Interview: JJ Bienaime CEO of BioMarin

If you could build a product that had a total worldwide addressable market of 3,000 people, would take an estimated 8-10 years to build, and cost around $70K per year per customer to manufacture, would you go after this business?

That’s what Jean-Jacques Bienaime set out to do when he took the helm of BioMarin as CEO in 2005.  And in doing so, he built one of the leading biotech companies in the world. How did he succeed? First of all, with a stomach for tough challenges, and an ingrained conviction that problems are opportunities in disguise. Second, by focusing on superlative results and dramatic innovation (first-to-market milestone therapies with high barriers to entry). I had the chance to sit down with Jean-Jacques to find out more.

History and Background

For starters, Jean-Jacques explained to me that the US government passed the Orphan Drug Act in 1983 to stimulate R&D in orphan drugs (drugs for a disorder affecting fewer than 200,000 people in the United States), offering businesses with the stamina to go after small markets tax incentives and protection. This, in essence, kick-started the orphan drugs market. BioMarin established its leadership by focusing on an even smaller market: they coined this ultra orphan drugs (exceptionally rare diseases).

BioMarin provides personalized medicine for genetic disorders. The company has now 4 drugs on the market: one with 3,000 affected patients (MPS I), the second with 1,100 (MPS VI), and the third with 50,000 patients worldwide (PKU). The fourth drug (Firdapse) was launched earlier this year to treat LEMS. BioMarin touts the only FDA drugs approved for those diseases.  Patients taking their drugs must undergo a genetic test to prove they have the disease (validate the need) prior to taking their drug. The diseases (problems) BioMarin sets out to solve are known, but the treatments are vastly unknown (high technology risk) and expensive to discover and produce. Jean-Jacques explained that this is one of the main reasons the biotech industry as a whole only became profitable in 2009, a full 30 years after Genentech’s founding. Of note, BioMarin is one of the few profitable businesses in the industry.

BioMarin employs a group of scientists who study orphan diseases to determine which ones are feasible to cure. They follow a genetic approach to treatment, as opposed to the shotgun approach used, for instance, in cancer treatment. The objective of BioMarin is to find drugs that can deliver dramatic benefits to their patients through personalized medicine. Incremental or competitive benefits alone are not good enough.

High Technology/Market Risk

We could say that BioMarin faces both high technology risk, and high commercialization risk.  The technology risk of finding a treatment are gargantuan, and the market/customers unknown. Epidemiology studies do estimate the number of affected people in the world, but they don’t tell you who those people are. Newborn screenings are not mandatory for most orphan diseases (with the exception of PKU). The challenge is that MPS patients often don’t know they have the disease; they go for years being mistreated and undergoing multiple surgeries before they are diagnosed with a genetic disorder. When there are so few people affected in the world, most primary care doctors will never see a case in their lifetime. So BioMarin needs to spend significant resources educating ophthalmologists and rheumatologists of the symptoms to be on the look out for in MPS patients.

How do you go about finding 1,100 patients who are widely dispersed around the world, and do not know they have a need?? And the challenge does not stop there.  Once found and tested, BioMarin still needs to ensure that patients take the medication. To put this into broader perspective, only half of all the prescriptions written in the US are filled. So it takes herculean efforts to find the customers, and educate them. Not for the faint of heart!

Once we find the patients, we need to help them get access to care, find hospitals who can administer the drug, and ensure they take the drug regularly. In some cases we need to arrange transportation — we even have a patient who lives on a tiny island off the coast of Portugal. Some of our patients are wealthy and take private jets to get to the hospital weekly, but others need reimbursement assistance. We have to educate the patients of the importance of taking their medicine regularly. Sometimes it means finding a hospital when they travel, or finding an alternate doctor when their doctor is on vacation.

A truly fascinating story, and one that is uniquely benefiting a formerly undeserved but profoundly affected population, thanks to Jean-Jacques’ vision and dedication.

