Impactful leadership begins with a strategy that is clear, compelling, supported by thoughtful analysis and designed to deliver competitive advantages, and is followed by an unwavering focus on execution. Strong execution relies on finding the right people and creating the right environment for them to succeed. Great leaders believe that it is pivotal to the company’s success to place confidence in their team, empower them and let experts in relevant fields be out in front on critical initiatives or in conversations with stakeholders to solve problems.
Inspiring leaders often work hard and let success be their voice. They lead by example and results. John Thero, CEO of Amarin Corporation, is one such exemplary leader. John and his team at Amarin Corporation look for people who have “can do” attitudes, who are smart, and John Thero have successful track records. They focus on outputs more than inputs. They create environments where people have room to be creative, solve problems and flourish.
Focusing on Improving Cardiovascular Health
Amarin Corporation is a rapidly growing, innovative pharmaceutical company focused on developing and commercializing therapeutics to cost-effectively improve cardiovascular health. Amarin’s roots trace back to 1993, with most of its early work in Ireland and the United Kingdom. The company’s initial focus was on rare neurological conditions, but that was in the process of changing when John joined the company in 2009. Later that year Amarin started two clinical studies as part of a multistep strategy to develop the company’s lead investigational asset for cardiovascular risk reduction.
After clinical study successes in its initial steps to proving the ability to lower cardiovascular risk, as a small company with limited resources, Amarin had to make choices. The company could go ‘all in’ and move as quickly as possible toward becoming a commercial-stage company, but with more limited potential; or it could remain predominantly an R&D company and stay tightly focused on demonstrating that its lead product significantly reduces cardiovascular events in at-risk patients – a need that had not been addressed by prior patient treatment options from any company. Amarin chose the latter path, and that has proven to be successful.
Amarin Corporation’s early emphasis was on demonstrating impact in reducing triglyceride levels primarily to prevent pancreatitis. High triglyceride levels were also an identifier of increased cardiovascular risk. The effects of Amarin’s lead product went beyond triglyceride lowering. These and other scientific insights motivated Amarin to continue on decade-long journey, which in turn led to approval of its ® lead drug, icosapent ethyl (VASCEPA ), for cardiovascular risk reduction indications in the U.S., Canada and Europe. Along the way, 17 leading international professional societies have recommended icosapent ethyl or incorporated its use for risk reduction into their guidelines – in a number of cases even before the product was approved for use in their region.
Letting Vision Become a Reality
When John first arrived at Amarin in 2009, the U.S. was in the midst of a major recession. It wasn’t the best time for a company to seek funding and a foothold in a new therapeutic area.
Amarin did, however, have some very encouraging science, and a dozen or so dedicated, talented, and experienced professionals who believed in its vision and potential to help people avoid the devastating impacts of heart attacks, stroke, and other serious cardiovascular conditions. John was recruited to be part of a newly constructed management team, in part because of his experience in the cardiovascular category and in turnaround situations like this one. Having worked further “downstream” in the space – in the recovery of patients after major cardiovascular complications — and with a history of heart disease in his own family, John was eager to have an impact in preventative cardiovascular care. Then, as is true today, in the industrialized world, CV disease was the most deadly and expensive condition in healthcare, which was another motivating factor for him.
Amarin Corporation finished 2020 with revenue growth of 43% to more than $600 million. It now has more than 1,000 employees, and its vision is becoming a reality. It has come a long way since those early days, and John couldn’t be prouder of what Amarin has accomplished.
Treating At-risk Patients with Pragmatic Innovation
Most importantly, Amarin’s drug, in addition to being clinically effective and safe, is affordable. It lowers the significant risk that remains for many people even though they’re on conventional therapies for cholesterol management. It is currently approved by multiple regulatory authorities, including in Canada, Europe, and the United States and is poised for approval in other countries. The data on its product has been broadly published in leading peer-reviewed medical journals and is out there for any clinician, or patient, to see. And they can take comfort in knowing that, based on that data, the product’s clinical results have been broadly reviewed and recommended. While there is no other cardiovascular drug approved for the same indication as Amarin’s, of all branded cardiovascular drugs in the United States with positive outcomes study results, the list price of its product is the lowest. Amarin wants its product to be accessible to as many at-risk patients as possible.
