Interview with ACMA CEO Will Soliman

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The pharmaceutical industry is under the spotlight, whether it's drug pricing, ethical marketing standards, or diversity in clinical trials, innovative and expensive biologics or slightly less innovative and expensive biosimilars, there's always something to talk about. Hi, everyone. I'm David Williams, President of Strategy Consulting Firm Health Business Group and host of the HealthBiz podcast, a weekly show where I interviewed top healthcare leaders about their lives and careers. My guest today is Will Soliman, CEO of the Accreditation Council for Medical Affairs the first and only organization for accreditation in the pharmaceutical industry. If you enjoy this episode, please press that like button and subscribe. Will, welcome to the HealthBiz podcast. Thank you very much, David. Pleasure to be here.

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Listen, I'd like to hear a little bit about your your background, your upbringing, you have any childhood influences that have stuck with you throughout your career? Yeah. Sure. So, you know, I grew up actually in the inner city in in Jersey City, New Jersey. So that actually come from a pretty modest background. My parents integrated from outside of the US, and really always encouraged me into the stem field. So I really fell in love with science, engineering, and math. And that kind of really propelled me to go eventually pursue a career or, you know, discipline in terms of science within biochemistry as my major in college and that really kinda set the stage, you know, eventually long term for what I would do in the pharmaceutical industry. You know, in terms of my influence, I would say my father. My father was a very, very hard worker. He was one of those guys that, you know, those stories that you hear of immigrants that come to the United States. He had no one here. He was the first Soliman actually to come from his country. And he when he got here, I actually had no police to go. So he spent the night in the JFK Airport Yeah. So he's one of those stories, you know, with, like, literally two hundred bucks in his pocket, you know, didn't know what he was gonna do. And, you know, over the years, he was able to eventually become very successful. And so I think looking at him as a model for hard work and perseverance and really being persistent and consistent in terms of discipline and whatnot, and for sure that made a big influence in my life. Howard Bauchner: So you mentioned Biochem, I think undergraduate, but you went on for master's in a PhD.

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Same subject? Or where did you what did you pursue? Yeah. So I focused actually in two different areas. I focused a lot on chemistry three education as well as kind of the the traditional biochem field.

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And I was very interested in particular with my PhD program and the interplay between the influence of chemistry, biochemistry sciences in general, on the economy. And what that would mean long term for, like, GDPs of different countries. And interestingly enough, this was back now, you know, over twenty years ago. But when I completed my PhD, my dissertation, predicted that there were certain countries in the next fifteen to twenty years that would rise in terms of their GDP based on their output of scientific production. And believe it or not, a lot of those predictions came true. China was one of the countries that I predicted back over twenty years ago. India was another one. Where we saw a big rise and low and behold, we're seeing that now today where India has had a big increase in their middle class. They have a lot of output and production. Of scientific information and papers. In China, of course, we're sending that as well.

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Especially post nine eleven, it used to be back in the day that a lot of people that pursued a PhD from China would stay in the US if they studied it in the US. But post nine eleven, we saw a shift and a lot of them actually went back to their home countries. And so the scientific output and production really benefited the economies there in China versus in the US. And part of that too is some of the changes in immigration policies probably in the last ten years. But that was kinda, you know, what I focused on. It was very always very appealing to me. This intersection between business and science and education. And I think this is, you know, kind of the genesis for eventually what I would have found with the company ECMA, the creation council for medical affairs. And building kind of competency standards for the life sciences? Well, not to get off track, but I think that, you know, nine eleven is big of an impact as it had sort of, you know, directly, the indirect impact and sort of what we've done to ourselves over that time. I think in some ways has been a lot more profound and negative. And I think, you know, immigration is exhibit a. Right. For that. So if you think about it's pretty clear people wanted to stay and, you know, have their scientific output be here and that has not in the case, and it's I don't think it's improved since then. Yeah. Yeah. Absolutely. I mean, I think people don't realize how many areas within the US. And in general, abroad have really been impacted by nine eleven. I mean, this is just one of the areas, but obviously, we all know public policy in general has changed a lot since nine eleven. And I think, you know, we we forget how it was, you know, prior to nine eleven in terms of how things were. So definitely had a tremendous impact. And, you know, so for me, that was very interesting to see those shifts and what that meant ultimately for the GDP of these of these different countries. So Now I saw you did a stint early on in your career as a pharma sales rep.

