As a part of my interview series with leaders in healthcare, I had the pleasure to interview Tim Walbert, chairman, president, and chief executive officer of Horizon Therapeutics.
Horizon is focused on researching and developing medicines that address critical needs for people impacted by rare and rheumatic diseases. Since June 2008, Tim has served as president and chief executive officer and has served as chairman of the board of directors since 2010. Tim’s leadership style is personal. Patients are at the core of the company culture, as it reflects his own experience as a patient.
Thank you for joining us! Can you share the most interesting story that happened to you since you began leading your company?
The story of the approval of our new breakthrough orphan medicine and the process involved in bringing it to market makes me proud of what we do at Horizon. In May 2017, we acquired a company called River Vision and with it, an investigational medicine called teprotumumab (now marketed as TEPEZZA) that was being studied for a rare disease called Thyroid Eye Disease (TED). For background, TED is a serious, progressive, vision threatening autoimmune disease, which is most often seen in patients with Graves’ disease. As TED progresses, characteristics may include: eye bulging (proptosis), misalignment of the eyes (strabismus) reported in more than 50 percent of people with TED, double vision (diplopia) reported in about 50 percent of people with TED and vision loss. We began the Phase 3 clinical trial in October 2017 and because this particular disease state had no FDA-approved treatment, what really stood out for me throughout the duration of the clinical trial was the collaboration within the TED community. Our clinical team was highly motivated to bring a new treatment to people impacted by TED. The physician and advocacy communities were highly collaborative and supportive, which helped make the trial a success. This type of partnership and collaboration should be emulated in other disease areas.
In December 2019, the U.S. Food and Drug Administration’s (FDA) Dermatologic and Ophthalmic Drugs Advisory Committee met to review the Biologics License Application for TEPEZZA. When a company submits an application for a new medicine to the FDA, it is common for a committee of experts to review the application in a public forum. As part of this day-long committee meeting, there is an open public hearing where members of the community, in this case people impacted by TED and advocates, have the opportunity to address the panel. There were more than 10 people who spoke at the open public hearing, including three women who had participated in the TEPEZZA Phase 2 clinical trial. The emotion-filled testimony truly highlighted the dire need for new treatments and the struggle that many people impacted go through on a daily basis. To hear first-hand what these people had gone through to get the right diagnosis to their approach to tackling daily activities being visually impaired to finding, or in some cases, not finding treatment was both inspiring and heartbreaking. It really shed light on the importance of the work that we do every day.
What makes your company stand out? Can you share a story?
The people make Horizon stand out. About three weeks into the COVID-19 pandemic, I made a video announcement to all employees with one simple request — reach out to me to let me know how they and their families were doing. Horizon has nearly 1,200 employees and I received messages from almost all 1,200. It was an amazing and unexpected response. I heard from colleagues who have been with the company for a long time, as well as new colleagues who I hadn’t had the opportunity to meet. Their stories ranged from creative solutions for homeschooling to how people were giving back to the community to being personally or having loved ones significantly affected by COVID-19.
One thing that this experience taught me as a leader is the importance of creating an environment where people feel comfortable in sharing, being vulnerable and transparent. We have built our culture on this foundation.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
We are innovating in rare disease. Nearly one in 10 Americans are living with a rare disease. There are over 7,000 known rare diseases and fewer than five percent of rare diseases have an U.S. FDA-approved treatment option. This unmet need is coupled with the harsh reality that it takes almost a decade to bring a new medicine to market in the United States, and that only happens when there is robust science that shows that the new medicine is a potentially viable solution. We want to change the odds for those impacted by rare disease.
To do so, we think differently about how we can deliver in new ways for the patients and communities we serve. We apply scientific expertise and courage to identify and then pursue research and development of the most challenging needs while constantly looking through a patient-informed lens. We also continually look to find new ways our current medicines can benefit patients. Our patient-driven approach also drives us to move urgently and decisively through the clinical process to bring new and novel therapies to patients. We bring a seasoned team of research and development expertise with more than 100 years of experience across our team, as well as the infrastructure and commercial expertise we’ve spent the last decade building, honing and expanding particularly in rare diseases.
Changing the odds in rare disease means delivering on our promise to bring meaningful therapies to patients, their families and the physicians who care for them.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
The Commonwealth Fund has been reminding the industry of the obvious for many years. I, along with other industry executives, have observed the following:
- The current U.S. healthcare system is a heavily regulated industry, with a patchwork of oversight functions and rules at the state and federal levels. It is purposely opaque and there is not enough attention to accountability.
- Patients rely on clinical decisions that are mostly beyond their knowledge. Even if they are informed, those decisions are beyond their control and often the choice of medicine is beyond the control of their physicians, driven by insurance plan design. More often than not, their patients find they have to wait an extended time for approval to receive an appropriate therapy for their condition and are sometimes forced to fail another medication first. If a patient doesn’t know how to advocate for her or himself, how do they get the best care? The lack of uniformity is remarkably challenging, particularly for our patients who are facing rare diseases where paths have rarely been mapped or traveled. I have an autoimmune disease and a rare disease and I know how hard it can be because each year I have to fight for access to my medicine.
- Healthcare infrastructure is as important as public education, public safety, transportation or utilities. The COVID-19 pandemic has exposed the gaps in the system and proven how hard it is to scale it so that everyone gets the right care at the right time, place and value. Digital technologies and aligned incentives can streamline and help clinicians make informed decisions that are supported through access.
You are a healthcare insider. Can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Protect the current U.S. patent system and existing intellectual property rights for biopharmaceutical innovation. Public sentiment toward drug pricing has recently led some lawmakers to pursue punitive measures that would inhibit new innovation. The pandemic has demonstrated what the pharmaceutical industry does best — develop medicines and vaccines to address the diseases of our time. Much of this innovation is possible because of how the United States treats new ideas. The United States has a strong patent system that allows for discovery and development of new medicines that treat and cure diseases. This system is working; let’s not fix what isn’t broken.
- The digital age can be used to more directly improve patient care, speed and broaden access and improve information sharing. Telehealth is an example of this and the pandemic has laid bare its ability to vastly change the state of care for some patients, particularly patients in rural and underserved areas.
- Invest differently in public health. The nation’s public health system will be transformed in response to COVID-19. There is tremendous opportunity for communities to engage constituents and populations who have been left out of the discussion in the past.
- At least a third of primary care providers are at risk of financial collapse. The evidence of their value to care delivery and value is overwhelming. Finding a way to stabilize front-line care is paramount to ensuring broad access to healthcare.
It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
As business leaders we have a duty to engage with our trade and professional organizations and our state and local components, to ensure that patients and the communities where they live are getting the resources they need. Sometimes that means we must help shoulder that responsibility. At the onset of COVID-19 Horizon made its largest philanthropic commitment to date by donating $1.5 million to funds and foundations that provided PPE to healthcare workers and funds to families in need.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
Twitter is my “go-to” resource when it comes to keeping up to date on healthcare, medicines, the pharmaceutical/biotech industry as well as personal interests.
How can our readers follow you on social media?