PHILADELPHIA—In 2010, Sabrina Johnson was at a crossroads. Cypress Bioscience, the company where she had spent 13 years, had been sold, and she had one more year in her post to figure out what she wanted to do next.
“It allowed me to take a step back and do some looking at what kind of company I wanted to be with. Did I want to be a public company COO and CFO and do the same thing again? Or do I want to maybe join a global nonprofit in women’s health and do something different?” Johnson, CEO of the women’s health company Daré Bioscience, told FierceBiotech.
And now that I’ve given it away, there are no prizes for guessing which way she went.
Johnson joined WomanCare, a nonprofit that identifies products approved in big markets like the U.S. or Europe and registers and launches them in developing countries. She started out in her old role—chief operating officer and chief financial officer—before transitioning from operations to leading WomanCare’s trading division, the arm of the nonprofit that selected the products.
“That was my inspiration for starting Daré. I was trying to find new products and I found a lot of interesting innovations in women’s health, but they were often not making it to FDA or EU approval,” she said. Instead, these treatments were languishing in phase 1 and phase 2, their inventors unable to find a partner to help them move forward.
It was an eye-opener for Johnson.
“I was coming from the CNS space, where finding a phase 2 asset is competitive. In CNS, there is no reason you can’t find a partner for an asset that has phase 2 data,” she said.
She figured she could do more good getting these midphase programs—some of which could have been first-in-class treatments—through approval and into the hands of patients. And the business proposition wasn’t terrible, either.
There were—and are—a number of pharma companies with a commercial footprint in women’s health, but they were pushing their legacy brands and not investing in R&D.
“Their stockholders want them to invest in immuno-oncology or rare disease, where the big bucks are,” Johnson said. “Although they had a sales force calling on gynecologists and obstetricians, they weren’t investing going forward.”
And some companies have offloaded their women’s health units altogether, or at least tried to. In 2017, Teva sold off its contraception, fertility, menopause and osteoporosis stable for more than $2 billion, a move followed a year later by Allergan and Pfizer each mulling a women’s health sale.
"We see it not as much as people getting out, but a shifting road map of who’s going to be fully committed in the space,” Johnson said.
The shift gives Daré the opportunity to loom large in the space and become the best development partner for the people inventing women’s health products. The company has a pipeline ranging from phase 3 to preclinical-stage programs, in a number of disease areas.
Partnering is key for Daré, and not just with innovators. The company sees an opportunity to partner with Big Pharma as well: “Whoever stays committed in women’s health but hasn’t been investing in their own R&D is going to need to pick up products. And that goes into when we pick a product for ourselves—we look at the most persistent unmet need, so the product would likely be first-in-category, which is also compelling to a potential partner,” Johnson said.
Daré spent 2018 building its portfolio and is spending 2019 on execution. It expects to report midphase data for Ovaprene, a nonhormonal contraceptive ring, and to start a phase 2b study for a topical form of sildenafil, the active ingredient in Viagra, in sexual arousal disorder. It’s also moving its lead program, DARE-BV1, a treatment for bacterial vaginosis, into phase 3 and kicking off a phase 1 study for a vaginal ring developed by MIT’s Robert Langer and Dr. William Crowley of Massachusetts General Hospital. The device delivers hormone replacement therapy for 28 days.
As for 2020, Daré will bring two more programs into the clinic and expects data readouts for DARE-BV1 and sildenafil.
Though Daré has picked up momentum since its birth in 2015, it hasn't always been easy. Johnson had no problem raising seed money for her startup, but when it came to wooing venture capitalists, it was a different story.
"Most of them had never seen an opportunity in women's health, it wasn't a therapeutic area they spent any time on. As they drilled down on a contraceptive product in one case, I realized they had never evaluated a contraceptive product," she said. "What I realized quickly is there is a learning curve when you are a company relying on investors. If the investors have never worked in your therapeutic area, the bar for them is so high. They don't know what they don't know, so they feel they have to vet everything."
Daré's solution was to go public via a reverse merger with Cerulean.
"We realized it was better to try to access capital that knows it can get in and get out," Johnson said. Instead of needing to surpass the high bar with venture capitalists, Daré just needed to convince the public markets it was a compelling opportunity.