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Is that how you got your starter pharma? Yeah. So, you know, like, a lot of good things sometimes in life. I had a girlfriend who I had met in my early twenties, and she was a a rep actually at a pharmaceutical company. And I had, you know, really no clue about the pharmaceutical industry. I was twenty one when I had graduated originally before I pursued my PhD. From NYU when I graduated. And, you know, I don't know what I was gonna do. I decided I would actually teach for a little bit. So I was actually a high school teacher and people a lot of people know that I taught high school chemistry and physics early on. And then she introduced me this idea of, hey, would you consider being a pharmaceutical salesman? Again, I'm no clue what it was.

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And interviewed, you know, fell on love really with the industry and what what we did in the industry in terms of going out there, building relationships, talking to doctors. Very fascinating, you know, space. But back then, you know, this is now in the early two thousands, late nineties. Being a pharmaceutical sales rep was very different. Than what it is today. Back then, I would say, it was it was kinda more like the wild, wild west. You could do a lot more with physicians. Unfortunately, and a lot of times it was unethical things that that reps would do with the industry would do in terms of being more lavish and they're spending on physicians. And, you know, some was good, some was bad, and I've talked about this before in other podcasts and articles. But clearly, you know, my initial impressions as as kind of a young guy in the in the industry was that, wow, you know, the industry has a big impact on physicians and on their prescribing habits. And, you know, At that time, I didn't really maybe understand a lot in terms of the clinical implications of that. But certainly now, you know, after I've got my PhD and twenty years later, you know, we can of course see that there's been a lot of issues that have occurred because of the influence the industry has on on prescribers.

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So after you were a rep, and then it sounds like you went back to grad school after that. And then did you come back out and wear an MSL at that point, medical science liaison or how did that? Exactly. Yeah. That's right. Exactly. That's exactly right. So I I came back out eventually I got my PhD in Pursuit, you know, the area of medical affairs working as a medical science liaison originally. And that at the time, you know, people don't know this and people listening aren't sure what a medical science liaison is.

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A medical science liaison really I I think of them as the the Navy SEALs field force for a pharmaceutical company there. So they're out there. They're educating doctors. They don't sell to doctors. Right? They educate And what they're doing really is talking in an in-depth way about the disease state, not only about the company's product that they work for, but maybe other products as well. Many of them will have an MD, a PhD like me, or a pharmacy degree, or as a pharmacist. And so they'll go out there and really build these relationships physicians most of the time were thought leaders. But back then, when you were a medical science liaison, you actually would be promoted from within sales and you actually reporting into marketing. So today, that's not the case. Today, you know, no one would actually even consider doing that. It would be seen as unethical. So today, there's actually a very specific medical affairs function that probably came out in the last fifteen to twenty years more formally within most major pharmaceutical companies.

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So that was, you know, kind of my first stint again in working on the medical side within a pharmaceutical industry. Got it. So then you went from being an MSL, I think, to managing MSLs. Yep. Is that right? What was that like? What was that? Like, so, you know, at the time when I first managed themselves, it was an interesting transition because I was on the team And then I got transitioned to, you know, manage the team that were my colleagues. You know, it's always a tough transition. You have to manage your your former colleagues. Yeah. But it's better though it's better though than than than the other way around, which is staying behind and being managed by up here. So Right. I guess so yeah. That's right. Look at look at it in glass half full. Right? Yeah. But but yeah. So it was it was a great experience. I mean, I, you know, I would say it was really my first kind of leadership role within the industry. And, you know, I was a very successful medical science liaison. I was actually part of it. You know, when they would rank us in, you know, in terms of our performance, I consistently got very high rankings in terms of my effectiveness as an MSL. I think that's one of the reasons why they promoted me.

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And working as a manager of MSLs, you know, leading an MSL team at the time. This is at AbbVie now AbbVie used to be AbbVie Pharmaceuticals. Great experience. I learned a lot about, you know, just how to really lead a team and to help them stay motivated, especially because a lot of them we're working remotely and how that whole thing, you know, comes together. So, you know, very good experience.

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And then it seems he went from there onto more of entrepreneurial and investment oriented activities. Why did you do that? And what was the first step in that path? Yeah. So, you know, I've always had kind of an entrepreneur real itch. One of the things that was very interesting to me was how analysts, you know, equity analysts, you know, bankers how they, you know, perform valuations on companies. So I was always interested in that, you know, and how that kinda worked. And so I took, you know, an investment banking program that I enrolled in in New York. And I learned a lot about modeling and evaluation methods and things like that. And it was, you know, it was an eye opener for me. And I began to kind of think about, okay, you know, what can I do in terms of, like, contribute to the industry?

