The next era of healthcare is personal

For more than a century, medicine has largely followed a one-size-fits-all model—but that paradigm is beginning to break. On this episode of The McKinsey Podcast, Stéphane Bancel, CEO of Moderna, joins Eric Kutcher, McKinsey’s North America chair, to explore how mRNA technology is transforming healthcare. From the rapid development of COVID-19 vaccines to new approaches to rare genetic diseases and individualized cancer treatments, Bancel explains how treating biology as information could reshape how drugs are discovered, manufactured, and delivered.

In this recurring series, Eric speaks with top CEOs about the practice of leadership.

The McKinsey Podcast is cohosted by Lucia Rahilly and Roberta Fusaro.

To watch the full-length version of this interview, visit The McKinsey Podcast playlist on McKinsey’s YouTube channel.

The following transcript has been edited for clarity and length.

Necessity breeds innovation

Eric Kutcher: What was it like in that moment when the world was shut down and many of us were uncertain about how it would reopen? You were working on a solution that was going to allow us to go back to “normal,” although it may have become a new normal.

Stéphane Bancel: We focused on doing our jobs and working as quickly as we could to get an updated vaccine. We had done nine vaccines in the clinic before COVID happened, so we were already in mRNA technology.

When things transpired in May, we had our first clinical data. We showed a high level of antibodies, similar to what people had when they had a natural infection. So then, our main concern was how to scale up manufacturing, and get into phase three, which is a large 30,000-person safety study.

Eric Kutcher: What are the things that stuck from COVID until now?

Stéphane Bancel: You have to work in teams, including with regulators, governments, and doctors. Drug development takes over ten years to develop, and there’s a lot of wasted time across the system. You can project manage the whole process so that people understand all the moving pieces and help each other, which can save you a lot of time. We weren’t taking any risk on safety or efficacy.

How mRNA turns information into medicine

Eric Kutcher: You sit at the intersection of technology and biotechnology. Talk a little bit about what the company is and the role technology plays in what you’re doing.

Stéphane Bancel: mRNA is why I joined the founding team of Moderna. Everybody learned during COVID that mRNA is an information molecule. And if you think about life, life is basically the flow of information.

When you die, you still have information in your DNA. We can retrace DNA in bones of people who have been dead a long time. But to stop the flow of information is basically death in biology. This information-based molecule allows us to figure out how to make a drug at the fundamental level of information.

In the case of COVID, we made a vaccine that gives your body instructions and information on how to make antibodies to COVID, to protect you when you are infected. We’re doing something similar with cancer, where we try to give information to the immune system on what to look for, so it can go eat your cancer cells. It’s all about information.

Eric Kutcher: If it’s all information, how does the world now evolve? How did biotechnology work before you started thinking about it as information, and where does it go next?

Stéphane Bancel: The pharmaceutical drugs that have affected billions of people in the last 100 to 150 years came from what was essentially an analog world. You threw spaghetti on the wall, saw what stuck, and what worked, and then took those solutions to patients.

Now, with the sequencing of a human genome and more research happening in academic labs around the world, we are getting closer to understanding how the body works, similar to knowing how a computer or a car works.

There are still a lot of things we don’t know about the immune system, which is why cancer is not solved yet. We are still learning how the brain works, which is a very complex system. But there’s more and more biology, and rare genetic diseases are the best example: If I know which rare genetic disease you have, I can confirm that most of them can be drugged with today’s technology.

From one‑size‑fits‑all to made‑to‑measure care

Eric Kutcher: In the spirit of learning our way through this ecosystem, what does that mean for something like a cancer treatment going forward?

Stéphane Bancel: We know today that cancer is basically an instability of your DNA, either caused by a genetic mutation, or caused by a virus. An example of this would be hepatitis leading to liver cancer. Cancer can also be caused by an external factor. An example of this would be sun exposure into the DNA of your skin and therefore driving melanoma skin cancer. Basically, cancer is instability of human DNA. Even if you are healthy, you have instability all the time. We all have instability all our lives. However, if your immune system is healthy, then you’re going to recognize that first precancer cell and you will “eat” it like Pac-Man so it doesn’t become a tumor. But if your immune system misses it, it becomes two cells, four cells, and you start to see a tumor growing.

One of the things we are doing at Moderna using mRNA technology is designing customized, individualized medicine. If you and I are diagnosed by the same doctor in the same hospital on the same day with skin cancer, we will now make a drug for you and a different drug for me. The drugs will be chemically different.

