Biotech From A To Z With Lundbeck

Speaker 1:
Welcome to Cowen Insights, a space that brings leading thinkers together to share insights and ideas shaping the world around us. Join us as we converse with the top minds who are influencing our global sectors.
Yaron Werber:
Thank you for joining us for another exciting episode in our biotech decoded podcast series, I'm Yaron Werber, biotech analyst at Cowen, and I'm super excited to be joined by Deborah Dunsire in this episode, biotech from A to Z, to discuss her insights from running global biotechs and pharmaceutical companies, her experience as a woman executive in the US and Europe and how growing up in South Africa during apartheid impacted her life's journey. Deborah has more than 30 years of clinical commercial and international management experience in biotech and pharma, primarily in the fields of oncology and CNS. She's been president and CEO of Lundbeck since September 2019, and was previously president and CEO of XTuit Pharmaceuticals, Forum Pharmaceuticals, and Millennium Pharmaceuticals. Deborah, always great to see, and thank you so much for joining us.
Deborah Dunsire:
It's great to see you, and it's great to be doing this right as we come off summer and go into the next close of the year.
Yaron Werber:
For us, this is really a great time. What I'm really excited about with this episode, again, we're calling it biotech from A to Z, with you, is that there's so much we can talk about. We can talk about, you've run technology based US biotechs, both private and public, you ran Millennium, which is commercial and tech, and you're running Lundbeck, which is a global commercial company focusing on neurology. And I've known you now for, what, about 15, 17 years?
Deborah Dunsire:
Maybe even longer.
Yaron Werber:
Maybe even longer. Since I was a baby, essentially.
Deborah Dunsire:
Yes, yes. Right out of kindergarten.
Yaron Werber:
Out of kindergarten. You were very successful in your roles, both at Millennium, and then you ran smaller, very innovative entrepreneurial sort of biotechs in Cambridge, which essentially were private. What did you harvest from those experiences that is now so instrumental at running Lundbeck?
Deborah Dunsire:
I think the smaller companies teach you how to do things in more of a quick way. You really learn about prioritization. You learn what is the most efficient path to get something done. And you learn that the bells and whistles are valuable, but you've got to know what's the most important thing, because you only have resources for the most important thing.
I think the passion that goes around startup companies and those smaller companies is just a delight, and you want to keep that and you want to keep reinvigorating that as the company gets bigger. I always say the smaller companies are like a small boat, you can really feel the ocean. When it gets to be a bigger company, you feel it less, but you've got to reconnect people to the science, to the purpose, to keep that spirit alive.
Yaron Werber:
I have little canoes everywhere. And I constantly talk about it to my team here. And it was actually more instrumental when I was at a company on the operating side to talk about the importance of being in a little canoe. You feel every ripple when you're small and you got to row together, and you got to know where you're going. It's a lot easier said than done. In your experiences, you talked about focus. You talked about the passion, but focus. What's the hardest thing for executives that are coming from big companies when they go into a small entrepreneurial, technologically based, private biotech, where they don't have the resources and they need to focus?
Deborah Dunsire:
One of the hardest things for executives coming from big companies is not to be surrounded by a staff. So having to think about things that you did earlier in your career, where you were the product manager or something like that, you might be the CEO, but dammit, you might be the person who knows the market research firm to use, and who knows how that study might have to be structured. And so you have to roll up your sleeves a whole lot more. And some people find that a little overwhelming and don't feel as good about themselves when they have to do something that they did a long time ago in their career. So the mindset of a person who's shifting from big to small, some people can make that shift and some people really can't. So that's one of the things that I would focus upon.
Yaron Werber:
Number one, it's getting executives from big companies to sort of scale down. Scale down and scale back up without having a lot of staff, having to roll up their sleeves. What about, with a technological based company there's so many ways you can go, and then how do you really establish a strategy and a pathway to value creation without getting too inundated with extraneous opportunities, which constantly take you off course?
Deborah Dunsire:
What a great question. I think one of the most valuable things in those startup companies where you're really dealing with the technology is having that great board. And it's often your investors, your VC investors, and they've seen the movie. I think they can be a great sounding board and a great value because sometimes your scientists are just so passionate about the technology that you can get drawn down various pathways.
