John Thero | Amarin Corporation
John Thero, President & Chief Executive Officer
With all his heart
John Thero revived pharmaceutical company Amarin with a data‑driven focus on affordable treatment for cardiovascular disease.
n one respect, John Thero is not unique: he’s all too familiar with the damage wrought by cardiovascular disease, responsible for one in every four deaths in the US.
It’s hit the men in his family particularly hard — grandfathers, uncles and others. His mother survived a stroke but continues to face challenges. He’s seen patients who had cardiac surgery but were too weak to recover.
“This is personal to me,” says Thero, now the President and CEO of Amarin.
What does make Thero unique is that he has an opportunity to make a difference — to help tackle the No. 1 killer of men and women and to reduce the treatment costs of more than $500 billion per year — through Vascepa, Amarin’s lead product. And in doing so, he can revive the fortunes of a company that had been on the verge of bankruptcy.
Following the data
When Thero joined Amarin about a decade ago, the economy was mired in the Great Recession, and the company had no commercialized products. Most recently, Amarin’s Ireland-based management team hadn’t achieved positive clinical results in a study of central nervous system disorders. After a transition, a new management team began focusing on cardiovascular disease (CVD) and giving priority to the US.
Thero became CEO in 2014. His mantra: “Follow the data.” He and his team had reason to believe that a CVD treatment could improve patient lives and grow the company. But getting there required risky bets that even much larger pharma operations may have struggled to pull off.
“A lot of development that gets done today is for rare and more acute diseases,” Thero says. “In those studies, you can get to answers much quicker. But when you’re dealing with chronic diseases, you need a lot longer to see them manifest themselves.”
A study for a drug to address a rare disease may include 100 patients, over six months to a year, at a cost of perhaps $30 million. Amarin’s CVD study, called REDUCE-IT, had over 8,000 patients in 11 countries, covering several years and costing hundreds of millions of dollars.
“We sometimes had to revisit our assumptions and make sure we were guided correctly,” he says. “But we have to keep following the data. It leads to the right things.”
When REDUCE-IT was completed in September 2018, Dr. Deepak Bhatt of Harvard Medical School presented the findings: Vascepa reduces the risk of major adverse cardiovascular events, including death, heart attack and stroke, by 25%. The company’s stock quadrupled in one day and kept climbing.
Vascepa has been approved for treatment of very high triglycerides and has already been prescribed to US patients over 5 million times. But Amarin is ultimately seeking approval from the FDA for broader applications, such as for people with diabetes or prior heart disease.
If you believe in where you’re going, others will follow.
Believing in people and his vision
Amarin now has more than 500 employees. When Thero joined the company, there were 15, and when he took over as CEO, he had manifold problems to contend with: high employee turnover, low morale, inadequate funding and liquidity challenges.
Thero says that finding good people is paramount no matter what problems you’re facing, because attitude and brains go a long way. To help his team understand its strengths and weaknesses, he has hired coaches and held training classes on people management. Doing right by patients is the glue that binds them.
“If you believe in where you’re going, others will follow,” he says. “Be passionate. Hype doesn’t work, but passion is important. There’s always money out there for good ideas and good people.”
Those are the lessons that Thero developed over his long career, at Amarin and elsewhere. A key mentor in his life, when Thero was in his mid-20s, was a chief operating officer who challenged him and gave him new opportunities.
“Under his tutelage, I learned a lot, and I became the CFO of a growing company before I was 30,” Thero says now. “He had a very nice way of saying, ‘John, I know you know this,’ and he would give me his advice, but he knew I probably didn’t have any idea.”
That guidance built on what his parents — a teacher and a nurse — emphasized during his upbringing: learning, discovery and confidence.
“I wanted to do something different from them, but I wasn’t sure what it was,” he says. “I started looking at some large companies but found that what I liked was innovation. One thing led to the next, and here I am.”
It’s a good place to be — but he’s setting his sights higher.
“We’ve accomplished a lot in terms of pioneering this drug,” he says, “but in another sense we’re just getting started.”