Exceptional, July - December 2014


Disrupting the status quo

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Victoria Hale is CEO of Medicines360, a nonprofit pharmaceutical company dedicated to giving all women access to effective and affordable contraception. The social entrepreneur tells us what drives her and why she’s not daunted by being a David in an industry of Goliaths.

There are so few players engaged in the women’s health space. That was one of the main drivers for us: there needed to be another player. In addition, there was a push from the reproductive health community in the US to give women more access [to contraception] and to make the best contraceptives more affordable — we’re talking about the long-acting ones like implants and IUDs.

Medicines360 is a sustainable social enterprise, which means it funds itself without philanthropy and operates like a traditional business. Our initial funding came from an anonymous individual, but our June 2013 agreement with [pharmaceutical company] Actavis gave us US$50m, and we’re operating mostly on that now.

Our main cost is an enormous clinical trial of the IUD we’re developing: multiple years, thousands of women. It will be on the market in 2015.

We met with nine companies regarding our IUD, and Actavis just stood out. They had been in the women’s health space for quite a while as a smaller player, and they wanted to play big. Most importantly, they really got our mission — you absolutely need that connection.

But as with any relationship, you have to put effort in. It’s almost as though you get married without fully knowing each other and then you have to work it out.

We will sell our IUD to both insured and uninsured women on a sliding scale. The price will be guided by our research into what women are willing to pay out of pocket for contraception.

In some communities that’s not very much, but in other communities it’s quite a bit because there’s increasingly a realization of how expensive children are. It’s an investment in not having a child until you’re ready. That’s what this is about.

It isn’t daunting to be a small player in an industry of giants. That’s part of my character. I like the pharmaceutical industry a lot — I even love parts of it. People who work in pharmaceutical companies are passionate about doing something for humanity, but the business models can make it hard for that to happen.

I really want to help them figure out how to take care of more people and how to do it in a way that makes business sense.

I don’t believe giving away medicines for free is the way to achieve real impact. I worked in developing countries where the poorest of the poor said to me, “If it’s free, it must not be a very good product.”

Some of our patient assistance programs that are about donating drugs for free are moderately effective, but I think they could be more effective if we just figure out how to sell for less.

We’re going to be partnership-driven when bringing our product to developing countries. We’re working with nonprofit organizations, like Marie Stopes International and Population Services International, that not only have experience working with governments and bringing new reproductive-health products to developing countries, but are also philosophically aligned with us in terms of the empowerment of women, human rights and a focus on health. We want our products to be used well and for these countries to be pleased overall that our products were brought there.

“The zero-sum game is a lie. There does not have to be a loser if you are open to more.” Victoria Hale, Medicines360

It does annoy me that Medicines360 has to exist. The US is so backward in reproductive health. I read a book about Margaret Sanger, who was arrested for the first time at her birth control clinic almost 100 years ago, and we’re still having the same discussions: whether a woman should be [consulted] about contraception, whether she can get it, whether she can afford it — which is a question now but wasn’t then — and it’s very bothersome.

But I needed to get over that and move forward, and here we are with what is potentially a very disruptive model.

I want this to be a proof of concept of what can be accomplished and demonstrate that you don’t have to lose money taking care of the underinsured or uninsured. In the US, universal health care is still a big deal — we’re fighting over it in Congress every day. But I’m trying to rise above all of that and focus on women and their needs. And hopefully the change will ripple from there.

We will move beyond contraception at some point. About six months ago, our board decided that we would open up to all of women’s health: urogenital issues, bone, menopause — all that stuff.

Social entrepreneurship is a spiritual pursuit for me. I’m looking for the fulfillment and the joy that comes from being a healer: a pharmaceutical professional who does healing in a larger way than is done right now. That is extremely rewarding.

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