Lilly's Bridge Builder, From Indiana To South Africa
Executive Summary
Rising Leader Christopher Jon Stokes of Eli Lilly explains how some early life lessons in the restorative powers of community has guided a distinctive career path marked by engaging widely, understanding intuitively and listening actively, all in the pursuit of forging productive human connections that strive to “meet the moment” for patients.
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For Rising Leader Christopher Stokes, early exposure to the community of the unwell has shaped every aspect of his personal and professional life. It all began as a pre-teen in the midwestern manufacturing town of Canton, Ohio, when his father was diagnosed with lupus, a debilitating auto-immune condition that can persist for years and is characterized by sharply reduced quality of life, for victims and care-givers alike.
“My father’s condition deteriorated over time, and I often found him laid up in the hospital at some of the most important times of my youth. When he finally passed at the age of 46, I was a rising senior in high school – old enough to understand the disease had stolen from me that most vital of all relationships yet for no reason that anyone could explain to me, because lupus – still, even today – has no cure.”
Stokes relates how his close-knit neighborhood of extended family and friends struggled to cope with his father’s condition and the support that network provided as he sought to find his own way forward after the loss. “How do you survive the loss of a parent at a young age? For me, it came from being the product of a place like Canton, where community sentiment is strong. The truth is people in Canton really came around for me. I owe them to this day. I’m motivated to add to that sense of community in everything I do, whether it is work or personal – to be a contributor, not just a consumer, of the great things that can happen when people think of others first.”
Early Life Lessons: That Human Bridge Called Community
Unusual for an experienced player in an industry fixated on facts and numbers, Stokes told In Vivo he found his life purpose in an early 20th century American fable titled “The Bridge Builder.” The poem recounts the story of an anonymous old man who spent his waning days constructing a bridge across a river chasm that had proved an obstacle, not only for him but for many others over the course of his life. When asked why, the old man spoke of the promise such a bridge would hold, not for him, but for the young people making that same crossing after he was gone. “It’s a moral tale about venturing beyond narrow self-interest to ease the path for the next generation,” said Stokes. “What I am today is the product of that way of thinking. Everything I do is focused on building links among people and communities that expand human potential, whether it be at home or at work.”
The early chapters of Stokes’ career proved rich with opportunities to serve, observe, and assess the ways communities influence how things get done. After receiving an advanced degree from the Indiana University School of Public and Environmental Affairs, Stokes took a position at a consultancy helping Indiana municipalities locate financing for infrastructure projects, from schools to roads. But his ambitions soon took him to Washington, D.C. where relationships are defined in a near tribal hierarchy of affiliations and interests. Stokes academic background in public policy combined with his father’s experience as a patient led him to health care and a position as a sales rep for.
ELI LILLY'S CHRISTOPHER STOKES
“Detailing drugs to busy physicians was character-building, to say the least. There is a lot of rejection that comes in sales. I found the best approach to counter that was understanding the community that underpins each medical practice. In addition to being technically competent, I saw that success in my job depended on figuring out how to educate physicians in a way that connected with the diversity of patients I observed as I was sitting in their waiting rooms. It was important for me to always be ‘in the moment,’ responding to the cues of others rather than just showing up as a visitor with a fixed pitch.”
The inner resourcefulness Stokes had to tap after his father’s death also helped him navigate more challenging assignments after he joined Eli Lilly and Company in 2008, as a US public policy analyst based at company HQ in Indianapolis. Lilly’s midwestern culture was different than Pfizer’s big city vibe, but Stokes contends that what is needed to prevail in any big pharma today is still pretty much the same as what worked back on the streets of Canton, Ohio.
“Two habits I drew from the home front helped ease the transition to a HQ role at a major multinational corporation. First up was being humble and avoiding hubris in interacting with the many smart people out there just ready to compete and, if necessary, take your place when you stumble,” he said. “Acting as the resident know-it-all is treacherous because big organizations are complex, with many moving parts; individuals rarely have the capacity to control events alone or predetermine an outcome.
