Latest / The BioHub - by Avetix / Episode 109 - Mike Exton - CEO Lexicon Pharma

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Episode 109 - Mike Exton - CEO Lexicon Pharma · The BioHub - by Avetix

0:04
Welcome to another episode of the Bio Hub.
0:06
I'm here with Mike Exton, the CEO of Lexicon Pharmaceuticals.
0:11
Mike joined Lexicon in 2024 after two decades of leadership
0:14
across Novartis and Eli Lilly, where he helped one some of the
0:18
biggest cardiovascular drugs in the world, including Entresto.
0:22
Now he's leading Lexicon through a bold new chapter with a
0:25
genomics driven pipeline, focus on cardio metabolism and
0:29
neuroscience, and a strategy built around.
0:31
Delivering best in class. Or first in class medicines in
0:34
areas of real unmet need? Mike, it's so great to have you.
0:38
Hey, it's good to see you again, Max.
0:41
No, it's a pleasure. Real pleasure.
0:43
So let's just start with your story, Mike.
0:46
You spent over 2 decades across Li, Lily, Novartis, and now
0:49
Lexicon. What have been the key chapters
0:53
in that journey? It's, it's interesting you call
0:57
them chapters because I do really see it that way.
0:59
And actually before Lily, I was an academic, I was working in
1:04
academic medicine doing my post doc in Germany.
1:07
So that was quite separate. And then coming to Lily, I
1:11
really had no experience in the pharmaceutical or biotech
1:15
industry. And I think over the 10 years
1:18
that I spent at Lily, because I came in, in business development
1:21
in in medical move through 6 Sigma and eventually commercial,
1:26
that was really sort of a, a first overview of the complete
1:31
value chain for developing new medicines.
1:35
And that that was really sort of teaching the foundation.
1:39
So that's chapter 1, teaching the foundation of how medicines
1:45
get developed and eventually brought to patients.
1:49
And then moving across to Novartis, where I spent another
1:55
14 years. In the end, it was really taking
1:59
those sort of foundational skills and applying them to
2:03
leadership. And that was a pretty important
2:06
chapter in my career because really, I think I I knew a lot
2:13
about the subject matter that I was talking about, about looking
2:17
to launch new medicines and grow them in the marketplace.
2:21
But I soon learned that you couldn't sort of press your way
2:26
and your will upon people and getting them to do things.
2:29
And I was lucky enough pretty early in my time at Nevada's to
2:34
have some really good coaches and go through a couple of
2:38
leadership programs that needed to.
2:41
That really had me questioning my own leadership style and how
2:46
I impacted others. And so those 14 years were
2:51
really spent around a lot of trial and error of looking to
2:55
sort of self reflect and improve the way that I lead teams into
3:00
achieving the best that they can do.
3:03
And I think that was really a massive chapter in my own
3:07
personal leadership development and just leading large teams are
3:11
the largest of which was about 2000 folks who were in the
3:16
cardiovascular team of the US over Nevada.
3:19
And then now being Lexicon CEO is kind of putting all that
3:23
together in a, in a really neat way where you're responsible for
3:28
the whole supply chain. Obviously, everything here at
3:31
Lexicon from early discovery and I and D manufacturing scale up
3:36
through clinical development and eventually having medicines on
3:39
the market. And so they've been pretty
3:43
discreet but somewhat integrated chapters.
3:47
Yeah. And that's how you say brought
3:49
you to Lexicon where you've had to make some pretty big
3:53
decisions early on as CEO. This for what?
3:58
What, what are some of them? And then how?
4:00
How did you approach them? Well, I wasn't exactly planning
4:05
it that way when I started, but that's probably the tale of
4:08
biotech. But the the first one I did
4:11
plan, which was really a refocus of the company at the time away
4:16
from heart failure, where the the drug that Lexicon has that's
4:22
marketed in heart failure was 1/3 to market in class.
4:26
And you talked in your intro about bringing first in class
4:29
best in class medicines to market that clearly didn't fit
4:33
that characterization and really didn't have much of a chance of
4:37
succeeding in the marketplace. And so to refocus the our
4:42
commercial efforts into a potential launch in Type 1
4:45
diabetes. So that was a a first
4:48
restructure of the organization, quite a, a significant drop in
4:52
the commercial footprint, particularly the field force,
4:56
which then turned into really a a complete pivot at the end of
5:01
last year where we had a CRL for that application in Type 1
5:05
diabetes. Incredibly disappointing for
5:08
company shareholders and patients alike.
