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Terrie Curran, President and CEO of Phathom Pharmaceuticals, sat down with Onyx for a feature length interview.
The available drugs for GERD have been around for decades and often aren't as effective as we'd like. What does Phathom Pharmaceuticals bring to the table that's better?
At Phathom, we're focused on transforming treatment options for millions suffering from acid-related disorders. Right now, the standard of care is proton pump inhibitors (PPIs), which haven't seen any major innovation since the late '80s and early '90s. However, our first-in-class, best-in-class potassium competitive acid blocker (PCAB), marketed as VOQUEZNA® (vonoprazan), represents a significant breakthrough in the U.S. by offering an alternative to PPIs, and a distinct and differentiated mechanism of action, meeting the demand for new treatment options among patients and physicians eager for innovation.
In our large, multi-national clinical trials, VOQUEZNA® showed superior results in eradication of Helicobacter pylori (H. pylori) infection and in the healing of erosive esophagitis (Erosive GERD). Importantly, we also demonstrated superiority and durability in maintaining that healing among all patients, including those with severe disease. In July 2024, we also received FDA approval for Non-Erosive GERD, expanding our access to the largest segment of the GERD market.
We’re early in this journey, but we’re also exploring eosinophilic esophagitis (EoE), a chronic inflammatory condition of the esophagus. PPIs are currently used off-label for EoE, but we aim to pursue both pediatric and adult indications with VOQUEZNA®, as well as a novel “on-demand” or “as needed” dosing schedule for the treatment of Non-Erosive GERD.
We’ve already successfully completed a Phase 2 trial showing VOQUEZNA®’s rapid action in alleviating heartburn for Non-Erosive GERD, when taken as-needed. PPIs are often used in this nature, but they aren’t effective given their mechanism of action, and dosing requirements, including the need to be taken with a meal for full effect. As mentioned, VOQUEZNA® is a new class of treatment, different from PPIs, that can be taken with or without food and offers the power to help provide complete 24-hour heartburn-free days and nights.
GERD affects millions of Americans. How many could potentially benefit from this therapy?
Out of the 22 million people diagnosed and treated for GERD, about 50% switch their prescription therapies each year. That’s where VOQUEZNA® comes in—those dissatisfied patients are prime candidates. We've achieved commercial access for about 85% of insured patients in the U.S., with coverage that requires just one step through a generic PPI, which was our goal. VOQUEZNA® is the first and only approved potassium-competitive acid blocker (PCAB) in the U.S. and brings the power of a new class of acid suppression treatment to a disease with high unmet need.
For patients with Erosive GERD, we have a first-line indication for both the healing and maintenance phases of treatment, and our label covers all four severities of the disease (LA grades A, B, C, and D), showing efficacy and superiority versus a commonly used PPI. We also have a first-line indication for Non-Erosive GERD, with the majority of market access again one step through a generic.
What’s the size of the market, and where is Phathom heading?
We hold the exclusive rights to vonoprazan across the U.S., Europe, and Canada. We believe the market potential across those territories is over $3 billion. Despite widespread use of PPIs, market research and prescription data trends show many patients seek alternatives, and this is more so evidenced by the strong early demand for our product. Our vision is to displace PPIs as the standard of care, and although we are still early in that process, the reception from our commercial launch reinforces our product's potential to make a meaningful impact. Our first full year of launch will be in 2025. We’ve got a sales force of 320 reps covering about 55,000 specialists and primary care providers, and we’ve launched a comprehensive direct-to-consumer campaign through digital channels, streaming and broadcast TV. It’s very consumer-driven—once patients ask their physicians about VOQUEZNA®, most physicians are willing to prescribe it.
What trends or developments in the industry do you think will be key in the coming years?
The industry is cyclical, and the last few years have been tough for biotech, especially smaller companies, which are the lifeblood of research and clinical development. Big pharma is facing a lot of expirations on their existing patents, and so they’re increasingly looking to smaller biotechs for innovation.
I've been in this industry for 30 years, and I’ve seen growth and downturns. Investors will return when they see real innovation emerging. Recently, there’s been a move away from solely focusing R&D efforts on rare disease and expanding to much more prevalent disorders with large unmet need. Worth noting as well, with an aging population in the U.S., there are areas like cardiometabolic disease and Alzheimer’s that have increasing potential because of the huge unmet need.
Can you walk us through your career path? What guides your leadership?
I started at Upjohn (later acquired by Pfizer) in Australia right after university, working as a sales rep. After three years, I transitioned into marketing, which I had studied, and then moved into increasingly senior roles at Pharmacia. I eventually became Country Manager in New Zealand, my first step into management. After Pharmacia merged with Pfizer, I moved back to Australia, and then to Switzerland.
Later, I was offered a U.S.-based role with Merck, where I led their global women’s health business for about five years. After that, I joined Celgene and helped to build a brand-new Inflammation and Immunology franchise with OTEZLA® (apremilast) as our flagship product. Celgene was later acquired by Bristol Myers Squibb, the largest biopharma deal in history. Over my career, I’ve gone through around eight mergers and acquisitions!
In 2019, I was approached about a potential CEO role, and while I was initially considering taking a short break, the headhunter convinced me to meet with a venture capital firm. That’s when I met Dr. Tachi Yamada, a world-renowned gastroenterologist, who shared with me the vision of the company they were looking to create. I was intrigued by the opportunity to build a company from scratch, take it through Phase 3 trials, and bring a new treatment to a dormant market. We had our Initial Public Offering (IPO) in October 2019, and here we are in 2024 with multiple FDA approvals and three marketed products under our belt. It’s been a phenomenal journey to say the least.
When it comes to leadership, for me, it's about ensuring everyone in the organization is aligned around a common mission and vision, with a clear understanding of their role and impact. Leadership must communicate concisely and set clear goals. I also believe in building a team that’s hands-on and gets things done. It's not just about qualifications – you need people who work well together, solve problems, and don’t point fingers.
If I had to sum up my leadership philosophy, it would be this: a clear vision, great people, and a well-defined path forward. Over the past five years, the Phathom team has overcome numerous challenges, but we did it all together, coming out stronger and even more resilient on the other side.
