This is also the rationale for Shire's diversified portfolio of niche segments such as ADHD, human genetic therapies, gastrointestinal drugs, and its recently created business called regenerative medicines. Says Russell, "Shire is in these areas precisely because we think we have established a clear value proposition that brings us beyond the existing standard of care. Value is no longer about proof of clinical superiority; it's not even about the underlying science. Rather, the key determinant of value lies in the question, 'Who is going to want to pay for it?' There is an emerging rule of thumb: If you want to set an NCE price at five times existing therapy, then your studies must demonstrate a direct payoff in patient outcomes that is five times higher as well."

Russell also believes in the notion that good management rests simply in rising to the occasion. When Russell joined Shire 12 years ago after a long stint in the diversified chemicals industry, he expected to serve out his time holding the position for which he was recruited: CFO. "I never thought I was groomed to take on the top post, as there is a clear difference between being on the operations side, where responsibilities tend to be self-evident, and the CEO role, which is unique to the person and cannot be relegated to a standard job description."

In his four years as CEO, Russell has defined four rules that structure his leadership style and performance: 1) above all else, set a good example by never demanding from others what you will not require of yourself; 2) cultivate human relations skills by establishing yourself as a personality, operating openly and circulating widely, and listening for feedback, while avoiding over-reliance on email and those graybeard intermediary staff; 3) focus on the pragmatic in recognizing what a single individual can actually achieve in a large organization, which means recruiting the best support cast of front-line management talent; and 4) leverage that pragmatism in crafting a vision and mission for the organization that every employee can understand.