Committed to focusing on health of the underserved 51% — women

Women’s health accounts for just 25% of revenue at MSD spin-off Organon, but it is the basis on which the firm intends to build

Simon Nicholson, Organon's managing director for UK, northern Europe and Israel, says there have been a lot of positive changes in women's healthcare over the past 20 years but biases remain. Photograph: Organon
Simon Nicholson, Organon's managing director for the UK, northern Europe and Israel, says there have been a lot of positive changes in women's healthcare over the past 20 years but biases remain. Photograph: Organon

Simon Nicholson is sitting in a shed at the bottom of his garden, wearing a T-shirt and trying not to bake in a July heat wave. It’s 28 degrees at the moment in his garden in Hertfordshire, where he lives with his wife and three children. This garden bolt-hole is also where Nicholson, managing director for the UK, northern Europe and Israel of US pharmaceutical company Organon, has worked for much of the past 2½ years, having decamped there in March 2020.

It has been a remarkably eventful period for him for reasons beyond even the obvious. In June last year Organon was spun off from US pharma giant Merck — known as MSD outside the United States — debuting on the New York Stock Exchange. Taking with it a portfolio of women’s health products, biosimilars and established brands, Organon, with its 9,000-plus global staff, became a big player in the women’s health market practically overnight.

He has just returned from a trip to Israel and Palestine where he met the members of his team there, many of them for the first time, despite having worked with them for more than a year. The trip was “a life-changing experience”, he says.

Such is his general enthusiasm that it is difficult to know whether the ebullient Nicholson is referring to the trip itself or the experience of meeting his Israeli colleagues — whom he calls his “friends” — in person.

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Nicholson, who had served in a host of different roles with MSD, first became aware of plans for the spin-off in late 2019. “At that point, it was still a pre-Covid world,” he says. “But even without Covid, it was still a very complex [challenge] to create a global scale organisation with a start-up mentality.”

Then the pandemic struck in March 2020, shortly after MSD publicly disclosed its plans for a women’s health spin-off. “We suddenly had to reshape our entire plan because we asked everybody to work from home, other than those who have critical roles, Nicholson says. “So we were like, is this even possible? Can you run a hugely complex programme of work from spare bedrooms and home offices and sheds.”

The answer was yes. Perhaps surprisingly, it turns out “it is possible to build a global pharma company during lockdown”, Nicholson says, though he admits he may be looking at that period through rose-tinted spectacles. To add to the chaos, Nicholson contracted Covid just before the company’s official launch last summer. “I ended up being admitted to hospital,” he says. “It really got me good.”

Shares in the company debuted at about $30 last June. Despite difficult market conditions, Organon stock has performed steadily, rising just under 10 per cent in volatile markets, with the likes of Goldman Sachs issuing buy ratings for the stock in recent weeks after the company posted first-quarter revenues of close to $1.6 billion, ahead of expectations.

Organon had roughly 60 products in its back pocket, across three categories of drugs when it was spun out of Merck. First and foremost are its established brands’ portfolio — off-patent products that include leading medicines used to treat illnesses from cardiovascular disease to diabetes. The most lucrative of Organon’s product ranges, it generated close to 70 per cent of Organon’s revenues in the first quarter of its financial year, according to its most recent trading update.

The company’s focus, as Nicholson puts it, is on ‘improving the health of women throughout their lives’

The company also produces a range of biosimilars, used in oncology and immunology, which accounted for roughly 6 per cent of that $1.6 billion revenue figure in the first quarter.

The remaining quarter or so of Organon’s revenue base is its portfolio of women’s health products and it is on this foundation, in particular, that the company’s brand identity is built. “Here for her health” is Organon’s slogan and it’s one that Nicholson and his colleagues take to heart, he says.

The company’s focus, as Nicholson puts it, is on “improving the health of women throughout their lives”. That means fertility, menopause, sexual health treatments and contraceptives like the implant Nexplanon, which in Ireland, is known as Implanon.

Nicholson says Organon has spent the last 12 months “listening to women” in the US and around the world. The company set up a website with a survey asking women for feedback about their healthcare needs and where they believe the biggest gaps lie and the “feedback is clear”, he says. “It’s described differently in different countries, but the feedback is: there is a large unmet need for education for choice” in areas like family planning.

Born in Nottingham, Nicholson graduated from Loughborough University in 1996 with a degree in geography before getting his first job in the industry as a medical sales representative at Searle. He has more than two decades of experience in pharma under his belt, most of them at MSD where he has served in an array of roles including head of partnership development and director of commercial sales. Before that, he was a sales manager at Pfizer.

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Nicholson says he has seen a lot of positive developments in the way women are diagnosed, treated and even spoken about in the healthcare sphere over his time. “In the main, over the last 20 years, there’s been significant shift in northern Europe, for example, in the way that medical school teaches new doctors, nurses and healthcare professionals [about women’s health], so there’s definitely been a rebalancing.”

