The smug, Botoxed face of everything wrong with medicine in America (PART 2)

If Brent Saunders had had his way, he'd be in Albert Bourla's seat at Pfizer now. (Would Pfizer still be shilling for mRNA Covid jabs? Probably even harder, if that's possible.)

(PART TWO: The Fall)

A January 2015 Forbes profile of Brenton L. Saunders, who at age 44 was about to become the chief executive of Allergan, the maker of Botox, begins unforgettably: Saunders lying in a chair “in an Orlando hotel ballroom as a plastic surgeon pierced his face 30 times,” injecting him with Botox and a dermal filler to plump his cheeks.

Saunders was remaking himself.

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(The button is back where it belongs. At the top! Come on, people, 20 cents a day.)

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He hoped to do the same to the pharmaceutical industry, getting it out of the boring business of developing new medicines.

As Forbes explained, under Saunders, Allergan “will eschew the core mission of most drug companies--inventing drugs… [and] will be the first big pharma that doesn't even pretend to invent medicines.”

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Saunders would repeat that mantra, telling Reuters in August 2015 that “actually building and running our own labs” would waste Allergan’s time and money. He preferred to buy drugs from other companies or university researchers, he said.

At the time, he still lived in New Jersey with his first wife, Amy, and their two daughters. Allergan had just given him a $36 million pay package. But in a friendly October 2015 profile in his hometown Pennsylvania newspaper, he positioned himself as a modest, hard-working guy, reminiscing about “cutting lawns in the South Whitehall Township neighborhood where he grew up.”

No matter that his father was a urologist and the chair of a local hospital system’s board, Brent had a working-class soul. He somehow scraped his way to an MBA and a law degree, then joined PricewaterhouseCoopers, “focusing on compliance in health care.” (A half-step from working on the docks!)

The October 2015 article features several photos of Saunders, including one of him at Allergan’s headquarters in New Jersey. He wears a blue shirt and tie and looks like generic upper management, though his plump cheeks and smooth eyes (thanks Botox!) make him seem a little young to be a chief executive.

A mean girl would call him “basic.” He didn’t plan to stay that way.

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(Yep, that’s the same guy as in the photo from yesterday’s article, only he’s eight years younger in this one. Who says American medicine doesn’t work miracles?)

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In November 2015, just eight months after Saunders officially became chief executive of Allergan, he made his biggest move yet, agreeing to merge Allergan with Pfizer, the biggest drug company in the world at the time.

The deal looked like huge win for Allergan shareholders - and Saunders. Pfizer agreed to pay $364 a share for Allergan, a 50 percent rise from the price Saunders’s former company had paid for Allergan a year before.

The deal was set as a stock swap, with Pfizer issuing new shares to Allergan’s shareholders. Pfizer had been around since 1849 and made medicines like Lipitor and Viagra, but Allergan shareholders would get almost half the new company.

Saunders was set to make almost $200 million from the merger - and become the heir to Pfizer chief executive Ian Read, who was 61. Saunders had put himself on track to run the world’s biggest drugmaker by age 50.

Not bad for a guy who not only had no background in medicine or research but had never brought a single important new drug to market.

As with Saunders’s earlier deals, the merger’s biggest driver was tax avoidance. It would give Pfizer the chance to shift its legal headquarters to Ireland and save billions of dollars a year in American taxes. As Forbes explained:

With Allergan Deal, Pfizer Would Flee The U.S. Over Taxes

But this time Saunders had overreached.

The proposed merger sparked huge (and bipartisan) criticism. Donald Trump, Bernie Sanders, and Hillary Clinton all spoke against the merger. Trump called it “disgusting.”

The outrage grew so intense that in April 2016, the Treasury Department issued new rules designed to block the merger’s tax benefits. With those gone, Pfizer simply walked away, proving that as critics claimed, the deal had been about nothing but tax avoidance all along.

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The failed merger marked Saunders’s high-water mark. Its collapse meant that instead of doing deals, he would have to actually run a drug company.

Running a drug company was not his strong suit.

But first Saunders took another shot at casting himself as a drug industry leader. In September 2016, Saunders publicly offered a “Social Contract with Patients,” promising not to raise prices more than 10 percent a year and to “invest and innovate.”

Saunders manifesto rang hollow not just because of his previous comments about drug discovery, but because Allergan’s top products in 2016 were Botox, prescription dry-eye drops called Restasis, and skin fillers. Saving the world one celebrity at a time!

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(Did he mean “contract with” or “contract on”?)

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A few months later, Saunders showed the world just what he thought of his own “social contract.”

Facing a Restasis patent expiration and the prospect of losing $1 billion a year or more to cheaper competitors, Saunders… made a deal with an Indian tribe in upstate New York, hoping that the tribe’s sovereign immunity would save the patent.

Nope, I am not making this up.

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(I’m really not.)

SOURCE

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In 2018, a federal court tossed the arrangement, and in 2019 the Supreme Court declined to hear Allergan’s appeal.

