Hyung Heon Kim:
Because I was general counsel in a pharma company, I was fortunate enough to see everything.
John Simboli:
That's the voice of Hyung Heon Kim, CEO of Metavia, headquartered in Cambridge, Massachusetts. Listen in to hear insights from Hyung Hung about leadership in biopharma and how Metavia is working to transform cardiometabolic disease. I'm John Simboli. You're listening to BioBoss. Welcome to BioBoss.
Hyung Heon Kim:
Thank you for having me, John.
John Simboli:
What led you to your role as CEO at Metavia?
Hyung Heon Kim:
John. I'm educated, trained as an attorney. I was a general counsel to one of the largest pharmaceutical companies in Korea. Four years ago now, I think it was during COVID. Back in Korea, they asked all the executive levels and beyond to come to office every day while the the other employees stayed home, and I was driving to work, it was a rainy day, absolutely no cars in the road, and it just hit me like, what are we doing these days? Like everything is so quiet, everything is not moving. We're just literally just living, surviving,. And I came up with this idea on the way to work that you know what, since no one's doing anything, we should do something, and we had two cardio metabolic assets, one in clinical, one preclinical, and figured maybe we should just move these assets over to the U.S. where the largest metabolic market is. I came up with the plan. I talked to everyone who came to work at the senior management, and everyone was like, "That's a great idea." Original thought was me leading the charge, doing the deal with a listed company, then find someone else who actually has a lot of experience in management and in U.S. biotech to take the charge. Now, after the transaction was all done, I was looking for people. We even had an interim CEO to come in, but the level of intensity, the level of focus, the level of that desire to succeed with these two assets wasn't up to par in my standards. So everyone around me said, "You know what? It's the best scenario where the person who came up with the idea run with it rather than having someone else do the job." So that's when I stepped in, and here I am.
John Simboli:
I read, tried to do the research for our conversation today. One of the things that really struck me, if I understood it correctly, was it wasn't simply that general counsel comes up with scientific and business concept, which is interesting in its own right, but that a step further, it wasn't just I have two assets I can try to bring forward. It was these two assets can work in harmony in a way that the the current approach towards cardiometric weight loss and and other medical needs—you imagined a way to do this that no one else had imagined. Is that correct?
Hyung Heon Kim:
I was seeing type two diabetes being not conquered, but still there was a lot of alternatives out there, but still, when you start looking into that space, GLP-1s are dominating it. While the history tells me that people grow tolerance to the medication, and once you grow tolerance, where do you go after that? What's the options then? I don't believe going into insulin. That's the last resort, and that doesn't really, to me, seem like it should be the only end for type two diabetes patients. We need more agents out there, and that is there. The GLP-1 glucagon that we have is another potential type two, and at the end of the day, like isn't weight loss what everyone was looking for? I thought it was a great idea, but it was funny. Like back in like four years ago, when I did the deal, before doing the deal, I met with a lot of KOLs, and back then Wegovy wasn't approved yet, and the KOLs told me, "Weight loss drug, no way. You need to eat less. You need to exercise. That's how you lose weight and be healthy, not with drugs." That's what I heard. I was like, well, but still, like, and they're like, no, no, no medication, no medication. Just eat less. So, it's interesting how things change so fast, and it's very exciting that my ideas are coming to life. I am still convinced that our drugs, when it gets approved, can help a lot of people. Some people tell me it's overcrowded in the GLP-1 space, but to me, it's not. Especially like our oral pill, vanoglipel, it has a potential for a type two diabetes agent. When I went to American Diabetes Association last year in Chicago, when I went there, I was thinking, well, it's diabetes, so half of them should be talking about type one, type two, new progresses, and those. No, absolutely not. It was everything was on GLP-1s and weight loss. And I was like, these people can grow tolerance at one point. What if what if their weight comes back where they hit the plateau and they still have type two diabetes? Not everyone's going to normalize completely, and in that case, what are we going to do? Because there is no type two diabetes agents out there, not not like in the past. So that's where I see the reason why I am, as an attorney, and it's interesting. My undergrad is in law as well, so for a non-scientist reading papers and doing research and trying to keep myself up to the newest challenges, and making sure that our direction is correct. It's just fun.