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Actually, my first company that I founded was called US Pharmacy Lab, which was a specialty pharmacy that also included compounding. And we focused on this idea of tailoring to really high end folks with very high end customer service. As you know, you know, if you've gone into a CVS or Walgreens, you could stand there for, you know, a half hour or you can come back an hour later, your medications not ready. You don't know your pharmacist says, they don't know you was very, you know, impersonal. So I I felt that there was a good market for providing more personalized service for farm for, you know, customers on the pharmacy side and also there was a big need for people that needed specialized kinds of medications where, you know, compounding could be useful. So, you know, that was a very successful business.

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Learned a lot about that whole process, including the prior authorization process would which later on would impact what I would do at the ACMA. We can talk about that later, but that was kinda my first foray, if you will, you know, in terms of a kind of as an as an entrepreneur? So you mentioned the ECMA, so that's the accreditation council for medical affairs. Something that you started up. Now clearly, you've been talking a little bit about, you know, the role for in sales and then what an MSL does and how they moved out from under marketing and sort of that that space and that profession has matured. What did you see as, you know, what was the vision? Why would what was there a need for such a council in the first place? Yeah. Great question.

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So one of the positions that I had had was building up medical affairs capabilities for a company out in the Silicon Valley area in San Francisco called Veeva, which a lot of people in the industry know. Right? It's it's the company that, you know, I would say probably ninety five percent of the industry pharma reps utilize the the Veeva CRM system for interacting with physicians. So I was brought in actually by the founders to build up their medical capability. At that time, they really want to focus on medical affairs at all. And so I would go out to these pharmaceutical companies. They're dealing with a lot of the top fifty pharma companies, and I was shocked to see the lack of consistency and the level of heterogeneity when it came to competencies and skills, a lot of processes that were just really gone awry and that I thought were a compliance nightmare for the companies. And I felt that really medical affairs needed a uniform competency standard to kinda level set the industry. I did not exist. I did not exist.

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And then to be honest with you, it didn't exist even on the sales side. So we we really didn't until ACMA came along, we didn't have anything. Now we have pharma, as you know, the trade organization. But pharma, the trade organization, they're primary role I would say is really more advocacy, right, and lobbying work on the hell. They don't really focus on that. We have the form of code which I think is more of a reaction to concerns about regulation from the industry. So it's a kind of a response of self regulation. Hey, we're gonna regulate. Don't worry. And we have our own code. But that's a that's a voluntary, you know, kind of thing that pharma companies can or cannot do, most do it, although we've had it recently after IRA, the inflation reduction act of few companies leave pharma like AbbVie, actually. And so that that puts a lot of questions in terms of what role they even have anymore, in terms of maintaining compliance until the ACMA came along, we didn't have anywhere.

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And I and I felt that that was really key, especially given what was happening around that time. If you remember around this time, there was the rumors beginning around the opioid crisis. There was a Pfizer in Iran in case. There was a few cases where It was a lot of kickbacks, a lot of places where MSLs were being used inappropriately. So there's a lot going on that I thought really necessitated, hey, we need to have standards. You know, there's nothing there for patients.

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Howard Bauchner: So, what you're talking about, you know, you mentioned before, started it as a sales rep and then MSLs used to be what people graduated to from being a rep, but MSL is really not supposed to sell and it's not under marketing and example you're doing there with with Pfizer was one where they're essentially selling something off label as opposed to more of an educational role. Is that Is that correct? Exactly. Yeah. And and look, remember, we actually operate in eighty countries. We have learners in eighty countries at the at the ACMA. So we we see the big discrepancy, especially ex US, where I would say till today, you still have pharmacologic companies, which utilize medical affairs, MSL professionals in a sales capacity. And I think that really erodes from the integrity of the medical affairs profession. So our focus was to protect the integrity of that function.