And of course, when you look at any of the companies who really grew from those very tiny to being very big, it wasn't the original idea that ever got them there. So there is a need to be open minded to different parts. So the question is when? How many parts do you prosecute at once? And that's where that partnership between me as an operating executive, because that was really my background, together with people who've really seen how companies incubate and grow and that dialogue between board, particularly the VC investors who I really admired and liked working with, it was a good back and forth.
Yaron Werber:
When you're thinking about your experience at Millennium, you joined and obviously the company became a commercial company and a global... Well, a US based company with obviously Johnson & Johnson was the partner ex US, how was that different than running Lundbeck?
Deborah Dunsire:
I think the partnership was very central, so we were really focused on one commercial product and a pipeline. With multiple commercial products in multiple jurisdictions you are constantly thinking about managing somewhat different portfolio, because Lundbeck's portfolio in different countries is actually quite different, because we are not that very large company. We're still a company that's forming and expanding. So our China portfolio really doesn't look the same as our US portfolio, and so you have to be able to look at the products in their marketplace and you're dealing with quite a wide range of different portfolios in different countries.
And then when we're starting up, we've just started up in Japan. We have licensed our products in Japan before, now we have our own commercial footprint in Japan, and we're partnered for that first launch with Takeda, and so we're learning. For Millennium, we were learning, too. We were how to be a commercial company in the US, but we didn't have to expand that and replicate it out into other markets. And I think that's what we are doing as Lundbeck, in that next stage of evolution of the company.
Yaron Werber:
You talked about on the commercial, on the commercial scale going global and how strategically, how do you do that, and Millennium, obviously that was less of a priority. What about culture, oncology, technology company versus a neurology, established neurology company that's innovating and also US versus European baseline culture and locale?
Deborah Dunsire:
Core, it's very much the same. It's about people who are passionate to make a difference. And the unmet needs in oncology are incredibly high, and the joy of working in Millennium for me, was working together with people who were so passionate about the transformation in oncology. I also appreciated that at Novartis oncology. In Lundbeck, it's all about how do we make a change in brain health. And Lundbeck's been very successful in psychiatry. The needs in mental health are so big and Lundbeck's been very successful there over many years and very focused there. So we have a cadre of people who are passionate about that mission to restore brain health. So that's common, the purpose and motivation that we have the privilege to work within our industry is common. Although obviously it's different in different therapeutic areas, but that's a commonality.
What's different, I think in the US ethos is there's a lot more focus on that short term quarter when you're a fully publicly traded company. Lundbeck is a European company, and it has a European ethos, it's also majority foundation owned. So that brings a different culture, a different framework of thinking about how shall this company be created for 50 years from now. You actually have that long-term vision that you don't necessarily have in, not only a US company, but a fully publicly traded company.
One of the biggest differences I found moving from the US to Europe was, the sustainability focus, from not only your total focus on ESG, both the environment, how we're thinking about the climate, the focus on the social good of the organization and the governance is somewhat different for European and US companies. But that focus on sustainable activity, to contribute to the sustainable development goals, to reduce your carbon footprint as a company, is an everyday part of your thinking and planning as an executive here, that really hadn't been a part of my experience up until then.
Yaron Werber:
ESG is actually really important for Cowen and we've rolled an ESG product. And one of the reasons we actually rebranded this podcast series away from biotech's external innovation to biotech decoded is we also wanted to focus on ESG. So maybe, let me dive into that. I know there was a little bit of a tension here. When you think of environmental, you're thinking sustainability, you're thinking production, minimizing energy usage, carbon footprint, recycling materials, anything that I'm missing on environmental, or is that more straightforward, let's say, then social and governance in terms of getting your hands around?
Deborah Dunsire:
It's all of that. And then the question is, how do you do your business and how do you cause your suppliers? So we work with scope one, obviously your production and your business. Scope, two, your sales reps, your fleets, everything you use to do your business. And then scope three is all your suppliers. So how do you, in your RFPs, move your suppliers along? That's an interesting broadening. You cover all the bases, but it's that horizontal across all your business, including your suppliers, that you need to think about.
Yaron Werber:
You can probably drive your own business easier in many ways in deciding how to influence your suppliers to align. And of course, you're in many ways, tied it to hip to each other. So you can't just move away easily to another supplier who might be more ESG focused.