John Simboli:
Is there any point at which you thought, oh, I I know I'll be a leader of something along the line, not necessarily a biopharma company, but were you on a path to becoming general counsel all the way, or were you did ever enter your mind? This might be?
Hyung Heon Kim:
In Korea. I'm a Korean national, and you have mandatory military service. During that time, I was gently surprised on how quickly the leadership role I could take over as an attorney and going in-house, all of those were, for me, more like targeting to be more in a active role than others. Like in the firm, you feel like you're helping your client, but at the end of the day, client says everything, right? You're doing what your client wants to do. In house, it was more like I was half there. I was half of the owner who was pushing it through an agenda or a lawsuit or a licensing deal, and I think those really built me into what I can do as of today,
John Simboli:
Can you recall when you were a a young person? You know, pick any age that would work for this question. But can you picture any, can you recall anything that where you were of age and looking for guidance from your parents? Perhaps like this is what I'll be when I grow up. I imagine it was probably not biopharma CEO, but what might it have been?
Hyung Heon Kim:
My interest when I was growing up was more on being a pilot. It's just that my eyesight didn't allow for that. My father, my dad used to work for Hyundai, and he retired as a CEO. And I think looking at him and his dedication to work and being a leader and everything really did have an impact on me as well.
John Simboli:
I was thinking back to what you said when we first started about driving your car that day and thinking about how we were all living our lives so differently during the pandemic, and one of the things I recall from that time is that the formal meetings I was having with CEOs, where I would sit and wait and wait and wait, because they had other meetings that had trumped mine, changed to, "Oh, John, call me at 11 at night. I'll be in in my kitchen. You know, let's talk." And and it was in a weird way. It was so much more effective and so much easier. Probably not for them, but it was for me. So what I'm trying to get at was, in those conversations, sometimes a wife or a kid would walk through the frame at 11 at night and basically be saying, "What's going on? And then that led me to the question of, "Do people understand what you do for a living. So, in in a large pharma company, they probably have an
image:
somebody in the, you know, the glass office making decisions. In a biopharma company, when you're trying to explain what do you do for a living, what do you say?
Hyung Heon Kim:
I say I'm managing a biotech company, which really is focused on metabolic disease. People tend to take it pretty well. It's just that they have no clue.. But sometimes when I say that, like people say, like, I'm on GLP-1, or I'm doing this, and it. . . pharma industry, the drugs that we're developing, it really does have an impact on people's lives, and that's something that that's why we are probably working this hard.,
John Simboli:
That makes perfect sense to me, and and of course you're fortunate because in so many aspects of biopharma-it's beyond the layman's understanding. With GLP-1s and weight loss. Suddenly, people understand. But if I turn that question towards, you know, what do you do if someone were to say, what do you do all day, each day? What would you say?
Hyung Heon Kim:
I'll have to say studying. I just because I was general counsel in a pharma company, I was fortunate enough to look at A to Z of what everyone does, like manufacturing side, logistics, clinical trials, research, domestic sales, international sales, licensing deals. I was fortunate enough to see everything, but I wasn't hands-on like on clinical trials. I looked at the contracts to learn, but that was about it. So, to me, my job is to make sure I study, study hard on every aspect of clinical trials. I study on the drug. I study other companies' drugs, and it just goes on and on. And I really like it, I really do. It's just fun, and based on those things I read and try to learn, I come up with new ideas, and that's where it really makes me feel like I'm doing something.
John Simboli:
As far as chopping up the 20-hour day, a certain number of hours each day, each week, you're talking to folks like me, fending off the the media folks, trying to tell the story. What part of it is involved with having to understand and then continually grow the financial side of it, the investment side of it?
