Why a Big Pharma Background Can Give Biotech Leaders an Edge

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Many biotech founders come straight from academia and may struggle with the new skill set that is required to run a company. Rob de Ree, CEO of Dutch biotech NorthSea Therapeutics, has a background in big pharma and medtech and believes his earlier experience was instrumental to his success as a biotech leader. 

After spending 14 years working in a big corporate environment at Byk Gulden and Medtronic, de Ree decided to take the plunge into the world of biotech. Following a short time working in business development at the large biotech Crucell, he made the move to the cardiovascular medtech company BMEYE where he later became CEO. 

Since then, de Ree has seen both BMEYE and his next company Dezima Pharma — a cardiovascular-disease focused biotech — through successful acquisitions. In 2016 he became an operating partner at the Dutch VC Biogeneration Ventures, before becoming CEO of NorthSea Therapeutics in 2017. 

What inspired you to get into biotech?

During my career at Medtronic, I interacted more and more with people in the startup environment, which is a totally different world, but when I learned more about that, that sounded really attractive to me. 

It’s at the forefront of science, so you really work on things that matter, that have a high relevance. In that regard, you also typically work with top key opinion leaders in different fields. I find it very inspiring. We work in very small teams of highly experienced people with great track records to get things done. This is an environment that I can really appreciate.

Did your experience at Medtronic help prepare you to work in biotech?

Without Medtronic, I couldn’t be where I am now. The educational talent programs you can benefit from at these large corporates have been fantastic for me. That’s where you learn all the basics – you learn how to manage, you get your marketing courses, your leadership courses; that is quite unique. You do that with small teams that come from all over the world and that is also quite inspiring. 

Probably in the ten years I was at Medtronic, I was in six or seven different roles. It’s really a learning and development environment, but in the end, working in a fast-acting, decisive, high impact environment is far more appealing to me. We work now in a small team and we move quickly. That is a big difference. 

What attracted you to become CEO of NorthSea Therapeutics?

First of all, I talked to the founders. They came from Pronova BioPharma led by Hilde Steineger. They developed next-generation drugs based on fatty acids. I found their proposition very interesting.

Biogeneration Ventures was exploring the option to invest in NorthSea and the moment they did that, they also looked at the team and considered me as a CEO candidate. Biogeneration Ventures was one of the investors in Dezima Pharma, my previous startup, so we know each other well. I became an operating partner afterwards and they used me for different portfolio companies. Initially, it was a part-time CEO role at NorthSea and that ended up as a full-time role.

NASH (non-alcoholic steatohepatitis) of course, is a huge opportunity. It’s complex, it’s not an easy disease to tackle, but the combination of the huge opportunity we had with a great team… I did appreciate the expertise and knowledge that came along from Pronova BioPharma. There were three founders still based in Oslo. John Kastelein was involved in the previous development of the molecule icosabutate at Pronova BioPharma for lipid indications. John was also involved in Dezima Pharma. I could bring Patrick Round on board as CMO. Teams are critical for success and I had a strong belief we had the right team in place to start building.

The race is heating up to be the first company with an approved NASH therapy. We’re all waiting to hear what comes out of the Genfit phase III trial. Do you think they’re going to be lucky?

I think they will make it, so they will have a positive phase III. I must also say I hope so. In general, the NASH field needs good news after a few failures last year. The efficacy will not be massive. I think it will be modest. 

The way I see it is you have this first wave of compounds that have been developed and are not that strong in efficacy, but will make it to the market – same for Intercept, of course. Then, there will come some new compounds, like ours, that will have stronger profiles. 

We, of course, have to prove that in our phase IIb trial first. We’re in phase IIb and that is fully up to speed now in 30 US sites with first data coming towards the end of the year in quarter four.

It’s a complex multifactorial disease, which probably needs a combination of therapies. More therapies are required to solve it, to treat these patients, so there’s enough space for multiple players there. 

Cardiovascular and metabolic disease has been quite a difficult target for biotechs. Do you think things are changing?

I think there’s more happening. NASH… there’s a strong impulse there. Most NASH patients don’t die of liver disease, but will die of cardiovascular diseases. Most patients have metabolic syndrome and are at high risk for cardiovascular disease

Besides that, you also see more activity around triglyceride-lowering treatments like apoC-III inhibitors. Staten Biotechnology is an example of a Biogeneration Ventures portfolio company focusing on the development of an apoC-III inhibitor. 

I think what gave an impulse to that as well is Amarin – their REDUCE-IT trial, which showed a further risk reduction, was quite impressive. There is more and more happening. I do think times are changing. 

