Diogo Rau
Appearances
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
No, we've not produced a wearable of our own. And it ends up being a little bit challenging as a manufacturer. It'd be a lot easier if we didn't make drugs to actually launch a wearable. But because you make drugs, then the question is, well, are you using this to, does it have to be, is it required for somebody taking the medicine?
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
So there's a whole host of things that makes it really complicated for us to do it. So for the most part, where we use these things are in clinical trials.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
If you're a nerd out on all of this. I think it's probably on the scale of two to three, I think. I think there are only so many places that you're willing to put a wearable. You can imagine there's your ring, there's a watch. You might be able to, if you've ever had a Zio patch or anything like that, a heart patch, those are not terribly uncomfortable. Insoles, you could imagine. But after that,
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
You don't have that many more places, I think, that you'd be willing to wear something. So I'll go with those three tops.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Yeah. There's lots and lots and lots and lots of things. No, I thought you were going to go down a different path, which is like the, what you might like enhancing your eyes or your hearing or things like that, which is also like, that's just another fascinating space of science.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
We do that with some of our clinical trials. You'll get like, here are the devices to take with you. But if you look at weight loss medications, we've, we're already all doing that right now, like, because we all have scales in our house, right? And so, and so I think that is a great example of like, if you give feedback to the person taking the medicine, they're
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
they're going to be more likely to stay on it. At least that's one of my hypotheses. I think that if you took away scales and you took away mirrors, I think a lot more people would drop off the chronic weight management medicines early on. But the fact is, when you get on the scale and you can see, hey, I lost some weight, you want to stay on it.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I think I have that reputation of being unusual. At least I like to try to do things a little bit differently.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
don't have anything like that for statins or anything else, right? And that's, again, like why people drop off. Just imagine if you could just see, oh, hey, actually, you know, or I'm taking cholesterol medication and you know what? Hey, my cholesterol went down versus yesterday, not versus three months ago.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Correct.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
That's my hope. But the data, ultimately, the first part of your question, the data really should be with the patient. And I think there's a tendency to say, even still today in this industry, that the data is really for the healthcare provider. And I think that's a mistake.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I think ultimately the data is for the patient, and the patient can choose to share it with the healthcare provider, and the healthcare provider can look at it. But it really is, it's really the patient's data.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Yeah, yeah. You worked in the tech industry for how many years? I worked in the tech industry, well, really my whole life. But the last 10 years before I came to Lilly, I was at Apple. And before that, I was doing other kinds of technology work at McKinsey. And before that, I was in the startup world. So I've really spent my whole life in technology.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I think the continuous measurement part is, you're absolutely correct about it. But I think it needs to be, I think she always needs to be able to see the data herself. Yes, you can see that.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And by the way, that's one of those things that sounds obvious if you're coming from outside the industry to inside, but inside the industry, it's like, wait, why would you share the data with the patient themselves? That's something that the healthcare provider should see first. I mean, What happens if your mom misinterprets the data without the advice of a healthcare provider?
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
That's kind of the big caution that would keep the industry from saying your mom should be able to see that data itself. But I take a very different view on that.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
right? This is... That's, if you don't mind me going on a tangent on that too, that's one of the reasons why I'm really, really excited about like how we can change things too. Because if you look at it today, it's, there are so many barriers to getting medicine. You know, like first you have to get a doctor's appointment, which we've all suffered through. Like it can take months to get one.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Then even after you have one, then you also have to be able to get it actually get access to the medicine, which is a big problem because I don't know if you've heard the stats before, but 45 million Americans live in pharmacy deserts. 46% of counties in the country are in pharmacy deserts where there's no pharmacy within 15 minutes of your house. And so I
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I think, and so if you add all of that together, it can take months from like the moment you say, you know what, I'm not feeling well, or there's something I want to change in my life to like the day that you get the medicine. I want to bring that like down to like the same day.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
You should be able to say, you know what, today's the day that I want to do something and you should be able to go in, you know, get a telehealth appointment. And if a medicine is appropriate, get it shipped and get it arrived, delivered, you know, the exact same day.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
The biggest thing for me is going to be the consumer side and actually really cracking this and being able to get that vision of people saying, I want to take a medicine and I'm going to get it the same day. and then I've got the tools to stay engaged with it forever. Like that would be, that's millions and millions of lives touched by just getting medicine and staying on medicine.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
That's one side. The other side where I would love to, make a mark is on the discovery side. Discovering new medicines, particularly with AI, I could talk for hours on that. But I think we're going to see medicines no human could have ever imagined coming out over the next decade. And because it takes 10 years or more to develop a medicine, it would take about 15 years for that to come to life.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I think so, actually. I think if we got swiftness and you could actually see an effect and know that something was happening, that would change things. And by the way, I love that model that you just mentioned. In the technology world, we have things break all the time. And what everybody focuses on is what's the root cause and what's the severity and how likely is it?
