Driven To Serve As Many Lives As Possible

An interview with Tony Coles, M.D., cofounder, chairman and CEO, Yumanity Therapeutics

N. Anthony “Tony” Coles grew up in and around the church. As the son of a minister, Coles learned at an early age to think deeply regarding matters of life and death. He was taught to be comfortable speaking in front of groups and saw firsthand what service leadership looks like. His youthful experiences and his family’s teachings taught him the importance of putting others first and that, first and foremost, a leader’s job is to serve—anyone and everyone who could support and enable the mission at hand.

Before going to work at Merck & Co. (Merck Sharp & Dohme outside the U.S.), Coles treated patients as an internist and cardiologist at Massachusetts General Hospital. At Merck, he led the company’s domestic cardiovascular business. During his tenure, Coles grew the company’s cardiovascular business by 30 percent. Shortly afterward, he was recruited to Bristol-Myers Squibb, where he helped lead the launch of the blood-thinner Plavix, one of the most successful cardiovascular drugs ever developed.

From Bristol-Myers Squibb, Coles moved to Vertex, a biotech company headquartered in Cambridge, Mass. The scientific mission of Vertex was to discover new drugs through “rational drug design,” a process used to create new molecules by designing them, one atom at a time.

After Vertex, Coles moved into the corner office at NPS Pharmaceuticals and later, in 2008, he joined Onyx Pharmaceuticals. While at Onyx, which specializes in developing cancer drugs, Coles oversaw the introduction of two therapies—one for multiple myeloma, a deadly blood cancer, and another for colon cancer. After five years at the helm as Onyx’s CEO, Coles sold the company to Amgen for $10.4 billion.

Coles’s latest venture, Yumanity Therapeutics, is a start-up. It was founded based on research conducted by Susan Lindquist, a biologist at M.I.T.’s Whitehead Institute for Biomedical Research. Yumanity’s goal is anything but modest: It is to develop treatments for neurological diseases such as Alzheimer’s, Parkinson’s and amyotrophic lateral sclerosis (ALS). What follows is an edited discussion that took place between Coles, Yumanity’s chairman, CEO and founding investor, and Joel Kurtzman, editor-in-chief of Korn Ferry’s Briefings on Talent & Leadership, in New York City.

When did you know you wanted to become a doctor?

Since the age of 9, it was my goal to take care of patients. When I applied to college, I had the choice between Columbia University in New York and Johns Hopkins. Accepted by both, I asked my father for advice about which school he thought I should go to. He wisely said, “If you want to be a doctor, choose the university with the best medical school and go there.” Johns Hopkins was one of the top-rated medical schools in the country, and on that basis, Hopkins won out.

It’s a great school.

Yes. And it was a great place for me. I really found myself and learned about the power of discipline and focus. I then went on to medical school at Duke.

Were either of your parents doctors?

No. My father is an accountant by training and now a full-time minister, and my mother was an office manager for the local telephone company. Both parents have always been wonderfully supportive of all the choices I’ve made. And, when I left the practice of medicine, they were both genuinely happy I had found something in the pharmaceutical industry I loved doing. Interestingly, in some ways, I feel what we do to create new medicines is something of a ministry because my personal mission is to make a transformational difference in people’s lives.

Did you grow up watching your dad preach to the congregation and ministering to its members?

Absolutely. And growing up in a church meant I was in the Easter play and recited the Christmas poem, and served as the master of ceremonies at various church events. It gave me the opportunity to be in front of a congregation, in front of people, and to be at ease in front of groups. I think it helped me to find and then use my own voice and tapped into some kind of latent leadership skill.

The ministry and medicine are both about helping people and making a difference in their lives. Do you see them as related?

Yes. As you say, they are both service-oriented.

Did you practice medicine before going into business?

I did. I was a cardiologist.

And when you went into business, where did you start?

I held several jobs at Merck, but the one that was the most formative was running the domestic cardiovascular business for Merck. It was an $800-million business when I joined, and we grew it by more than 30 percent over the next two years to just under $1.2 billion.

What was your experience at Merck like?

I thought I was the luckiest guy around. I had the best job in industry. I had an opportunity to help physicians learn about the newest medical therapies and got a chance to help them discover the best ways to use them for their patients. Most people would call it marketing, and I felt right at home using my education and training to help shape new standards of medical care.

That does sound like you are providing a service.

To do what I’m describing you have to start and end with this question: “What’s in the best interest of the patient?”

Keep in mind, this is one of the few industries where your end user is not your customer. Your customer is the physician, or a provider group such as a health maintenance organization, or the federal government, and so on. As a result, you have to develop a way of supporting your customers so they can make the best choices on behalf of the patient. It’s a different model of necessity, because you become partner and collaborator with the intermediary to focus on what’s best for the patient. But, this type of “patients first” strategy puts the business emphasis where it should be—on the end users. This service-oriented strategy is how we built Merck’s cardiovascular business.

How long did you stay at Merck?

Four years.

Then what did you do?

I received an invitation to join Bristol-Myers Squibb to lead the launch of a new product called Plavix. Plavix is now a very well-known and successful product. It’s a blood-thinner people take after a heart attack.

Were you involved in research on Plavix?

No. But I was there for the launch of the drug. In fact, I remember the day the envelope was opened and the final results of the clinical trial was delivered. When we saw the results, we suddenly knew that we had an extraordinary opportunity to change the practice of medicine—because the data were that compelling. I’m a cardiologist, but do you know what? It was remarkable for me to see how excited other cardiologists were about even the smallest improvement in benefit for their patients, especially if it meant a reduction in mortality. That made a big difference because it meant they could do more for their patients. For physicians, it all goes back to “what’s the best I can do for my patient?” And, on that basis, I’d say improvement in the death rate after a heart attack was a big advance. And this is how we launched the drug.

