The next wave of cancer care
Icon Group is the first Australian healthcare company to export Australian cancer expertise into China where cancer incidence is expected to increase by 70% by 2025. We talk to Cathie Reid, Grop Co-Founder, about starting out, tackling $35 million debt to build a $1 billion business, and how experience delivering cancer care into regional Queensland set up Icon up to break into Asia.
Without a cure, as yet, cancer is very much a part of many people’s lives. According to Cancer Australia, one out of every two Aussie men and women will be diagnosed with cancer in their lifetime. Fortunately, Australia’s healthcare system is in pretty good shape, and the chance of Aussies surviving at least five years post diagnosis is around 69%. For those in other countries, like China, with a population of 1.4 billion – that’s almost 20% of the global population – the number of people requiring cancer care is significant, and, unfortunately, on the rise.
Brisbane businesswoman Cathie Reid co-founded Icon Group, Australia’s largest and fastest growing provider of integrated cancer care services, encompassing medical oncology, radiation oncology, pharmacy services and chemotherapy compounding services.
In September 2017, Icon Group was valued at $1 billion and has grown substantially since that point, increasing its reach into New Zealand, China and South East Asia and became the first Aussie healthcare company to export Australia’s world-class cancer care expertise and technology into China. The group now employs more than 3,000 staff across more than 36 sites, and now impacts more than 2 million cancer patients each year.
After selling part of the business, self-confessed “tech geek at heart” Cathie’s role is now Digital Advisor to the Board. How, though, did Icon – which stands for Integrated Clinical Oncology Network – come to be? Well, it very nearly didn’t.
Rewind to the mid 1980s, country Victoria, and 16-year-old Cathie Reid was stacking nappies at her local pharmacy with no ambition to become a pharmacist whatsoever. “I was a very good typing student,” tells Cathie, who submitted her Grade 11 subject preferences to major in Typing, but noticed that had changed to Chemistry when she commenced Grade 11. “I went to work that night and told my boss how weird it was, and he said, ‘Oh yeah, I organised that.’” It turns out Cathie’s boss was also best mates with her school coordinator, and had changed her major without discussing it with Cathie or her parents.
“That literally changed the course of my life,” says Cathie. “By the time I actually finished grade 12, he had me fully brainwashed; I was going to be a pharmacist.” Cathie studied at the Victorian College of Pharmacy (which later merged with Monash University) where she met her future husband, business partner and “secret weapon” Stuart Giles, though they wouldn’t connect as more than acquaintances for some seven years after graduation.
Cathie had actually married her high school sweetheart post-uni graduation, “who turned out not to be such a sweetheart”. That marriage breakdown was another significant moment in Cathie’s life. “I got a stark reality check that life doesn’t always go to plan, that taking the conservative pathway doesn’t always deliver the outcome you think it will,” says Cathie. “It disrupted my personal risk profile.”
“I got a stark reality check that life doesn’t always go to plan, that taking the conservative pathway doesn’t always deliver the outcome you think it will.”
Cathie says she became more willing to seize the day, to take risk. When she met Stuart Giles again, in 1998, at a mutual friend’s birthday party, they clicked. Stuart was playing professional cricket in UK during the northern summer, and returning to Australia for the southern summer to work. Cathie by that stage had identified opportunity in the aged care and private hospital pharmacy markets created by changed accreditation standards, and shared her idea with Stuart.
Three months after meeting, Cathie and Stuart got engaged. Five days after getting engaged, they settled on their first pharmacy; and purchased another three pharmacies within three months.
“At that time, it was very unusual for people to own pharmacies in multiple states,” says Cathie, whose first four pharmacies were in Melbourne, Sydney, Brisbane and Sunshine Coast.
“We looked for very cheap pharmacies, strategically located near arterial roads, as we didn’t want ones with strong passing retail trade. Our customers essentially never came into the physical pharmacy, we went to them – our couriers were on the road constantly.”
The business, APHS (which was rebranded to Epic Pharmacy in 2014), experienced significant growth until 2007 when Cathie’s largest customer moved their pharmacy services in-house. “We were going to lose 60% of our revenue and profitability as that client’s contracts expired,” recalls Cathie, “it would make our business, in its current form, unsustainable.
“The sky was falling. We needed to sit down and rethink what we were doing and what we could do into the future. We identified two opportunities: one out of the aged care pharmacy business and one out of the hospital pharmacy business.”
Manual packing of medication was commonplace in the aged care business, so Cathie brought in technology from Korea to automate the process. The other opportunity was the emerging and ongoing need for cancer care pharmacy services. Cathie and Stuart devised a three-point strategic plan. “Step 1 was to build up the oncology pharmacy capability; Step 2 was to move into ownership and operating of cancer hospitals; Step 3 was to export that service to Asia,” shares Cathie. “At that point, neither Stuart nor I had even been to Asia.”
By the time the GFC hit in late 2008, both opportunities were underway; but, the business was $35 million in debt. “It was an incredibly challenging time, but we put our heads down and ground it out, and every month that we delivered on-budget financials that illustrated our strategy was holding, it got ever so slightly easier.”