Basquiat and the Art of Innovation

I had a conversation with Ron Martinez of Invention Arts following his thoughtful comment on my post (thank you, Ron). As we both share a background in technology and the arts, I was eager to delve deeper on the topic with him. Specifically, since winning products need a combination of internal inspiration and external validation, how do we reconcile our creative vision with the needs of others? Does validating products with customers mean doing everything customers ask? What are the boundaries we should consider?

Image via Wikipedia

Let’s take a look at successful artists to explore those far-reaching questions. In many ways visionary technologists are like modern art painters: they have a strong subjective self that enables them to see beyond the mundane, give shape to their inner dreams, and create a vision for a new product, or a great piece of art. They could not achieve those results by surrendering their subjective selves to others.

This being said, if we seek to build winning products, or art that can sell during our lifetime, how do we find resonance with others, be it prospective customers or gallery owners, without surrendering our original creative vision? This is a vexing dilemma faced by technologists and artists alike.

Jean Michel Basquiat: the Art of Innovation

One artist who did this exceptionally well is the late American painter Jean Michel Basquiat. Born in NYC in 1960, he soon rose to fame to become an international art star. His paintings fetched multi-million dollar price tags (in his twenties!), and his art was shown in premier galleries and museums around the US and Europe. I learned from Ron (who had the privilege to be his friend), that Basquiat started working from sketches, and showed his sketches around to get people’s reactions. Here is was he told me:

Basquiat was famous for walking up to Andy Warhol and others at restaurants and showing them his sketchbook. He showed me his book at any random time. The work was for sale if you wanted it, or just to let people know what he was doing and get their reactions. No question, anyone who was privileged enough to have been shown his notebooks was a potential collector, on the spot.

Fascinating! If we make the parallelism with customer development in technology, Basquiat was an adept practitioner in many ways. He engaged in customer discovery and validation, showing his sketches (minimum viable product) to get feedback on his work, and find visionary early adopters. Interesting note: Basquiat and Warhol became great collaborators following the restaurant encounter.

Here is a prime example of a person with a strong subjective self, balanced with superior inter-subjectivity skills. Basquiat was able to keep a pulse on the outside world, and take input from others, while keeping grounded in his creative vision. His paintings are utterly distinctive, his style fiercely original. He was a true visionary, who led the neo-expressionist movement of the 1980s together with other contemporary artists. Basquiat achieved world recognition during his lifetime, and financial success (rumor has it that he wore Armani suits as overalls). One of his paintings fetched a record $14.6 m at Sotheby’s in 2007.

This example illustrates that listening to customers does not mean doing what customers ask, but is about finding what resonates and being able to innovate within those realms. Steve Jobs is another master practitioner at this.

At the Other Extreme: Thomas Kinkade

At the other end of the spectrum we have Thomas Kinkade, who was (interestingly) born around the same year as Basquiat. His paintings have nothing fresh or innovative about them. Kinkade’s claim to fame was to bring mass marketing to the arts. His work (or reproductions) can be found in 1 out of 20 American homes today. He built a fortune understanding what has mass appeal – bucolic paintings and idyllic settings such as gardens, streams, stone cottages –  and that’s what he set to paint. Kinkade said it best:

There’ve been million-seller books and million-seller CDs. But there hasn’t been, until now, million-seller art. We have found a way to bring to millions of people, an art that they can understand.

Lessons Learned

Basquiat defined new category in modern art, while Kinkade brought watered down art to the mass market. Both made a fortune. Whether you follow the Basquiat path or the Kinkade path to richness, validating that your subjective vision touches others in meaningful ways remains essential to the success of your venture.

Book Commentary: Delivering Happiness

Interesting book Delivering Happiness by Zappos’ Tony Hsieh. I heard him give a keynote a few months back in anticipation of his new book, and had enjoyed his pertinent and candid commentaries. You can watch the video on Yes, I am a happy Zappos customer, and love getting Zappos boxes in the mail (who does not?). Although it wasn’t always that way; I had a bad experience once, receiving the same shoe in the wrong size 3 times (!) and gave up on the company. I eventually forgot my dissatisfaction, and was lured back with better luck.

