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Championing Pharmaceuticals for Opiate Addiction: An Interview with Behshad Sheldon

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She is a second generation Iranian-American and the daughter of a prominent Persian cardiologist. She is a global senior pharmaceutical executive with a passion for serving the underserved. She is an esteemed member of Female Opioid-addiction Research and Clinical Experts (FORCE), an organization of women dedicated to combatting opioid addiction and its stigma. She is compassionate. She is innovative. She is Behshad Sheldon. 


Sheldon was born in Pontiac, Michigan, though she lived in Iran from ages three to fourteen. During her childhood in the Middle East, her father nurtured her intelligence, encouraging her to follow in his footsteps and enter the health care field. “Sometimes people find it odd that I was told to follow in my father’s footsteps given that I was a woman back in the 1970s in a Persian family, but that’s how it was,” Sheldon laughs. 


My dad was my North Star and always has been. He always said, “You and your sisters can do anything you want to do.” There were no boys and in an Eastern family, as you might imagine, especially back then, boys were very much coveted, but we were all treated as we could do anything a boy could do. We were forgiven for not following in the footsteps and going to medical school and were always supported in whatever we wanted to do. He not only taught me how to be a good person, but even a good businessperson. My husband coined this about my dad: he is a caretaker of life. He said that one time watching him garden because he gardens with the same intensity and attention that he would give to a patient in his office. 


Sheldon had exceptional women as role models in her life as well. “I know way more strong Iranian women than really strong Iranian men in terms of who is the alpha in the household,” she said. “For example, my best friend’s mom is kind of like a second mom to me. She was the first woman pilot in Iran and the first woman parachuter in Iran. The women I knew were always doing things that they thought they wanted to do and no one was going to stop them. Persians don’t like to be told what they can and cannot do,” Sheldon explains. 


Upon moving back to the United States, Sheldon found herself experiencing a bit of a culture shock. “I entered high school at a time when no one knew where Iran was at all,” she explained. 


No one in my high school even seemed to know where the Middle East was, but when I said “Asia” a light bulb went on. Ironically I had a British accent and since no one had any idea where Iran was, it all seemed exotic. My maiden name, Behshad Dowlatshahi, made me stand out as not being a typical Eurocentric American from Michigan, but people just thought of it as an exotic thing so it was kind of cool. 


But that was not to last. After the Iranian Revolution and the Iran Hostage Crisis in the late 1970s and early 1980s, however, Sheldon noticed a definite shift in opinion amongst her peers.


Suddenly everyone knew where Iran was. I have to say that, though I never experienced any personal backlash, I definitely heard locker doors slamming and people shouting “Nuke Iran! Let’s nuke them to kingdom come!” and similar sentiments as we’re hearing now. It was definitely kind of an odd feeling, but I didn’t take it personally. The only thing we ever heard in our house is what it means to be a Muslim. It means to be a good human being. It means treating everyone the way you want to be treated. It means having respect for your elders. It means taking care of those who can’t take care of themselves. That’s what it actually means.


Sheldon’s multicultural and varied geopolitical exposure has notably been an asset to her as a businesswoman and as a leader in the healthcare space. She has over twenty-five years of experience directing pharmaceutical advancements and commercialization around the world.


I’ve had a lot of alliances where it was required that I work with people from other countries, mostly European, but it still always came through to them. They’d say, “You’re not what we expect of a typical American person. You understand that there’s another point of view and perspective, not just the American one.” That’s been a tremendous help to me as a matter of diversity of culture and thought, and how we could make better decisions by having all the perspectives in the same conversation. Now it sort of seems like a really sad day because what I saw back then, the ability to use diversity to make ultimately better decisions for the company, for our shareholders, for patients, for caregivers, is so torn apart by everybody looking only at how different they are. The worst part of it is the loss of opportunity that comes from loss of embracing diversity and just calling somebody “the other” and demonizing him or her.


Her worldliness and background was particularly influential in her work at Otsuka Pharmaceuticals, a Japanese pharmaceutical company focused on excellence in global health care. Sheldon spent ten years at the company and cofounded the Otsuka Princeton office in her current hometown of Princeton, New Jersey in 2002. She served as senior vice president and was responsible for global marketing and commercial organization, alliance management, and early development strategy. She also served on the board of directors of Otsuka’s Research and Development sector, overseeing eighteen preapproval programs for products in a wide variety of areas, including CNS, cardio-renal, dermatology, oncology, and pain. The Otsuka experience proved to be formative for Sheldon, especially in terms of work ethic and cultural awareness. 


Mr. A. Otsuka was a visionary and continually emphasized that we will always put patients first. That was something we always carried forward. Innovation and creativity were more important than process improvement. These were the cultural principles. He believed diversity of thought was the pathway to innovation and creativity, and that diversity of experience was its foundation. He thought that the only way you could harness innovation and creativity was by having diversity of thought, and the only way to have diversity of thought is by having diversity of experiences. He built his company out of people of different backgrounds, however you want to define that . . . any experience that makes you different and gives you a different perspective makes you important to be included. 