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We felt that if you really wanted to provide objective information. One, you've gotta be competent. I I don't know if you've watched the Hulu series SICO with Michael Kean. So I always point to there's one episode there. We're in the series where the folks that Purdue executives are showing the sales team graph. And the and the intervals on the graph are not evenly distributed. I don't remember that scene. And what they basically do is by manipulating the intervals on the x and y and x axis is change the trajectory of the curve. By changing that curve, it makes it look like oxycodone isn't as addictive. Right? If you're a doctor and you look at it quickly, It might appear that it's not addictive. So, you know, but the thing is if you're a medical affairs, MSL professional, when you look at data, You've got to be able to know how to interpret that data properly, how to present it properly, if you're designing clinical trials, you've got to know how to do that properly. And what people don't realize, and this might scare people out there listening to this, is that if you're a doctor, if you're a PhD like me at pharmacist, we're actually not trained on how to do that. We're not trained.

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So the idea was to build competency standards in a program that we developed, the board certified medical affairs specialist program, or BCMS, That program is comprised of twenty courses or twenty modules that build on on those competencies. There's technical, there's other areas as well. But from a technical standpoint, even, you know, I was shocked at the level of just the lack of competence that competency that people had in those areas. So who have you, you know, have participating? It sounds like, you know, you could see the need for it based on your your background and but some more extensive experience and training than than most have. But do people kind of does it resonate when you talk about this? And do people sign up? Absolutely. I mean, like I mentioned, we have learners now in eighty countries, you know, thousands of people that are board certified, you know, within a relatively short period of time. Yeah. I mean, currently, the the ACMA works with about two hundred pharmaceutical companies. So we have, you know, oftentimes, individuals will enroll, so you can enroll directly online for the board certification program. But we have companies that'll come to us and say, you know, I wanna board certified two to three hundred people at a time. And you can do that as well. And the idea again is why do that is to is to level set to establish uniformity within the organization. I always say that everybody's kinda singing from the same hymn sheet. Because, again, if you don't do that, it becomes dangerous. I I think it's a compliances for the companies. So it sounds like something that's well recognized.

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A lot of people going through the program. What sort of barriers have you encountered in building this? I would say the biggest thing, like a lot of, you know, new things. I mean, we've been doing this probably for about eight years now. Is you have people, right, the old guard. There's the old guard in the industry that's been around for, you know, twenty, thirty years. And they're you know, they feel like, oh, we, you know, we don't need a standardization. We don't need, you know, to have a board certification having. Our our doctorate degree is good enough. And so there's some folks like that who are resistant, who don't wanna kinda move things forward. And I think you find that in any industry where you find people that just don't wanna adopt new things. But by and large, definitely, there's been a, you know, overwhelmingly positive response people believe that this is really important, really critical to the industry in terms of as really, I think of it as a next era and a next stage.

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Within the pharmaceutical industry. We need every thing about every industry has standards. Right? I always give the example of a hairdresser, you know, who cuts hair. They have to have a license. They don't have standards. If you're a pharmacist and you graduate pharmacy school, you can't go and stand behind a, you know, the counter at a Walgreens or CVS without having. A license, which you have to get by completing an exam and passing. It sets standards. This is the same thing. Right? Medical affairs, MSLs, we have a big impact on clinical trials, on research in this country, and abroad. And we really need to make sure that people are held to some type of standard.

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You mentioned before the Inflation and Reduction Act as it related to some tensions with pharma and AbbVie's departure there. You know, do you consider the IRA to be a big deal? You know, then some some would say, well, it's just, you know, affecting a few drugs and few years from now, but sets a precedent maybe. What what's your take on it? I think it's a big deal. I mean, you know, it's really the first time in a long time where there's been kind of a requirement now for drug manufacturers to pay the federal government if the price is for single source drugs and biologics under the Medicare Part B are, you know and nearly all the coverage on the Part D increased faster than the rate of inflation. I think that's That's a big deal. I also think that some of the effects of IRA are going to favor, for example, biologics over small molecule drug and because of some of the pricing incentives in terms of the protections from from negotiations with Medicare. I also think that it'll potentially increase the use of biosimilars in the market because they're incentivizing providers to prescribe biosimilars, paying them an additional. I think it's a two percentage point increase in the average sales price. So I think, yeah, this is this is gonna make a big difference because ultimately, you know, it impacts the bottom line. It could impact innovations for pharmaceutical companies. I know that rare orphan drugs, single rare orphan drug indications are exempt from that. So you might see again a shift there. We already know that, I think it's based data that I've seen twenty twenty one over fifty five percent of specialty meds make up the prescriptions in the U. S. So I think we're moving that direction anyway. And I think might have an impact again on small molecule drug production on diseases that are kind of more of the traditional chronic diseases. Could that impact innovation there? I think that might.