“Second, it follows that you need to be at the top of your game as a team player,” Stokes continued. “Growing up as one of 42 grandkids from my father’s side of the family alone, I learned that lesson early: finding your way forward in the group means brushing off those bruised elbows while never stealing the limelight from everyone else. Success must be shared and the ritual ‘taking one for the team’ is an inevitable part of the process of getting ahead.”
On an individual level, Stokes cites the power of mentorship as another critical driver in his professional development. One key mentor was Kraig Kinchen, a Harvard Medical School graduate who now helps direct Lilly’s diabetes franchise but at the time Stokes met him was charged with building the company’s health information technology capabilities as a member of the company’s global public policy team.
Stokes noted, “he taught me something fundamental: how to present effectively to senior management and to develop my writing style so that it was crisp, clear and connected to exactly what these people needed to know to expedite good decisions. Who would have thought? The time and effort he expended developing me as a manager is probably the best thing that has happened to me at Lilly. I could not have planned it any better – yet the circumstances of our connecting was sheer luck. The experience proves the point that success is rarely achieved though siloed, solitary pursuit. It’s the community of others that brings you along.”
Opportunity Knocks: Lilly’s Go-To On Obamacare
Good fortune also intervened when then-President Barack Obama introduced his 2010 Affordable Care Act (ACA) overhauling the way medicines were regulated and reimbursed. Suddenly, expertise in the complexities of drug pricing became a priority for big pharma – and Stokes was ready to serve as the man of the moment. “The Administration and Congress were literally restructuring nearly 20% of US GDP – it fell to big pharma players like Lilly to decide what its place in the new order would be. This gave me an opportunity to apply my public policy and payer finance background as well as my direct knowledge of the industry’s commercial sales model to help find the best landing for patients to access Lilly medicines under the new regime.”
Stokes carved out a role as a subject matter expert on the 900-page ACA and its more than 13,000 pages of implementing regulations, which led to him chairing Lilly’s internal cross-functional US Healthcare Reform Steering Committee. In addition to educating Lilly’s senior management in evaluating options and scenarios to guide business strategy going forward, he spent countless hours with individual brand managers to find a clear path forward to position Lilly for success in a fast-changing patient landscape. He also personally reached out to dozens of external stakeholders affected by the legislation, sharing Lilly’s interpretations with influential third-party payers like the major health insurers and PBMs as well as patient advocates.
“In many ways, I took the road less travelled by focusing so heavily on outside audiences that weren’t the traditional go-to-see targets for big pharma, yet in the new order introduced through Obamacare it proved a game-changer in advancing my career,” Stokes told In Vivo. “I developed a broad, cross-stakeholder perspective on policy that, at the time, was frankly unique for an industry whose historic focus was on the physician. I really helped guide Lilly’s future as a more globally integrated business, centered on the patient.”
“I developed a broad, cross-stakeholder perspective on policy that, at the time, was frankly unique for an industry whose historic focus was on the physician. I really helped guide Lilly’s future as a more globally integrated business, centered on the patient.”
Having mastered the patient playbook on health care reform, his next career move was applying those learnings to the new product launch cycle and the commercial re-positioning of some iconic Lilly brands. In the latter case, Stokes was assigned in 2013 the task of reviewing the patient financing and reimbursement profile for one of Lilly’s key drugs in the PDE inhibitor class. “It was the 10th anniversary of the launch of the product and it was clear we needed to take the franchise in a direction more aligned with the evolving patient experience in using the drug. Relying on my expertise in access and reimbursement, I helped the commercial team restructure the product’s prescription co-pay and savings card to link it more directly to the new patient point of-care cost-sharing opportunities introduced because of the reform legislation.” Stokes offers that, once again, his ability to trace the ripple effects caused by the ACA through the entire patient journey in health care helped Lilly do more than just react to change, but to shape it.