Hyung Heon Kim:
I think it's about 20% to 30% of my time, and it's all a lot of the studying is geared towards them. At the end of the day, the company, we changed the name is a reverse merger company, meaning when it got listed., it didn't really have a fundamental institutional backing, and because of that, unlike other biotechs, it's hard to get people's attention because people don't understand. Like when you do the reverse merger, they don't know who you are, and because they don't know who you are, they're hesitant, and those things are the challenges that we have. And another portion of it is that our research center is over in Korea, so these two were homegrown from scratch from the research center, which actually has like 400 PhDs working there. It was the first South Korean pharmaceutical research center opened in 1975. Now the thing is, nobody knows about it over here. Nobody knows. So that's those aspects of our company that needs to be. That's that's where I try to let people know, try to meet more people, to make them understand that we're not just a little tiny little company here in Cambridge, Boston. It's more like it's more globally networked, and has a lot more, I think, advantage over other companies. Make the right decisions, have the passion to push it forward. No matter who says what, it doesn't matter. Push it through if you have the belief that it's going to be a drug that can change people's lives. Then you just push it through, and something special will happen.
John Simboli:
Do you have any way of working that helps you to figure out when to seek consensus and when to simply trust your instinct?
Hyung Heon Kim:
I always think about the day I came up with the idea, and I ask myself, "Do you think you'll do this or that?" I don't think of it as right now in my understanding, my thoughts. I just go back then and say, "What was your vision back then? Is this decision going to change that? In which direction? What would you make that decision on that day?" And it's really, it's interesting. Like the, since I'm coming from the legal side, there was always somebody to blame. You blame on the client. You blame on something, right? But here, basically, I have no one to blame for. It's like I came up with the idea. I'm leading the charge. Who am I going to blame? My dog? So it's like every decision I make is based on that vision I had. How to get to that vision and the goal is what I base on.
John Simboli:
I was thinking about a CEO I spoke with who he didn't come from legal background, had not been general counsel, but he had been at the company. He became CEO. He had been the business development guy, and he told me a story, which sort of I'm curious whether it has any you know traction for you, he said. "I am speaking the guy's voice now. I was accustomed to presenting options to the CEO and the executive team. We could do this or this or this, and he said as quite good at that. But then, when I became CEO, I found myself defaulting to that. And in the group, in the decision-making group, he'd say,"You know, here here are our options. And he said, in the very first meeting he did that, people just looked at him blankly and they said, "Yeah, but which one are we going to do? So it is a group decision I know often, but still, CEO has to make that decision. So, does that relate at all to what you were just talking about? The
Hyung Heon Kim:
The hardest part is that whatever decision is coming from the CEO, whether you take the option A, option B, option C, it doesn't matter. It's the decision of the CEO, and the CEO needs to live with it, and that's the hardest point.
John Simboli:
I spoke recently with a CEO who said these are two contrasting points of view in answer to that question I was just posing to you. One said I had to learn that I could pivot. I had to learn that I could make a choice and turn out to be the wrong choice, and then I could change. And another one said I learned that I have to have optionality. I have to continually be looking around the corner, trying to anticipate the problems. Those are not mutually exclusive, of course. Is being able to pivot part of the job?
Hyung Heon Kim:
Yes, I definitely agree with that. Sometimes you see like CEOs, biotech CEOs who've been who are medical doctors or pure scientists who've been teaching the rest of their lives and come into that role, and those people, it's hard for them to pivot because they're not used to doing it. Especially scientists, they live with their data and they stick with their data. Having to pivot is going to be pretty hard for them, especially with this environment that we are in, that the volatility is too high, the competition is too fierce. Have to be always ready to pivot or move very fast. I guess to a different direction if we believe that the direction we are taking needs to be changed. So, and that's one of the reasons why I just have to spend a lot of time studying because if there is something there that needs reconsideration, I need to see it.
John Simboli:
What is differentiating about your approach?