Deborah Dunsire:
Right. And you can't just say, "Well, we're good," when you are just basically outsourcing your carbon footprint to suppliers. You really do have to be active across the chain.
Yaron Werber:
So how do you think about social and the social responsibility? And of course, that could be so broad. And how do you measure that?
Deborah Dunsire:
For us, we obviously, the access to medicines is part of our thinking about the impact on communities. So when I think about social, I think about how are we an actor for good in the communities where we operate, and then in the communities where we don't operate, low and some of the middle income countries, how do we create access to medicines, particularly for mental health? So, yes, it's our core business. And then they're the pieces that are part of our business, but not in medicines, like for example, parity of access for mental health. How do we become an actor in policy setting in different countries to drive parity of access? How do we drive reduction of stigma in the countries where we operate as part of our contribution to the social fabric? And then of course there's creating the diverse, inclusive workplace. And what does that mean in China? What does it mean in Israel? What does it mean? And it means different things in different countries. So it needs to be a nuanced approach to diversity. And how do you pull it down from the top all the way through?
So there are many parameters for social that I think we ask our companies to engage, also, in their local community. How do you become that force in your local community?
Yaron Werber:
Which part of the social focus is toughest to implement?
Deborah Dunsire:
I'd say that there's more work to be done in diversity and inclusion, because that requires moving people's learning along in things like unconscious bias. And it requires, yes, the challenge is different in different places, but how do you set baselines? How do you set goals and how do you keep measuring and seeking improvement?
Yaron Werber:
Yeah, that's a huge focus within Cowen as well, so I feel like I know a little bit what you're going through. But at the same time you have a global local end, which is definitely very interesting. I mean, the culture in Israel and the culture in China, just jumping off on the [inaudible 00:16:16] you mentioned are extremely different. And so what that means to them on the social, and where they are under social thinking relative to, let's say, Europe and the US is far different.
Deborah Dunsire:
Right. So you have to start where you are and make progress forward.
Yaron Werber:
What about when you think of governance, what comes to mind and what are you focusing on?
Deborah Dunsire:
Interesting, Europe is quite different in terms of corporate governance. And then within Europe, there's some differences that... In Denmark, for example, we have that the CEO cannot be a board member. That's, by law, is not allowed. We have employee representatives on the board. You have to have 50% the number of employee representatives as you do independent board members. So I'm working with four employee representatives who are board members of Lundbeck. So they're exposed to succession discussions for the executive management and they may report four levels down in the organization, so it's a very different level of transparency.
We have unions, so working with the unions, making the collective bargaining agreements. There's a lot of things, European regulation, that we need to look at. We've got ESG regulation coming out of the European commission very shortly that makes Sarbanes-Oxley look like a walk in the park for implementation. And so there's a lot of focus on data privacy, the GDPR, in a very different level of maybe focus and seriousness and reporting, then there is in the US. So you do have to understand where you're working and what regulations drive you.
Yaron Werber:
The employer representatives who get on the board, how are those chosen?
Deborah Dunsire:
Every four years, there's an employee election. People can canvas their colleagues and it's based on the number of votes obtained.
Yaron Werber:
And they cycle every four years?
Deborah Dunsire:
Every four years.
Yaron Werber:
Every four years. So they're not up for reelection, so to speak?
Deborah Dunsire:
No. They can stand for reelection after four years, but they're not reelected every year. Our independent board members are elected every year.
Yaron Werber:
Interesting. That definitely creates a phenomenal dynamic with a foundation on top of it, which is not similar to most companies, certainly US based companies.
Deborah Dunsire:
Yeah. It's been a real learning. Anytime I've moved to different countries, and I've lived and worked in a number, it's such a learning and growth experience, because it challenges your assumptions about how things are and should be. And you have to learn to lead in a different way in a different culture. And Denmark's no different. I have to learn again, how to lead. And the Danes are phenomenal in terms of their command of English. So we work in English, and so you make the mistake of thinking it's very similar, initially. And it really isn't. You can't think of Europe as one, because Denmark's as different from Italy. There's nothing really common about those cultures just because they're both part of Europe.