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
The thing that nobody ever focuses on, which is where I was trying to get teams focused on,
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
is uh swiftness the mitigation time to mitigate how long did it take you to mitigate that human process of like how quickly did you take the feedback and adapt uh that's really you can you can have all kinds of risks as long as you've got as long as it's reversible and you can switch uh that's great so when it comes to medicines if you could try it and get feedback that it's not working or not turning in the right direction and change it that would be uh that that would be
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
amazing. And I think you would find that people would say, hey, now I know that this medicine I tried wasn't working. I'm going to try a new one today. I can see progress. I'm going to stay on it because I know it's doing something.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Excellent. Thank you, Malcolm. Yeah.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Well, yeah, and that's the way a lot of these things start. There was a recruiter that I worked with who gave me a call and said, hey, I've got this opportunity. It's in life sciences. And I was like, I've never done anything in life sciences before. He's like, that's okay. So I look at the spec and the spec is, it's pretty interesting. So I'm like, okay, it's worth a phone call.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And then I meet our CEO and our head of HR, and like, these people are really nice. And so that's like the second thing that I notice is that they're really, really, really nice. And that's a big difference, by the way, coming from versus the tech world. Happy to say a little more about that.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And then I start talking to our head of research and development about some of the problems that we're trying to solve in life sciences. And I realized, wow, this is like a fascinating space. I kind of thought that like everything exciting in the world was happening in tech. And then I came to realize, no, actually, there's a lot of exciting stuff that's happening outside of just the tech world.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Well, the number one thing that I actually saw was actually the nice people part. But you know, the second thing that I noticed was really long time scales. Like the size and the duration of things is just beyond belief. My first executive committee meeting in 2021, we were talking about a revenue forecast that was for 2030. And that's nine years out.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
In tech, looking like 18 months out in revenue is ridiculous. Wait, so when you see that, what's your reaction? Oh, it's BS. There's no way we can predict our revenues for nine years from now. And of course, now I realize that I'm in here, that there are a lot of things that you can predict. And it is actually very predictable. It's a big bet. And if it works, you'll hit it.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
But it's much less volatile. It's, these timescales are crazy though, because like at our last executive committee meeting right before the break, we were talking about a product launch. I'll ask you a question. When, guess when our product launches that we were talking about in December? Well, now that you've primed me, it's going to be five, six, seven years. No, 2036. Oh, my God.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And I can guarantee you there are zero tech companies right now talking about what they're going to launch in 2036. Yeah, yeah.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Yes. You can't be certain, of course, that anything is going to be approved. And so we apply a probability of technical success. This phrase I'd never heard of before I got here, but every step of the way has probability of technical success. And so you factor it in and you take all that into account. But you know when you have a good medicine and you know what it's going to take.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
But it just takes 10 years to bring a medicine to life. And I don't think that was one of the things that I realized before I came into this, just how long it takes and how much money it takes. So it is possible that you will work on things that you will never see come to fruition? In fact, most of our scientists that work here will never see their medicines that they're working on come to life.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
which is kind of crazy to think of. How does that affect the culture of an organization? It gives it a really long-term perspective, like a crazy long-term perspective.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
When we're talking about things, making decisions, we're really not thinking, you know, like in an executive committee level, there are some things that we're doing on a this-year basis, but there are a lot of things that we're doing that we're really talking about like the 2030s, like just... just a much different time scale from anything else.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Pushkin
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And so we're not going to do anything stupid, I think is one of the good things. We're not going to trade off some of the long term to get a little bit of benefit in the short term. So I think it makes us much more rational that way. I guess I would say we play the long game.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
My boss, our CEO, gave me a mandate to really change, to bring in technology into everything that we did. So it was not a caretaker role sort of a mandate. We want you to just keep running the things. We want you to really figure out what can you do to shake things up. And so that was really the goal. And I think a big part of it was bringing a consumer orientation as well.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And I think this is an industry that has largely worked the same since the 1950s. I mean, if you look at it, the way you get medicines today as a patient is basically unchanged. You go to your doctor, they write a form. Maybe now they submit your prescription electronically. You still have to make sure you can pay for it. You still have to go to a retail pharmacy in most cases.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
None of that's really changed since the 1950s, even though we have so much more. So a big part of what we're trying to do is actually... A big part of my mandate is to really bring this into the 21st century, or at least the late 20th century.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I mean, what's the kind of remit? The great thing is that I get to focus on all of that stuff. So everything that's technology related. I do cover everything from the discovery side through the consumer side. And actually, those are probably some of my favorite parts. Because, of course, I shouldn't be saying favorites.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
But I love the discovery side and discovering new molecules and what we can do there. A lot of cool stuff, especially with AI, we could talk for hours about. And the consumer side is also the place where I see, where I have a passion coming from my prior life at Apple and just seeing the potential we have to change everything there.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And I think this whole industry hasn't really focused on like, how do we make it an amazing experience and work backwards? I think the kinds of things that you see at Apple and a lot of other consumer-oriented companies just haven't arrived here yet. And how does putting the customer...