0:21:13
Drug pricing is obviously top of mind topic. And when we talk about prices going up, usually point to the pharmaceutical industry, but they're not the only player in the chain and the drug companies, generally not the one that's selling the product directly to the individual. For prescription product anyway. What's the role of other players? You know, you hear about PBMs, you see, you know, sometimes hospitals. I know from personal experience with commercial insurance that, you know, I received a bill from a hospital where the drug price was marked up by probably a factor of eight over the list price, and they're also a 340B hospital. So who knows what they they had paid for it? But -- Right. -- you know, the pressure is all on the on the drug companies. What what's your sense of where responsibility wise? Howard Bauchner: Yeah.

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So, you know, of course, I think the PBMs, people that don't know after the pharmacy benefit managers So they they clearly are controversial. We know that oftentimes they might incentivize manufacturers to hike up the price so they're covering more expensive drugs so they get greater rebate on the drug manufacturer side. And clearly, that's problematic. That's problematic. I think especially this year, you know, all eyes are on what the PBMs are gonna do with biosimilars because this year, with HUMIRA, which was the largest selling, the biggest selling drug, really I think in the history of products. Now is gonna have, you know, almost a dozen biosimilars. What are PBM's gonna do? Are they gonna cover these biosimilars or not? What is that gonna mean long term? So I think definitely the PBMs need to be looked at more carefully. I think back when PBMs first started, it was it was probably a greater need for them. I think today, given how things are, we need to kind of reexamine the the impact and kind of the reach that PBMs have in the industry. Howard Bauchner: You mentioned before some questions about, you know, ethical behavior or lack thereof, throughout the world for pharma and MSLs in particular.

0:23:15
I understand you have a new site op report pharma dot orG. What is that site? How do you expect it to be used? How how is it being used? So it's real simple. Right? This is basically a web portal. Where if you're a doctor, nurse, a PA, any type of healthcare professional, you interact with pharmaceutical reps, you interact with medical science liaisons, And, you know, god forbid something happens that is unethical. They do something wrong. It could be that they forget information in a bias way. It could be a sampling issue. You know, it could be anything. This is a place. This is a resource for you as a healthcare provider to report that information to the ACMA.

0:23:54
I think it's really important because right now, again, there's really no accountability. If you think back to the opioid crisis, There was one story that sticks out to me where there was an individual that was at a pharma company that was selling opioids got fired because they were involved in a kickback scheme no record of accountability, you know, what they just basically did. They got far from one job, went to the other job -- Yeah. -- and then they started just to to do the same thing again. So there's no, again, no industry wide accountability. What report pharma dot org does basically is ensure account and accountability. It ensures that pharma companies now need to do something about it. Our job as ACMA, we're gonna report this to the company, and and I'm assuming the company in good faith will have to do something about it. The ACMA, we have contacts at the FDA as well. As a matter of fact, one of our recent programs, the board certified biologics biosimilars specialist program, BCBBS, we had our steering committee people from the FDA. But certainly that, I'm sure, will play a component as well in terms of reporting any type of bad or unethical behavior?

0:24:58
I have a final question for you, which is whether you've had a chance to read any books and anything good that you like anything that you would recommend? Yeah. That's a great question. So one of the people that I I really love to hear his thoughts and and read his work is Ray Dalio. And he wrote a book called Principles. It's a great book. He, you know, people that know banking world. He's a big hedge fund investment banker guy. And he has a lot of great principles that are not just good for business and entrepreneurship, but in general, I would say was in life. You know, in terms of how do you lead a business? How do you lead in general a team? How do you remain disciplined? What are ways that you could, you know, look at certain patterns that you may have run into in your professional life, your personal life, and being able to kind of think about the second, third order consequences of those patterns. So that you prevent those mishaps against. That's actually a great book. We'd highly recommend it. Great.

0:25:55
Well, Will Soliman, CEO of the Accreditation Council, for medical affairs. Thanks for joining me today on the Health Business podcast and talking about the NFL space and your your life and all the work that you've done there. Yeah. Absolutely. Thank you so much for having me. You've been listening to the Health Biz podcast with me, David Williams, president of Health Business Group. I conduct in-depth interviews with leaders in healthcare business and policy. If you like what you hear, go ahead and subscribe on your favorite service. While you're at it, go ahead and subscribe on your second and third favorite services as well. There's more good stuff to come and you won't want to miss an episode. If your organization is seeking strategy consulting services in healthcare, check out our website healthbusinessgroup dot com.