Unlocking Solutions in Chronic Diseases: Q&A with Bobby Azamian

Bobby Azamian
CEO and chairman
Tarsus Pharmaceuticals

Bobby Azamian, CEO and chairman at Tarsus Pharmaceuticals, is focused on finding new treatments for diseases that he believes have been overlooked. He spoke with Pharmaceutical Executive about his approach to finding ways to treat the root causes of chronic diseases.

Pharmaceutical Executive: Can you explain your mission at Tarsus?
Bobby Azamian: My career mission has been to try and unlock solutions to big chronic diseases. I started as a scientist and then became a physician internist, where I saw a lot of big chronic diseases and realized that we don't have many definitive therapies for those. We don't have treatments that really address the root causes for a lot of those big diseases. That really motivated me to become an entrepreneur, so I started out investing in early-stage venture capital, because I thought that's where I could really get my feet wet, cut my chops, and understand what kind of companies I wanted to build and focus on. Now I'm three companies into doing that. I've co-founded two companies and run one of those in cardiovascular devices.

That really shows the way that the pharmaceutical side is actually where you can have a really scalable impact on medicine. A lot of my passions are not only around great therapies and treating root cause diseases, but also building great teams. In pharmaceuticals, we've been able to do that so well at Tarsus, which is still a young company and a relatively new story. We're about seven years old. What we're doing is pretty different for biopharma in a couple of ways.

We're doing something called category creation. And what that means is we're going after diseases that never had solutions. We're doing it in eye care, which hasn't had a lot of novel advances. I humbly say that, obviously, vision is very important to us. But the disease we're going after, blepharitis, has been thought about for a long time, but only in the last 10 years has it been possible to the see that it's caused by damage in many cases. There are 25 million Americans affected by blepharitis, and we're the first and only FDA approved treatment.

We're doing that with a drug that truly is a novel approach and is targeting the cause of a disease. It's a drug that is designed to be of high impact to the patient, doctor, payer, and all the stakeholders in the healthcare ecosystem. First and foremost, that means it's a very effective and very easy to use drug.

PE: What do you think causes certain diseases to be overlooked?
Azamian: I think it's often when you're starting a company, developing a program, or talking to investors, that it’s often clear to go after the existing categories. You can say that a certain disease has a current market, and we're going to be another drug in that category. We're going to capture a certain part of that market. One opportunity that not a lot of companies realize is when you're defining a category, when you're building in a wide space, you must make some good estimates about what that ultimate market impact can be.

And you can't point to another comparable drug and say, “We're going to be a slice of this market.” I think that's fundamentally why a lot of companies don't go after new categories, because you're leading and building a market. In a lot of ways, that’s more challenging to do.

It requires education of the market and belief that you're going to have light at the end of the tunnel when you launch the product, and you're going to be able to serve millions of patients, or whatever the market potential is. I think that's why a lot of companies aren't doing it. In eyecare we look at this historically, the drugs that serve millions of patients, the blockbusters in our space, are very few and far between. It's only every five years or so, and it's drugs that are creating the categories.

Look at the Dry Eye Disease (DED) category that was created on the drug side over 20 years ago now. The first drug there became a blockbuster. You look at retinal diseases, and usually the first drug is the one that becomes a blockbuster. You go way back with glaucoma, and first in-category drugs become blockbusters. When you take those type of risks and say, there's a big unmet need and we're going to be first, you do get rewarded. However, it's often harder to convince people that that's a great opportunity to go after whether you're in a big company, or you're starting a company.

PE: Would you say that the industry in general is risk averse?
Azamian: No, I wouldn't. I think the pharma industry is one of the great servers of our society. I think every drug that gets approved has beaten a lot of odds along the way. And we know those odds from discovery through approval are tough.

But I think it's those odds that cause people to often say, “Well, there's this large existing market, let's try to do better in that market.” They say this, as opposed to saying, “Let's try to go first to the market.”