Disruption and innovation in the biopharmaceutical industry: An interview with GSK’s chief commercial officer Luke Miels

In this episode of The Heidrick & Struggles Leadership Podcast, Heidrick & Struggles’ Charlie Moore speaks to Luke Miels, the chief commercial officer at GSK, a global biopharmaceutical company headquartered in London. In this interview, Miels discusses the changing healthcare industry, both from an R&D perspective and from a commercial perspective, highlighting the changing digital and AI environment and sharing how the profile of the successful leader is changing as a result. He also discusses some tips for collaboration between R&D and commercial teams, the challenges of change management, and GSK’s culture journey. Finally, he offers advice for leaders and aspiring leaders looking to build a career within a pharmaceutical company.

Below is a full transcript of the episode, which has been edited for clarity.

Welcome to The Heidrick & Struggles Leadership Podcast. Heidrick is the premier global provider of senior-level executive search and leadership consulting services. Diversity and inclusion, leading through tumultuous times, and building thriving teams and organizations are among the core issues we talk with leaders about every day, including in our podcasts. Thank you for joining the conversation. 

Charlie Moore: Hi, I’m Charlie Moore, a Heidrick & Struggles partner and a member of our global Healthcare & Life Sciences Practice. In this podcast, I’m excited to speak to Luke Miels, GSK’s chief commercial officer. Headquartered in London, GSK is a global biopharmaceutical company aiming to positively impact the health of 2.5 billion patients by the end of 2030. Luke’s career in the industry started in Australia in 1995 with AstraZeneca. This was followed by leadership roles in Thailand and the United States with Sanofi, where he led the merger of Sanofi and Aventis. He then went to Roche in Switzerland in a global marketing role and then as regional president for Asia Pacific, where he lived in Shanghai and Singapore. He then went to AstraZeneca in the United Kingdom to lead global product and portfolio strategy as well as medical and corporate affairs—quite a job—before becoming executive vice president for the European business.

Luke, that’s quite a journey. I think I counted seven countries in 25 years. Welcome, and thank you for taking the time to speak with us today. Can we start by running through your current role responsibilities, to give us some context around what we’re going to speak about today?

Luke Miels: My responsibilities in GSK are really two: one, overall responsibility for commercial operations, where we operate in about 120 countries, with just over £20 billion in revenue; and two, pairing with Tony Wood, our head of R&D, to allocate resources in the pipeline and hopefully find some innovative medicines that can help people.

Charlie Moore: Can we touch on that—the pipeline and where you are today? You’ve been quite busy over the past couple of months. Can you tell us a little bit more about that? 

Luke Miels: Sure. I think any pharma company is very active in terms of progressing internal innovation, but the fact is that most innovation occurs outside a company. So part of what I’ve been doing—and I spend about a day a week on this, which is probably more than what is typical for someone in my role—is identifying and then transacting programs that we can bring in or companies that we can acquire. So we’ve been active in hematology, identifying a molecule for myelofibrosis, which hopefully will be approved this month, right through to antimicrobial resistance, which is an area that we’re increasingly engaged in and that anchors on a historical strength of GSK, which is infectious diseases.

Charlie Moore: Let’s focus on the commercial side of that, and we’ll come back to the R&D piece in a moment. There’s a lot of change in the industry: the reduced access to healthcare professionals, changes in physician autonomy, the digital AI environment around that, and then, in the United States particularly, you’ve got the Inflation Reduction Act (IRA) [and its prescription drug provisions]. How is that impacting the industry in terms of commercial design? And the follow-on is, does that change the type of profile that is going to be successful in those roles going forward?

Luke Miels: If you look at the industry, it’s always in a state of flux. It’s built into the nature of the industry. There are patent expiries, scientific evolution, clinical practice changes, and those have commercial consequences. You then add in elements that tend to be more country- or region-specific like IRA or access, and that means that as a commercial organization, you’ve got to be constantly challenging yourself. And we have very fast feedback loops. If you think about it, if you’re looking at R&D productivity in an organization, it may take 10 years for that to be visible. For a commercial organization, that is tangible within a couple of quarters, where you can see whether you’re improving or you’re losing ground. So I think elements like IRA are going to have a big influence commercially. And it’s not always downside; there’s upside as well.

