Nate Massari on the Pharmaceutical Industry and Rumpus Therapeutics
Nate Massari
Nate has nearly 20 years of healthcare experience in consulting, marketing and sales, corporate strategy, management and corporate development across the pharmaceutical, biotech, device, health services, and distribution industries. He began his career in management consulting within the Health & Life Sciences practice at Accenture. Nate also held various commercial leadership roles at Johnson & Johnson, AstraZeneca and Endo Pharmaceuticals. Most recently, he has served as the senior vice president of corporate development and strategy for AmerisourceBergen where he co-led M&A and strategic planning. Nate has a BA from Princeton University and an MBA from the Wharton School at UPenn.
Business Today (Richard Yang): Starting off, I want to know a little bit more about your experiences. I know you have ~20 years of experience in healthcare consulting, but what got you to co-found Rumpus Therapeutics?
Nate Massari (NM): I started my career in consulting because I thought it would give me the greatest breadth of experience: both in terms of skill set as well as in companies. I started at what was then Anderson Consulting before becoming Accenture, and I had the good fortune of being staffed at a number of big pharma clients in the early 2000s. I got to work on two mergers: the first one was the merger of Astra and Zeneca, and then the second one was the merger of Sanofi and Aventis to create the current Sanofi company that it is today. I got exposed to a number of different areas in pharmaceuticals. First and foremost was sales and marketing. We did a lot of strategy around go-to-market, segmentation, sales force effectiveness, and promotional spend and optimization. Secondly, I got exposed to managed care and access and reimbursement. I think my experience in the early 2000s was still in the area of mass market blockbusters. Big pharma companies were trying to launch drugs into huge conditions. Think about Statins: Astra Zeneca launched Crestor for high cholesterol, and PPIs (Prilosec and Nexium) to treat GERD. I spent 4 years in consulting in the industry and worked at AstraZeneca, Sanofi, Novartis, and other large pharmaceutical clients.
I felt that consulting was a great introduction, but I wanted to be more of an owner and operator responsible for some of the strategies and recommendations versus working at a client engagement for three or six months and moving on. For this reason, I decided to go back to business school to round out my experiences, get more classwork in finance, and also expand my network. In between my first and second year I had the opportunity to intern at a biotech company called Centocor, which is wholly owned by Johnson & Johnson. After I graduated, I went there full time. I got to work in brand management on the marketing team for a product called Remicade. What was happening at the time was Centocor had Remicade, Amgen had Enbrel, and Abbott, which is now AbbVie, had Humira. These were immunology drugs that for the first time provided the ability to treat inflammatory conditions, like Crohn’s disease or Ulcerative Colitis, which are inflammatory bowel diseases, and rheumatoid arthritis and plaque psoriasis. It was this incredible time where all my consulting experience was focused on small molecules and now to work on biologics and it was a different patient identification, price point, and go-to-market strategy including, back to my earlier learnings on managed care, buy-and-bill reimbursement. Everything was just different moving from small molecule to large molecule. I was there for about five years, got to launch new indications and work with patient societies, do some consumer marketing, and I absolutely loved it.
I then decided to move to a company called Medimmune, which is the biotech division of AstraZeneca, so I moved down to the Washington DC area. My job there was in the pipeline; instead of working on commercial products, I was working on pipeline products. In essence, when I worked at Centocor, I learned what finished looked like from product development, and at Medimmune, I learned what started looked like. We would work alongside researchers and clinicians for drugs in preclinical phases and phases I, II, and III. We would do everything from the valuations and NPV analysis to justify investment decisions to target product profiles to market research as to what would be important for payers, providers, and patients. Afterwards, I moved back to the Philadelphia area and had the chance to work at a small, specialty pharmaceutical company called Endo Pharmaceuticals. One of my roles there was in pediatric endocrinology with a drug device implant for a rare disease called central precocious puberty. That was just an incredible opportunity to run a sales and marketing team, have P&L responsibility, and work in an orphan condition with children’s hospitals in a small patient population.
From there, I moved to AmerisourceBergen for two primary reasons: I wanted to better understand the supply-chain. AmerisourceBergen is a wholesaler or distributor, so they make sure that products get from manufacturer’s to physician offices and pharmacies; they manage the supply-chain and logistics and also the cash flow in-between, so I always took for granted when the prescription that had been written, how does it get from point A to point B and working at AmerisourceBergen helped me learn that. Then, I also got to work in the M&A group, so I got to do more than 20+ transactions that totaled over six billion dollars in capital deployment. I say all of that because what I was trying to do in those years was develop general management skills. I wanted to understand product management from pipeline to commercial; I wanted to understand sales, marketing and strategy, as well as finance and M&A; I wanted to get some global experience, so I had some teams based in the UK when I was working at AstraZeneca; I also wanted to round it out with the supply-chain, knowing that some point in my life I wanted to go work for a small, start-up, biotech and be their chief business officer or an early employee number on a small team.
