Alydia Health was one of the first Companies-in-Residence at Fogarty Innovation and one the organization has been deeply passionate about, with its promise to solve postpartum hemorrhage (PPH). An enormous unmet need, PPH is the leading cause of maternal death globally. Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth, with PPH being one of the major contributors.
In Alydia Health’s mission to get the device to as many women as possible, the company went through many of the inevitable ups and downs, especially in the quest to obtain substantial funding during its early stages. Through perseverance, passion, commitment and a well-executed strategy, Alydia Health was recently acquired as U.S. subsidiary of Organon.
In early 2020, Alydia needed to shift toward the development of a cohesive commercial plan and team, which was in Rob Binney’s “wheelhouse.” As a 25-year senior executive leader in both medtech and pharmaceutical companies, Rob had a track record of taking early-stage companies with no commercial experience to market, resulting in over $100 million in annual sales. Of particular note, he had played a vital role in building success for two other Bay Area companies that have also been acquired, Intersect ENT, acquired by Medtronic, and AccessClosure, acquired by Cardinal Health. In sum, the aggregate deal value for the companies that he has been a part of exceeds $1.7 billion. The expertise that led to these accomplishments made him an ideal fit for taking the reins as Alydia Health’s new CEO.
Fogarty Innovation’s vice chairman of the board, Fred St Goar (FSG), who has been a long-time mentor and champion of Alydia Health, had the privilege of sitting down with Rob (RB) for a wide-ranging conversation discussing the road that so many startups wish to travel and to share the many lessons he has learned during his journey.
FSG. Tell us about your background and how this all started.
RB. Believe it or not, I started off as a communications major at the University of North Carolina, Chapel Hill; I wanted to be the next Steven Spielberg. I started interning at the Turner Broadcasting headquarters in Atlanta and right after college I became one of the first and youngest writers for Robert Obsorne of Turner Classic Movies. I would spend a week digesting about 800 pages of background on movies like Casablanca and distill them down to about two minutes of intros and outros – all for a paltry $100. So I quickly realized it was a lot of work for very little money and just not a lot of fulfillment, and at the time I was looking to support my bride-to-be. Completely randomly, I answered an ad in the classified section and took a job at Hoechst Marion Roussel, a pharmaceutical company selling the first calcium channel blocker on the market called Cardizem CD. I didn’t know what I was getting into, but I knew I enjoyed science and connecting with people.
Through the ‘90s, I navigated a series of mergers and acquisitions in the pharmaceutical space and had the privilege of launching some really innovative products, like Lantus, the first once-a-day basal insulin. I hadn’t yet had any exposure to medtech, but my brother was in the industry, and I had my first taste of the field’s innovation and explosive growth when I joined Boston Scientific and had the chance to be a part of the launch of one of the first drug-eluting coronary stents, Taxus.
As I was moving my way into various-senior level leadership positions, I met one of my Bay Area mentors, Leslie Trigg, who brought me to Silicon Valley where I joined AccessClosure. I was one of the first to be hired on the commercial side, giving me the chance to launch an innovative vascular sealing solution that was born out of Fred Khosravi’s incubator, INCEPT, called The Mynx. We set out to flip the large ($1 billion) but somewhat sleepy, tired space of vascular closure with a novel solution. It was truly the first exposure I had to early-stage startup companies, and I was definitely hooked.
In 2011, I met Lisa Earnhardt, one of my other mentors, through Leslie Trigg. She brought me in to Intersect ENT as vice president of sales, pre-FDA approval. We had an incredible run and chance to build a great story with a world-class team, taking the company public in 2014, and now culminating in a $1.1 billion exit with Medtronic. Following Intersect, I met you (Fred) and the Alydia Health board of directors and the rest, as they say, is history.
FSG. What was the clinical problem at Alydia and how did you know it was significant enough to pursue?
RB. Through my due diligence it was very enlightening to understand the global context of postpartum hemorrhage. There are 140 million births every year worldwide. Even in higher- income countries like the U.S., approximately 10% of these can end in PPH or abnormal uterine bleeding. Speaking of the U.S., there was a three-fold increase in severe maternal morbidity and mortality from the period of 1997 through 2014, which coincidentally was right in the period of time that Alydia Health was getting started. Clearly this is a trend that is going in the wrong direction. This was a real head scratcher to me; I couldn’t understand why, in such a well-resourced country like the U.S., we had such a high rate of abnormal bleeding. But, it is somewhat explainable in that it is tied to advanced maternal age and rising comorbidities s such as asthma, hypertension, obesity and malnutrition, to name a few. In addition, there are other factors we are still grappling with, such as huge disparities in access and care in our country with women of color having a threefold higher rate of PPH.