Yaron Werber:
Let's talk a little bit about, a lot of the podcasts until now has been about mergers and acquisitions or deals. And at Lundbeck, you have started doing more M&A and doing more collaborations. And you have done them at Millennium, you've done them of Novartis. You've done them in many of your prior roles. What separates companies and collaborations that go well from those that don't?
Deborah Dunsire:
I'd say you'd separate out acquisitions from other types of partners. If you licensing or partnering, I'd say the fundamental is trust and communication. And we've been partnered with Otsuka on a couple of products for 10 years, that partnership has been. And it's not that we've always agreed, but there's been a very strong level of respect, mutual respect and communication, a very disciplined calendar of regular meetings and layered governance meetings that people take very seriously. And I think when you have a disagreement, working in a disciplined way to navigate to a common good and a common understanding. And Japanese companies are very good at being partners, because they do think about enlarging the pie together versus winner taking all. So it makes for a pleasant partnership.
In an acquisition, I think one of the key success factors is being intentional about the creation of the company culture that needs to be the going forward company, and making sure it's clear, and onboarding people to it. And then being also clear that people who don't onboard need to leave. I think a company that allows a swirl and an unclarity and a clash of cultures to persist will ultimately not be successful with that acquisition.
Yaron Werber:
Within Lundbeck. Is there a certain level of forced attrition every year or no?
Deborah Dunsire:
No.
Yaron Werber:
Based on performance, no.
Deborah Dunsire:
We do have, obviously, a performance driven culture, but we don't have the old GE philosophy of bottom 10% out. We act on performance during the year. It's never one time in the year.
Yaron Werber:
Yeah. You manage for success.
Deborah Dunsire:
Yeah.
Yaron Werber:
Let me maybe shift over, and I want to focus a little bit on your personal journey and your personal career, both as a woman and, obviously, growing up in South Africa during apartheid. Let me actually start with that. How was growing up at that time period really impacted you as a person in your life's journey and as an executive?
Deborah Dunsire:
Yes. I think you grow up, not questioning as a child the fact that there's white people who have education and access to things, and then there's black people who operate in your life as servants, as gardeners. And you don't question it. And then as you get into your teenage years and you start to say, "Why is this so?" And then gradually, at least for me, it was a dawning of this is not right. And you look at the history of the continent and say, "Wait a second. There's something wrong here."
And when I look at it, I see the absolute waste of human potential that actually is undermining those countries even today. Because the power and the resource and the possibility to create value in Southern Africa is so high, that the countries are not where they could have been had they been able to utilize the combined intellectual capacity and power of their whole population. That, for me, is a driver for eliminating and acting relentlessly to ensure that we do access all the talent and that we have diverse workforces, we do create inclusive workforces because that loss of potential creates a smaller pie. It plays a short game. And if you really want to expand and be able to harvest full potential, you need everybody on board.
Yaron Werber:
I recently traveled. I was in south America, actually, for the first time. And I've traveled to Latin America. And I think a lot of the commonalities, these are all areas that were colonized historically. I was shocked. And maybe I shouldn't have been that surprised, but it definitely dawned on me, I was in Columbia about three weeks ago, how the culture still emanates from, in many parts, slavery in that area and obviously colonization. And it's completely has weighted down the whole continent. There's no question. You feel that completely in Latin America. Where is South Africa, in your view now, on the journey toward the recovery? I mean, it sounds like it still is in very much a stepping stone path.
Deborah Dunsire:
It is. And when I look back at the days of Nelson Mandela as the president, the hope was enormous. I think some of the subsequent leaders have not achieved that high standard of leadership. And I think when corruption comes into a country, it doesn't matter which geography, ethnicity, it's poisonous. That has been part of South Africa's more mid past culture. I'm hopeful for the current leader. I think a lot of Cyril Ramaphosa and I hope that he can root out that corruption and put South Africa back onto that path. Because I was actually born in Zimbabwe. Zimbabwe is a country that has been ruined by tribalism and corruption. And unfortunately it's not on a good path.
Yaron Werber:
Deborah, but you're one of the leaders in biotech as a woman. There aren't a lot of women who are running global pharma companies these days. There's a handful only. It's increasing, but it's not where it needs to be. And it's probably where it's going to be in 20 years or 10 years from now. What has been your experience building your career as a woman in the industry and how is it different now than it was 10, 20 years ago?