Along the way, I fell in love with rare and orphan diseases and decided to start Rumpus Therapeutics with a colleague from business school named Topher Brooke whom I had worked together with and a co-worker from Centocor named Greg Keenan who is a pediatric rheumatologist. The three of us have a nice blend of skills where I have the business finance, business development, Topher has the commercial leadership and general management, and Greghas the clinical and scientific expertise. The reason we started Rumpus is also a personal one. My wife, Sarah, and I have three kids, and our middle child, Luke, has a rare, genetic disease called Ehlers-Danlos syndrome; it is typically a connective tissue disorder where you don’t produce collagen in the right places. There are actually thirteen different types of the diseases, and his is called hypermobile in which his collagen is lacking in the joints. When my Greg,Topher, and I were forming Rumpus Therapeutics, we sat down and talked with the Ehlers-Danlos Society. They told us about a type of this disease called vascular Ehlers-Danlos, which basically is a lack of the collagen in your aorta. What happens is that you have a genetic mutation and at some point in your life the collagen tears away from your aorta or somewhere in your vascular tree and you experience a vascular rupture which is oftent fatal. In short, we started Rumpus Therapeutics to try to bring the first product to market to treat vascular Ehlers-Danlos.
BT: So moving on from there, could you give a general overview of your company and how it works with startups and early companies to improve therapies for pediatric diseases?
NM: For context, there is a statistic that says that ~70% of all medicines used for kids are used off label, meaning that they have an adult indication and are not appropriately studied for kids. At Rumpus Therapeutics, we want to do the opposite; we want to study it in kids first and then expand it into adults second. As we got started, the Ehlers-Danlos Society introduced us to a researcher at a leading university, and oftentimes these academic settings are really the spark for the innovation because they are conducting scientific experiments and running animal models in which you try different things to better understand the pathophysiology of the disease or mechanism of action. From there, the academic researchers might file a patent for an interesting finding. Therefore, when you partner with these institutions, you help put together the science with the business.
The way that it typically works is that you’ll license the rights to the patents that they’ve generated, put together a business plan that includes the R&D strategy and clinical trial design up to the marketing forecast, and then go raise venture capital. You take the licenses that you have from academia, but sometimes they may be from industry settings like big or small pharma companies; maybe they have a molecule that they are not interested in and are willing to license it. You can reference the data they have generated for safety reasons, and then you are talking to venture capitalists. The pitch is around what are the capital efficient ways to help make a difference and impact in patient’s lives, but also address that these are financial institutions that need to get a return on investment. Is there a fast to market strategy? Is there an untapped market potential? In the case of vascular Ehlers-Danlos, there is literally no approved medicine, so if you can get approval, you have a good commercial opportunity, not to mention the substantial impact you are making on the patients themselves. I consider the start-up entrepreneur to be the fulcrum or lynchpin between academic research and science and industry or small pharmaceutical companies to gather the financing, build the teams to do the work, and then bring the products to market.
BT: Going along that line, could you expand on a client that your company has worked with and the role Rumpus has played. I know that you said that you’ve worked with vascular Ehlers-Danlos syndrome, but maybe expand a little bit more on what your company has been able to achieve so far.
NM: We started the company in January and are ten and a half months in. What we did was first and foremost started with patients in mind, so we spend a lot of time with the advocacy groups. It was understanding the huge unmet need in the vascular type because all of the types of Ehlers-Danlos are debilitating. For the first month or so, it was really spending a lot of time with the advocacy groups, and there is a patient and physician component to really understand the unmet need. Then, we transitioned to spending a lot of time with the academic researcher. The concept was to better understand his research, his animal models, how he replicated the genetic mutation, and how the animal model would translate biologically to the human condition. Then, it was working with some regulatory consultants to better understand what would the strategy be to take it to the FDA and get their guidance on how many trials we would need to do and what end points we would need. Then it is the business component really around what are the costs and time around what we need to do. Finally, where we are right now is talking with venture capitalists to try to raise funds to finance the program to go in and do the work that was described. Overall, it is many building blocks. We like to go in and first start with the patients because that keeps us grounded with the reason I love working in this industry. Then it is the science. Then it is the regulatory or clinical pathway, and then finally the business case to provide the financing to go in and do the work that was described.
BT: I was also wondering how you see your company expanding in the future and how does it stand-out from other healthcare incubators?