At this point in my career, I was at a phase where I really wanted to find a company that allowed me to give back, and Alydia Health was the perfect opportunity with its elegant solution – the Jada System – that offers a chance to preserve families by saving women’s lives or preventing the many complications that arise due to abnormal bleeding at birth. And in terms of treatment options, there hadn’t been a lot of innovation or evolution in the space of labor and delivery until Alydia Health came along.
FSG. When you joined Alydia Health, you still didn’t have formal FDA approval and weren’t ready to commercialize. How did you take the company to the next level?
RB. We started by focusing on making an impact on a small group of physicians. Lisa Earnhardt was one of the first who really challenged me with her belief that if you demonstrate adoption and traction with providers, the rest will follow. I think one of the reasons we attracted so much strategic interest is because we were able to get out of the gates very quickly and demonstrate adoption in places like the Cleveland Clinic and the Northwell Health system, which was no easy feat. Historically it is systems like these that can take years to penetrate, but we were able to do so in very short order.
We did all of this while keeping our mission front and center. Our goal was never to build the company to be bought, but instead it was to focus on building a company with healthy fundamentals and good patient outcomes. If you achieve that, eventually these companies become attractive and get bought, but you have to have the right intentions and disciplines to get there. So I didn’t have any aspirations of exiting the company quickly. In fact, we were looking at a Series D funding round, and quite honestly, had line of sight to raise $80 million if we had to do so.
Yet, as we started sharing our story with strategics, they drove a high level of engagement. We simply kept telling the “good news” and focusing on the commercial execution. The knowledge that we had fundraising lined up for our Series D and revenue growing with some very high- profile, “non-friendly” accounts, provided us with a very confident position from which to engage strategics and truly was a great position to be in with multiple suitors at the table. And most rewardingly during this time, was how physicians would share letters received from their patients, thanking them for being so progressive in using the Jada System and saving their lives. This further added to our bullishness in the strategic diligence process.
FSG. Rob, on behalf of the Fogarty Innovation family and all the mothers of the world, I would like to express our heartfelt thanks to you and the superb Alydia Health team for all that you have accomplished. The impact that the JADA device is already having, and will have for years to come, is amazing. To finish off, how did the partnership with Organon come about and how did it set up Alydia for having a global impact?
RB. Thank you Fred. It was really an accumulation of all the building blocks that had been put in place over the years, a strong, passionate team generated compelling clinical evidence of an innovative solution and early commercial success, which made us a very attractive proposition. We had three very good offers and chose Organon largely because we felt they represented the best partner to allow us to leverage their resources, and global expertise in the pursuit of making childbirth safer for all mothers. Our founders’ original vision was to influence the PPH rates in the lower resource markets and Organon shared this same mission. Through our acquisition, we now have the chance to realize this vision more rapidly.
If you come back to the fact that 94% of all maternal deaths occur in low- and middle-income countries, you can see why aligning with Organon was an easy choice because they have the infrastructure and “footprint” in many of these countries that we can capitalize on. We feel confident that this partnership offers the opportunity to accelerate getting our product to those deserving mothers.
On a personal note, this is also especially rewarding as we welcomed a new member to our family, my niece, Julienne, who was adopted by my brother’s family from Burundi, Africa, where there’s a very high rate of maternal mortality due to PPH. Julienne’s mom passed away just shortly after delivery due to PPH. There are so many downstream effects and generational impacts from losing a mom; it’s truly tragic. In Julienne’s story, her father took his own life after losing his wife, and the family was completely torn apart with Julienne being put into a foster home and separated from her two brothers who went into family custody. That’s what gets me up every morning – the idea of being able to help prevent mothers from dying when they don’t have to, and families from being ripped apart. At the end of the day, in my old age, I have come to appreciate the fact that if you stay focused on developing and selling a technology or innovation that addresses unmet patient needs, then the rest falls into place. It should never be about revenue or whether you get acquired; it’s about impact and aligning the company behind a shared mission and vision that is grounded in helping patients to live a better, healthier and more complete life. When we stay focused on that, well then I find it much easier to rest at night and wake up in the morning completely on fire!