Hyung Heon Kim:
It started off as a project to make type two diabetes drug, not like other drugs where you're trying to get obesity drug, most of the GLP-1s right now in development. They're trying to chase the obesity, but this drug, both of them were designed for type two. That's the biggest difference. And when you look in the GLP-1 space, there's tons of drugs in development, but when you look at any of these drugs with a glucagon in it, pretty nasty AE profile, because GLP-1 and glucagon has similar side effects: nausea, vomiting goes on. What we tried to do when we were making it from scratch as a type 2 diabetes agent with a GLP-1 glucagon, while we have a very safe tolerability profile, because we have seen others not working that well, and at the end of the day, it's phase one, but we've seen great glycemic control with glucogon in it because GLP-1 lowers glucose, while glucagon actually increases it, and increasing it basically makes people's energy expenditure go up. So that's its mechanism. So glycemic control is hard to get with glucagon in it, but we showed that and showed weight amazing weight loss. And glucogon has a direct hepatic effect, so we're seeing liver stiffness going down faster than any other. And those are the attributes that we are chasing after. And if we can show something very safe, then we really do have a very different drug..
John Simboli:
I kept coming across the word balance in how you were explaining, and I like to explore that a little bit. So, the balance between lowering the desire to take in more food, and then increasing the potential to burn that, and then bringing those two into balance. Did I understand that more or less?
Hyung Heon Kim:
That's the balance between the GLP-1 and glucagon. Everyone's balance is different. One of the companies they have one-to-one perfect balance, which sounds good, but because of that, they cross out certain effects, efficacy, such as glycemic control. Doesn't show anything. It's perfectly balanced. Then you have other ones who are very more heavy on GLP-1s. They look good, but it's just that because they have a lot more on that side, maybe that's the reason why there is so much AEs coming out. So that balance between the GLP-1, glucagon, ours is three to one, and we believe that's where the type two diabetes glycemic control we believe was going to show, and right on the point we're showing that and weight loss.
John Simboli:
The balance that you're seeking, if it does succeed in the way that it does, how would that affect patients' lives if someday, you know, these therapeutics were approved?
Hyung Heon Kim:
Well, let's look at the approved drugs because on the lower dose, starting from the lower dose, people are experiencing a lot of GI-related side effects. That's why the approved drugs, in order to go up to the maximum, it takes six months. Every month you escalate six months. If our drug, we're running a titration study. If there's, but it's only one step and two step, meaning a month or two months. And if people are feeling comfortable removing that scaredness of trying a GLP-1, remove that, and tell people that if we can lose like my goal will be about 13 to 15 percent of body weight in just four months, then why would you take other drugs? That's fast, but it the best part of our drug is that it's the waist. How much the waist come down? We didn't do any titration, but on the 48 milligram, in just eight weeks, mean waist reduction was four inches, almost four inches, 3.8. Now, when you ask anyone who wants to lose weight, where would they want to lose weight? Your cheeks or arm, right? It's it's the belly, it's the belly. So, yeah, like four inches, almost four inches reduction in just eight weeks. That means you need to buy very happily a lot of pair of pants. So, isn't that something that people will enjoy? I think so. Would that change people's lives? I believe so, especially if it has glycemic control as well.
John Simboli:
I've been wondering about this question: What happens when people stop taking the GLP-1 drug? I guess the word I would like to ask you about is sustainability. To what degree does your approach take that into account? The idea of sustainability.
Hyung Heon Kim:
We haven't really. Our study is way too short in phase one to actually see that effect. But when we ran obese mice model in the preclinical stage, we saw one study where we did a head-to-head with tirzepatides that well lost almost the same weight in the mice, but the mice on our drug ate about 20 to 30% more food while losing that much. Now, what I'm comfortable with that is mice if they're not feeling good, they're animals. If they're not feeling good, they're not going to eat. Tirzepatide mice ate 50% less food than what they used to. Ours only reduced by 20 to 25% Now that means a lot. So it's not like people on our drug needs to will be feeling that bad to be not eating, while the drug itself is going to make people lose weight. That's the difference between just the regular GLP-1 and regular GLP-1 and GIP. That glocogon side of the drug. So that's what we're really looking for. It's just that right now our studies are way too short, so it needs to be a longer study to actually see that effect come to play.
John Simboli:
How does your approach, if if it were successful, how does your approach address the question about lean muscle loss from obesity drugs?
