Amplifying Scientific Innovation® Video Podcast with Dr. Ron Cohen, CEO, Acorda Therapeutics

Thank you so much, Sophia. It's wonderful to be here.

Well, that's such a big question. Everyone is going to see it through their own particular lens. As a physician and not a bench scientist... here at this time next year discussing it. But if we just talk about healthcare innovation, to me it really is anything that ultimately improves our ability, or the ability of healthcare professionals, to improve the lives of patients, full stop. If that means a novel scientific platform, for example stem cells or mRNA, that one can then use to launch a whole new generation of therapies that are more effective, more broadly applicable than others had been before, then that's obviously scientific innovation. I think in addition, finding new ways of accelerating the time to market for therapies that can improve lives, or just to get them to market at all when otherwise they might not have been for lack of the right data, the right trial design, the right execution, even that is scientific innovation. It's really anything that has not been thought of or reduced to practice before that effectively advances our understanding of disease, of illness, of biology, and enables us to manipulate that or apply that understanding in a way that improves the lives of our fellow human beings.

Well, I actually did want to mention that my mother was a magnificent concert violinist, and the reason I didn't become a concert violinist is that I was very far from magnificent at the violin. Getting into biotech was serendipity. I actually had another passion in life, and it wasn't the violin, but it was in the arts, in theater, and primarily musical theater. I grew up singing and being in shows all my life since I was in first grade through college through... theater and medicine. In college, I didn't declare pre-med until junior year, which is very late. I had to make up the courses during the summers, and right at the end I sort of flipped: medical school, acting school, medical school, acting. It was when I realized that there's a truism in medicine that says the person with the lowest GPA in your medical school class is still called doctor, whereas actors who can be the finest actors in the world can be waiting tables for 25 years. So I essentially took the easy way out and went to medical school. When I got to my residency at University of Virginia in internal medicine... that what we knew we had to do and what we know how to do as physicians is a fraction of what people need us to know. That goes back to our innovation question and the desperate need constantly to be innovating and advancing medical progress. I was going to do a neurology residency like my dad, and I was about to apply, and I did this show my senior year as a resident because I had a three-month block of primary care where I had no night call. They were auditioning one of the musicals I always wanted to do. I auditioned, I got the lead. It was the town theater, and we did the show, and then we got a really good... putting my neurology residency on pause. It turns out I never got back to it because I went back to New York and I was living a dual life for a few years where I was practicing medicine, doing emergency medicine, doing walk-in clinics, urgent care centers. The reason I did that was that again I had no night call, so I could do the theater and juggle my schedule. I could work two or three days a week or even do two 24-hour shifts in an emergency room, pay the rent, and then audition, take class, and so on. I did TV commercials, off-off Broadway, I did... friends. They're married, they are PhDs, they were at NYU in the same lab, and they just left because they have tissue engineering technology and they formed a little biotech company. This was in 1986, the very beginning of biotech. They asked us to help find them a doctor who could do the clinical things because they're PhDs. I said, 'Well, why are you calling me? I have no business background, I have no idea about business. Call my brother, he went to Wharton.' They said, 'Well, we thought of you because they specifically wanted a physician who also had presentational skills and experience, and you did theater.' So... they had rented on East 33rd Street, East 34th, East 33rd. I walked in, spent half a day, and they took me through the science, and I got hooked. They were growing bone marrow in a dish that looked like three-dimensional human bone marrow, and they were going to use it for transplants and for other organs like skin and liver. I thought, 'Wow, this is amazing.' They asked me to join them on the spot. There's a whole story that goes with it, I don't think we have time for it although it's really funny, but essentially the woman of the two, her name was Gail Naughton, pulled out an employment agreement from a drawer and pushed it across a desk at me and said, 'Sign here.' Wow. And so it was very strange. It turned out that the friends who had introduced us had sent her a couple of videotapes of me on TV, and based on that she already decided she was going to work with me. She was very entrepreneurial, very forceful. For reasons to this day that I'll never fully understand, she said 'Sign here' and she pointed at the line, and I signed. I joined this little company. I gave up what I thought was giving up medical practice and the acting. I went to work for this little company. Of course the joke was I was the fourth or fifth employee. I said, 'Why, Herb?' and he said, 'Am I doing a bad job?' He said, 'No, no, you're doing a great job, although honestly how you would know anyone was doing a great job at that point is beyond me because we were winging it the entire way.' He said, 'I can't afford your salary.' Instinctively, the first thing that came out of my mouth was, 'Oh, that's fine, I'll work for free,' because I was having a ball. It was so challenging, so interesting. The whole idea of taking science out of the lab and putting it into patients was so alluring to me that I just said I'll work for free. For another couple of years I was doing that. It was exhilarating. Then we found a real CEO from Eli Lilly, a guy named Art Benvenuto, who came in. He became my first mentor in business. He was really strong, and he moved us to San Diego kicking and screaming because I'm a native New Yorker and you just don't do that. I spent six years in San Diego. We took the company public, and ultimately I was running national trials for a skin replacement, a human dermal replacement that we were growing for burn victims. That was my history of getting into biotech.

Thank you. And you hit on my core learning through all this. When people ask, and younger folks who are trying to get into industry or thinking about it, that's what I always tell them. It's age-old wisdom, and if you read a lot you'll see it comes up all the time, and it's because it's true. There are other things that come up all the time that aren't true, especially these days, but this is true: do what you're passionate about, do what turns you on. If you do that, you will be happy, you'll be fulfilled. No... that's what you want to do. I think a mistake I've observed people make is that they stick with something knowing they hate it, knowing they don't like it, knowing it's not for them, but intellectually they're thinking, 'Well, I'll put in my time, I'll pay my dues, I'll do this, and I won't do this other thing that I have an opportunity to do right now because it's too risky, even though I would love it.' I think that's a mistake by and large.

Maybe... no. I've got recency bias and selection bias because there is so much that is exploding. Whether it's bispecific antibodies, particularly in cancer. Obviously mRNA, which with the COVID pandemic has come to the fore, but even in mRNA there's progress now with circular mRNA, and that's going to presumably last longer and be more effective. You've got RNA interference... inclusion to lower cholesterol, one shot every six months, you don't have to remember to take pills. It's mind-boggling. Stem cell therapies, CAR T-cell therapies. Just this last week there was a remarkable report from a Vertex-sponsored N-of-1 trial in a man with type 1 diabetes who appears to have been cured by injecting insulin-creating cells that were created in a lab out of pluripotent stem cells. If that holds up, and even if this one doesn't hold up, it's almost there, it's coming. CRISPR for gene therapy and all of the children... beyond. It wasn't until the early '90s that monoclonal antibodies took off. When they did, there were two spectacular failures in the industry in clinical trials that took down all the companies that were trying to do monoclonal antibodies, and people gave up on them. Well, what's pretty much the most commonly used or developed therapy right now? Monoclonal antibodies of one kind or another. So that's the nature of progress. What we're seeing now after the Human Genome Project in 2000, 2001, when we first sequenced the human genome at a cost of billions of dollars and years and years... has been logarithmic. That wasn't always the case, but it is now. I can guarantee that in five years if we have this conversation, I'll be giving you a whole new laundry list of my favorite therapies.

Well, thank you, Sophia. And in closing, one more point I want to make to the audience. I do want to point out because some of you are looking going, 'Did he buy that and is it important?' Art is critically important. I want you to know that I think one of my... related things and some of the awards and things, but right behind my desk you have this because I couldn't think of anything more important that you would want to put up in your office.

I'm so sorry you brought that up, Sophia. But thank you so much for the opportunity.