Dezima Pharma was another example. I think that has to do with the fact that we realized that you can’t get everyone to the LDL level you would like, so you need ‘on-top-of-statins’ therapies, but also you have quite a big group of patients with statin intolerance as well. 

What is your approach to financing a company?

Typically, I’ve been involved in companies that have just been founded. I was there from the inception, or close to the inception. Usually, the first thing is you work with VCs. What’s important for me in working with VCs is they can contribute. I have been in a position twice that I’ve really worked with venture capital firms that highly contributed. Forbion and Biogeneration Ventures were involved both in Dezima Pharma and were very active and supportive.

It’s always very helpful that you have expertise on board that can support you, especially in very small organizations. That’s what I’m looking for on the VC side. Therefore, I am so pleased with Sofinnova and venBio. They have fantastic US networks and track records, so their expertise and knowledge is so welcome. That really works well for me. 

Partnerships… I definitely believe in them as well. It really depends on where you’re at, what you’re looking for, what your propositions are. 

In your last two companies you’ve had an acquisition and then, you’ve stayed on for a little while after each one. How was the transition for the teams?

From BMEYE to Edwards Lifesciences was really great for the team. My proposition to Edwards Lifesciences was, “You are the leader in invasive hemodynamic monitoring. If you really want to expand it and reach more patients, it should be a non-invasive solution.” That was strategically spot on. They were looking into that themselves already. They fully followed my logic and they said, “We appreciate it so much that we will make the Amsterdam BMEYE office the R&D center for non-invasive solutions,” and it’s still that today. That acquisition was in 2012 and the team is still in Amsterdam, focusing on non-invasive solutions. 

To get these programs incorporated in Edwards, I saw it as my initial task and they did everything from their side to make that work. They would’ve liked me to stay in my role. They wanted to have me in the US and at that moment in time, that just didn’t work out for me personally. 

After the acquisition of Dezima by Amgen, that was different. Amgen really did want to get it incorporated in their own organization and move on on their own path. That, after staying for six months, was sufficient. 

When do you think a company should go public?

I think it depends on a few different topics. To have a pipeline is very helpful in that respect to show that you’re not a one-trick pony or just have one asset. 

What is so important as well is that you have news flow and that you have news flow to the public market. It’s important that you address significant markets as well to be attractive enough. 

Last, but not least, you need to be backed by strong investors that are also willing to bring you forward to an IPO. Having that investor base that can financially support your IPO is very important as well.

What do you think your biggest management lesson from your careers is?

That’s getting back to my first experience at BMEYE. When I joined, the company was up and running. They decided to focus on indications or applications for their monitoring device for cardiology. I just followed. I went in the same tunnel as the rest of management. I was coming out of cardiology and I did not have a broader look at that moment in time. 

We were dead wrong with that initial strategic choice and we learnt that in the first year. We got some sales, but the market opportunities we went for were just not strong enough, or the markets were much smaller than we had anticipated. 

What happened all the time is that a cardiologist said to us, “Oh, I would like to involve the anesthesiologist as well. Let’s see what he has to say.” That opened up the door to a far better application for this device in the operating room. That’s a hard story to tell the investors. 

Being too quick with your proposition or market assessment is a lesson I had from those days that is so, so important. 

How do you keep learning every day and how do you decide what to learn?

I think it’s very important to keep learning. What I started doing at BMEYE was that I asked for an independent chairman as well as the VC board members. That was Tim Irish coming from Philips. He was the CMO there and left the Philips organization early in his career. I did ask for a chair with that experience to really be my coach and mentor as well. We did projects together that I was less experienced in and he was someone I could just discuss matters with, not always in a formal way. 

I am quite an open, transparent person, so that makes it easier. Be vulnerable yourself, ask for feedback and that is an environment I’ve created for myself to learn from. That’s the way I try to continue to do things. 

On the other hand, I don’t think you have to learn everything. What I’ve learnt as well is that you have to trust other people that are specialists in different areas. That really worked well in my BMEYE days, in my Dezima days and again now. I work with top experts as a scientific officer, as COO. You make sure that together you have all the expertise and knowledge that is needed for the company.

What advice would you give yourself if you could go back in time to when you started in the industry.

In the beginning when I moved on from the corporate world, I would’ve liked to have been more open in the beginning, more curious to other people, listen better and not only think about how I was raised and educated in the large Medtronic organization. I would’ve had a higher appreciation in the earlier phase for how you can do things differently. I think that is something that I would have liked to have realized earlier.

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