RamaOnHealthcare August 26, 2022
Today, RamaOnHealthcare talks with Dr. George Magrath, the CEO of Lexitas, which holds ophthalmic clinical trials for drug companies. Dr. Magrath discusses emerging trends in clinical trials and ophthalmics and, as a vocal proponent of “pharma for good,” what needs to change in drug development.
Dr. George Magrath, CEO of Lexitas
RamaOnHealthcare (ROH): Tell me about your healthcare background and how this led you to become CEO of Lexitas.
Dr. George Magrath (GM): My path started at the Medical University of South Carolina, where I had an ophthalmology residency treating eye diseases in children. It was where I received an early – and stark – lesson about what can happen when treatment for a disease isn’t accessible.
At that time, eye cancer treatment wasn’t available in South Carolina. Patients were referred 650 miles away to Philadelphia. It’s an arduous process as the treatment can take years. I remember one mother who found the traveling too much to handle. I was later part of a surgical team that removed her child’s eye because there were no alternatives.
It inspired me to move to Philadelphia to learn the treatment from experts at the Wills Eye Hospital and bring it back home to South Carolina – which I did in 2016. The experience provided both business nous and medical training, as I also studied for an MBA and a master’s degree in Applied Economics during that time.
Later, I transitioned to the drug development space as Medical Director at Hovione, spending five years in dermatology, ophthalmology, and inhalation. I joined Lexitas as CEO 18 months ago, and during that time, our workforce and the number of clinical trials have tripled.
ROH: As well as your work with Lexitas, you still work “on the ground” in healthcare, treating patients with rare eye conditions every Friday. Why is this, and what does it give you?
GM: There are two reasons. First, and most importantly, I’m the only physician in South Carolina with fellowship training in treating cancers in and around the eye. I’ve been fortunate enough to learn how to treat people in a way most other medics cannot, and frankly, I don’t want to waste that.
Second, it has the added advantage of informing my work with Lexitas. It’s a role where medicine and finance come together, and I can maintain that marriage by seeing patients. If I weren’t seeing patients, I would become more removed from what’s happening “on the ground,” as you say. Many pharmaceutical leaders have medical backgrounds, and I recommend pursuing this hybrid approach. It reminds me why I went into the industry in the first place… and it’s rewarding!
If I weren’t seeing patients, I would become more removed from what’s happening ‘on the ground,’….
ROH: Lexitas is in the clinical trial space. What trends do you see currently emerging in this space?
GM: I think the future of clinical trials is becoming increasingly decentralized, which has significant benefits. I can see more trials being hosted on apps and avoiding the need to bring people to a medical facility. Tech firms are already developing this concept, where parents, for example, can take videos of their children on a tablet and send them to scientists for analysis using an app. This kind of innovation is a silver lining from the pandemic, which shocked the system in how we think about trials. It was a needed change anyway.
I think the future of clinical trials is becoming increasingly decentralized, which has significant benefits.
There is also a growing push for diversity in clinical trials. A recent congressionally mandated report found a “lack of representation in research is compounding disparities in health outcomes, with serious consequences for underrepresented groups and the nation as a whole.” Every clinical trial should look at the effect of a drug on every single ethnic group, age range, and socio-economic group. That’s what we are prioritizing at Lexitas. Trials should mirror the demographic of the USA as a minimum requirement.
Companies need to be proactive in ensuring all aspects of a trial are accessible, understandable, and relatable to different populations, so any person in the country can complete it. And it also comes down to company culture: employing other people from different backgrounds will offer different perspectives and feed into how clinical trials are carried out.
ROH: And on that note, what are the trends emerging in ophthalmics?
GM: There are two key trends: gene therapies for inherited retinal diseases which cause blindness and treatments for macular degeneration and diabetic eye disease. These are two leading causes of blindness in the US and the world. A lot is coming out in those areas in terms of therapeutics which will help people.
ROH: What are the challenges surrounding drug development in eye care?
GM: The research challenges have been around COVID. These populations, just like any clinical trial population, can often be vulnerable to infections. So, it has been a massive challenge to conduct clinical research during these times. We are starting to come out of that, but that has been the biggest challenge over the past few years – which links to my point about the growing decentralization of clinical trials.
We also see challenges with the nature of treatments. Many of them are focused on ultra-rare diseases that affect a small number of people worldwide. Within gene therapies, there may only be 200 people in the world with the specific genetic defect. There are operational challenges with identifying and locating these people, getting them to locations for treatment, and doing the follow-ups. It is an operational hurdle that companies must embrace.
ROH: Finally, you have spoken of the need for a “pharma for good” movement. What is this, and what could it achieve?
GM: There is a well-developed “tech for good” movement, so why not “pharma for good”? We need this because there are significant problems with the economics of drug development in the US, which results in many treatments not going to the market. The private sector is skewed towards profitable drugs, sometimes at the expense of other important programs. There needs to be better alignment in the development process, where the people who develop a drug get rewarded, the people who risk money with investment get rewarded, and the people who suffer from the medical condition get their treatment. Pharma for good would be a step in that direction.
There is a well-developed ‘tech for good’ movement, so why not ‘pharma for good’?
In its current form, pharma for good in the US manifests itself in government grants and funding from philanthropic foundations. This is not sustainable because it is very challenging for such an organization to fund a drug for the market. It’s often a case of getting to the 20-yard line but not scoring the goal. Put simply; the drug development system needs venture capitalists on board.
The system is unlikely to change. But what if we realigned our thinking within that system towards pharma for good? We need a movement of profit-orientated venture capital firms with an overall mission to achieve something more significant by investing in drug development. Being driven equally by profit and purpose is the way society will benefit.
About Dr. George Magrath
Dr. George Magrath, 38, is the CEO of Lexitas, a 140-person company that partners with pharmaceutical firms to develop novel eye care drugs by running clinical trials. Dr. Magrath is a trained ophthalmologist who, despite his busy day-to-day work leading Lexitas, still takes one day out every week to maintain his practice and treat patients with rare eye conditions. He is the only physician in his home state of South Carolina with fellowship training in treating cancers in and around the eye. He joined Lexitas as CEO in 2021, leading it from 45 employees to 140 and tripling the number of trials Lexitas is running at any time. He is certified by the National Association of Corporate Directors (NACD) and serves as an advisor or director to several companies.