Delivering Happiness was a lot more autobiographical than I expected, but a great read nevertheless. I enjoyed the candor with which Tony shared his entrepreneurship adventures, starting with his first worm farm as a child, to his button mail-order business in middle school, and flourishing pizza joint in college…. onto LinkExchange… the rest is history. As he moved up the ladder of needs, focusing first on profits, then on passion and purpose, Zappos’ revenues skyrocketed, and he fulfilled his dream of delivering happiness to millions. Customers were not the sole benefactors, as happiness masterfully rippled through the entire ecosystem — internally to employees and externally to value chain partners.

As I was reading his book, I wondered about applying Tony’s happiness framework to new product development. Instead optimizing the supply chain for happiness, why not build happiness into the products themselves?  For shoes it would mean (I speak for myself) mixing high-style with high-comfort. Some brands are attempting to do this, but results are falling short of expectations. Why does it have to be either or (or medium-style for medium-comfort)? I recall trying shoes at Neiman Marcus and complaining about discomfort, to which the salesman retorted: “We don’t sell comfortable shoes here, Madam”. As I said, there is room for improvement!

Going back to the software development arena, what would it take to shift our focus to building products that WOW customers? Apple applies the principle masterfully. We need a combination of Apple + Zappos in software. Which software companies do you think pass the bar?

Founder View: OpSource CEO Treb Ryan

I had an opportunity to meet with Treb Ryan, co-founder and CEO of OpSource, last week. I was curious to get his views on customer enlightenment, and hear how his product development team engaged with customers. Over the years Treb has devised an organic development process that seems to work well for his engineers. He was kind to share his views with me.

Know Thy Customers: In-Context Learning

Treb believes that good products are internally inspired (based on one’s experiences) and externally validated (through customer feedback).  He’s a firm believer that founders need domain expertise in order to build successful ventures. He advises young entrepreneurs to get a job in the industry they are trying to serve before starting a venture. He gave me the example of healthcare, where a lot of IT companies fail, due to a lack of actual healthcare expertise.

Treb also believes that feedback is best obtained by listening to customers “in context”. [Which resonates strongly with Customer Enlightenment principles]. Towards that end, he has his product engineers regularly sit in sales calls, customer service calls, and customer training sessions, to hear customer problems first hand.


It’s a great way for engineers to learn about customer problems. They can hear what questions customers ask, what works and what doesn’t. After speaking to 15+ customers, they often start to see common themes and problems emerge, and can bring this feedback to improve our products.Our head of product development is particularly skilled at this; he goes on a lot of customer calls, and brings back phenomenal insights.

I asked Treb if this process also applied to new products, or only to existing products. Interestingly, he said that the process had been useful to steer the company’s direction as well. He gave me the example of their SaaS delivery product. OpSource saw an unfulfilled need in the market, and spoke to 50+ customers to validate their assumptions and tailor product requirements accordingly.


Overcoming the Discomfort Barrier

I wanted to dig a little further, to understand what made Treb’s head of product development so effective, when technologists are often challenged when dealing with customers.

Engineers are typically insular in dealing with problems. They like to solve problems on their own, and are not big on social interactions. As a result they shy away from engaging with customers. And if/when they engage, they follow a stilted process that does not yield great results.

So does Treb’s head of product development have a knack for social interactions then? Treb said that he didn’t have a particular knack, but because he’s very knowledgeable, customers like to talk to him, and he has good listening skills.

What works in his case is that he’s not the one running the meetings, or having to lead with questions. His main role is to listen. And in the context of listening to real world customer problems, he’s able to glean valuable insights about our customers’ needs. When a customer mentions a problem, he may then intervene and ask: “If we were to do this, would that solve your problem? Would you pay for it?”


Good insights from Treb. OpSource has found an effective approach for getting engineers to engage with customers, without the unease of having to lead with questions. This approach has paid bottom-line dividends in OpSource’s business.

