Bold Advances in Healthcare

Exact Sciences is a US molecular diagnostics company that develops tests to support patients before, during, and after diagnosis. The company is best known for Cologuard, its innovative at-home product for detecting colorectal cancer. The company’s bold approach to cancer detection has helped to dramatically expand the number of screenings for this deadly disease.

In this interview, Chief Commercial Officer Everett Cunningham sits down with BCG’s Torben Danger to explain how Exact Sciences addresses the challenges of spreading colon cancer awareness and ensuring that its products are available to all populations. They also discuss Exact Sciences’ approach to diversity and inclusion, as well as the macroeconomic challenges companies are facing today.

Edited excerpts of Danger’s conversation with Cunningham follow.

What has been your biggest challenge at Exact Sciences so far, and how have you addressed it?

Cunningham: The biggest challenge in the colorectal cancer screening space is twofold. First, it's habit that people think the only option out there is colonoscopy, and that's not the case today. The second challenge is just the nature of colorectal cancer. A lot of times in the early stages, it's asymptomatic. People think that if I'm not bleeding, then there's no real reason for me to go and get screened for colorectal cancer, and that's not the case. If you're 45 years old or older and of average risk, you need to get screened. Asymptomatic, no familial history, you need to get screened, and it's an urgent thing. And how do you create that sense of urgency for people?

When you talk about colorectal cancer screening, what are the obstacles you see when it comes to health equity and how do you overcome them?

Cunningham: We just formed a team about a year and a half ago whose major remit, every single day, is making sure that our products are available regardless of the zip code you come from, regardless of what you think about screening and wellness. Maybe it's not in your culture.

Our health equity team goes into vulnerable zip codes and populations and makes that top of mind. Whether it's through making sure our products are covered from a Medicaid, Medicare, commercial standpoint, we have great coverage with our products. Whether it's making sure our marketing materials are in different languages, whether we need to say things differently in different cultures—that is top of mind for us.

I spent a day on Capitol Hill talking to different legislators about March, which is Colorectal Cancer Awareness Month. We want to partner with legislators and go to vulnerable populations with the message that getting screened is so important. That message has to be explicit. It has to be in our yearly operating plan that we're going to have a very pinpointed, targeted strategy for vulnerable populations.

Which progress around diversity and inclusion have you seen in the health care industry? Where do you see the biggest gaps, and how would you address those?

Cunningham: I wouldn't be sitting here if it wasn't a strategy, a passion for medtech health care, to really think about diversity and give people opportunities for different roles within health care. I'm happy that we're making progress and strides to making this top of mind, but we're not making strides fast enough.

Our female population [at Exact Sciences] is about 58%. Our non-white population overall is about 28%. So, we're making strides and getting better every single year. But if you go to the director level and above, that drops. We need to be really intentional about how we make diversity and inclusion and equity part of the business strategy. My tagline that I always say to our organization, or any organization that I'm from, is we should look like our customers. Our customers used to call it the quadruple aim, now they call it the quintuple aim because they've added in health equity and diversity and inclusion.

There are significant macroeconomic challenges all over the world. How do you and how does Exact Sciences build the resilience it needs as a company to deal with this increasing speed of disruption?

Cunningham: First, the way we run our business, and Kevin Conroy, our CEO and chairman of the board, is leading the charge in terms of we at Exact Sciences, we have to be more disciplined in our investments. We can’t have a scattershot approach, trying to do a thousand things to eradicate cancer and the suffering that it causes.

In addition, we must become profitable as a company now. To do that, we’ve got to make sure that the money that we spend has the right return on investment. So, as the chief commercial officer, how do I create leverage? Either how do I grow our products and grow them faster, or how can I grow more with less? I'm pleased to say that our growth with Cologuard has been tremendous this year, and we've done it by spending wisely.

The second piece is the fact that cancer doesn't go away. We still have to be that company that's out there supporting our customers, and we have to do it more productively, more wisely. So how can we provide the same solutions to our customers, knowing that their profitability is challenged? We can't just simply say, well, okay, we can't partner with them. We provide very economically smart solutions for cancer care—that's what our goal is.