But the core theme strategically is that a commercial organization needs to work in what I will call positive tension with the R&D organization. And I think the most productive companies in the industry are those that have this very positive tension between R&D and commercial. If R&D’s too strong, we end up with scientifically compelling projects that may not be clinically meaningful. If commercial is too strong, then we end up with the 18th ACE inhibitor, which no one really needs. So trying to find that balance of something that is scientifically compelling but also clinically meaningful, which is then therefore supported in terms of access.

Operationally with commercial right now, COVID of course was very disruptive, physician patents have changed, and diagnosis rates have changed. But structurally for us, we’re seeing a convergence of the remote access giving physicians more options in terms of when they interact with us but also, critically, a convergence with some of the machine learning and AI technologies, where we can not only respond rapidly and effectively and give material and scientific information to physicians, which is valuable, but also get to a predictive dimension of when we see a pattern of request for information, what is likely to be the next consequence and sequence for that physician. So that has very positive elements.

But I think the core element, and we saw this with COVID, is if you want to influence behavior, the most effective way to do that is a human-to-human interaction. So all of this for me is incremental; it’s providing options, but at the end of the day, whether it’s a sales rep or a medical science liaison (MSL), it’s that human interface in terms of outlining the clinical arguments for using product A versus product B. That’s still at the core of what we do.

Charlie Moore: And to double down on that, does that change the competency and the profile of people on both sides of the spectrum, your R&D team on the one hand and your commercial team on the other?

Luke Miels: Yes, I think it does. From a commercial perspective, the theme that we are really focused on, in terms of selecting people who can go up to senior levels in the commercial organization, is scientific fluency. Now that doesn’t mean you have to have been educated in a scientific discipline; it means that there’s a passion around understanding how products work and how products can help patients and equipping yourself with that knowledge and remaining current.

For the R&D organization, it means starting to factor in elements like IRA, in terms of target selection, best in class versus first in class. These are all important parameters, which may not have needed to be incorporated before because there was probably more room for error.

The other element, from a marketing point of view, is the cycle times, as I mentioned earlier, using these tools. You saw a centralization of marketing. I think you’re going to see standard global product positioning, the label, and so on. But in terms of generation of content and material for individual physicians, those cycle times are going to get faster and faster. So I think we’re going to see a decentralization of a lot of the marketing elements, but we have to balance that with making sure that it’s compliant, on label, and so on. I think that’s the emerging challenge for the marketing organization.

Charlie Moore: As you think of adjectives that are going to be critical for success in that marketing organization, around competency, around capability, what are some you are noodling on?

Luke Miels: I think you need to be a lot more quantitative. Historically, if you look at individuals in marketing, we’d take them from the field force, and they may not have been formally trained in marketing. I think this is going to be increasingly critical, maybe not when they are promoted but that they develop those skills and that there’s greater emphasis on quantitative and qualitative information, at least outside the United States, as the United States has always made that a critical part of their marketing organization. But I think there’s now a greater demand for that, and we’ve got the tools now. We’re operating the sales force and the marketing organization to be a lot more quantitative, a lot more directed, and a lot more fact based in terms of how we interact with and make decisions around resource allocation.

Charlie Moore: Are there some tricks to getting the R&D teams and the commercial teams to work closely together? 

Luke Miels: Absolutely. I think it’s this positive tension that I was talking about, in which you want the R&D organization to understand the factors at play from the commercial organization’s perspective, and vice versa. So for us, and this is a model that was originally developed at Aventis, we have a rule that if you want to become a first-time general manager in this organization, you must have worked in global marketing. Now global marketing for some companies is a dumping ground for nice, well-meaning people who may not necessarily have a strong career trajectory. In our company, we’ve tried to make it where our best and brightest go, because there are two big advantages to that. One is for the individual, as they are able to develop a deep understanding of how the R&D organization works, which, as they become more senior, is more and more critical. And you have that positive feedback into the R&D organization but also empathy to what is possible and what is not possible in an R&D context. 

But as a company, if you’re a general manager or a business unit head or a marketing manager or a sales manager, you are stuck with decisions that were made 10 years ago by your commercial colleagues, either with high involvement or low involvement in R&D decisions, so your capacity to influence that is relatively limited. Whereas if we have a group of commercial people working closely with the R&D organization around choices in terms of which programs go forward, comparative dose, benefit–risk trade-offs, you can have a 20-year impact on an organization by making the right choices. So having a cohort of people who are skilled and who we don’t keep in headquarters too long, with a tour of three to five years there to learn how R&D works, and then we send them back out into the operations and accelerate their career, I personally strongly believe, and I’ve seen this at Roche and then AstraZeneca and now hopefully GSK, that you end up with better and more competitive products that are able to help more people.