Hyung Heon Kim:
We haven't done that yet because our studies are way too short. It's just that when we look at the wais, are we looking at like these people are extremely big, right? BMI over 30, like 35. Is that all muscle? I'll tell you, probably not. It's probably mostly fat, and if we're losing like four inches of that lean mass, fat mass, man. So, what we're trying to do in our titration study is we're trying to run a full body MRI, and we'll be able to see what the drug is doing, especially around the waist. I really want to see that. Is it the fat outside fat or the real inside fat?
John Simboli:
After you make a presentation about about the company, particularly to institutional investors, is there any kind of pattern where people misunderstand what you are trying to do, and then you can help them say, "No, that's actually not it. This is our focus.
Hyung Heon Kim:
If there is any comments like that, I think it's focused on where are we going with this obesity drug. I think that's where a lot of that comments come out. When you look at obesity, when you look at approved drugs with their CV outcome studies and everything, we're looking at 1000s and 1000s of patient clinical studies with billions and billions and billions of dollars going in, so think the investors are, especially the institutional investors, they tend to want to hear from me, where is our focus with this drug? Is it going to be obesity? Is it going to be type two diabetes? Is it going to be MASH since we have glucogon in it, and the reason for that I totally understand because we're a small biotech, but we need to build data to get to a certain point, and I believe I would love to push this to commercial, but I don't think that's possible, and that's not good for a drug because, for one, we won't be able to put billions and billions and billion dollars into CV outcome studies. In that case, the the drug ain't gonna go into the full potential. So, at one point, we will have to partner with a big pharma, and in order to do that, we need to focus on certain areas. Now, it gets a little confusing there. So, is this drug going to say we are a MASH drug with amazing weight loss and amazing glycemic control, or we're going to say it's an obesity drug where it has glycemic control and we're showing great MASH data. The messaging gets a little bit confusing. I think that's where people tend to be giving me those comments, and I totally understand. But we're in phase one, and I don't believe this is the time to change from an obesity drug aspect of it because we're in phase one. We're looking at safety, and our weight loss is very compelling. Probably one of the top five drug candidates out there who loses this much weight. It's just that at this point, I think we we're going to say it's an obesity drug with these subcategory benefits. But after this titration study, which goes up to 16 weeks of full body MRI with liver MRI-PDFF, that's when we'll be able to say if we need to pivot, right, John? If we need to pivot at that point, say yes, we are we have a MASH drug, amazing MASH drug compared to no other, with , amazing weight loss with this, so the the pivoting point will be coming. It's just not now.
John Simboli:
Thank you for speaking with me today.
Hyung Heon Kim:
Thank you, John, for having me. It was a great pleasure talking to you.
John Simboli:
After more than 80 conversations about leadership with biopharma founders and CEOs, I understand. There are many pathways to leadership, and they can all be successful. For Hyung Heon, the journey to leadership has a solid foundation in his experience as general counsel for one of the largest pharmaceutical companies in South Korea. As many BioBoss listeners will know, biopharma in South Korea plays a strategically important and rapidly growing role in global drug development, and is now one of the largest sources of new drug candidates. In Hyung Heon's words, "Because I was general counsel in a pharma company, I looked at A to Z of what
everyone does:
manufacturing, logistics, clinical trials, research, domestic sales, international sales, and licensing deals. I was fortunate enough to see everything." This broad perspective appears to offer Hyung Heon the possibility to see things from multiple viewpoints. This perspective could be especially important in a field where data change fast, and the need for vision at the leadership level is pronounced, Hyung Heon goes on to describe the capability for a biopharma CEO to pivot, if needed, to align their vision with changing information. Since Hyung Heon had the original idea at Metavia to bring the company's assets to the U.S. with the goal of transforming cardiometabolic disease. He said to me, "I always think about the day I came up with the idea, and I ask myself, do you think you'll do this or that? I just go back and then I say, "What was your vision back then? Is this decision going to change that? In which direction?" This part of Hyung Heon's leadership journey reminds me that the power of innovation extends beyond the realm of scientist founders, and can potentially become the basis for bringing new therapies to patients in need. I'm John Simboli. You're listening to BioBoss.
Unknown:
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