Deborah Dunsire:
Well, I think different now is that there are more women at senior levels. When I was coming up through the industry, I was very, very frequently the only female in any given meeting room. That's no longer the case that you would be the only. When I was first set on boards, I was the only woman. Now on most boards, there's at least two, if not three women. So we are making progress in that way.
When I think back, I'd say two things. One is of myself, having the confidence to not hold back and to be able to push back on people who want you to sit down and be quiet, in a way, fulfill a more traditional female role. That's within me, and I think it comes thanks to my father. But the other place I'm really grateful to are all the men I worked for because I never have worked for a woman. I've always worked for men. And those men were the people who offered me opportunity, who pushed me out of my comfort zone. So those people, and my first boss in South Africa, Roger [Trifle 00:28:35] , David Epstein at Novartis, are people who gave me opportunity to grow. You're always going to, in any job, need the support of your boss to be able to grow and move forward, so working for great bosses has been something that has helped me a lot.
Yaron Werber:
I mean, it sounds like you found mentors, right? Did you feel lonely and was it easy to find mentors and have good conversations with them?
Deborah Dunsire:
My mentors have pretty much been my bosses. Sometimes people talk about finding a mentor. I think your boss is going to be that person, so work for the right people. If you're working for somebody who really isn't about building all the people who report to them, not just women, but who really is interested in developing people, then you should change jobs and find a boss who is interested in developing their people.
I think that I've also stayed in touch with people I've worked with before. I think about Thomas Ebeling at Novartis or Jerry Karabelis at Novartis, who even after they left, I could call up and bounce an idea off. So maintaining relationships with people that you admire and who've known you, you get some really great advice. And you don't have to have long, hourly meetings every month. Just even, I remember calling Jerry Karabelis about one job change many years after we had... We'd never worked together. And we hadn't really spoken for a number of years. It took about 20 minutes, and he was willing to give me that time. And it was just so helpful. There are plenty of people who can be a resource. And I think about, rather than a mentor, which implies a single person, a library of people who know you in different contexts that you can draw on at different times.
Yaron Werber:
Did the same rules apply to men and women? Or did you find that they were different?
Deborah Dunsire:
I think they're pretty much the same in that score. What is easier, I believe, for men is that, there are more, or certainly in the 80's and 90's, there are more opportunities for men earlier in their careers to interact with men later in their careers. And there's always, there's a little bit more, in some circumstances, standoffishness between men and women. And I think we kind of need to get past this. But of course, in a workplace, there's going to be that interaction, which is why it's been the mentorship through bosses or bosses bosses that I've built those mentoring relationships.
Yaron Werber:
It is interesting, because we hear that a lot. When we ask this question, there have been different rules in the sense that there's just different social interaction that has made it easier or harder for women over time to break in or naturally have those engagements and conversations and connections, so to speak. And now we're beginning to hear more about how things are swinging to the other side in a little bit, which is also an issue. Because at the end, it's all about connectivity as to how you develop cultures and make connections and move on in your career. Younger women who are beginning to go through their career or mid stage of their career, what do they crave the most, in terms of feedback or opportunities for progression? What tools do they need or connectivity do they need to really make it to the next level
Deborah Dunsire:
First of all, the ambition. Second of all, the willingness to do what it takes. I have counseled women before that if you say you can't move because of your family or you're the caregiver for your mother, which is a very legitimate point of view, you need to understand that may, may bring limitations, so then choose the types of companies that don't need you to do that for advancement. They need to be willing to seek out and hear the feedback too, and willing to take on stretch assignments.
One of the things that I counsel women a lot about is the tendency for women to want mastery before they move on to something else. And the tendency for men to say, "Hey, I've done this. 85% is great. It's time to add more." We don't need to get to the 100%. And there's a generalization, but it's a generalization because it's common. And so sometimes women say, "Well, I need a bit more experience." And it's like, well, maybe you don't. Maybe you need to take this step. Maybe you need to put up your hand. Women will tend to want to be noticed, men are prepared to put themselves forward. So there's some strategies that I think women need to hear and learn.
Yaron Werber:
How is the role of women changing or the opportunity set for women changing in biotech?
