Trevena CEO Maxine Gowen sees health care and pharmaceutical business changing

Trevena, a 30-person drug company in King of Prussia, is led by CEO Maxine Gowen, formerly with GlaxoSmithKline. Cofounder Jonathan Violin is head of biology. Gowen says finding financing takes up about 50 percent of her time.

Trevena chief executive officer Maxine Gowen leads a 30-person pharmaceutical company, whose lead product is in phase 2b of development and, thus, years from generating revenue. But she also worked at a giant drugmaker, GlaxoSmithKline, which had 103,000 employees when she departed at the end of 2007, according to GSK's annual report.

Gowen shared her thoughts on running a small business in Monday's Inquirer. Trevena is in King of Prussia, just outside of Philadelphia. A link is to the story is here and the Inquirer's Tom Gralish has a video report, too.

Gowen had plenty of interesting thoughts on a range of health-care issues that didn't fit in the print edition, so we'll share them here. She grew up in the United Kingdom with its National Health Service and but has lived in the United States for most of 20 years. She and her husband, Brian, have three sons, one of whom is a scientist at Trevena.

In recent years, big drug companies tended to strike licensing deals with smaller companies rather than buy them whole. Trevena struck a deal with Forest Laboratories, that could be eventually be worth more than $460 million to Trevena. But in the beginning, it means Forest will pay $30 million for an equity stake. The cash will go toward paying for the next clinical trial.

"Ten years ago at GSK and other companies, they were doing most of the drug discovery inside GSK and the others," Gowen said, whose job at GSK was to scout small companies for the much larger GSK.

"That really opened my eyes to the activity, drug discovery and development that was going outside big companies," Gowen said. "At the time, big companies felt they were doing the most important work inside those companies.

"GSK led the way in having large companies turn outward on early stage research and development. All of the companies were doing licensing in late stages of production and research, but not as much external R&D in early stages."

Sheryl Sandberg, the chief operating officer of Facebook, wrote a book with collaborator Neil Scovell entitled, "Lean In," which discusses her career and how women might ascend the corporate ladder. The book was No. 1 on Sunday's New York Times best seller list for print versions of non-fiction books and was second on the list for combined sales of print and e-reader versions.

"I believe there are many women who can ably lead companies, large and small, who are being overlooked," Gowen said. "It is still something of a puzzle. I believe that everybody's human tendency is that when they find themselves in stressful roles they tend to surround themselves with the familiar. That ends up often being other men. They often have similar experiences and backgrounds. But that has shown not to create the best environment for business success. Clearly, diversity is incredibly valuable in business, like in every aspect of life.

"Women have different characteristics, as a group. Generally, they are less self-promotional than men. I don't know if that might be an issue that enters the mind of people making the choice of the CEO. That's one of the components of Sheryl Sandberg's thesis in "Lean In." Those of us who have become CEOs have a responsibility to act as role models for other women who aspire to that type of position. They need to ask for those roles rather than assume they will have to go into more traditional roles like marketing.

"Women seem to do well in school, college and graduate school, and often out-perform male counterparts. Women are now a majority of the med school students, which is clearly a massive change. In the educational phase of life, women are doing really well and often better than men up to the senior management and top positions. But at that point, many women seem to be getting stuck. I don't know how to advise them en masse."

Beyond carrying a child in the womb for 40 weeks (more or less) and giving birth, women still bear more of the burden of child care than men in most families. Many issues and perceptions surround that idea, any one of which can impact a woman's career, much less an ascension to the the CEO chair. Not that it should, but it happens.

Again, family dynamics can matter.

"I have three sons and a fantastic husband, who is immensely supportive of my parallel career," said Gowen, who knows that not all women as as fortunate.

The changing dynamics of health-care spending and cost containment are issues for executives of health-care companies of all types and sizes.

Small drug companies, in the past, have focused on the mixing molecules to create something worthwhile. Now, that is no longer enough. The people paying for drugs don't need the 10th or 11 version of a previously produced medicine. It needs to be bigger, faster, stronger, to borrow the lingo of the Olympics, meaning it must show that it dramatically improves outcomes for patients compared with prior medication and directly or indirectly helps overall costs.

"That is a common mistake of small companies," Gowen said. "They have such limited funds that they focus on showing their drug is useful clinically. You can have a drug that is cool scientifically, but if it doesn't make difference in outcomes, why should anyone pay for it?"

Gowen argues that Trevena's acute heart failure compound is on track to produce a drug that will significantly improve outcomes and reduce costs.

"It will make a big difference in patient's lives because they will feel better and live longer," Gowen said. "But payers will be willing to pay because it will reduce the total cost for care because it will help patients avoid further hospitalization and surgery."

Gowen still has her British accent from growing up in the United Kingdom. Britain has a national health service. Brits might grumble about certain aspects, but neither conservatives nor liberals would trade it for America's inefficient and more costly system.

Conservatives in America says they would like to scrap President Obama's new health-care plan that is meant to begin covering some of 30 million or 40 million Americans without health insurance and reduce costs in other ways. Some of those conservatives says the Affordable Care Act will be especially problematic for small businesses.

Gowen runs a small business and she scoffs at the idea of not providing health insurance to her employees, given that it is the norm in America. But the whole idea of employers being the conduit for health care make little sense. Asked about America's health-care system, Gowen sighs.

"There are a lot of problems," Gowen said. "Having health insurance through employers came about accidentally and doesn't make sense at all. There should be a system where everyone can access health care, but it doesn't have to be free access to absolutely every test in every case. The U.S. could learn a lot of lessons from systems elsewhere, Europe and Canada, where the outcomes are no worse but the costs are much less."