5:11
That's still ongoing, but that necessitated me to essentially
5:17
pivot the company from a commercially focused
5:20
organization into really putting full attention into our pipeline
5:26
and our development activities. And so, you know, over that
5:29
time, we went from a team of about 250 down to currently 94.
5:36
So they were, you know, tough decisions, but necessary ones.
5:40
And, you know, unfortunately, like most people in this
5:43
industry have gone through these types of restructures a number
5:47
of times. And thankfully, what I've
5:49
learned is the best way to do that is to be transparent, be
5:53
open and show the people that there's a clear rationale for
5:58
why you're taking that strategic decision and help people on
6:03
their way to finding their next best career move.
6:06
And often times when you do it like that, people appreciate the
6:10
process, even though the the end result might not be what
6:13
everyone was hoping for. See that's that's.
6:17
Really nice to hear that even though people were were being
6:20
laid off, they were still having that support to find their next
6:23
opportunity. How, how, how do you do that?
6:26
Is that through? You like, you know you, you do
6:30
it through engagement with the associates.
6:33
You, you tell them that if they're, they're going for an
6:36
interview that they can have the, the, the company call me.
6:42
And it wasn't just me. I must say my leadership team
6:45
did the same in helping place a number of our individuals into
6:49
other companies. We all have pretty significant
6:52
networks and we can recommend individuals and, you know, just
6:57
a willingness to to help them and to speak fairly because we
7:01
really had and still have an incredible team.
7:05
And that was one of the, the amazing things that I learned
7:08
coming to Lexicon as the experience and capabilities of
7:12
the team largely at par with what you'd see in any big
7:16
pharmaceutical company. And so for those people,
7:19
thankfully, because they were very, very good people, everyone
7:23
was able to find themselves in a, in a position of finding
7:28
their next career opportunity. So really it's just, I think
7:32
having an openness and frankfully, frankly, just
7:37
caring, I mean, caring for your people and, you know, wanting
7:41
them to to do the best. And in this industry it becomes
7:45
pretty circular. You know, people know a lot of
7:48
people know a lot of people. And I find that the best way to
7:53
both hire, retain and and potentially have come back to
7:59
you in the future is to to treat people with respect and, and the
8:03
care and dignity that they should have in these kinds of
8:06
situations. 100% it's a it's a big industry but somehow feels
8:12
really small and like everyone knows everyone.
8:15
I've always gotten it to be a way we're just talking about
8:20
reshaping lexicon strategy. But you you talk about lead to
8:24
succeed. What do you mean by that?
8:28
And then and how is it changing the way you you operate?
8:32
Yeah. So lead to succeed really
8:35
embodies what you mentioned upfront and that is developing
8:40
medicines that are either first in class, only in class in many
8:45
cases because of the unique Genome 5000 platform upon which
8:51
Lexicon was based, the target discovery platform.
8:55
And we main lead as in being the first one in that particular
9:00
mechanism, the first one with that particular target or
9:02
potentially the only one. And succeed because that really
9:08
certainly in the US, but in many countries is now important for
9:12
your overall success. If you can have a mechanism that
9:15
is highly differentiated and you don't have a number of other
9:19
competitors with a similar mechanism, then your likelihood
9:24
of succeeding commercially, succeeding in being able to
9:27
reach as many patients as possible is just all that much
9:31
higher. And so lead to succeed is both
9:36
from a viewpoint of what types of medicines we will develop.
9:40
It encompasses being first and only in class, but it also sort
9:44
of encompasses a little bit of an ideology around Lexicon's, a
9:48
small company. But the medicines we're
9:51
developing, we can lead, we can play with the big companies both
9:56
from our own commercial efforts, but as well-being able to
10:01
partner some of these assets with the best and brightest of
10:06
of the big multinationals. Yeah, that's awesome.
10:11
And then when you think long term, obviously this comes into
10:14
it a little bit. But what?
10:15
What's the big picture for Lexicon?
10:16
And what what are you ultimately trying to build?
10:20
Yeah. Look, we are very much focused
10:23
on bringing our development candidates to market.