Deborah Dunsire:
It doesn't only apply to women. It applies to any minority. That role models are important. Because what a role model is, and you're a role model at a higher level in an organization no matter who you are. But if people see somebody who looks like them, there is a much higher willingness to believe they can get there. And you see it in sport, for instance. You find a little country that has suddenly a breakthrough tennis player or a breakthrough swimmer, and don't you know, five years, 10 years down the line there's a ton of other swimmers that come out of that country, because people then believe they can do it. So I do think that as more women are in roles, or more people of color are in more senior roles, any minority, the fact that there are role models will inspire confidence in that younger generation of that minority to say, "Yeah, it's possible for me." That's why I think diverse leadership teams, diverse boards are so important because if people cannot see somebody like them in a leadership position, it creates a barrier for progress.
Yaron Werber:
It's hard to see the path without it. Perhaps what three advice would you give minorities and women who are starting in biotech? I think you alluded to some of them, but appear to prioritize three things to keep in mind for them.
Deborah Dunsire:
I don't care who you are, whether you're a minority or not, love your work. Focus on the enjoyment of your work, and the career progression is somewhat secondary. That's the first thing. People often ask me, "How did plan your path to be a CEO?" And I was like, "That's a joke. I never planned to be in business, nevermind being a CEO." But I just kept doing things that I really enjoyed. And I kept wanting to learn new things. And so that outreach for, gosh, that would be interesting. And then somebody saying to me, "Gee, could you do this job?" And me saying, "Well, I don't know anything about that, but hey, if you think I can, I'll give it a go." So the openness to learn, the openness to try something that you might fail at is the path to growth. You do need that resilience to say, yeah, it's not always going to be successful, but the path to growth is to try what you haven't done before.
Yaron Werber:
Take risks. They could lead to failing up, essentially.
Deborah Dunsire:
One of my favorite quotes is a Churchill quote and he said, "Success is not final. Failure is not fatal. It's the courage to continue that counts."
Yaron Werber:
Yes. That's fantastic. I'm going to have to use that at some point. Let me ask you, we're going to go into my favorite part of each podcast and it's really getting to know the person. I feel like with you, we've getting to know you a lot. Obviously, there's so much to talk about with you. But tell me one thing about you that no one knows.
Deborah Dunsire:
I think I'd have to pick on way back when, in my teenage years I was a figure skater. And I figure skated for my state in South Africa. Ice dance was my specialty.
Yaron Werber:
Wow. And how did you do?
Deborah Dunsire:
I was a state champion, but not a national champion.
Yaron Werber:
Wow. That's fantastic. That's pretty impressive.
Deborah Dunsire:
I will say, it wasn't the biggest sport in South Africa. But I enjoyed it.
Yaron Werber:
We've heard different things. People have been rockers that you don't expect and people are global sailors. It's always great to see what everybody does in their life. What's your dream job? If you weren't running Lundbeck and you weren't a biotech executive, what would you have done in your life?
Deborah Dunsire:
Well, if you go back to the beginning, when I was growing up, what I really, really wanted to be was an astronaut. And I still love, I love astrophysics, the James Webb telescope photos coming in and just seeing what is out there, it still inspires me and creates excitement. I listen to Stephen Hawking, I know that he's passed away now, podcasts. The fascination of our cosmos is still a part of what is, I find, incredibly interesting. So I would've been an astronaut.
Yaron Werber:
My nephew actually is a rocket scientist. He works for NASA, literally is a rocket scientist.
Deborah Dunsire:
Lucky him.
Yaron Werber:
I just finished reading Einstein by Walter Isaacson, which was terrifically interesting to actually hear about the theory of relativity, which to be honest, I've never really dove into in my life, to really understand the four dimensional nature of the universe and his contribution to humanity. I never quite understood how many contributions he's had over so long and what he actually got the Nobel Prize for relative to what he should have gotten it for. It's super interesting to see what happened historically.
Deborah Dunsire:
It's super interesting to think about that brain, that he could sit and just envisage that and then create the mathematics that proved it. I find him astounding
Yaron Werber:
Deborah, it's always great to see you. Really, really interesting and really appreciate your time.
Deborah Dunsire:
Great to see you. It's fabulous to have a chat. Thanks so much for inviting me.
Yaron Werber:
It's our pleasure.
Speaker 1:
Thanks for joining us. Stay tuned for the next episode of Cowen Insights.

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