But despite all that change, “biases are still hard-wired into the system”, Nicholson says, “and that’s been there for centuries”. Yawning gaps still exist in areas like clinical trial design, as a recent study by researchers at Brigham and Women’s Hospital highlighted.

“Women are underrepresented in clinical trials,” Nicholson says. “Even when they are represented, there are subtleties not always taken into account. For example, the impact of the menstrual cycle. So there have been significant shifts, but it’s the perhaps subconscious and the underlying bias that still exists.”

Crucially, women’s bodies remain a political battleground even in the most economically developed and dominant countries, as the recent US supreme court decision on Roe vs Wade reminded us.

Organon does not have a corporate stance on abortion, Nicholson says. But as a company with a “legacy of reproductive health”, he said it is committed to ensuring “that every woman around the world has access to contraception options and the information that they need to achieve their family planning goals”.

Is he concerned that contraception could become the next front in that particular war? “We’re not going to speculate on what comes next,” he says. But Organon is “focused on exploring new ways to expand access to contraception and contraceptive counselling”.

He says he tries to bring the ‘authentic’ Simon Nicholson to work with him every day

Founded in 1924 in Oss in the southern Netherlands by entrepreneur Salomon van Zwanenberg, the original Organon merged with Dutch conglomerate AzkoNobel in the late 1960s before being bought by the US company Schering-Plough in 2007. Two years later, MSD bought Schering-Plough, folding the company name into its portfolio.

With its strong legacy of innovation in women’s health among healthcare professionals, the choice of Organon was a no-brainer for the new company, as MSD chairman and chief executive Kenneth Frazier put it in 2020. Basing your brand identity on a steadfast focus on women’s issues is one thing. But how does Organon aim to do that without coming across as patronising or even hypocritical?

“For us to so publicly launch with our mission,” as Nicholson puts it, “we better be walking the talk, right?” In that respect, Organon “feels different” from any of the other companies he’s worked with.

Nine out of the company’s 13 corporate board members are women, while half of his own leadership team and more than half of the company’s global workforce are women. Moreover, Nicholson says the company’s focus is on diversity, addressing “all genders” and backgrounds, and extends to its internal “values”, which he suggests are not your “typical corporate speak” cliches. “We all belong” is Organon’s guiding principle, he says.

One might split hairs about whether it’s a cliche or not but, for his part, Nicholson believes “it says everything about us” as a company.

“We want every single founder — we call our employees ‘founders’ because that’s what we are; we’re essentially the people creating this organisation — to feel equally as valued, included, safe, comfortable, whatever that means from any perspective of diversity inclusion “Organon is demanding of us to be our true selves,” he says. “It’s very easy to say that but it’s much more difficult to do it.”

Nicholson tries to put his “true self” on show as much as possible. He paints in his spare time and several of his works adorn the wall of his shed, visible behind him on Microsoft Teams.

He says he tries to bring the “authentic” Simon Nicholson to work with him every day, something he says Organon chief executive Kevin Ali and the company’s senior leadership team overall put a particular emphasis on. Naturally, there is a corporate upside to all of this inclusivity. “The bet that we’re placing,” he says, “is if people feel safe and included and valued, they’re likely to be happy, they’re likely to be productive and likely to be able to deliver on our corporate objectives.”

What we’re doing is working with policymakers and with the health system to listen to their specific needs

With a headcount of about 50, Organon has a rather small Irish footprint at the moment. Many of its staff are based at a WeWork office at Dublin Landings in the docklands and Nicholson is relatively coy, for the moment, about what the company’s plans are here.

“We have a commercial partner in Ireland. I don’t want to disclose who that is for the moment. Right now — we’re taking the same approach across all of our markets in the cluster of 11 countries I’m responsible for — we currently supply and provide the full portfolio in Ireland,” he says. “But what we’re doing is working with policymakers and with the health system to listen to their specific needs.”

Starting next month, the Government will make contraceptive pills free for women aged between 17 and 25, a “ground-breaking” policy that Nicholson said will “drive to a certain extent where we partner, where we operate”. But while Organon fully supports the policy, in the same breath, he says it won’t hugely affect the business on the commercial side.

What is positive, however, is that it dovetails nicely with the UK government’s Women’s Health Strategy, Nicholson says. “So even though politically and geographically, there are some differences between the UK and Ireland, the reality is that what we’re seeing is a real alignment around women’s health policy, and that’s incredible.

“Can I put a dollar sign to what impact it will have? Not really. But it aligns with our mission around ‘here for her health’ and we’ll do whatever we can to support it.”

CV:

Name: Simon Nicholson

Age: 46

Family: Married to Olivia, they have three children — Joe, Laura and Sophie

Lives: Hertfordshire, England

Hobbies: Painting and reading

Something we might expect?

He says he is fiercely loyal to and protective of people that I care about both in my personal life and my professional life

Something that might surprise?

When not in the office, he works from his garden shed.

Ian Curran

Ian Curran

Ian Curran is a Business reporter with The Irish Times