10:28
What we have is a little bit unique in the current
10:32
environment of sort of gene therapy, whether that be
10:37
complete gene replacement therapies, whether it be the
10:40
XRNA types of approaches and certainly large proteins.
10:46
We're a small molecule company that is looking at not only
10:52
single indications but these pipelines in a pill where we
10:56
have a mechanism and lead candidate against that mechanism
11:02
where we believe is not just a single indication, but it has
11:06
the possibility for four or five or more indications for that
11:10
particular medicine. And so really the ambition for
11:14
Lexcon is to be a fully integrated pharmaceutical
11:19
company as we are now, but one that becomes self generating
11:24
based on revenues from our development portfolio.
11:27
We're not there yet, but the current crop of candidates that
11:32
we have across 9851 which we license to now the Nordisk for
11:37
obesity and related disorders, whether it be pill of Apoden
11:41
which at the moment we're working towards a phase three
11:45
ready program in neuropathic pain and a number of other
11:49
neuroscience and cardio metabolic conditions.
11:52
These are medicines that have the potential for great revenues
11:57
addressed large chronic unmet need and then finally now core
12:02
expertise of cardio metabolic in hypertrophic cardiomyopathy
12:07
where sodagreflosin really has the potential to be the first
12:13
SDLT inhibitor approved in that particular space.
12:16
So a lot of things for us to look forward to, but really
12:21
becoming a fully independent from a revenues perspective
12:27
company over the next five years is critically important.
12:31
And what what's the road map to get there?
12:33
Are you looking at like deals and partnerships to help you get
12:37
them over the line? Is that, does that also mean you
12:40
like discount acquisition propositions, things like that
12:43
or other things you're thinking about?
12:46
No, absolutely. Look, we're very much focused on
12:52
our core expertise, which is cardio metabolic.
12:55
Myself and a number of the leadership team come from
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companies that have developed significant assets in cardio
13:02
metabolic disease and we're focused on areas where we as a
13:09
smaller company can develop these in indications where we
13:13
can be successful. So as a part of that, making
13:17
sure our pipeline is focused is critical.
13:19
So what we've done this year at the end of quarter one we
13:24
licensed out our preclinical asset to Nova Nordisk for a deal
13:29
worth over a billion dollars. That was significant,
13:31
significant deal for a non clinical asset and it just shows
13:37
the novelty of the mechanism and why Nova Nordisk was very
13:41
interested. And that's important because it
13:44
allows allowed us to really focus more on our core expertise
13:49
while at the same time giving the asset the best chance of
13:53
success with one of the, as you know, two big behemoths both now
13:58
and in my view in the future in the obesity and and related
14:01
cardio metabolic disorder space. So that doing that deal allowed
14:05
us to focus more on our core expertise.
14:09
At the moment, we're going through the final analysis of
14:13
our Phase 2B data for neuropathic pain for Pillar of
14:17
Apiden 9211. And we expect that we will also
14:20
partner that particular program into a company that really has
14:26
strong neuroscience capabilities, which will then
14:29
allow us to very much focus on hypertrophic cardiomyopathy is
14:35
an area of huge unmet need. There are a couple of therapies
14:40
that are very reserved for the more severe patients called the
14:47
cardiomycin inhibitors they use is currently one approved is
14:52
pretty limited. It's penetrated about 1% of the
14:55
market and so to the flows and if it turns out to be positive
14:59
which we have high confidence it will in both obstructive and non
15:03
obstructive. HCM would be the first drug that
15:08
not only is applicable to the broad scope of the 1,000,000
15:11
patients in the US that have HCM, but most importantly to all
15:16
the prescribers and not just limited to a small prescriber
15:19
base. So that really is lead to
15:21
succeed in action. And so I'm a believer in focus
15:26
and making sure we use their resources appropriately and in
15:30
the best way for all success for all stakeholders and focusing
15:35
the pipeline. Now it's taken a year to sort of
15:38
March us down this path. And I think over the next 6 to
15:43
12 months, you'll see you're very focused a company that then
15:47
has the potential for for further pipeline expansion
15:50
either organically or inorganically, depending on what
15:55
aligns with our with our strategy going forward.
15:59
Well, that's exciting. And does the current market or
16:04
the current political environment change like the road
16:07
map in any way or could it potentially?
