How Medical Nonprofits Set Winning Strategy

Recent years have seen record numbers of drug approvals. In 2019 alone, there were incredible strides in developing treatments for notoriously-hard-to-treat diseases, including metastatic breast cancer, sickle cell disease, and bladder cancer. But despite these accomplishments, much more progress needs to be made. How can we accelerate the pace of the quest to find cures? Almost 20,000 nonprofits have been founded to serve this goal. Some of these organizations are bringing us closer and closer toward cures; others are not. What makes successful organizations effective? Four years ago, the Kraft Precision Medicine Accelerator was born at Harvard Business School. Tasked with accelerating progress in precision medicine in cancer, our quest was funded by the Robert and Myra Kraft Foundation in honor of Myra, who had succumbed to ovarian cancer. In the course of our work, we examined nearly 100 nonprofits supporting the search for treatments — both inside and outside of precision medicine and cancer. We identified a common pattern: Without exception, the organizations making the most progress had a comprehensive strategy, superb leadership, and an aggressive, innovative funding model. In this piece, we’ll share what we learned about their strategies. Developing a strong, actionable strategy is hard for any organization. But when your mission is to drive toward cures, your strategy is going to be even more complex for three key reasons. First, science and technology are evolving faster than ever before. Second, you’re operating within an extremely vast ecosystem that includes researchers, health care providers, insurance companies, policymakers, and, of course, patients and caregivers. Third, you’re trying to deliver for a “customer” that’s on an urgent deadline. In order to make the most of the rapidly advancing scientific and technological innovations, connect the vast ecosystem, and match the patients’ sense of urgency, your strategy must answer the following three questions: Where will you put your stake in the ground? Most disease-focused organizations focus on one of three areas: policy, education, or research. Advancing work in each of these areas is important, but true strategy also means deciding what you won’t do. Most successful cure-seeking organizations tend to zero in on research and drug development. Why? Because cures start in the lab, and with support from cure-seeking organizations, they move even faster. Even within the research space, you must still decide how broad your scope will be. Perhaps you choose to focus on multiple diseases like the American Cancer Society does. Or, you can focus on a single disease like the Prostate Cancer Foundation does. Or perhaps you or a loved one is a patient diagnosed with a specific subtype, and you see a need for more extensive research surrounding that subtype. That’s what the loved ones of a young mother did in 2006, when they founded the Triple Negative Breast Cancer Foundation after she had succumbed to the disease. With the rise of innovations in science and technology, including genomic sequencing and data sharing capabilities, we’re likely to see even more narrowly focused groups emerge. But how do you decide how narrow or broad to go? Follow the science and take stock of the work already being done. If there is an established group that is willing and able to advance work around your disease, don’t duplicate efforts. But if the science is showing a real need for more narrowly focused work, you may be better off forming a new effort or organization. How will you fuel progress? To push medicine closer to the next breakthrough, most cure-seeking organizations operate somewhere along what we call a funder-doer continuum. On one end, you have funders: organizations that raise money, call for grants, and distribute funding — often to academic centers. On the other end, you have doers, who design and execute programs or models that support novel research and build collaboration within the ecosystem. Doers identify challenges and build models that integrate the needs of patients, scientists, and even industry. For example, many doers start by launching registries and clinical trial networks. To decide where your organization might fall on the continuum, examine the current state of the science. If there is minimal awareness or support for your disease, a funder model can be extremely effective because grants and funding attract scientists to the field. Funders can choose to evolve their business model to execute increasingly complex programs. The trajectory of the Multiple Myeloma Research Foundation (MMRF) exemplifies this evolution. Founded in 1998, the MMRF attracted scientists to study myeloma, a relatively unknown cancer at the time, with grant funding. After recognizing the need for more information around the biology of multiple myeloma and the need for new drugs, the MMRF designed and built a tissue bank and clinical network. Next, the MMRF moved to genomic sequencing and data sharing in its CoMMpass study. Who is on your team? Wherever you land on the funder-doer continuum, you’re going to need to build the right team. To do this, you must decide programs you want to manage in-house and what you can contract out. For instance, if you’re going to fund research grants, begin with hiring PhD support as well as an external scientific advisory board. But if you’re going to start a registry, you’ll need a strong administrative team to keep the data pristine and secure and to handle data-related queries. If you plan to conduct clinical trials, you’ll need clinical research associates or — depending on who holds the investigational new drug application — a chief medical officer. At times, you may need to partner instead of hire. When the Pancreatic Cancer Action Network (PanCAN) decided to help patients obtain molecular profiling and analyze the biology of their individual tumors to make more informed treatment decisions, for example, it partnered with Tempus, a precision-medicine-technology company. While PanCAN had access to patients, Tempus had the technology. Naturally, your partnership and hiring approach will need to evolve over time, as will most elements of your overall strategy. But by answering these three questions — Where will you focus?, How will you operate?, and Who will be on your team? — you’ll power through many of the most common challenges and mistakes that that can derail the journey toward cures. What’s more, you will be better prepared to answer the next two critical questions: What type of leadership do you need? And how will you fund your quest for a cure?

How Medical Nonprofits Set Winning Strategy

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