Mr. Otsuka acted as a role model for Sheldon, along with several others at each company she served, such as Bristol-Myers Squibb.


The sentence “Do the right thing for patients, the rest will take care of itself”. . . I think the first time I heard it was from Sam Barker from Bristol-Meyers Squibb and he was the president and CO at that time. So when people like to beat up on Pharma, I have to say that in all my time I’ve never heard anything other than “put patients first.” That’s why it just seems so natural; it was always about doing the right thing. Another really key person at Otsuka was Caro Iwamoto. That was one of those relationships where we were mentors to each other because he was also a philosopher scientist, but he didn't really know anything about commercialization, so he asked me to teach him. He in turn taught me in different techniques in enabling and authorizing to be creative and innovative. 


Sheldon has taken the sentiment “put patients first” to heart, especially during her three most notable drug launches: Glucophage for diabetes, Plavix for heart disease, and Abilify for psychosis. These drugs are by any measure blockbusters, both in sales and in impact. They have been widely used in clinical settings and have bettered the lives of millions.


The key to success in all three of those products was finding out what the patient experience had been and where it needed to go, what else patients were looking for and how could we help them get there. This is one of those things that strikes me as different between the way that men and women approach things like pharmaceutical marketing; my idea was always more like a live-together strategy than a kill-the-competition strategy. I just thought about, do places exist where things can be combined so that the patient has a better experience? It turned out in all three of those that combinations with something else was always actually a good idea because you could minimize doses and side effects and maximize efficacy. So it just kind of builds on each other. Another thing all three of them had in common was patients actually taking an active role in their own treatment, whether it was early patient education or posters at bodegas or direct to consumer advertising for Plavix. For Abilify specifically, there was an enabling patients idea that would lead them to ask questions to their doctors and hopefully end up with better care. I think that ended up being another key thing that seemed to lead to clinical success.


Sheldon has turned a bachelor’s of science degree in neuroscience from the University of Rochester into a head position at pharmaceutical company Braeburn Pharmaceuticals, which is a rare and impressive feat. The organization primarily deals with central nervous system disorders and the use of molecules that are made available to patients through novel delivery systems, and Sheldon’s strong, compassionate presence as president and CEO has been vital in turning these goals into realities. Not only has she worked to fully understand the disease states and patient populations she works with, she also tackles every obstacle in her way to best serve those populations. When asked what makes Braeburn Pharmaceuticals stand out from the competition, Sheldon replied:


We want to serve the underserved. We want to go where Big Pharma and maybe most other Pharma aren’t going to go, which is to provide hope for patients who are stigmatized and whose diseases are vilified and at best kind of ignored and swept under the rug. We want to make a real difference, not just make a twice-a-day drug to a once-a-day drug. We want to do something that will make a big difference now, that’s why we’re dealing with molecules that are already successful, but also investing in the future in different ways of getting at the problem, so different kinds of solution, but always for people who get the short end of the stick from society, people who are marginalized and ignored at best and vilified at worst. 


In a letter of recommendation, National Institute on Drug Abuse (NIDA) Director Nora Volkow calls Sheldon a “trailblazer” and a credit to women in health care:


She is at the very top of the list of outstanding senior executive women; her vision has engendered a proven record of achievements that have changed the health care industry for the better. I have followed her trailblazing career for many years and have always been impressed with her commitment to bring innovative treatments options to treat chronic diseases that are all too often made worse by the shadow of stigma, such as opioid addiction, pain, and schizophrenia. She has been a beacon of steady leadership and clear vision in an industry that can often be described as stormy and unforgiving, focused like a laser on serving patients suffering from health conditions for which, for too long, there has been little innovation. In short, Behshad combines truly unparalleled administrative and professional accomplishments with a strong and inspiring leadership style that rewards diversity of thought and encourages excellence. There is no doubt in my mind that she represents an exemplary role model for young girls to follow and a much needed reminder, for every person with a passion, that the fundamental values of hard work and social responsibility still matter.


As president and CEO of Braeburn Pharmaceuticals, Sheldon has been revolutionary not only in her successful product launches, asset acquisitions, and research developments, but also in her staffing abilities. She has recruited an extremely diverse group of individuals throughout her career and has taken the time to train, mentor, and appropriately promote them across their professional lives. Her mentorship of other women has been notable, and she engages with patients and physicians to get the understanding she needs to push the boundaries of current treatment landscapes within a disease area. The time and effort she invests is extraordinary and speaks volumes about her passion to put people before profits.


