Finding that Spark

Lisa Conte
CEO
Jaguar Health

Life is all about finding spark moments. Those are the moments when something happens that inspires a person to make a big change. For Lisa Conte, those moments can come at the top of a mountain or in the middle of a meeting. According to the executive, there are two major “spark moments” that changed her life and drove her to change course and focus her work in the life sciences industry.

Conte is the founder, president, and CEO of Jaguar Health. She created Jaguar’s predecessor company 34 years ago with the mission of taking natural treatments derived from plants and plant-based materials and bringing them to the market as tested and approved pharmaceuticals. Jaguar Health has taken treatments directly from a tree growing in the rain forest and brought them to patients in the US.

Pharmaceutical Executive spoke with Conte about her career and the company’s achievements.

“It’s a very exciting time,” she says, “because top-line results are forthcoming for our pivotal Phase III trial that’s been in the works for six years to expand the indication of our drug, crofelemer, to cancer therapy-related diarrhea (CTD), which is the No. 1 side effect cancer patients are dealing with and for which there’s no approved treatment. The standard of care for CTD often involves reducing, pausing, or going off the cancer therapy, which is not a good answer. We do have some discovery efforts going on in the psychoactive and mental health areas as well, but 90% of the efforts of the company are on clinical expansion.”

Crofelemer, branded as Mytesi today, is Jaguar Health’s lead drug, a naturally occurring medicine derived from raw plant materials sustainably harvested from the rain forest. The company’s first FDA-approved drug, it was initially cleared to treat the important, though relatively small indication of HIV-related diarrhea.

For Conte, crofelemer is more than just a product. Instead, the treatment represents something she considers to be an overlooked aspect of the healthcare industry: supportive care.

QUALITY MEASURES

Conte believes there needs to be a more concerted focus in drug development and healthcare on a patient’s quality of life, comfort, and dignity.

“What’s interesting is that one of the ways to have supportive care become more prominent is the fact that it impacts outcomes as well,” says Conte. “So, cancer just seems to be right here at the right time for supportive care, especially for diarrhea in particular. There are all these new targeted therapies that are really allowing patients to manage cancer as a chronic situation, and it has converged with the emergence of the metastatic patient voice. For the metastatic patients, the struggle isn’t just about existing. They are wonderfully living for five, 10, or even 15 years or more on these therapies. They really want to have these side effects successfully managed and regain a quality of life.”

A side effect of many cancer treatments is diarrhea, and as Conte describes it, these events can be very debilitating. Patients can find themselves homebound and may even need to visit a doctor for rehydration treatments. Some patients have even died due to dehydration caused by diarrhea related to cancer medicine. Unfortunately, the treatment for this is often to temporarily take the patient off of the cancer drug, which is not an ideal option. This leaves many patients stuck in a situation where they are forced to decide between treating their cancer or not being stuck with severe side effects.

It’s important for patients to be able to maintain a quality of life, as Conte explains, as opposed to trying to find a new normal that incorporates painful and possibly deadly diarrhea. While there are some other medical options, these often include taking drugs that are actually opioids, which can leave patients constipated and feeling unpleasant, and generally aren’t considered for chronic conditions. It is critical, Conte points out, to not to start down the path of treating a side effect with an agent, that then causes another side effect that has to be managed, and on an on.

Obviously, many people are uncomfortable talking about these side effects, which can lead to patients not being taken as seriously as they should be. These types of reasons are exactly why Conte wants to help bring better treatments to the market.

When she started her career, however, Conte didn’t expect to be working on plant-based treatments. Things changed, however, when she had what she called a “spark moment.”

THE SPARK MOMENT

“About 34 years ago, I was a young venture capitalist (VC), and at that time I was focused on the biotech industry,” she recounts. “There was a lot of attention on new discovery technologies and basic enabling technologies. I was climbing Mount Kilimanjaro in Africa and about halfway up, I discovered that my climbing partner was suffering with severe altitude sickness. However, there was one of these makeshift pharmacies and he ended up taking something to give himself a boost.”

Conte remembers it being “something like an African Coca,” and says she was struck by its response in her climbing partner.

“I saw the effectiveness and began to think about using these traditional medicines that have been around for thousands of years to look for medications that are more likely to be safe and effective,” she tells Pharm Exec. “I was a pharmaceutical person and I always thought that I would be working toward prescription pharmaceuticals. After this experience, however, I came back, quit my job, took out my credit cards, and started a company. I didn’t have kids responsibility at the time. That was the spark or the light bulb moment.”

While Conte had been working as a VC, she had a background in science. She had spent her career looking for new technologies to invest in, but she shifted her focus. Now, Conte was looking for traditional treatments. She believed that if her company could discover how these natural treatments worked, they could be brought to a wider market.

“There’s no doubt that my experience on the mountain was a transformative moment that made me decide to start what would become Jaguar Health,” she says.