Beginning with the Patient Experience in Mind
Surveys of patients and health care professionals emphasize the importance of medical therapy which is preventative (helps avoid major negative health consequences), outcomes-based (proven to work in many patients over extended study), cost-effective, readily available and easily administered. Technologies that are supportive of preventative approaches, and are accessible and useful to patients in helping to track and enhance outcomes can be helpful — especially if and when they’re integrated with the right clinical interventions alongside approaches designed to consistently engage patients in risk-modifying behaviors.
One of the complications of preventing heart attacks and strokes is that risk factors are often unnoticeable. Over time, technology may be developed to better identify and help to address cardiovascular risk from a behavioral perspective. Amarin has pursued a pragmatic path to help patients by: a.) identifying those patients needing cardiovascular risk reduction based on elevated triglyceride levels, a measure which is common in standard (widely accessible) lipid blood tests, and b.) making a clinically effective therapy available to them that is easily administered, accessible, and has been shown to work across a broad population of patients with similar risks.
People and Data Drive Solutions
Four keys to innovation are people, data, resources and time. Time is a valuable but limited commodity for innovators and, while it never expands as needs grow, it can be made more productive with a collaborative and talented team. Resources, in turn, are always available for good ideas, steered by compelling data, and with the right people behind them.
At Amarin, our people found compelling insights in data on a particular compound, which led to an idea, and ultimately a mission to lower cardiovascular risk in a category where many others have failed to demonstrate impact. The idea alone was not enough. Developing this idea required years of hard work and focus from talented people driven to innovate and to help improve patient care.
The path to get there wasn’t easy, or straightforward, and John expresses that Amarin would not have been able to overcome many of its challenges if it were not for a dedicated, “family-like” culture which emphasizes teamwork, quality, integrity and results. As Amarin has grown, proactive steps have been taken to ensure that the most positive elements of its culture are retained. As a result, Amarin has built a team of people and a culture that has allowed John Thero to pursue his plans to retire in 2021 with knowledge and confidence that what he has helped get underway will continue to be advanced.
Having a Remarkably Focused Team
John believes that focus and accountability are the most important qualities to have as a CEO. He says, “When you’re trying to improve healthcare, and there are so many unmet needs, it’s tempting to try and do everything you can rather than doing the most important things really well. Without adequate focus, much less gets accomplished.” Amarin is fortunate to have a great team that believes in what it is doing and is remarkably focused on its end goals, despite the many challenges and disruptions the company has had to overcome along the way.
Expanding Accessibility of Services
In the near future, Amarin’s priorities are to continue to grow its business in the U.S., successfully introduce its lead product in Europe, and directly, or with the help of commercial partners, expand globally, including securing regulatory approval for the drug in China.
Amarin has some incredible opportunities in front of the organization– not only with the recent approval of its drug in Europe and potential approval in China, but also through other assets it may develop or bring into the organization in the years ahead. It has built an incredible commercial organization in the U.S. and is creating a similarly strong commercial team in Europe. The company’s outreach to leading cardiologists, GPs and other healthcare professionals gives it a strong foundation to continue to grow based on its lead product while considering opportunities for diversification into other therapeutic areas and indications.
Rejecting the Herd Mentality
The pharma industry today tends to prioritize innovation around specialized condition areas like rare diseases. Such innovation is certainly needed and worthwhile.
Unfortunately, other conditions that are prevalent and costly in our society are consequently getting less attention. Chronic conditions such as cardiovascular and pulmonary disorders are especially neglected given lengthy time frames needed to develop therapies and limitations on patent protection, which combine to disincentivize drug development. These circumstances can also lead to higher prices and costs associated with products and procedures for acute medical conditions (rather than lower costs and reduced suffering when the focus is on earlier interventions and preventive approaches).
Many of the large companies which were pioneers in developing cardiovascular solutions decades ago today have very limited or no focus on cardiovascular disease. When Amarin entered the cardiovascular disease market a little over a decade ago, relatively few companies were continuing to invest — and fewer still like Amarin were focused exclusively on the problem of heart disease. Amarin saw this growing void as an opportunity for major impact.
We believed in the science, we stayed true to our strategy, and now have a strong foundation for global growth – while also being a leader in addressing risks associated with one of the world’s most costly and deadly diseases. With smart people and using scientific data as a guide and improving patient care as motivation, Amarin elected to not follow the herd and, to paraphrase Robert Frost, following the path less traveled has made all the difference.