenties, but I really get now. And then just in terms of, how to reach out, I’m always happy for a chat, talk more, available on LinkedIn, that’s probably the best way to get in touch with me, Kati Sadiwnyk on LinkedIn.

Kyle Wildnauer-Haigney:
Awesome. Well Kati, absolute pleasure speaking with you today. Thank you so much for coming on the show and sharing your story and the impactful work that you’re doing, and have a great day.

Kati Sadiwnyk:
Thanks so much, that was fun.

Kyle Wildnauer-Haigney:
Thanks.

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