Charlie Moore: If you look at some of the skill sets around what makes that impact or what makes that change, your current role, in terms of change management, I suspect is pretty full-on. What are the challenges around the change management aspects of what you’re doing today?

Luke Miels: Everything comes down to people at the end of the day. This industry is constantly moving, but people make a massive difference. So a lot of decisions we make are around matching the right person with the right challenge. And if you get it right, then things can happen that may not have happened. I’ve seen a number of times where there’s a highly innovative product that may have failed without one person standing up and saying, “I believe in this.” And they’re not usually senior management; it’s usually someone on the team who passionately believes in it. So it’s that flexibility, but it has to be based on something. So again, scientific fluency is really important for commercial people and being prepared to do that. So a lot of that change is about finding great products embedded in the pipeline or outside the company and then marshaling the resources in partnership with R&D to accelerate them. And if you do that, you’re creating value. 

Charlie Moore: Is that tough to do in an environment that is large and historically slow? It takes a long time to develop a drug, and the knock-on effect of that is that things don’t happen overnight. So, how are you speeding things up at GSK?

Luke Miels: The industry has relatively slow time frames for many good reasons, but it’s how you are relative to your PSA. And I think most of that value in a large company you can concentrate down to a small number of people. Internally, we talk about the two most critical roles in terms of having impact overall in the company: the general manager, because they’re in the operation, and they represent the company in that country, and then the people who are responsible for the programs in the pipeline. And that group is a very small number of people, even in a big company. There might be only 10 to 12 programs, maybe 15 at the most, that are going to make a difference to the organization’s health in 5 or 10 years’ time. So getting those people right, both the R&D and commercial, is absolutely critical. 

Charlie Moore: As you look at the digital AI piece, which we’ve touched on a bit, what are you seeing that’s going to change the future state?

Luke Miels: Our strategy there is to be a fast follower. So we are actively looking at what other organizations in the industry and outside the industry are doing. When we see something that is inflecting, then we try to essentially industrialize that idea. That’s been our approach. Linked to that is this decentralization that I talked about before. Letting countries and teams experiment, and if we see something good there, we scale it.

AI is the topic of the moment, but I think for biology it’s particularly interesting, because if you think about the knowledge that we’re getting around a typical phenotype in a disease, when you multiply the number of people who may have that particular disease, we tend to look at it as a model. Breast cancer is a classic example. If you go back 20 years ago, breast cancer was a singular entity; now we know it is multiple diseases in one. So then, where is the granular point? At what point do we get to an electron or a quark or a subatomic level? To apply physics in this context, the typical human brain can’t see those patterns. So we’re working with 23andMe, where you’ve got all of this genetic information as well as components about a person’s family history and so on, and using machine learning and AI to try to spot patterns.

And this is a race, because genetic information is relatively static. It’s like minerals in the ground—it’s always been there, but it’s not visible. So the industry is involved in a race to try to identify those patterns and then identify targets. That’s going to be a good thing because it’s going to increase productivity, it’s going to make more drugs available. That is where AI probably has the potential for the biggest impact in the industry, in picking patterns that may have taken us 10 years to see, if ever, and we’re certainly seeing that in terms of the number of targets being produced.

In commercial, again it’s pattern recognition around behavior and resource allocation and provision of information.

Charlie Moore: And does patient choice change the dynamic on that?

Luke Miels: That’s really interesting because you’ve got more informed and more engaged patients now. There’s a spectrum, of course, in terms of how much they’re involved, and that varies by individual education level and so on and also by the disease. Let’s say you have pancreatic cancer. You’re probably going to defer to your physician more than you would if you had rhinitis. But there is also good information and bad information out there. And I think that’s the challenge for the industry, which is providing fact-based, clinically validated information for patients, still recognizing, though, that the most important interface for that patient is their physician and their healthcare provider but supporting everyone to help them make appropriate decisions. So more informed patients, more engaged patients, is a good thing.

Charlie Moore: Let’s talk a little bit about culture and change and what you’re trying to do, what GSK is trying to do, to change the culture?