VC View: Customer Validation Litmus Test

I sat down with Prashant Shah of Hummer Winblad Venture Partners last week. I was curious to hear the view from his vantage point as an investor. How does he gauge customer validation, and what impact does it have on his investment decision? What advice does Prashant have for technologists seeking funding from his firm?

Customer Validation Litmus Test

Not surprisingly, founders must validate their product with customers to get Prashant’s vote. He can usually tell by asking the following two questions:

1) Why would customers make a buying decision?
2) Why would they buy from you?

Prashant finds that tech entrepreneurs often go on at length about describing generic market pains, but have a hard time giving him a credible answer to the question: Why would customers be compelled to change their status quo and make a buying decision? To illustrate his point he gave me two examples:

Geico: Their lavish campaigns tout that they can save you 15% on car insurance. Fine. Granted we pay too much for car insurance. But in the grand scheme of things, lowering my auto insurance is low on my priority list contrasted to bigger expenses such as housing. I am not compelled to make a switch to Geico when I see those ads. Those campaigns fail to pass the first test. A quantifiable ROI is not enough for customers to make a decision to buy; it needs to be an ROI that matters.

Virtualization: On the other hand, expanding the use of — and realizing savings from — virtualization is high on the list of priorities for enterprises. And companies such as vKernel, Pancetera and EvoStor (all of which Hummer invested in) can use this natural market momentum to get in front of customers. These start-ups don’t have to convince customers that what they are doing is important to them; their ROI already matters.

Overcoming the Barriers

I asked Prashant why he thinks technologists have a hard time answering his litmus test questions. The problem, he thinks, is that technologists excel at mastering technical problems, but have a hard time understanding behavioral customer dynamics.

He gave me the example of his brother, a distinguished engineer who tried to dabble in real estate as a hobby. Prashant’s brother got his license, and was bewildered to find out how difficult it was to understand customers when he held his first open house. He didn’t expect them to be so fuzzy in making a buying decision (thinking about furniture and such!). It was too much for his logical engineering mind.

Engineers are not always able to see the world through the customer’s eyes. Prashant cited an engineer who could not grasp why a 3-step install was too cumbersome for customers. “If it works, what’s the problem?” The engineer was furthermore convinced that if he made his procedure simple the customer would not fully appreciate the value of his (enterprise) product!  [Note that seen through a customer’s eyes a simple procedure is valuable. Seen from this engineer’s eyes, a simple procedure would hide the value of his creation].

Another barrier Prashant sees is that technologists often don’t know what to do to validate their products with customers. Many ask the wrong questions. As a result, they get marginal feedback on features: “Yes this feature is good/not good”, but fail to gain insights on what would make a customer buy.

In that light he sees a need to help technologists better understand how customers think. [And we seek to address those very questions in this blog].

Prashant’s Parting Advice

Prashant advises technical founders to seek a co-founder with a customer bent to complement their strength. He reminds them that addressing the technology risk is not enough: they must tackle the market risk and get clarity on “why would a customer be compelled to make a buying decision?” In fact Prashant places the market risk higher than the technology risk.

Good advice to keep in mind. Founders be warned if you are seeking funding from Prashant. Be prepared to answer his litmus test!

Customer Development & Design Thinking

How do product designers work?

Product designers first seek to understand customer experiences… They work in tandem with customers to design products… They build sketches/prototypes and iterate forward with customer feedback.

On that note, I recommend an excellent article: “3 Ways to Think Like a Designer”.  It strongly resonates with our quest for Customer Enlightenment!

Design thinkers gather information that helps us understand customer experiences. Once we understand the people surrounding our business challenges—their needs, desires, problems and aspirations—we can identify relevant business opportunities. Then we experiment our way forward, prototyping new solutions and getting these solutions out in front of customers as early as possible. As we prototype, we learn from people by observing, gathering feedback, and refining our approach.

How do high-tech products get built?

The successful ones follow a similar process, whereby product developers reach out to customers to understand their pains and needs, engage in customer development, and build their products with customer feedback.  Hats off to Steve Blank, author of The Four Steps to the EpiphanyThe Four Steps to the Epiphany, and father of Customer Development, for his leadership and teachings on this. The benefits are manifold, and countless startups have embraced his methodology with success. If you haven’t read his book, get your copy today!