When it comes to her success, Conte credits her family experience. She grew up on Long Island in New York where her parents owned a pharmacy. She spent much of her time working there, which helped build an interest in the life sciences industry. Since she also excelled at science in school, Conte naturally looked for a career in science. While attending Dartmouth, she took an undergrad in biochemistry. Conte was then inspired to do some graduate research at the University of California, San Diego.

It was there that, by chance, she attended a presentation by a VC. The investor discussed its desire to work and collaborate with different researchers in diverse areas, and Conte realized that there was a possible career for her in VC focused on innovations in the life sciences.

Attending that presentation was another spark moment in Conte’s life.

“I loved being in the research group and being a part of these remarkable scientific breakthroughs. But what I found was not fitting well with my personality—that it takes a long time for [discoveries] to happen,” she says. “I just didn’t expect that and wanted to move a little bit faster. I’m learning that I respond to spark moments, and it was definitely a spark moment when I walked into that room and realized that I was going to be a venture capitalist. That way, I could work on science but I can bring some of these innovations to fruition faster. That’s how I ended up going to business school and then worked in venture capital. Then I climbed the mountain and here we are 34 years later.”

When asked about her experience as a female CEO in a male-dominated industry, Conte jokes that she should be better at answering this question after so many years. She acknowledges that there are advantages and disadvantages to being a woman in her position, but she says that she doesn’t have a specific experience that she believes was significantly impacted by her gender.

“One thing I can say about being a woman is there are some benefits based on how men and women generally behave,” she says. “The culture in our company is very much a family culture and I think just some of the different gifts that women have are helpful in the environment. This includes being more communicative, attentive, knowing everybody’s kids, their dog, and it’s more than just the job.”

Illustrating this point, Conte cites the traditionally low turnover rate at Jaguar Health despite times over the years when, for example, stock options were significantly underwater.

“Fortunately, people aren’t here because their stock option is locking them into the company,” she says. “There’s a commitment to the mission of the company and that commitment to the culture, your fellow workers, and all of the stakeholders. We started the first day with the company by recognizing the intellectual contribution of indigenous knowledge and I think that is pervasive throughout the culture of the company to this day.”

ACCEPTING CHANGE

While Conte is clearly very passionate about her work, she says that this wasn’t necessarily the career path she thought she was going to take. Once she decided to become a VC, she thought she had found her calling. And even after starting her own company, she says things didn’t necessarily unfold in ways she had expected.

“Clearly, that change created a direction and purpose in my life that has become my professional career,” explains Conte. “This is my 34th year doing this, and I initially didn’t intend to do this for this long. In those days, a lot of investors became the interim CEO at a company they started and would then eventually bring in a different CEO, usually somebody that perhaps had more operational experience behind them. Once we got started and things progressed, I just didn’t feel that it was a place for me to leave.”

Another influencing factor was the official approval of crofelemer, which occurred on Dec. 31, 2012. Conte acknowledges today that it’s rare for an emerging or startup biopharma company to shepherd a product into market from its own discovery process—and on its own.

“We didn’t in-license our product. It was discovered from our own enabling-rainforest, indigenous knowledge-focused process,” she says. “This drug completely transformed the way gastrointestinal medicine could be done. I remember on that day when I received the news the FDA had approved crofelemer, I was skiing, and I fell down and couldn’t get up. It was like all the muscles in my body went out. Once I could get up, there was a renewed commitment for the company, my cofounders, and coworkers.”

One of Conte’s core characteristic traits is that she seeks out opportunities. Whether she’s climbing a mountain, attending a presentation, or even just dealing with the regular issues that companies experience, Conte seems to have a knack for finding ways to move forward. One specific example she shares offers more proof.

“There was a point when we were going through a lawsuit and the human asset was all tied up. Instead of just waiting for that to clear up, we started a small animal health business,” says Conte. “We’re very proud to say that we also have a product that has been conditionally approved by the FDA’s Center for Veterinary Medicine for chemotherapy-induced diarrhea in dogs, which is an important problem and quite analogous to the human situation. If you have a dog right now with cancer and diarrhea, you can get a prescription to treat that.”

FROM A MOUNTAIN TO THE FOREST

Jaguar Health has a clear mission: to bring natural remedies to the modern world. According to Conte, cultivating and maintaining a clear focus is a major aspect of her success. It’s something she says that she instills in her company today. Every organization encounters struggles, so it’s vital, Conte stresses, for leadership to make sure that its employees stay focused on the areas where they can succeed.

“We do something that’s called the ‘tomato meeting’,” she explains. “Basically, we let everybody in the company speak in a protected way to what their concerns, fears, risks, and positive success factors are. We then prioritize, because there’s only a certain number that you can deal with, and we determine which ones are going to make the difference in the success of the company.”

It’s clear that Conte isn’t afraid to pivot and take chances if she has a clear goal to focus on. Based on her early years, one might not expect her to be the sort of person to work at one job for 34 years, but here she is. While she made plenty of course corrections during her formative years, they were always purpose-driven—she saw an opportunity and made a decision. Not every CEO’s journey starts at the top of a mountain, but, then again, Conte hasn’t had a typical journey.