But the damage was done. Even Saunders admitted the deal had been a mistake, telling a healthcare news site that it “clearly eroded trust.” Besides making a mockery of his “social contract -” which can no longer be found on Allergan’s Website - it made Allergan and Saunders look desperate.

Then again, they were.

The collapse of the Pfizer deal meant that for the first time public shareholders would have a clean look at how well Saunders was running a company over a long period.

Previously, he had had the benefit of big mergers, which let companies hide their costs in “one-time” deal-related charges and make year-to-year sales comparisons difficult. Aggressive executives can use that flexibility to goose their profits - for a little while.

Without mergers, Allergan’s sales flatlined. And Saunders’s promise that he could figure out what drugs to buy without investing in basic research proved hollow. Allergan spent $2.1 billion in 2015 to buy a company whose primary product was “the first and only injectable double chin treatment” — then admitted three years later that it had overpaid by at least $1.6 billion.

That write-off was far from Allergan’s only stumble. Investors noticed. Allergan stock fell almost 20 percent in 2017, and the company said in November 2017 it would fire 1,000 employees and eliminate 400 vacant jobs. Yet Saunders was paid $33 million that year, bringing his total compensation at Allergan and Actavis just shy of $100 million since late 2014.

In 2018, the wheels truly came off. For the year, Allergan reported an operating loss of almost $6 billion after one-time “impairments” and other adjustments. And the Food and Drug Administration rejected Allergan’s application for a drug for uterine fibroids, a drug Saunders had long talked up.

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(If any article is a two-button article, it’s this one. Don’t miss your chance!)

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At the start of 2019, Allergan shares traded at $144 - 60 percent less than Pfizer had agreed to pay in 2016. (Yes, in changing the tax rules to block the Pfizer-Allergan merger, the Obama Treasury Department did Pfizer a huge favor).

In March 2019, Allergan announced that its experimental depression drug rapastinel - another Saunders favorite - had failed to help patients in a large clinical trial. (Both rapastinel and the fibroid drug were drugs Allergan had licensed or purchased, showing the problems pharma companies face when they try to evaluate medicines where they don’t have basic development expertise.)

By then, no one was asking Saunders for his vision of the drug industry anymore.

Now he and Allergan were merely prey. In June 2019, he bowed to the inevitable, selling Allergan to AbbVie, an Illinois-based drug company that had grown wealthy off the success of its arthritis treatment Humira, for $188 a share.

Allergan’s shares had fallen about 15 percent in Saunders’s time running it, and he had attracted national scorn for his tax dodging and patent games. In January 2017, he talked up six potential medicines to Allergan investors, saying they might produce $13 billion in sales a year. (He wasn’t including the double-chin injection, which he mentioned separately.) Five of the six never reached patients. The last, a me-too migraine treatment, will generate about $800 million for AbbVie this year.

For this four years of work, Saunders took home one more payday, almost $40 million, his “golden parachute.”

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The Allergan debacle may have ended Saunders’s hopes of running a globally important drug company, but it didn’t stop his personal transformation.

In 2018, he and Amy, his wife, moved to South Florida. She was a Georgetown University law school graduate who kept a very low public profile, though Brent occasionally mentioned her in articles. (In 2017, he claimed she had encouraged the “social contract.”)

But in September 2019, Brent and Amy sold the home they had bought a year before in Palm Beach County. Just three months later, Saunders moved further south, buying a mansion in Miami for $10.75 million. Amy was not mentioned in articles about the purchase; her LinkedIn page suggests she returned to New Jersey.

Saunders found new love, though, in the arms of Daniela Botero, a Colombian model.

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(Looks like more of a smirk than a smile.

ALT: You’d be smiling too.)

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He married Daniela in June 2022, and the newlyweds put their 6,700-square-foot mansion on sale for $22 million. “We need something just a little bigger,” Brent told the Wall Street Journal. “It’s time to move on to better things.”

Last month, the lovebirds found their new nest, a waterfront Miami Beach mansion that was once owned by Cher. It’s a cozy 12,450 square feet with six bedrooms and an interior courtyard.

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Now Brent is back running Bausch + Lomb, where it all began. (See Part 1.)

In his early halcyon days at Allergan in 2016, he sniffed at Bausch, saying Allergan probably wouldn’t even consider buying it because he didn’t understand its “growth profile.” (Remember, he had been running Bausch only three years before, when it had supposedly been growing almost 10 percent a year.)

But things are different now. A $6.5 million sign-on bonus isn’t Allergan money, but it’s okay. Ish. Plus Bausch is a publicly traded company, which gives Brent a platform he hasn’t had in a while.

Three weeks ago, he used it to criticize Elon Musk (for supporting Tucker Carlson, who had questioned the influence of pharmaceutical companies on the media).

Yes, friends, Brenton L. Saunders is back, here to defend the honor of Big Pharma and the billions it spends advertising Botox and the rest of its wares from meanies like Elon and Tucker.

It’s hard to keep a good man - or industry - down.