NM: First, we have to secure the financing that I was talking about. Then, make sure we are utilizing those resources efficiently. Some of that will be hiring the right people and some of it will be utilizing the right vendors. There are a number of contract research organizations in the industry that have the breadth and depth to conduct these trials. You have to make sure you hire the right people because they are sort of speak, permanent members of the team. You have to find the right vendors and partners, so you can deliver on the business plan you laid out both in terms of meeting your budgets and timelines. We are focused on diseases that are not necessarily being focused on. We think about being able to bring a product to market for our lead case, vascular Ehlers-Danlos, but then there is a huge unmet need in the NICU as well. There are a number of babies that are born prematurely and at low birth weight that suffer from respiratory diseases or gastrointestinal diseases. There is not enough research going on there, and we think there may be an opportunity to take a cell or gene-based therapy—one, two, or three-time infusions that provide a lifetime of therapeutic support. The concept is how do we move from treating chronic conditions to resetting their immune systems or providing the boost to get their cells to do the right thing and harness the power of the body and immune system to fight off some of these diseases.
There are these conditions in the NICU, one of them being bronchopulmonary dysplasia. These are kids that are on mechanical ventilators, and their airways get damaged. Are there ways to have cell-based therapies as an approach to that? There is another disease called necrotizing enterocolitis, which is an intestinal condition in which the babies’ intestines do not develop, so they cannot absorb and get the nutrients they need. These are the types of diseases that we want to spend the rest of our lives working to solve and partnering with industry, advocacy, and regulators to focus on new-born health and neglected, pediatric diseases.
BT: A few last questions, but what has been the most rewarding aspect of starting your own business and for our readers, who are aspiring entrepreneurs, what advice would you give them when they first start out?
NM: Let me tackle the second question first. Find your passion. I know it sounds cliché. I know I didn’t always know it in collegebut after graduation I landed in life sciences and have loved it ever since. I love being able to try to help patients every day. I feel like if you have that purpose or mission, then it will help you fight through the tough times and the obstacles and give you a reason to push through. The concept would be to think about what you like, what you’re good at, and what skills you want to develop. Then, work at them and actively work to figure out ways to find jobs that help round out your skillsets, spark a passion, or play to an interest. As I describe my career, I spent the first twenty years gathering experiences from a variety of functions and stages of company and types of companies all within the healthcare system. Now, I feel prepared with the general management experience to tackle different challenges that come up. If you are passionate about something or interested about something, then you will be willing to go the extra mile, work a little harder, not take no for an answer, and knock down obstacles that are in your way. I think it’s easier to do that for a job, career, or industry that you love. My advice to people is find your own path, instead of listening to people who say you have to do it a certain way.
To answer your first question, it is just so rewarding to be so close to patients and patient care. To your point, there is an industry, business, and finance component of it. At the end of the day, it is a business that needs to raise the right amount of money to return to investors, but the day-to-day work I do is incredibly rewarding. The two things to keep in mind being an entrepreneur is that you have to love it and then once you love it, it is amazing because you get to work on different things at different times. Back to your point about what we have done since we started Rumpus Therapeutics, one month was spent going really deep on regulatory plans, one month was spent on developing a business plan, etc. If you like that concept of constant change, then being an entrepreneur is a really amazing place to be.
BT: Amazing. One of the last questions I have is as you said you were working in a comfortable corporate, finance business/job, was it every scary to start your own company and get away from that type of stability?
NM: I describe the experience as being terrifying and exhilarating at the same time. I would say three things: one is that the exhilaration trumps the terror. Secondly, Greg, Topher, and I have known each other for coming on twenty years, and we all decided that we were going to set aside our own time and savings to do this. The thought was we didn’t want to wake up ten years from now and say, “I wish I had tried this.” The last thing I’ll say is that that provides important motivation. All three of us have spouses, kids, and bills to pay, so it provides the incentive to work harder and faster to accomplish our goals. There is a leap of faith jumping from a cushy corporate job to a bare bones start-up where you are funding the beginning from your own personal finances, but I think that is the right incentive to prevent people from just shrugging their shoulders, giving up, or moving on. At the end of the day, it allows for you to really absolutely love what you’re doing and jump out of bed every day to work on it with people that you know really well, are like-minded, and have complementary skill sets with a common goal of helping patients.
BT: Definitely. Thank you so much for taking the time to talk with me about your experiences and Rumpus Therapeutics.
NM: The last thing that I’ll say is that we named the company Rumpus Therapeutics in a nod to the children’s book, Where the Wild Things Are. It was an important book in my childhood, and I read it to my children now. There’s a great line in the book that says, “let the wild Rumpus start.” The concept in Rumpus is all about kids and pediatric health. Also, the name connotes doing things a little bit differently: we focus on diseases with no other therapies, try to be the first pioneer for new treatments, and have a predominantly female board of advisors, which is not necessarily common in the industry. We think having a contrarian approach to doing things a little bit differently is important, and we wanted to get that across in the name of the company.