Ironwood Pharmaceuticals is charting a course to become a giant in GI

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Rain, shine or blizzard, Tom McCourt always made a point to walk home through the streets of Cambridge, Mass., alongside his coworker at Ironwood Pharmaceuticals, then chief scientific officer, Mark Currie, during his early years as chief commercial officer. McCourt, who previously worked in both drug development and marketing at Merck & Co., AstraZeneca and Novartis, says the goal of the walks was to help integrate Ironwood’s development and commercialization efforts.

Ironwood CEO Tom McCourt

Permission granted by Tom McCourt.

When I first joined as the chief commercial officer at Ironwood, we were in two buildings in Kendall Square. We had Peter Hecht, the CEO, and a group of execs in one building, and Mark Currie and the discovery and development group in the other,” McCourt remembers. “[Hecht] wanted me to sit by him, but I said, ‘I’d rather sit next to [Currie] because if we don’t understand each other, this ain’t going anywhere.’”

Twelve years later, McCourt, now the CEO of Ironwood, is still taking that approach while steering the gastrointestinal (GI) focused pharma company past its first blockbuster drug success with Linzess. The drug, developed in partnership with AbbVie, is used to treat irritable bowel syndrome with constipation (IBS-C). It reached $1 billion in annual sales in 2021, earning it blockbuster status after nearly a decade on the market.

The company hopes to capitalize on that success in the coming year with plans to expand Linzess’ market into pediatric patients and build out its pipeline of GI medications. Those include the company’s wholly owned guanylate cyclase-C agonist IW-3300 candidate to treat chronic pelvic pain and its option for US rights to Cour Pharmaceutical’s CNP-104 candidate for the treatment of primary biliary cholangitis, a rare autoimmune liver disease.

“We believe we are in a strong position to realize our vision of becoming the leading US GI healthcare company,” McCourt said during the company’s first quarter 2022 earnings call.

Here, McCourt talks further about his integrated approach to drug development and commercialization, next steps for Linzess and his strategy for achieving Ironwood’s goal of leading the US GI pharma market.

This interview has been edited for length and clarity.

PharmaVoice: How do you blend drug development with commercialization efforts and how does patient centricity fall into the equation? How do you approach patient centricity at Ironwood?

Tom McCourt: I’m an insight advocate. For me, insight is about unearthing the ‘why’ that drives human behaviour. I think it starts with understanding the problem you must solve. The first question is whether there is an unmet medical need. The answer in our category was absolutely. Then the question becomes, what is the patient’s primary complaint? We felt that for us to reach the right patients, we needed to position Linzess as a pain drug that also improves constipation because we knew that doctors would likely prescribe the medication for IBS-C patients because they have nothing for these patients.

One of the key problems we had to solve was the communication between doctors and patients because the patient would communicate their condition as constipation. But constipation for that patient is not just ‘I can’t go,’ it’s also ‘I hurt, I’m uncomfortable.’ How do you get the patient to better communicate their real problem? Then, how do you also get the doctor to ask the right next question? If the patient calls it constipation, can I get the doctor to ask the patient what other symptoms they have? We knew that once the doctor understood that a patient had a pain and bloating problem with constipation, the probability of them picking Linzess would go up exponentially. That was really the premise around our whole direct-to-consumer campaign. To me, that’s patient centricity.

What insights have you gained while working on Linzess and bringing it to blockbuster status? What are the next steps for Linzess?

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