Eric Kutcher: How far are we until we’ll be able to get that to happen? Immunotherapy, is that the term that people use?

Stéphane Bancel: Correct. It’s immunotherapy. It’s how you use your immune system as a therapy, as a medicine, to go eat your cancer. What we shared in January of this year is five-year survival data using our individualized technology.

We’ve shown a 50 percent improvement standard of care, and later this year, we should have the Phase III data, which would allow us to file to the FDA for approval. So, we’re currently expecting a 2027 launch of this product, meaning patients will have access to that medicine most probably next year.

Eric Kutcher: What you’re highlighting is that we’re now approaching the end of average, where you can treat every individual, their DNA, and their unique health challenges based on all that information together.

Stéphane Bancel: Correct. Because as I just mentioned, cancer is an instability of your DNA. The way we have historically developed medicine is that everyone gets the same medicine. For some diseases, it works because the mechanism of a disease is the same in your body or in my body. But in some diseases like cancer, because it’s an instability of DNA in your body and in my body, we need different solutions.

How drug discovery changes

Eric Kutcher: What does that mean in terms of drug discovery and the way we do clinical trials?

Stéphane Bancel: Everything changes. In the past, you basically got an approval for a drug. In this case we had to go to the FDA and other regulators around the world. The process we’re following is the approval of a manufacturing process, where I have to prove to a regulator that every time I get the same input, the same information about somebody’s DNA, they get the same output, the same medicine. But when every medicine is different, I cannot get the drug approved because the drug for you and the drug for me would be different chemical inputs.

Eric Kutcher: In this pathway going forward, how do you avoid missteps to get the benefits that you’re describing?

Stéphane Bancel: We test in a very large clinical study. The Phase III study is more than 1,000 people with melanoma disease. We randomize it against standard of care, which is Keytruda alone. It’s how we prove both the safety and the efficacy of a treatment like the old method. The only difference is that instead of having one molecule approved, I’m getting a new process approved.

Prevention, screening, and the real cost of care

Eric Kutcher: Unsurprisingly, the other thing that you hear about all the time is the cost of healthcare. Obviously, medicines are a nontrivial portion of that cost. How do we think about the cost of the way we did things in the past versus the cost of what you’re describing as where we’re heading?

Stéphane Bancel: The cost of medicine is 10 percent of the cost of care. And the other piece for me is that we understand how the body works. How do we also invest, as a society, in prevention and screening?

Let’s go back to our discussion about cancer, because everybody’s interested in cancer. The best thing I can do to prevent cancer is eat the right food and exercise. I must sleep enough because my immune system gets reset—gets restored—during my sleep. So, if I don’t sleep well, I won’t have a strong immune system. All those things are important to prevent disease.

Then there is screening. As we all know, detecting cancer in stage one of the disease, when it’s very early, increases the odds and thus reduces the cost of treatment.

So how do we deploy cancer screenings at large scale? If every treatment is customized for you, the price tag might be higher but you will have a much better outcome and less side effects, because you don’t waste the cost of a drug that is not tailored to you. When you get immunotherapy today, five years out from the start of treatment, only 50 percent of patients have responded well. If you think of it from a cost standpoint, half of the cost of a drug went into the garbage.

Eric Kutcher: Not to mention all the treatment that happens afterward.

Stéphane Bancel: And the hospital costs. Exactly.

Eric Kutcher: Makes total sense.

Stéphane Bancel: Let’s go back to the car analogy. If you do good maintenance on your car, it can drive for a very long time. If you don’t change the oil, if you push the car all the time and you go fast when the engine is cold, you can damage your car.

Eric Kutcher: You and I talked a little bit about the whole premise of longevity and personal care. About 18 months ago, I started to get into this more. I’m not always perfect about it, but I wear multiple devices to monitor my health. And it is remarkable to see how your body reacts to everything, depending on the state it’s in.

If I don’t sleep enough, I watch the way my body reacts to certain foods in a way that it wouldn’t ordinarily. It really supports your points around preventative care. And what you’re saying is that prevention doesn’t always work.

Stéphane Bancel: Correct. And what you just said really confirms that biology is an information-based science. It’s only information.

Investing in mRNA

Eric Kutcher: Let’s talk about Moderna’s role in this evolution of the biotech and life sciences space.