16:10
I suppose you've always got to be on your toes, I guess, with
16:13
certain changes. Yeah, look.
16:16
I think currently there's a there's a couple of things that
16:23
at least on paper, or at least what has been spoken about,
16:27
actually help lexicon rather than hinder us.
16:31
The 1st, if you know, in the US, they have the Inflation
16:35
Reduction Act, which calls for review of the top ten drugs on
16:40
Medicare each year on a rolling basis.
16:44
And a couple of important points with that is that a couple of
16:50
our potential competitors are on that list.
16:52
So they're going to see significant price reductions.
16:54
But importantly, the Trump administration wants to repeal
16:59
the the pill penalty, as it's known, because oral medicines,
17:04
small molecules are reviewed after nine years, whereas the
17:08
larger biologics, it's after 13 years.
17:13
So that's going to be equalized, I believe.
17:16
So certainly bodes well for our portfolio.
17:20
But in addition to that, I think there's still an increased focus
17:26
on PBNS, these middle managers as they're called here in the US
17:31
and the possibility that gross to net calculations might
17:38
benefit from a review of those, those middle men, if you like
17:42
is, is something that we'll be incredibly interested in moving
17:45
forward. That's so good to hear.
17:48
That's a country of what most companies.
17:51
In bride's eye, we've got to see the the upside.
17:55
Yeah, 100%. And I, I want to change the
17:59
conversation a little bit because you talk about core
18:03
values a lot. In the case of Lexicon, we're
18:07
talking love, loyalty, courage, and growth.
18:11
How do you make sure that these aren't just, you know, words on
18:14
a wall and they actually become part of the company culture?
18:20
Yeah, so actually they're my personal values.
18:25
So which, as I mentioned before, I started on this journey of
18:32
sort of introspection really with Novartis, when I started
18:37
with Novartis and, and thinking, what is it that I stand for?
18:41
And what it, what if it, what do I truly believe in?
18:44
And, and a really, you know, amazing, I guess you'd say coach
18:50
or philosopher on life. A guy called Michael Bunting LED
18:55
that particular series and it impressed on me significantly
18:59
this idea that to be true to yourself, you really need to
19:03
understand your core values and to lead appropriately, you need
19:07
to understand what it is that you stand for.
19:10
And so over the course of a year, but then I mean, this is
19:14
an ongoing situation. I came up with those four values
19:18
of being key to what drives me. And the importance of that for
19:23
Lexicon is the right when I started.
19:25
And I do this now with all things that I to start with is
19:30
that I tell them what my core values are and I define them in
19:34
some detail because, you know, the descriptor I use may not
19:38
necessarily translate to what I, I really believe in it.
19:43
And the important thing then is a, they understand what kind of
19:46
leader I am. But more importantly, if I don't
19:50
live up to those values, then they have license to give me
19:55
feedback and make sure that I'm aware of it, both because, you
19:59
know, that's how I told them I would lead, but more importantly
20:02
because I want to continually improve.
20:05
And so having feedback when you sort of draw outside the lines
20:11
if you want to speak from your own core values, I think is
20:15
pretty, pretty motivating to a lot of people.
20:18
And it just so happens that a lot of folks can get in behind
20:23
those core values and and see some relevance of.
20:27
Of those to to what they believe in and what they're doing here
20:31
at lexicon. So that's that's how we utilize
20:34
them. I think that's really cool to
20:37
have your own personal like for me of ethics, it was really the
20:43
first time I even touched on culture.
20:46
You know, my last business we did, we did the thing.
20:49
I think we, well, we had, we had words in a wall.
20:52
I can't even really remember what the words on the war were.
20:55
I think 1 was honesty, but that just shows really we weren't
20:58
distilling those behaviours across the company.
21:02
Whereas now I really started to understand what culture is, how
21:08
you actually portray that across the business.
21:11
You know, I even dug deep into Netflix's first culture deck
21:15
that they grow out in 2009, which was hailed the most
21:19
important documents come out Silicon Valley, You know, that
21:24
that it's it's starting to show and even in the industry now, I
21:27
feel like everyone's clicking onto it.
21:30
Everyone wants to retain the best people.
21:31
So it's therefore how how do we do that?