Stokes later took an assignment as senior sales director in the specialty neurosciences franchise. His responsibilities included building the sales team for launch of a novel CGRP-antagonist in Lilly’s home state of Indiana. Much of his efforts were directed to educating a new class of science-driven sales representative able to give physicians more insights on using the drug to relieve migraine and its many quality-of-life side-effects, thus improving patient outcomes at a level sufficient to justify its high-touch biologic price. Says Stokes about the October 2018 roll out of the drug, “this is where I learned that technical knowledge and a strong, evidence-driven value proposition had become the new benchmark for a successful drug launch.”
Into The Breach On COVID-19
Stokes found himself on the cusp of another dramatic transition after being asked to serve in a senior administrative role as Chief Operations Officer (COO) for Lilly’s US business. Stokes assumed the post in February 2020; one month later came Covid-19.
“I knew immediately that the world as we knew it had changed. We had to make quick decisions that impacted the entire organization, including not only our employees, families and contractors but members of Lilly’s extended community of stakeholders across the country. With our field-facing teams, I had to find appropriate ways to keep them safe while continuing to educate customers and ensure our products received that extra level of support required in the midst of a public health emergency.”
Notable was that none of this was in the COO’s job description. In large, diversified organizations the COO role is to be a listening post, a mediator and a team builder; the aim is to facilitate consensus among the group, not to dictate or impose a single perspective. “Any COO will run into trouble if he or she just caters to the C-suite and doesn’t constantly take the pulse of those who work in the trenches. I plunged into the fray by once again applying those learned attributes of community engagement: to consult, to combine facts and data with the art of human persuasion, and – most important, in the face of a fast-moving situation with no set precedents – to run good meetings. Where things got done.”
Stokes continues, “the latter is not always easy in big organizations that attract lots of talented, ambitious people, but the pandemic offered me that special opportunity that stems from crisis. Our minds were concentrated; I didn’t have to beat the drum; we all knew that time was of the essence. My contribution was to ensure every encounter that I chaired had a clear purpose and a transparent agenda; I prodded myself to pursue active listening and the solicitation of contrasting viewpoints; to make sure that our team objectives were clearly identified and that every team member knew what was expected of them; and that we all had each other’s back.”
Collectively, their work helped ensure Lilly was able to keep pace with the changing contours of the virus, especially in those uncertain early months of the pandemic.
Find out who else made the list for 2022's top 30 Rising Leaders.
On To South Africa – And Points East
In November 2020, with adjustment to a pandemic-laced business cycle well in hand, Stokes began a new career chapter, moving out to the field as General Manager for Lilly’s South Africa affiliate, which also includes supervising operations for all other countries in sub-Saharan Africa. Given the nature of the region, the assignment represents yet another opportunity for Stokes to apply his policy and community-building skills in places where the infrastructure for doing business is still developing and where market success depends heavily on the “situational awareness” that comes from respectful personal relationships and accurate assessment of the local political landscape.
It also offers the chance for Stokes to shine in a region that Lilly, more than most US big pharma, sees as a bona fide long-term growth opportunity for the business. An optimist himself, Stokes points to Africa’s status as host to the world’s youngest and fastest growing population, with a significant incidence of chronic diseases that currently are not being treated. In fact, South Africa has been selected by Lilly HQ as one of four emerging country markets – including India, Brazil, and Mexico – to serve as proving ground for innovative business partnerships to treat non-communicable diseases (NCD) with a significant impact on public health.
Stokes set two early priorities for the South African business under his watch. First was bringing the fruits of Lilly’s drug research pipeline to patients in South Africa. “When I arrived, we had five new products here ready to launch, so the immediate priority was to be sure we had the competencies to effectively launch and then educate our customers in a manner that was both compliant with the law and responsive to medical need.”
“Beyond that, I initiated an ongoing review of operations to enable us to prioritize and identify any gaps in resources so that what we do is fully aligned to the expectations of South African patients and providers. This has resulted in a real operational shift that I would summarize as embedding a ‘listening to the customer’ mindset in the culture of the company. As a single corporate subsidiary, we could not do everything – so the benchmark going forward has to be doing better at finding the right mix of what’s most important to the people in the country we serve. Two years in, I think we’ve come far toward meeting that goal.”