For those individuals protesting Pharma as a source of pure evil and corruption in this world, Sheldon recommends going back to the evidence and data:


There is a genetically defined void to any kind of addiction. Pharma marketing of opioids didn’t help, but I wouldn't even 100 percent agree that this crisis was caused by those people. I understand that we love to point fingers, especially in this day and age and in this country, but if we’re going to point a finger, we should point it at the disease. We have a problem in society not teaching children how to deal with stress, not training their brains to be resilient. That’s our biggest problem. But, no matter how you got to the point of having the disease of addiction, we think you deserve a way to survive and thrive, and we are trying to provide a solution. Also, looking at pain as the cause of the problem will never fix it. We shouldn’t sacrifice one group of patients for another. This idea that we should now stop treating pain because a substance may be prone to become addictive, that’s not going to work either. 


The future looks bright for Sheldon and for Braeburn Pharmaceuticals. The company is currently investigating some promising nonopioid molecules for the treatment of addiction and pain. In addition, Braeburn is trying to manage easy access to Probuphine for as many of the right patients as possible and bringing new injectables onboard. For example, the company is working on getting a new implant for schizophrenia approved. Sheldon states,


We believe that long-acting medications, like injectables and implantables that guarantee adherence, are essential to improving outcomes and treating brain disorders, because obviously when you don’t take your medicine there are numerous bad outcomes and consequences for patients, their family members, and society that can be avoided. The ability to guarantee compliance is essential. Things are already improving and that’s happening through education of both doctors and patients and obviously the longer the time, the easier it will be for patients to accept the formulations. If you don’t get people to accept and overcome that, it’s a thorn in the side of long-term program development. To some extent it’s more about doctors accepting these formulations, because in some cases it just doesn’t jive with their specialty. So for psychiatry it’s pretty significant. They usually don’t even have a sharps box in their office. It’s quite a paradigm shift to figure out how you’re going to deliver this different formulation that you’re not used to administering because you don’t normally touch patients. It’s also about the prevention of abuse, misuse, diversion, even pediatric exposure. When we have formulations that are administered by the doctor so you can’t have pill mills, prescriptions for sale or kids accidentally getting a hold of it—that’s an added benefit to society and certainly to the patients themselves because they’re getting the dose that the doctor wanted them to get.


American Society of Addiction Medicine (ASAM) CEO Penny Mills finds Sheldon’s accomplishments to be quite noteworthy, referencing in particular her dedication to Braeburn Pharmaceutical’s production of Probuphine: 


Behshad worked tirelessly to overcome hurdles with the FDA to bring an extended-release formulation of buprenorphine, a medication to treat opioid addiction, to market in 2016. It was Behshad’s compassion for the patients and drive to expand the narrow array of treatment options that pushed her to overcome internal challenges and work with the FDA on next steps for Probuphine. With the magnitude of the opioid epidemic, Behshad’s leadership of Braeburn Pharmaceuticals is an invaluable contribution to the health care field.


Along with her work as CEO of a flourishing pharmaceutical company, Behshad is a leading figure in Female Opioid-addiction Research and Clinical Experts (FORCE), an organization dedicated to preventing addiction to opioids, making treatment widely accessible and acceptable, and reducing opioid-related damages.


The first idea of FORCE was statistical: women make 80 percent of health care decisions in the US. Having a group of women who can speak to women about what they can do to save their family members, their loved ones, from opioid use disorder and from the potential of overdose and death seems like a logical thing to do. However, the fact that we balance as women the softer side, the more caring side of things, the balance of rationality and compassion, definitely was a factor too. I’ve never met quite so many women concentrated in a specific therapeutic area, and I’ve been in the pharmaceutical field for a long time. There are so many brilliant, dedicated women in opioid addiction who are either doing research or treating patients or both, it seemed like it was waiting to be done to bring them together so they can be part of making a change and being part of treating the opioid epidemic.


Fellow FORCE member and executive director of public policy at Aimed Alliance Stacey Worthy argues that Sheldon is at the top of the list of most influential healthcare leaders of 2016. “I have seen firsthand her steadfast commitment to helping millions of Americans affected by the disease of opioid use disorder,” Worthy says, “I am honored to have the opportunity to work with Behshad to promote individualized patient care.” 


Behshad Sheldon has dedicated her life to civic responsibility and has accomplished a great deal in the health care field while still staying true to her commitments of heart and conscience. She is an exceptional individual who has gained the respect of many and will continue to better the lives of patients all over the world. She has proven herself to be an outstanding senior executive; pharmaceuticals can be a cold and unforgiving industry, but Sheldon has stood steadfast in the face of adversity, unafraid to be a woman with a passion of heart. Her commitment to the disenfranchised masses speaks to her insight as a modern leader and her determination to seek solutions to problems she genuinely cares about. She has fully immersed herself in the patient experience to better understand the unmet needs of patients, and then set out to restore their health with the drugs and formulations she has created. Keep an eye out for Sheldon’s name in the future, as she is surely destined for further greatness.