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
That was the most fundamental thing that I learned from my time at Apple. And I think most companies will say, oh, we care about the customer. But whenever you start a project, People will have, I don't know, they'll have five pillars or five things they need to go after. Well, maybe there's the business case, the product, the customer, you know, you'll have like five or six different things.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And the way you'd always do things at Apple was different. You would always start by like, what's the customer, the consumer experience that you want to create? and then work backwards and then figure out, can you make it a financial case around it? Well, maybe you can't. Okay, so maybe we can see how we can change things back and forth. But everything was centered on the customer experience.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
It wasn't like a pillar of one thing of five. It was like the thing that was guiding everything. And I think that's, we're not there yet, but that's the kind of thing we need to do every single time. We need to go back and see what's the customer experience like. We need to actually focus on making a customer experience better. Yeah, yeah.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Okay. Great.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
share with everybody that, like, Malcolm and I had a little prep call before, you know, a couple weeks ago, and it was only about 10 minutes because he just said, okay, you know, if you've got any toys, any goodies, like, bring them along. And so, like, my team gave me a box of goodies here, which is all splayed out on the table. And then I think he said, okay, I don't want to talk too much more.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Let's not do any more prep. Let's just get going.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
That would be the only thing that was top of mind. Awesome. All right. So let me grab a box. All right. I'm going to show you something that is... No, let me grab that one. Yep. And I'm going to hide it here for just a second and tell you what the problem is that we're going after. One of the big challenges in the world right now is medicine and medicine safety.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
When I was at Apple, I saw counterfeit iPhones and I couldn't believe it. You wouldn't know that they were counterfeit until you actually picked them up and played with them for like half an hour. And sometimes we'd have to send them in and have them get x-rayed to know that they're fake. Well, those were on products. That was like a $1,000 product, electronics.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Very hard to make a counterfeit, but the economics were there. Medicines are a lot easier to fake, or at least make them look fake. All you need to do is copy the box, and if it's in a vial, put a label on it, something like that.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And with some of the medicines that are out there right now, there's a huge financial incentive for people to say that they're making medicines that they really are not, and they're faking them.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Well, right now, in chronic weight management, we have the GLP-1 medicines. And so, both for us and the other leading maker of GLP-1 medicines... Counterfeiting is a real, real threat. And back to formularies and things like that, a lot of insurance plans do not cover chronic weight loss management.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And so there's a huge financial incentive on the black market to say, hey, we're going to go... And some uncertainty about outcomes. So it would take you a while to figure out you're taking a fake. Correct. And I mean, it's not only...
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I mean, it's not only fake, it's actually, many of these cases are risky because once you see, once you see like the sterile environments that these medicines go through to be made, you know, that it could, in the best case, it's harmless, right? I mean, the best case is you don't get any effect. And so what I've got here is a product. I'm going to, this can be any product.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
And so don't pay attention to what product this actually is. And I've got the product right here and I can tap my phone against it and I will get it in an NFC tag. And that NFC tag is just like when you do a contactless payment. And it will bring up a page to show you that could actually verify that the packaging matches something that we've produced. Unlike a QR code, it can't be copied.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
It's cryptographically secure. And this is where the technology part gets interesting because they can copy the box. They can do all kinds of things like that, but they can't copy that tag. There's one and only one tag that you can tap and then we can verify it.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
So this is something we did within my first few months of coming here. And we haven't launched it yet. So the designing it is very easy. The developing it is very hard.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Correct. And the manufacturer. That's absolutely right. And, you know, we actually don't even care about it necessarily being just for us. Like, this is the kind of thing where we'd say, this is a great thing if adherence can improve for patients across all medicines, all manufacturers, that would be fantastic.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
So this is version one, which is on the box. And then version two, which we'll come to later, will be on the individual medicine itself.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Absolutely. Then you could actually make sure that you're taking the right medicine. I also think making sure that you haven't taken your medicine more than once in a day is also an important thing because you know what? It's actually very easy to do.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
I also think that in a hospital environment, you could tie it into systems and make sure that you're actually administering the correct medicine, not something that you can imagine a alert flashing up on the healthcare provider's device if it's the wrong medicine.
Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
The pill itself, I don't know if we'll ever get past the consumer stage. acceptance of RFID, like actually being in the pillow itself. But if we could get there, that's not super far out. That's probably, you know, probably five years out. Yeah. Yeah. But it's not, the technology is there.