Stokes’ second priority is a logical extension of the first: talent development. As GM, Stokes presides over a tight operation. “We have a little more than 60 staff working in South Africa in core functions like sales, marketing, regulatory affairs and compliance, finance and HR. So being a ‘force multiplier’ is a necessity.” Expanding the local skills base and encouraging staff to accept short-term development assignments has been high on his to do list. Harking back to his own experience in Indianapolis, Stokes has also established an affiliate mentoring program where staff are matched with someone more senior who can help them grow into their career areas of interest.
“The importance of building out our human capital immediately became clear when I arrived and we had to gear up for the successive launches of multiple new products – normally for a subsidiary like Lilly South Africa, a new product introduction might take place once every few years.” Stokes is insistent that his affiliate be ready and prepared for handling any of the innovations that spring from Lilly’s R&D pipeline, now judged by some observers as one of the industry’s best. “My agenda is pretty simple: when Lilly South Africa decides to put boots to the ground, it’s for the sole purpose of reaching out to more African patients who can benefit from our medicines,” he explained.
“My agenda is pretty simple: when Lilly South Africa decides to put boots to the ground, it’s for the sole purpose of reaching out to more African patients who can benefit from our medicines.”
Stokes prior background in public policy has encouraged him to use his position as regional GM to dialogue with the government, legislators and the NGO community. “I’ve reached out to express a willingness to partner with these stakeholders on issues that have caused divisions with the industry in the past. What I tell them is that I measure my own performance as head of the local business on the number of patients Lilly can help in South Africa and the region at large,” he said. “My goal is for Lilly to be seen in South Africa as a good collaborator with the government and as an advocate for values centered on the patient experience, including access to the medicines most appropriate to their conditions.”
A global pandemic has complicated the sensitive issue of access to medicines in a region where use of modern drug therapies is quite low in comparison to the rest of the world. Nevertheless, Stokes told In Vivo that the South African government and other constituencies he has met throughout the country are open to discussing collaboration with multinational drug companies. “As Lilly’s local representative, I’ve felt more than welcome. The government representatives listen and asks good questions. I always keep my eye on the historical context, from an African point of view; listen carefully; assess without presuming motive; and take care not to over-commit.”
What’s next for Stokes? Is there a plan to build that imagined bridge to ease the path of strivers to come, for a larger community beyond those familial roots in the “rust belt” Midwest? More directly, where does this 43-year-old In Vivo Rising Leader expect to be in five years?
Stokes explained that “it remains a personal mission of mine to build bridges, even more now that I have witnessed the lived community experience of another country than my own. The potential to create relationships that improve lives is greater and for that reason I see myself continuing to work for Lilly in the international arena. In fact, I believe Lilly will only remain an exceptional company and employer if we continue to bring forward leaders able to operate effectively across the globe. That gives me a good reason to continue learning new ways to build those bridges beyond the Indianapolis HQ.”
Nevertheless, his roots in the US remain deep. “I still consider Indiana near to my heart and my community affiliations are a key part of who I am today. For example, my wife and I are proud of the Rophe Community Health Clinic we co-founded in 2018 along with a Lilly retiree and pharmacist, Curtis McManus, as a free non-profit service for patients in Indianapolis’ low-income neighborhoods. Helping build these institutional solutions in healthcare means that that I expect to return to Lilly’s home base eventually.”
Right now, however, Lilly management has other things in mind. Stokes tells In Vivo that he has just been offered a new role as Lilly’s General Manager in South Korea and plans to start there in the next few months. “It’s a chance to learn more about another key market critical to Lilly’s future as a fully engaged global enterprise,” he enthused. “I love working around siloes that keep us from the patients we serve – internationally, addressing that tends to come with the territory.”