Merck's Jane Brandman was working on the issue of managed markets and reimbursement before it was industry's cause célèbre. Not so long ago, reimbursement in oncology, for example, wasn't even an issue—if it was approved, it was reimbursed, says Brandman.

While pursuing a pharmacy degree in Canada, Brandman says she became interested in drug development, and was selected for an internship at Ciba-Geigy (now Novartis). After graduating, she went back to Ciba to work as a pharmacist in the company's medical information department, and that's when she started to recognize that pharmacoeconomics and market access were going to be key determinants in where the industry headed.

Things were sailing along, and then several of Brandman's family members got cancer. That instigated a change in direction, and a new focus on oncology. "For me, this particular space was so unique because if you were able to really work with key opinion leaders and see the science through, you had a phenomenal impact on patients' lives," says Brandman. Novartis oncology made an offer, and Brandman came in to "give them some guidance on how to think about market access and reimbursement and pricing." With Gleevec nearing FDA approval, Brandman was able to contribute to the franchise by making sure the right information was being collected to address the issue of reimbursement. Finding herself in a marketing role at Novartis was unexpected, but Brandman's background in science was crucial to marketing efforts, where "the science level is so high, you really have to be on your game," she says.

After rising to associate director at Novartis, Brandman left for Merck to drive lifecycle management for Zolinza, an oncology drug (she's currently international marketing leader). She describes her management style as collaborative: "I don't like micromanaging," she says. "I don't want to be in there telling people how do things, or to do things my way." It doesn't matter how things get done, so long as they get done, and get rewarded when it's deserved, she says.

For Vatche Bartekian, pharmaceutical work is all in the family, and has been for years. "I had many uncles, aunts, and cousins who were doctors, pharmacists, and pharma professionals, including my own brothers," he says. "The pharmaceutical and health industry has always appealed to me." Which is why, in 2007, when Bartekian became president and founder of his own Canadian CRO—Vantage BioTrials—those trusted family connections were one of the main ingredients in the recipe for success. His brother Viken is the company's VP of business development, and his brother Vahe is VP of clinical and compliance.

More than 13 years of industry experience, from an analyst position in a clinical research lab to a role in Big Pharma with Pfizer Canada, helped prepare Bartekian for leading his own organization. He has also worked in more than 15 therapeutic areas, including oncology, cardiovascular, ophthalmology, infectious disease, and CNS. Bartekian says that this diverse background has led to relationships and networking opportunities that are the backbone of Vantage BioTrials' success. "I have been very fortunate to work with highly skilled and talented individuals who have become good friends and colleagues," he says. "Most of the business that Vantage BioTrials currently acquires is through word-of-mouth referrals. It is this kind of relationship-building and engendering the trust of our clients that has seen us through the toughest economic downturns in our industry."

Bartekian reflects on the changes he has seen in the industry: "I started my career in 1998, when pharma and the North American economy was in the middle of significant growth. There were new regulations, mergers and acquisitions, and a dramatic increase in the use of CROs for clinical development and basic R&D activities. From 1997 to 2007, our industry experienced the biggest growth in the number of blockbuster drugs hitting the market," he recalls. "Fast-forward to now and we have much more stringent regulations, more scrutiny by regulators, and a drastic change in industry's outlook as generic competition has forced Big Pharma to refocus on product and process innovation, as patents on the aforementioned blockbuster drugs will soon be ending."

What do these changes mean for Bartekian's leadership skills and business strategies? "As the president of a small, privately-owned CRO which came into existence in 2007—right before the 2008 global economic crisis hit—my team and I have been forced to re-evaluate our game plan in order to remain competitive, and refocus our business to not only serve the traditional Big Pharma and biotech sector, but also diversify our client portfolio," he says. Vantage BioTrials has done this, according to Bartekian, by investing heavily in obtaining and retaining highly qualified and experienced team members. Plus, he says, "Our main competitive edge has been our ability to offer all this quality and experience at a significantly lower cost." In other words, smallness counts as a differentiating factor in the overall service proposition.

As a leader, Bartekian recognizes that keeping a team engaged and motivated during challenging times requires a proactive approach. "I achieve this by encouraging innovation from the team," he explains. "I believe that there is an entrepreneur in everyone and I always encourage identification and improvement of processes in order to re-energize an individual's sense of contribution to the team."

Finally, Bartekian uses the high standards the company sets in its relationships with clients as a model for relationships with his own employees. "I strive to always exceed my clients' expectations and I expect no less from our employees by asking them how they can improve study timelines, increase all stakeholders' cooperation, and achieve better cost savings by increasing project efficiencies."

"It also helps that our business is based on strong family-oriented values," he adds. "Working with your own brothers helps you learn how to treat each other with respect and clearly communicate ideas to move forward and progress together through challenges."