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Leadership Illuminated: Mark de Souza, Serial Entrepreneur in rare diseases and dermatology at DeSouzaTech LLC, answers 7 burning questions

[Argus talks with clients every month about things that matter.]

A: What is your favorite thing about your job?

MDS: Everything we do is new and exciting. No one day is the same, and in the end, we have a very lofty goal. Our goal is to develop drugs that have a meaningful impact on someone’s life. It’s not just a job. In some ways, it’s a calling. It sounds weird to say that, but it’s true.

Also, I get to work with very cool people. Everybody is an expert in what they do, and more importantly, everyone knows what they don’t know. So in many ways, we’re like a sports team that plays well together. When you play together for many years, you know that someone is going to be there to catch the ball when you throw it. I’ve had the privilege of working with a couple of fantastic teams, a rare disease team, and a dermatology team. Everyone on each team is essential and has a different role. I play the quarterback. I know a little bit about a lot of different things, and I help make the work happen, but they’re the ones that do a lot of the heavy lifting.

What really interests me is the ideation part. By ideation, I mean coming up with a way to treat a disease that has no treatment. I get to talk with scientists and physicians who have an excellent idea of how to treat a rare disease or skin condition. I also get to work with them to turn that idea or early-stage discovery into a human clinical trial where you can actually prove the concept. I’m less interested in the commercial aspects of the drug.

A: What would you tell students about this work?

MDS: You have to be comfortable taking risks. I started out in a more traditional job track (regular hours, a reporting structure and HR, etc.), but what got me out of that was an appetite for risk. Maybe I should have done this five years earlier than I did, but I didn’t have an appetite for risk. My wife finally said, “what’s the worst that can happen?” It was still a tough decision to start working on my own because I had a great job, but I wanted to do more.

The work that I do is very fulfilling. How do you put a price on a drug that you helped develop that allows someone to go to school or go to work when they couldn’t? The work I do can enable people to really live their lives, where before they could not. Very few jobs give you that satisfaction. It’s exciting! Doing science that impacts clinical research that changes people’s lives is never mundane, but it is a big responsibility.

Every experience is a learning experience. Especially in a small organization, you can be flexible and learn about different things. No one can really teach you about drug development; you have to go and experience it. Working for a small organization early on, I was able to learn about so many various aspects of the process; manufacturing, regulatory interactions, and eventually pricing, sales, and marketing. All things that I wouldn’t have otherwise learned as a scientist, and in many ways, it was a priceless education for me.

A: What would you tell graduates about this work?

MDS: If you love what you do, it won’t be work. People accuse me of being a workaholic, but I love what I do. It’s what makes me happy.

A: What are the most important decisions you make as a leader?

MDS: For me, it’s where to prioritize my time. I say no to lots of things, and sometimes I wish that I didn’t. In fact, I have to really control myself, so I don’t take on too much. And likewise when to stop working on something.

Recently, I shut down one of my ventures. I still think it’s a fantastic story about pediatric hereditary cancer. The scientific founder had promising data in animal models of the disease. Nevertheless, we couldn’t raise money to advance into clinical development, and we tried and tried. We applied for grants, and we didn’t get any of them. We talked to venture capital, and we couldn’t get anyone to commit because everyone thought it was too early. I finally decided that I’d spent three years and put “X” dollars behind it, and I felt like I wasn’t prepared to do that anymore, and so I shut it down. It was painful, but if the data aren’t there, you can’t keep throwing good money after bad.

The other important decision you make as a leader is about who you pick to work with. I’ve been really fortunate, for the most part.

A: What would you like to share about your company that not everyone knows?

MDS: It’s a completely flat organization, and you have to wear many hats. Sometimes the hats are less exciting like today when I have to do some administrative stuff I hate doing that has to get done. You get to wear the leader hat, but you also have to wear the finance hat or the coffee maker hat. You have to do it all. I find that titles mean nothing. People who get the job done have domain expertise.

Sometimes you look really impressive on paper, like the first company I founded, Lotus Tissue Repair, which had a $26,000,000 Series A. Still, I was the only full-time employee. Or PellePharm; we raised $23,000,000 and had no employees until late into two Phase 2 clinical trials. We ran the company from my living room table for over a year before we got a Regus office. That’s been a recipe for success. You’re spending the money on what matters – making the drug, treating the patients, not fancy offices.

A: Marketing: How do you encourage others in your organization to communicate your core values, your brand?

MDS: My core values include “Patients First” and “Follow Good Science.” I don’t believe in drugs that will require extensive marketing or large sales forces. I remember when one of my companies, Lotus Tissue Repair, showed we could reverse a devastating disease in animal models, one of my friends said, “this drug will sell itself.” I like that, and it helps me describe what we’re trying to do. If you genuinely have good science and you are putting patients first, the drug will sell itself because it’s a meaningful thing that you’re doing.

Also, when I want to look at a drug’s effect, I feel it should be a dramatic effect. It shouldn’t take a substantial statistical analysis to see the impact. It should be obvious. I like the labels “first in class,” “best in class.” Those are all words that people have used to describe the things we do.

I also believe in the motto at my kids’ school, “Be good to one another, and pass it on.” It’s a good one. You don’t often see that. You have so many people in this industry that act like jerks. It’s evident to me that life is too short, you need to enjoy what you do, you need to enjoy the people you work with, and you have to have fun doing it. If it doesn’t fit those criteria for me, I don’t want to do it. Others in my organization will say the same thing. If they don’t hold the same values, then they’re going to leave. That’s certainly been very clear to me, and I’m pleased to say that everyone I’ve worked with over the past 10 years still works with me. Clearly, we share the same values.

A: What challenges is your industry facing at this time?

MDS: When you have both Bernie Sanders and Donald Trump painting the Pharmaceutical industry as a bunch of greedy pigs, the industry has a problem. I don’t disagree that there is price gouging, and the US has an unfair healthcare system. I believe health care is a right, but it’s hard to imagine implementing what Canada and others do given how polarized this country is. We have a problem, and it’s a very politicized problem.

Fortunately, what I do is not affected by healthcare politics. I’m not working on drugs to extend survival for six weeks and charge $80,000 for that small extension in survival. I’m hoping that the medicines we develop will prolong people’s lives who otherwise would not survive, and who will now have a healthy quality of life. In this way, it’s easier to make a pharmacoeconomic justification… You may have a rare disease and a high priced drug, but without that drug, there is an even higher price to the healthcare system.

For example, a disease called dystrophic epidermolysis bullosa can cost someone $200,000+per patient per year with no effective treatment. That money is just spent on palliative care such as bandaging, pain medication, surgeries, hospital stays, and so forth. By developing a drug that provides quality of life, you can make a very compelling case for a good business model. I’m interested in ultra-rare diseases and whether or not you can develop a drug that has a meaningful impact that also justifies the cost of the drug. So, in the end, you can also give your investors and shareholders a return. I think we can do that without price gouging. I think we can do that with reasonable pharmacoeconomic justification.

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