Stéphane Bancel: Before the pandemic, we believed Moderna could build a platform that had a lot of different verticals, which are applications like vaccines, cancer, rare genetic diseases, lung disease, and so on.

What we were trying to do as a company was to increase the span of that platform. Once we get a certain drug therapy to work once, we can make many more types of medicines because it then becomes copy and paste. You just change the genetic information, as we did with COVID, and you have another medicine. So that’s where we are as a company.

If you look at the company today, we have three approved products. We have two more under review by the regulators as we speak: a flu vaccine and a flu-plus-COVID combo in a single shot.

And then in Phase III, we are working on a rare genetic disease where children are missing information in the DNA of their liver cells. There is a lot of acid accumulation and brain damage because of that disease. We are working on cancer, as we just spoke about. And we’re also starting to work with autoimmune disease. We are trying to increase what the platform can do to really be able to bring medicines to patients very quickly, because the big advantage we have is a manufacturing advantage.

We make all mRNAs in the same reactor with the same recipe, because you just change the order of the letters to get information outputs. You will be able to produce things very quickly. We have not talked about it enough, but the reason we were able to move so fast during the pandemic is because we did not have to invent the manufacturing process.

Eric Kutcher: One of the things that is very prescient in the moment is this question of manufacturing. What impact does location have on your ability to move quickly?

Stéphane Bancel: We have been US-based since day one. We have recently built factories in Canada, the UK, and Australia, because those governments wanted on-the-ground independence. Those countries basically entered into long-term agreements—almost ten-year supply agreements—where we build the factory, we pay for it, and we run it.

It’s a service-type business model where every year they committed to a certain number of doses. Every year, they can change the mix because, for us, the manufacturing process is the same. They’re basically receiving a tool that’s able to be adaptable year by year based on which virus is more prevalent in their country. If, God forbid, there’s a new pandemic, they could ask us right away to switch any amount of capacity toward that new pathogen.

Eric Kutcher: You can change the lines of the manufacturing because, as you point out, you’re just changing letters. How micro can you get in the process and still be effective and efficient?

Stéphane Bancel: We can go as micro as we want. If you think about it, individualized cancer treatment is very micro because we literally shrunk everything down. So, I make a product for you. And then once we clear out all the small reactors in the robot, we make a product for me.

How AI is affecting Moderna

Eric Kutcher: It’s pretty remarkable to think about where AI is going and the implication it can have. Describe some of the ways AI has impacted where you’ve gotten to and where you see it helping as you go forward.

Stéphane Bancel: Even though we’ve implemented a lot of AI since 2017, the impact is still tiny compared to what’s coming. I think there are two big buckets of value. One is on the discovery front by inventing new medicines in-house. What we’re trying to create there is a feedback loop where we have experiments run by robots, where all the new lipids are being tested in cells and animals. And when the data goes back into an AI system to iterate the next set of experiments, to keep learning as a flywheel, it will be able to expand the size of the operating system of Moderna.

The back end, which is when you have a drug and you say, “I want to test this drug in the clinic,” this is usually the ten-year development timeline of a drug. A lot of this time is dead time. What we’re trying to do there is apply AI, whether it’s GPTs or using vibe coding, to be able to create new apps to tie the business together and remove all the air gaps. It’s hard for me to tell you that in three or five years we are going to reduce drug development time by 30, 50, or even 70 percent, because we have not mapped it process by process. It’s going to be extremely significant because most of the time it’s not used for clinical trials.

Eric Kutcher: You described the way AI will impact the core R&D, but what about the rest of the business? How do you think about it from a sales or finance point of view?

Stéphane Bancel: What we do is typical for what you see in our industries. The sales team is working with AI to increase customer product adoption and to be closer to feedback on new products. Our HR team uses a lot of GPTs to help streamline things, whether it’s performance management, benefits, communicating world matters, or all those things that you see across industries.

We’re not smarter than other people. We’re just trying to think about how to reduce the air gaps, enable the users to access data, and talk to data. It’s a bit like an airline making me check in online. If I’m happy, they’re happy. It is the same kind of mindset.

In manufacturing, AI is helping us a lot in robotics. I think a lot of people in service industries do not appreciate how much the world of robotics is changing and is going to change because of AI. And one of the things they’re saying to do is to use AI to allow us to deploy robots faster.

Eric Kutcher: What is it about the physical AI that enables you to do more, differently?