Fast forward to 2012, and Cathie and Stuart had the opportunity to buy into a set of Southeast Queensland day oncology hospitals. They sold the manufacturing business to fund the acquisition and those hospitals were rebranded to Icon Cancer Care (now Icon Cancer Centre), which in 2015 formed Icon Group with Epic Pharmacy and the other acquired businesses.
In 2014, Cathie and Stuart part of their business to a private equity group to allow Icon to execute on their strategy. In 2016, Icon established its Singapore presence and cracked the Asian market. In early 2018, Icon Group signed a milestone agreement at the ASEAN-Australia Summit to deliver cancer care infrastructure and technology in Vietnam. In February 2019, Icon Group signed a milestone agreement with China’s Sanbo Brain Hospital Management Group to deliver radiation oncology services. These services are set to open late 2019 in their Chag’an hospital in Chongqing. The Sanbo announcement was quickly followed by an agreement with United Family Healthcare in June 2019. Icon’s Asia expansion plans include intentions for 10 Icon cancer care centres operating in China in the next three to five years.
Across its four divisions – medical oncology, radiation oncology, pharmacy services and chemotherapy compounding services – Icon is making an impact via more than 2 million patient interactions each year. That figure has doubled from 1 million in just a few years. “That’s the main metric we talk about when we’re talking with our team – how many patients we can impact,” says Cathie. “Obviously, we pay attention to financial performance, but impact is our most significant performance measurement.”
Instead of requiring patients go to large hospitals for cancer care, Icon has used technology to enable a network of local cancer care centres. Many of Icon’s cancer centres are located in regional areas, including Cairns, Townsville and Mackay.
“Our mission is around delivering the best care possible to as many people as possible, as close to home as possible,” says Cathie. “Cancer is super stressful. Radiation oncology is a quick treatment; it’s 10 to 15 minutes, but it’s every weekday for five or six weeks. If you live in a regional area, where you don’t have access to radiation oncology, having to move to a centre for that five to six weeks adds to the stress on every single front, whether that be the mental stress, financial stress or leaving your support network. A lot of our patients are able to continue working through their radiation therapy, they can still drop off and pick up their kids from school.”
When it comes to delivering world-class cancer care to as many people as possible, Australia’s population is fewer than 25 million people. Exporting services into Asia opens up opportunity, not only for business growth, but for improving cancer care in a market that is in need. China’s population alone is 1.4 billion, with around 3.12 million people each year diagnosed with cancer. That figure is expected to increase exponentially.
“There’s such a huge, unmet need for services in China,” says Cathie. “It’s actually been our focus on servicing regional Australia that set us up so well to be able to make that move into China. In delivering services into regional Australia, we developed skills and products so we could provide services with remote support. We’re able to do a lot of our treatment planning through a centralised team, which alleviates pressure on having specific human resources at every clinic,” explains Cathie.
The evolution of Cathie’s business, from a single pharmacy servicing aged care homes and private hospitals in 1998, to a billion-dollar integrated cancer care company in 2019, comes down to a willingness to change perspective.
“Stuart and I have always believed in changing your perspective, and that if you just look at things through the same lens you will only see what you already see.”
For this same reason, Cathie is signed on as a Future Astronaut, training for space travel with part of Richard Branson’s space tourism company, Virgin Galactic. As yet, there is no definite launch date for Cathie, but it is getting closer with another successful test flight completed February this year.
“For me, going to space is kind of the ultimate expression of changing perspective, because space is the ultimate way of looking at the world from a different perspective! Richard [Branson] makes predictions around when they’ll be starting to fly. He said that he would be in space last year; that obviously didn’t happen. He is on record of saying he fully believes he’ll be in space this year.”
As well as her role as Digital Advisor for Icon Group and as Managing Director of Epic Pharmacy, which includes Epic’s philanthropy arm Epic Good Foundation, Cathie is on the Board of the Brisbane Lions Club (AFL), and Chair of AUCloud, which provides digital infrastructure and information governance for sovereign data assets.
What’s her secret in building such an epic career? “A hell of a lot of hard work, preparation, and preparedness to actually knuckle down and commit when things do get hard,” says Cathie. “Also, if Stuart and I hadn’t done it together I don’t think we would’ve done it. I think we are each other’s secret sauce.”
In 2007, during Epic’s significant business disruption, the leadership team underwent Gallup’s strength profiling and discovered Cathie and Stuart are scientifically a ‘perfect match’. “The facilitator from Gallup told me Gallup had never seen two co-founders with such aligned and complimentary skillsets,” recalls Cathie. “She said, ‘It’s right off the charts, and we’re not surprised that you can do what you do together.’”
In September, both Cathie and Stuart will celebrate their 50th birthdays. “I am 48 hours older than Stuart. That single day where he’s married to an older woman is his favourite day of every year – he actually probably celebrates that more than either of our birthdays! – he’s christened it ‘Older Day’ and our children [teenagers Sascha and Sam] have been forced to celebrate ‘Older Day’ for pretty much all of their lives,” she laughs.
“When you work in the industry that we’re in, you have daily reminders that life doesn’t always turn out for people as they planned. Some people may find reaching milestone birthdays quite confronting, but for us, we’re very much of a view that they’re to be celebrated and embraced.”