Luke Miels: I think the biggest impact on anyone’s day-to-day working experience is their manager; it’s the most important relationship they have. So we have really tried to change the culture, from a commercial perspective, to be more robustly competitive, one that rewards people who innovate and think differently. So we’ve changed through either promoting or moving almost all of our general managers, and then you see this natural cascade. If we move someone from, say, Thailand to Germany, then there is a cascade of the organization changing and creating opportunities for people to move or be promoted.

And the culture we’re trying to create is one that’s a meritocracy, where people who produce and generate results the right way get opportunities, and they get opportunities in a flexible context. So we’ve spent a lot of time on that. And so a big part of my role is to look deeply into the organization and to try to understand the talent and the individuals that we have, which is the most rewarding part of my job—working with the team to create opportunities for people to progress their career. 

Charlie Moore: And what are the challenges that you’ve faced or some of those folks have faced as you’ve gone through this cascade of change and moves?

Luke Miels: The most important element is building understanding of an organization about what we’re trying to achieve and the reasons for it, which is trying to find more differentiated products. And, ultimately, that alone is not enough. The arguments need to be made, and the products need to be translated into successful commercial outcomes, so that we get the right to reinvest in a new wave of R&D. And so the commercialization—and having the right people who really understand that in the right place—is absolutely critical. That takes time, but so far it’s yielding results. We’re seeing an acceleration in our growth, and people are getting opportunities that they may not have gotten in the past. That’s also very exciting.

Charlie Moore: Spin back 20 years—what were you doing 20 years ago?

Luke Miels: Twenty-three years ago I was in Thailand as a general manager, in the middle of SARS. That was an interesting experience.

Charlie Moore: What do you say to, say, a country manager in Thailand today in terms of career progression and the things that they should and shouldn’t do?

Luke Miels: I think every career is different. The main element in a country management role at that scale is really trying to understand your whole team and ultimately how you can work with them to create value. I was very focused on expanding access for patients in Thailand. I was at Aventis at that time. Sanofi then acquired Aventis, and I had the opportunity to stay in Thailand, which was a safe bet, or I could move to work in the United States. But moving to an environment where an integration was occurring and no one knew who I was, I could have been ejected from the United States quite quickly as part of a merger synergy. But I made the decision with my family to go to the United States. It’s calculated and educated risk-taking. If you’ve got the fundamentals right, calculated and educated risk-taking is the thing you should do at certain points in time.

Charlie Moore: You certainly have, and I counted seven countries you’ve lived in in your career. 

Luke Miels: A very tolerant wife. 

Charlie Moore: And family. 

Luke Miels: Yes. 

Charlie Moore: Can you give some advice in terms of managing a career within a pharmaceutical company? 

Luke Miels: Number one: be obsessed with products. If you really understand the products, the products will help people, and not losing that connection. So understanding your portfolio, the competitor’s portfolio, and how that information changes over time. And then the other one is being focused on the people around you. I’ve been fortunate to work with incredible people, and that’s so important, because if you’ve got a really strong team around you, that makes a difference. 

Charlie Moore: Maybe take some risks, jump at things?

Luke Miels: Yes, it’s calculated risk. You can’t bet the house on everything, but it’s a portfolio, a series of choices, and sometimes it’s going to be right for you and your family to take that risk, and other times it’s not going to be right. And as you grow and mature over time, you’re hopefully better equipped to make those decisions. And the other element is, if you’ve got people around you who are experienced, listening to that advice is always helpful. It doesn’t necessarily mean you have to follow it, but the more people who you can cross-reference your thinking with, that’s a good thing. 

Charlie Moore: So you have mentors and folks you can turn to? 

Luke Miels: Yes, I’ve been very fortunate to have great mentors and the opportunity to learn from people. But you can learn anywhere. I’ve learned things from people all over the place, and I’m still learning. And that’s the fun of this industry—you work with really, really clever people. It’s very humbling, the knowledge that people have and the passion they have. So yes, you’re always picking up something new every time.

Charlie Moore: Thank you, Luke. I really appreciate the time together, and I wish you well.

Luke Miels: Thanks, Charlie. It’s been a privilege to be here today.

Thanks for listening to The Heidrick & Struggles Leadership Podcast. To make sure you don’t miss more future-shaping ideas and conversations, please subscribe to our channel on the podcast app. And if you’re listening via LinkedIn, Twitter, or YouTube, why not share this with your connections? Until next time. 

About the interviewer

Charlie Moore (cmoore@heidrick.com) is a member of Heidrick & Struggles’ Healthcare & Life Sciences Practice and regional leader of strategic accounts in Europe; he is based in the London office.