21:35
Well, honesty is an interesting one from a core values
21:38
perspective, right? And and the values of the
21:40
company because you know if you as a as a personal value or a
21:46
company value, value honesty. The, the classic example of this
21:50
I always think of is how many times have you been in a meeting
21:55
where your boss or your boss's boss or your boss's boss's boss
22:00
is saying something and you think it's all BS, right?
22:04
You think, oh, this isn't right, etcetera.
22:07
And you have this sort of internal dialogue of do I tell
22:11
them that it's crap or do I withhold it?
22:15
And I would bet you that 90% of time people withhold it.
22:21
And if that's your core value, then it makes you uncomfortable
22:24
because if your core value is honesty, you should be able to
22:28
say to your boss's boss's boss that what they're saying is
22:32
baloney, but you don't. And so you get this sort of
22:35
discord. And so being able to call that
22:38
out, just as one example in the day-to-day experience is the way
22:44
to make a culture spring from the wall into the actual
22:49
boardroom. I agree.
22:51
I agree. And the best definition I've
22:54
seen of culture is if one of your core values is excellence
23:00
and someone puts a piece of work into their manager and and they
23:03
go, sorry, that's not good enough.
23:05
Remember our our core value is excellent.
23:07
They go back, they redo it again, we go, OK, great.
23:09
Yeah, perfect. That's that's good enough.
23:11
Then you go into a boardroom and someone puts a piece of work in
23:14
the middle. The manager goes, no, that's,
23:18
that's not good enough. I'll call.
23:19
What I call values is excellent, go do it again.
23:22
And they bring it back and it is.
23:24
And then you go on holiday as a manager and they have a board
23:28
meeting without you and someone puts a piece of work in the
23:31
middle and then the rest of the room goes, no, no, that's not
23:34
good enough. I'll call value is excellence.
23:36
That's when you know you've got it and you've really distilled
23:39
those behaviours into the into the company.
23:42
And that was Brian Chesky there, the CEO of Airbnb who who spoke
23:47
about that. And I I thought that was the
23:49
best way to explain it. It is, it is people, people
23:53
living it and people calling it out.
23:55
And you know, so long as it, and this can happen in larger
24:00
companies, so long as that doesn't get demonized, you know,
24:04
people can sometimes use that sort of phrase of this is this
24:09
is how we do it Or, you know, we value excellence to then
24:14
potentially Dr. some bad behaviors as an example, right?
24:18
Like, because you could see how the potential for that to
24:22
become, you know, nasty is not a long stretch where if you, if
24:28
you don't like a particular person, continue continuing to
24:31
reject their work and saying and hiding behind a we value
24:35
excellence rather than giving proper feedback.
24:37
So it's a, it's a living, breathing work in progress
24:42
culture. It's not a perfect thing, right?
24:45
Yeah, that, yeah, you're right. And I suppose that comes back to
24:49
hiring the right kind of profiles that fit into that and.
24:53
That's what you come in. Yeah.
24:55
That's you. Well, yeah, you.
24:57
Well, I. Always think that's the hardest
25:01
thing for me is working with a new company, first time.
25:06
I don't necessarily know how they work, the kind of profiles
25:09
they like, what personalities they like.
25:12
It's only really two, three times working with the that I'm
25:16
like, yeah, I really get it now. I really started to understand
25:19
that and that's why these in person meetings, you know, we
25:22
obviously met a bio and was lucky enough to go out for
25:25
dinner and then, you know, you start to understand the person a
25:28
lot more than then over a team's call and that's when it becomes
25:32
pretty important. Yeah.
25:34
And if you get the opportunity within a company to ask people,
25:39
yeah, how does work get done around here?
25:41
What's it like to work here? You'll pretty soon get a sense
25:45
of what the culture is like above and beyond what is on, you
25:49
know, the, the company document or the wall or, or whatever.
25:53
People tell you the truth. Yeah, 100%.
25:57
Yeah. I mean, you, you've LED themes
25:59
through both breakthroughs but also setbacks.
26:03
But what what have those moments taught you about leadership,
26:08
especially in in biotech pharma perspective?