Stéphane Bancel: If you look at most industries, many deviations that are being reported were human errors. If you can remove those from the business, not only do you improve quality, but you save costs and time, your customers are happier, and you are less out of stock.

There’s huge value in driving recurring deviation and errors out of a system. If you’re able to deploy robots, you can have those robots being taught by the user closest to the use case. In the old days, you needed to have engineers deploy robots. Now, AI is basically this interface that you talk to, and the AI system basically transcribes and codes the robots or the task. You save a lot of time, and you reduce the cost of deploying the robot this way. And then when you start to have robots learning from each other or doing the same processes, you really fly.

Challenging established business processes

Eric Kutcher: One of the things I’m always fascinated about is culture and org, and I think that’s particularly important in the moment. How does your organization look different relative to what most biotech or most life science organizations look like?

Stéphane Bancel: I think there are two examples. One is the platform. We believe mRNA is really unlocking what should be dozens and dozens of medicines coming from that information platform. We have a team of over 150 scientists whose only job is to invent methods to increase the surface area of what the platform can do. They’re not focusing on drugs. They’re focusing on mRNA technologies to increase the world of possibility. The second piece is we combine HR and digital, so my head of HR is also my head of digital.

Eric Kutcher: Fascinating.

Stéphane Bancel: We believe that in today’s world with AI and robotics, the key change of our organization is to reinvent work. We want to be able to go back to business processes across the organization and say, “Okay, what work has to be accomplished to drive value for customers?”

Then we can work backward from, “If you’re AI-centric and robotic-centric first, how will you design the work? What’s the role of software? What’s the role of GPTs? What’s the role of robotics? What’s the role of the human in that world system?”

Eric Kutcher: The design of what you’re creating makes sense. If I were to look in the organization and I compared you to your favorite competitor, what is it that looks different?

Stéphane Bancel: The speed at which we can learn is different. Our feedback loop is very quick. If you go back to the platform—the basic mRNA science—the feedback loop is so fast that sometimes in two to three months, we’ve invented a whole new category of medicine. Usually what will take you five or ten years in pharma happens in a matter of months. So it’s just a different scale and pace of learning.

A faster, more predictable drug pipeline

Eric Kutcher: What will drug discovery and, frankly, drug manufacturing look like a decade from now?

Stéphane Bancel: I think two big variables will change profoundly. One is time. The time it takes to develop a drug will shrink. As I said, I don’t know if it’s going to be from ten years to five years, from ten years to six or four years. But it’s going to shrink in a very profound way, meaning the drugs will come faster to the clinic. This also means they’re going to be less expensive to develop.

The second piece is probability of success. As you know, a drug that enters the clinic today for a Phase I study has a 10 percent chance of getting approved. If you look at Moderna’s track record, we are more than 60 to 70 percent. This is because we’re information based.

I think that number is going to get better as we keep on learning. The industry will also get higher. If you combine much shorter development time and a much higher chance of working outcomes, the impact on patients with the number of medicines coming is going to be very different.

Why talent still trumps tech

Eric Kutcher: Is there anything that you wish you knew that could have changed your direction as a leader?

Stéphane Bancel: I think the importance of people and teams is really something that determines the trajectory of an enterprise. At the end of the day, we started with nothing and now we’re this company that has 25, 30 drugs in the clinic.

It’s making sure that the people we hire, we ensure we have the right cultural fit over time, and that we are disciplined to sometimes not fill a job when there’s urgency. If you put in a candidate that is good but not amazing, over time you pay dividends for that. I think that I would want to tell my younger self to pay attention to the people. Make sure that you keep a high bar, and don’t confuse quality and speed.

A legacy defined by patients, not products

Eric Kutcher: This is an unfair question because, as Oprah Winfrey taught many of us inside the firm, you don’t actually get to define your legacy. Rather, your legacy is the interactions you have with everyone every day. If you could paint the picture of what your legacy would be from this role and this company, how would you paint that?

Stéphane Bancel: Outside the company, it’s really about the medicines we’re bringing to the world. That’s the only thing I really care about. If we can make a big dent on cancer and a big dent on autoimmune disease, help kids that have rare genetic diseases that have no hope today, continue to prevent disease through vaccines or prevent people going to the hospital, that would be an amazing legacy.

Internally for me, it’s about how I make sure when the day comes that I’m not around, that people stay as passionate about our patients. That the fight stays a very personal fight. And that the culture remains where every day matters—because if somebody is going to be waiting for a drug on any day, we will not have done our best work.