MSD’s David Peacock on moving UK healthcare forward

David Peacock has worked across the world for MSD and other companies, and has now taken the helm of MSD’s UK & Ireland operations. In the latest article in our UK Leaders series, he tells us about the opportunities and challenges he is excited to take on in the region.

Peacock has had a strikingly international career, including jobs in the US, Australia, Singapore, Vietnam, Japan, and Hong Kong – working across many different roles in various healthcare companies and even setting up his own business, hydration tablet company Nuun.

The UK might seem like a small change after all that, but Peacock said he was “tremendously excited” at the opportunity to be heading up MSD’s business in the region.

“The world watches the UK when it comes to market access, whether that’s in terms of HTA or the commercial relationships that are established with Public Health England and the NHS,” he says.

“The health system continues to move as the NHS and our industry continue to adapt. Through that process of adaptation, MSD in the UK has led trends for the company globally. I was very excited about having the opportunity to come in and work with a group that has this reputation for embracing new ideas.”

Peacock says his goal coming into the company is to maintain that reputation and build “true partnerships” with the NHS.

“I recognise that I’m coming into the UK when the country is dealing with affordability challenges,” he says. “One of my goals is to understand how this healthcare system is operating, and what challenges it is facing.

“I'm a true believer in partnership and collaboration. What I'm looking for, as I come into this business, is how we can continue to move past the traditional promotional models – like simply pushing messages out to clinicians that represent the risks and benefits associated with our products.

“Those models worked for many years, but they’re not going to be good enough going forward. We need to move past being suppliers to healthcare systems towards becoming true partners. We have skills, expertise, and assets that we can bring to bear to help solve the NHS’ problems. My goal coming into the UK is really to keep us on the path to achieving that.”

Bringing pharma and the NHS together

Luckily, Peacock says that the foundations of this kind of thinking are there for MSD and the NHS to build upon, and he has seen “bright spots” in the health service where these kinds of partnerships already exist.

“The joint working opportunities in the NHS are fantastic – we can go into a meeting space with the NHS and clearly put on the table that we want to work together to solve a problem. That framework doesn’t really exist in most of the world; there is real intent for partnership here.”

Peacock adds that if the sector is to truly solve issues around achieving better patient outcomes, we will need more forums where we can bring together a multitude of partners.

“We have to bring in not just pharma and the NHS but also other industries and patient groups, and tackle problems in a systematic way. At the moment we tend to focus on a particular capacity constraint.”

He says that the patient voice in particular is central to this – especially when both health systems and pharma share the goal of saving and improving lives.

“I don't view our industry as majorly competitive because we're all aiming at that same goal. We may use different words, but we're completely aligned on it.

“The focus is on the patient, so we can't look at them in a detached manner – we have to actually engage and understand their circumstances, their wants and needs, and their environments. The only way that we can really do that is to directly engage with patient organisations.

“Ultimately, we want them to guide us. I think the NHS wants the same. We just have to figure out a way to connect all these pieces together.”

Peacock says enthusiasm for change from the NHS’ side can vary depending on where you look – although there are pockets of great progress.

“I have certainly talked to people in the NHS who are passionate, who are frustrated and, equally, are hopeful. The NHS is on its own journey, with its own long-term plan. I'm fully supportive of the efforts they've got underway, but it’s a large organisation to change. Getting people aligned, not just in their understanding, but also in their beliefs, is hard.”

And from MSD’s side of things, Peacock says that it is important the company considers how its internal structures and its employees can contribute to better collaboration.

“We need to make sure that we have the people, the mindsets, and the skillsets for collaboration, so that when we engage with the system, we're able to articulate the value that we bring in a way that is not seen as just being self-promotional. That takes time, though, because the reality is that it hasn't been the operating model for most of the industry’s lifespan.

“It will involve reviewing how we incentivise our people, how we recruit, and how we allow employees to get a broader perspective. Traditionally, people have focused their careers on one area, e.g. commercial, R&D, medical, etc. We need to look at how we can create opportunities for people to move across those boundaries.

“We’ll still need specialists, of course, but we also want generalists who have familiarity with different types of problems and how to solve them.”

Progress during COVID-19

In some ways, he says, the COVID-19 pandemic has set back this progress – and the industry will need to think about how it engages with the NHS to get them back on track – but in other ways, the crisis has accelerated such thinking.

“We’re certainly seeing more people looking at things from an end-to-end perspective. The crisis has forced the system to actually look holistically and break down some of the silos that exist within the NHS to drive better patient outcomes.

“When we were providing products that were needed in ICUs, the NHS was quickly able to break down barriers, work directly with us to source and supply from global outlets all over the world, and bring in the MHRA to provide regulatory support to enable products to flow directly into the country and straight into the hospitals. The speed at which we did that was astounding – things that would normally take us a year were happening within 48 hours.

“That shows the NHS can move rapidly when there's purpose. My hope is that we can build on these initial stages and make it real. We just don't want to go back to those old ways where it's committee after committee after committee.”

In general, though, Peacock says he remains excited about the future of the UK ecosystem.

“The UK has so many opportunities – a single health system, a single payer  environment, and an immense amount of data and scientific publications. All the pieces are in place now – we just need to look at how we can tie them together.

“People should feel positive. What we need to do now is help the people who have these dreams to realise a better future.”

About the interviewee

David Peacock is currently serving as the managing director for MSD in the UK and Ireland, having taken up his position in 2019. Prior to this David served as the chief of staff for the office of the chairman, president and CEO of Merck & Co. Over the course of his career with MSD David has gained a broad set of leadership experiences including serving as the CFO for MSK K.K. in Japan, leading the company’s business in Hong Kong & Macau, and successfully delivering in a variety of other commercial roles based in Japan, Vietnam, Singapore, and the United States.