26:12
Yeah, I think in a way, you know, I grew up in a military
26:17
household, Max, and that's probably shaped, well, it's
26:22
definitely shaped why, you know, a couple of my core values or
26:26
loyalty and and courage. And I think in these situations,
26:31
particularly around setbacks, what I, I know folks appreciate
26:39
is when you're sort of leading a large team, but you're not the
26:43
boss of the company, you're not the CEO, you know, being that
26:47
filter. And often, you know, taking some
26:50
of the hard feedback and being able to protect your team so
26:55
that they can focus on what it is that you've instructed them
26:59
we need to do to to win, to be successful.
27:03
And I think if you can as a leader sort of withstand some of
27:08
that and not let the frankly the shit roll downhill, that's where
27:14
you get a lot of respect from people and you will get the best
27:18
out of people and they will understand, you know, that you
27:21
are really advocating for them and, and what we are doing.
27:26
And that's something that I have seen work very well.
27:31
And I've seen the opposite work very poorly, where all of a
27:34
sudden the CEO or whoever is very stressed and angry, They
27:39
put it on to the, if you like, senior leader or mid level
27:42
leader. And all of a sudden that stress
27:44
gets transferred to the rest of the team.
27:47
That org is very poorly for, for that team.
27:50
And you being able to just focus on what you need to do to win.
27:55
And, you know, I think that's incredibly important as a
27:59
leader. And something that yeah, is, is
28:03
not, you know, is is tricky to do.
28:08
Yeah. So when when the setbacks try
28:10
and keep that that aid and take the pressure yourself.
28:14
But when there's there's breakthroughs, you all celebrate
28:17
and take credit. Or do you just take the credit?
28:20
No, and actually, you know, this is this is very much again a
28:26
military thinking that I'm I'm very happy for my team to get
28:31
the credit. I don't need to sort of self
28:34
promote myself because if my team does well as a leader
28:39
automatically, I feel, and I know that I've done an
28:43
outstanding job and you know, good things I think will come to
28:47
me in my due course. But I, I'm a big believer in
28:51
giving the, the people, the kudos who've done the work, who
28:55
really deserve the attention for, for what they've done and
28:58
the, the positivity radiates right.
29:01
And, and so I will get my fair share of positivity as a result
29:05
of that. I don't need to put myself 1st
29:08
and and foremost in in the winds.
29:11
Yeah, I love that. I'm 100% with you on that.
29:15
I've just got one last question for you, Mike, and I'm unsure
29:19
how much time you've had to think about it, but if you could
29:22
have dinner with any scientist or innovator, past or present,
29:26
who, who would it be and why? Yeah.
29:30
That, that is a good question then.
29:32
So, so many choices, right? Yeah.
29:37
Look, perhaps perhaps where I'll go with this question is, is
29:40
someone who was both both of those, but who was really been
29:46
somewhat of a role model for me in this industry and that is
29:50
David Epstein who you he he LED oncology at Novatus, then he was
29:56
the pharmacy O at Novatus. Of course, he then went to
30:00
flagship and and LED Siegen over in Seattle biotech.
30:06
And the reason I say David in this instance is because, well,
30:12
first of all, he's just a genuinely nice bloke, one of
30:16
those guys who I met pretty early actually, right at the
30:20
start of my career in Novartis. And so for that reason, I was,
30:25
you know, a middle manager, manager of, of people, but by no
30:29
means a, a big shot. And he was CEO of farmer and,
30:33
and the guy was just so incredibly approachable and, and
30:36
we, we struck up conversation. So being a good bloke is
30:40
important for having dinner. Like you my friend, when we had
30:44
the chance to catch up, you would you would definitely fit
30:47
into that category. I'm not quite Davis.
30:53
But he's also scientifically brilliant.
30:56
He asked the right questions. He's incredibly curious and
31:01
wants to do the best things for patients.
31:04
He challenges the status quo and will take risks.
31:09
And yeah, I think he's done an incredible amount of good for,
31:13
for so many patients, so many incredible breakthroughs that
31:18
have literally saved the lives of of thousands, if not millions
31:22
of patients. And he would be a He'd be a
31:25
great one to catch up with for dinner again.
31:28
I agree. Amazing.
31:30
Thanks so much for coming on, Mike.
31:32
It's been a pleasure. Always mate, look forward to the
31:35
next one. Yeah.
31:36
And please everyone like and subscribe to the Biohub.
31:39
Thanks again, Mike. Cheers, Mike.