It sounds like you view that drug as a service, too.

Well it is. As I said, we all work for the patient, and our work counts in terms of people’s lives, every day. I always challenge myself and our teams to remember—to really remember—whom we work for at the end of the day. In my case, it is clear to me that I work for the employees. My job, as CEO, is to remove barriers and find ways to accelerate what they are doing, so they can be successful on behalf of patients. Removing barriers is a very important job of a leader, and it’s a great principle by which to abide. In essence it’s the centerpiece of servant leadership. Next, I always remind myself and our employees that while I work for them, we all work for the patients. Patients who are counting on us and waiting on us to find the next cure for their diseases. That’s the reason we are here in the first place.

When you think about it that way, it helps you put away your disagreements and put away those things that plague organizations, like politics. When you put away all of that, you remember that at the end of the day we often are involved in real, life-and-death problems. And it’s never really about just one person. We are there for a patient’s family, friends and loved ones, too. And if you multiply the impact of this on a global scale, you begin to get a sense of the potential transformation that comes from what we do. It can be significant. And it’s certainly very humbling.

If you get everyone to focus on the patient, then everyone will line up and help remove the obstacles, won’t they?

That’s the way I think about it when I think about the architecture of leadership. If we’re doing what we’re doing simply to make money for ourselves, then we’re missing a very important and rewarding opportunity in this industry to help transform people’s lives. The point is, in our business we can do so much good. George Merck, a founder of Merck Sharp & Dohme, used to say if we put the patient first, then the profits will follow. I concluded long ago that if we seize the opportunities we have to change people’s lives by giving them better health, then the returns will come. And you know, I think that’s the right relationship. I just think it is true. If we can really help the patient, the profits will be there.

Can you create businesses that are truly service-oriented and also profitable?

Yes, of course. And we have. We’ve created some extraordinary business opportunities with great returns for investors with that simple mantra.

Will that remain your goal as you develop new ventures?

Yes. For most of my adult and professional life, I’ve been very fortunate and had some great opportunities to help change lots of lives. There are so many ways one can do that. But if you do it by providing access to better health care, that’s huge. I mean really huge—and meaningful. Think about the number of lives that are broken by diseases and illness, and think about the fact that we don’t have cures for so many devastating diseases, such as Alzheimer’s and other diseases of the brain, and many cancers. Imagine what a different existence it would be if we could eradicate some of these commonly occurring and devastating illnesses.

By focusing your new company, Yumanity, on treating Alzheimer’s, Parkinson’s and ALS, you are focusing on a number of gigantic unmet needs. That will be a huge service to humanity as well as a huge financial opportunity.

Absolutely. From an incidence point of view, these diseases affect about 50 million people worldwide, at a cost of almost $700 billion a year, if you include direct health care and indirect economic costs, and that cost figure is expected to triple by 2050.

How do you approach solving a problem that’s so big?

Our new company, Yumanity Therapeutics, provides an opportunity to impact millions of lives. When I worked in cardiovascular diseases, it was a great foundation-setting exercise. I learned the industry, l learned about the business of creating and developing new medicines, and I learned how to create and grow value—all the while remembering that we worked for patients and their families. When I joined Onyx, the aim was the same—to help change the natural course of some of these diseases and improve lives by treating patients with newly discovered medicines. At Yumanity, we are focusing on some of the greatest medical needs we have, certainly as measured by the number of people affected and by the cost of those diseases over time. So you have very large problems to solve, which means you have significant opportunities to make an enormous difference for people—which means, as George Merck eloquently stated, the profits will come.

And, by the way, I think we can do it. Really do it! Some of what attracts me to this project is the scale and significance of the problem—the sheer intractability of treating and curing neurodegenerative diseases.

At present, you and your scientific cofounder are funding Yumanity yourselves. How do you know you are making the right bets?

We don’t. But how do you ever know anything in science until you actually ask the question and study it? With Yumanity, we are at the juncture between asking the question and studying it, and finding clues and answers to get deeper understanding of the biology of Alzheimer’s and Parkinson’s. We’re studying these problems at a cellular level to try and understand the basic biology of these diseases, and at the same time—and this is the beauty of it—we’re interrogating the science and using state-of-the-art drug discovery methods to find new treatment approaches. Because of our approach, we’re learning about the biology at the same time that we’re identifying new compounds, targets and mechanisms to find solutions to these devastating health problems.

Instead of doing it sequentially— studying the biology and then attempting to remedy the problem—you are doing it all at the same time. That sounds like a new approach. Is it?

Yes. We’re in effect asking the science to show us what will make a cell better once it has been affected. We do that by creating the same problems in yeast cells and in neurons that are observed in patients with the diseases we’re studying, and then we screen new compounds to try to understand what will rescue the cells after they have been affected. That’s the approach we’re taking to find new therapies.

Where are you in the process?

We are in the earliest stages of discovery. We are gaining insights about the basic cellular mechanisms of the disease. In fact, we’ve already uncovered a previously unknown mechanism that we think is involved in the development of Parkinson’s disease. It’s fascinating. And we have newly discovered compounds that we believe interact with this target, which could one day be a new treatment. That’s why the science is so wonderful and so exciting. We’re not just learning about what goes wrong and causes these disorders. We’re finding things that we hope will correct them.

Is this your life’s mission?

Yes. If this works, we will have changed the course of history. The implications are that big. You can understand why I’m attracted to this. I have always enjoyed a great challenge, and this one is sized just about right. My personal mission in life is to impact as many lives as I possibly can and to productively use my time on Earth to do that. My goal is to always think of a bigger, more challenging set of problems that would be even more important to the lives of people today. I believe that is my purpose. I also believe—with help—we can do it.