Two women leaders; Two diverse response to crisis !

Three stories in the recent past have caught my attention, all featuring female protagonists. 
The first being Theranos CEO Elizabeth Holmes, second - Mylan’s CEO, Heather Bresch and 
the third - Yahoo’s CEO, Marrisa Mayer.

Let me take the first two in this post since they are linked to Biopharma segment, hence closer 
home. Let me give you a background of both these companies & women leaders so you get to
understand their perspectives & decisions taken by them in light of the recent storms; which 
they continue to face till date. Elizabeth Holmes, a Stanford dropout founded the company Theranos in 2003. The promise of Theranos was a revolutionary technology that allowed 240 
blood tests to be conducted (cholesterol to cancer) with few drops of blood taken from a finger 
prick akin to routine blood monitoring of blood glucose done by patients with diabetes; a shotgun
approach to blood tests which rely on venous blood (blood drawn from the vein which can be painful for some people and cumbersome for many). Theranos was valued at $9 Bn dollar 
company when the controversy started in last quarter of 2015.  

Heather Bresch joined Mylan in 2002; in the capacity of a clerk at their factory. She rose to 
become the CEO of Mylan in 2014 and was named by Fortune magazine as one of the '50 most
powerful women in business' in 2014. Mylan acquired the rights to Epipen, the quick dose of 
Epinephrine used by people to stop allergic reactions in 2007. Epipen is the life saving constant companion of parents with children who have nut allergies or those who are allergic to bug 
bites. In 2007, the cost of Epipen was about $94 for two. Nine years later, it's above $600. 

Unsurprisingly, this inducted Mylan into the public rogue's gallery of "greedy" drug makers

(in the company of Valeant & Turing Pharma) who jacked up prices and more important, kept

life-saving treatments out of the hands of patients who need it. Profits over people, as slogan

goes.

With that background, lets get to where they are now !

Theranos has been banned from operating in the blood testing market for atleast two years & 

facing federal criminal investigation into whether it misled investors about its technology and 

company operations, Heather Bresch is facing intolerable amount of heat from the US Congress 

with both Republicans & Democrats baying for her blood.

Being a Pharma Nerd, I was/am  following both these stories avidly. I was keen to understand their response to the crisis since there were valuable lessons to be learnt here....

Lifeguards know a little secret that saves lives. When a current is dragging you to the sea, stop 
fighting it and start swimming parallel to the beach. The current will shift soon enough and you 
will reach the beach without drowning yourself. 

Mylan’s Heather Bresch handled the outrage towards her company’s pricing of Epipen in a 
similar manner. Rather than swim against the criticism, she started swimming along, hoping 
to change the narrative. As anyone who has sold a drug knows, there are many added cost a
and layersthat touch the product, wholesalers, distributors, pharmacy- benefit companies, 
retail pharmacies, etc. Bresch said the $608 price tag brings in $274 to Mylan. Rest goes to 
the middlemen.  She went on to say, instead of raising prices, she wishes she could lower prices, 
without risking the profits required to keep the Epipen in the market. “No one is more frustrated 
than me, Everyone should be frustrated" 

By turning the discussion towards the law makers, this may  seem risky, but in a political season 

when no one trusts politicians, it helped to reshape the narrative. Days later after raising its 
copay coupon system to cover $300 of people's out of pocket cost for Epipen, she went on to 
reveal plans for launch of generic version of Epipen at half the cost. Apart from the obvious
benefit of ensuring a larger market share for Mylan when the market opens up to more 
generic players, this move also crecreated a price barrier for these said generic players.

Shifting the attention to the second protagonist, Elizabeth Holmes, the self made billionaire 
who founded Theranos in 2003. Theranos wowed investors, journalists and even groups like
the Cleveland Clinic and Walgreens with what you might call an “iMedicine” vision of blood 
testing. Basically, the idea was this. A few drops of blood from a fingertip are collected into a
“nanotainer” collection tube and analyzed on the company’s proprietary machine, named
after famed inventor Thomas Edison. How exactly the Edison devices work is unknown. But
the claim was that many, possibly dozens of tests could be run on those few drops of blood.

Trouble started when Wall Street Journal did an exposé which alleged Theranos might actually 
be performing the majority of its tests using traditional machines, the kind already in use in 
labs across the country, instead of its own much touted Edison devices. And then the FDA 
called the nanotainer an “uncleared medical device.” In contrast to Heather Bresch’s approach 
to swim along and change the narrative, Holmes went out all guns blazing. The day the article
broke, Theranos issued a point by point rebuttal of WSJ allegations on its website. And later 
that evening, Holmes sat down for an interview on Mad Money. "First, they think you’re crazy,” 
she told Jim Cramer with her characteristic gravitas, “then they fight you, and then all of a 
sudden you change the world.” By promptly hitting the media circuit immediately afterwards,
Holmes showed he world she was “not backing down, not shying away.” She also issued a
statement accepting full responsibility for the issues at Theranos labs and undertaking 
comprehensive remedial actions. Theranos is now additionally facing federal investigations over
misleading investors and regulators about its technology and company operations. 

Recently, when Holmes was invited to deliver a 90 min talk at the American Association for 
Clinical Chemistry (AACC), instead of using the session to present scientific data in defence of 
her company’s proprietary blood- testing technology as it was expected to, she audaciously 
used her appearance tounveil a completely new machine, the MiniLab, which she said could 
enable small samples of blood to be analysed remotely using cloud computing. She continues 
her fight to keep the company afloat.

If Theranos indeed has the ground breaking technology they claim to possess, they will be able 
to tide this crisis over and Elizabeth’s spirited defence is a brilliant response but if her guts tells
her to do this knowing that its wrong, then it is entirely different story because peoples lives 
are on the line !

Two diverse response to crisis ; will both prove to be right in their own space ? Were they the 
most appropriate responses ?  Only time will tell. Meanwhile I will be closely following both 
these stories and updating it here. Watch this space : )

Source : WSJ, The Entrepreneur, The Scientific American