Vivek, 31, and Pavan, 35, agree that one reason things have worked out so well between them is that they have eerily similar backgrounds. Both have parents who met through arranged marriages and emigrated initially to the Midwestern part of the United States from Southern India. Both have doctor moms and engineer dads. Both are married to doctors. And both feel at least in part defined by their immigrant values, especially the importance of family and personal relationships.
Each also draws professional inspiration from early exposure to patient care. For Vivek, that exposure came very early. His mother was a geriatric psychiatrist who treated Alzheimer’s patients in Cincinnati, and, growing up, Vivek often played the piano in local nursing homes for residents with dementia (Vivek’s mother came out of retirement to help lead Axovant’s outreach to physicians and caregivers of individuals with dementia; his younger brother, also a doctor, works at Axovant on medical and scientific communications).
Alzheimer’s “is different than other diseases,” Vivek said. “It really goes to the core of your humanity. The biggest victims, from my mother’s experience, more than the patients, were their families. That struck a particular chord with me having grown up in such a tightly-knit extended family.”
Vivek’s decision to focus Axovant on Alzheimer’s and other forms of dementia and to be chief executive officer of that company is no coincidence.
“I would not have had the same personal commitment to Alzheimer’s disease if it had not been for my mother and my upbringing,” he said.
For Pavan, the realization that he wanted to find a way to have a larger impact on patients came when he was working as a cardiovascular fellow at the University of California San Francisco.
“I would see patients who had been treated with drugs that showed a lot of promise but were no longer available because the company developing that drug abandoned it midway through the process,” he said.
That is precisely the problem Roivant was created to address. By focusing its attention and—because of successful capital campaigns—considerable resources on drugs that otherwise might not have been developed, Roivant hopes to bring medicine to patients in a quicker, more cost-effective way. It’s the “humanitarian” mission behind an assuredly profit-seeking enterprise, Vivek and Pavan say.
“It is staggering the amount of private and societal investment that has gone into those drugs, and to see them go by the wayside is wasteful—it’s just wrong,” Vivek said. “Our goal is to realize the value of those drugs that never would have seen the light of day if we had not gotten involved.”
The other major problem in the industry that Roivant hopes to tackle is the high price of drugs, in part through the application of new technologies. One innovation? For the intepirdine trial, called MINDSET, which has approximately 1,150 Alzheimer’s patients enrolled at 175 sites around the world, a Roivant lawyer who doesn’t have a pharmaceutical background suggested using the rideshare app Lyft to make sure participants show up for their site visits. It was an incredibly simple solution for a major obstacle in clinical trials involving dementia.
Both Vivek and Pavan emphasize that they hope to disrupt the pharmaceutical industry by stacking their company with the people who know it best and the people who don’t know it at all. To round out their pharmaceutical chops, they look for “high performers” in other areas like technology or finance. Pavan himself considered opportunities at Google and McKinsey & Company—where he had worked before his residency—prior to joining up with Roivant.
“I often tell candidates, if your decision is between coding the next app that puts a mustache on someone’s face or being involved in an industry where you can have an impact on millions of people’s lives, to me the choice is pretty clear,” he said. “And we hope to create the kind of environment that attracts precisely those people.”
For now, the impact of Roivant and the rest of the “vant” family—on drug pricing, the healthcare system, and patients—remains to be seen. They still don’t have any drugs to sell.
That was an early criticism of Vivek and Axovant when that company exploded onto the market without an FDA-approved drug to its name—that both were indicative of a biotech “bubble,” shiny and pretty but not here to stay.
Vivek rejects those claims, saying, “the need for a more innovative and efficient drug development process is something that withstands the test of time.”
Pavan agrees. It’s why he moved his wife and young daughter across the country and, ultimately, across the street from Roivant.
“I told my wife, ‘I think if we do this right, this will be the way pharmaceutical companies are conceived of in the future,’” he said. “We’re not doing this as a sort of flip-to-sell approach. We’re really here for the long haul.” ∎
April 10 update: Axovant's new CEO is David Hung. Vivek Ramaswamy will remain on the board of directors and assume the fulltime role as CEO of parent Roivant Sciences.