We are concerned about the casualties in the trenches though… where products are being built in a vacuum, with little customer understanding. What can we do to help? Granted everyone should read Steve Blank’s book. Is there anything else? In particular we are curious to understand if something on the behavioral side is preventing technologists from enjoying fruitful interactions with customers, the way product designers do.

Is it a lack of skills? A communication divide? What do you think is the hurdle?

We’ll go interview engineers and designers to get to the bottom of those questions… Meanwhile suggestions and comments welcome!

Getting the “Hole” Picture

As engineers, we are trained to build drills. We work hard to create the best drills, hoping customers will be impressed…. but customers don’t care about drills; what they want are holes.

Sales people are trained to sell holes. Savvy marketers know how to turn drill bits into “hole” messages. I believe engineers would benefit from getting the “hole” picture; and not leave it to sales and marketing to spin a story (after the fact).

For this, we need to empower technologists to have insightful conversations with customers early in the new product development cycle. Engineers are notoriously skilled at solving complex problems. Combine this with an understanding of the “hole” picture, and a greater number of customer-winning products will undoubtedly unfold.

In a recent speech at Stanford Randy Komisar made the comment: “it is not because you can make a dog jump that customers want a jumping dog”. Good point. So let’s work at getting the “hole” picture, and gather rich contextual information around the issues customers face in the process of getting to the holes they need; then back track from there.

In other words, we need to think of ourselves as “hole-enablers” rather than “drill-makers”.

Bridging the Communication Divide

A friend of mine, Shomit Ghose of Onset Ventures, loves to share his top 3 methods to validate an opportunity:

1. Talk directly to customers
2. Talk directly to customers
3. Talk directly to customers
4. There is no fourth best method.

I love this slide (and his sense of humor). In practice however, there is a divide which often impedes technologists. They may understand the need to speak to customers, they may go speak to customers, but not all are able to gain business-validating feedback from those visits. I’ve seen engineers come back to the office frustrated, saying “customers are no good to speak to”.

Technologists are from Mars and Customers from Venus

It’s often a communication problem. Engineers are from Mars; we think and are comfortable with bits and features. Whereas customers are from Venus; they live on a planet whose language is value. And they are having hard time understanding how the bits we show them translate into value.

We can’t expect customers to learn our language. We are already asking them for a favor: their time, to help us validate our product. Therefore we need to learn to speak their language, and translate our bits into value, so we can have a fruitful conversation.

In future posts, we will explore how to bridge the gap. Comments and ideas welcome.

Think Like your Customers

I loved this post:Think and Act Like your Customers, by Scott Anthony in Harvard Business Review:

At most companies, it is a mark of shame to use anything other than the company’s product. I doubt that you would see many tubes of Crest at Colgate-Palmolive. Try bringing a Coke product into Pepsi. Steve Ballmer from Microsoft famously berated an employee last year for using an iPhone at a company event.[…] It’s kind of silly, isn’t it? An innovation-focused company shouldn’t have an avoid-the-competition-at-all-costs mindset.[…] Some companies have people who focus solely on competitive intelligence, but the simplest form of competitive intelligence is to encourage employees to act like “regular” customers. Pick whatever solution gets the job done better than anyone else.

I wholeheartedly agree. Being able to get into the shoes of our customers is a foundational step towards Customer Enlightenment. How else can we uncover, or anticipate, the needs of those we seek to please? Thinking and acting like a customer is good practice; and that should include getting a taste for competitive products.

Ultimately, it is not what we think about our products that truly matters, but what customers think of our products (in light of alternatives). So why blind our eyes, and keep in our ivory towers?

Customer enlightenment is about tearing down the veils that blind us, to seek understanding. It is about leaving our egos and offices behind, to experience living a day in the life of our customers. It is about abolishing the walls that limit us, to venture beyond our assumptions. It is about wondering what the world might look like, seen through someone else’s eyes. There starts enlightenment.