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Q&A With Court Horncastle, Vice President and Business Unit Head, Respiratory, US Commercial for GSK


Court Horncastle discusses how his career led him to work with treating COPD and asthma.

Court Horncastle

Court Horncastle

Patients suffering from COPD and asthma face unique struggles. Court Horncastle, vice president and business unit head, respiratory, US Commercial for GSK, spoke with Pharm Exec about his work in the area.

(Pharm Exec): What are the struggles that people with respiratory issues face regarding the current global market?

Horncastle: There are 25 million people in the United States living with asthma and 27 million people living with COPD, the third leading cause of death worldwide. This amounts to countless people across the country unable to participate in regular activities such as playing with their children or grandchildren, exercising, or even being outside. Unlike some chronic conditions that are treated proactively to lessen symptoms, patients with COPD or asthma often under report the burden of their symptoms until they experience a major event–like an exacerbation of COPD or an asthma attack. As a respiratory community, we have an opportunity to improve this together.

At GSK, we developed a portfolio of treatments to help ensure the right patient receives the right treatment at the right time. We’ve been first to market with several innovative asthma and COPD products. The good news for patients is that treatments today are designed to fit each patient’s disease profile and focus on treating a specific individual rather than a collective population.

(Pharm Exec): How does your global experience impact your decision-making process?

Horncastle: I’m fortunate that I’ve lived seven years outside of the United States because of my time in the US Army and my work at GSK. I’ve also spent time in many countries including Haiti, China, Ukraine, Japan, and Saudi Arabia. I’m fascinated by new cultures, cities, and different ways of living. I’ve found that around the globe we all seek good health, stability for our families, and happiness. I believe we all have more in common, regardless of circumstances, than we may realize.

As a leader at GSK, I often rely on the critical thinking I developed in the military and my world travels. I have learned that decision making is at the heart of leadership. Particularly as a senior leader, being sharply decisive about a single strategy is required, but not often practiced. This is because being singularly focused strategically is inherently riskier than pursuing several moderately complementary strategies.

Additionally, as a result of my Army and global business experiences, I have realized the performance-enhancing value of diverse teams made up of people of different ages, genders, races, and ethnicities. While diverse teams can sometimes require greater effort to reach decisions than a team of “clones” because of the diversity of perspectives, they offer varied options, recommendations, and decisions, which benefits all.

(Pharm Exec): What was it like transitioning from being in the military to working in Pharma?

Horncastle: It was a relatively simple transition because I was already comfortable with large organizations, structure, and acting independently based on a leader’s intent.

As a cavalry officer who led scouts on reconnaissance missions, I was well trained in understanding the scope of my role while working within a cross functional team. With that experience, I was able to quickly understand the importance of the interdependencies between the market access, medical, finance, and regulatory teams at GSK in the same way I understood the interdependencies of military intelligence, artillery, supply, and aviation in the Army.

I value qualities like ambition, accountability, and doing the right thing–which are taught in the military and match GSK’s values. Being a strong leader means having the courage to make timely decisions, challenge inconsistencies, and ensure that we all get ahead together.

(Pharm Exec): What drew you to the US Respiratory Business Unit?

Horncastle: I was given the opportunity to join the GSK Respiratory Business Unit as a sales representative, and I happily accepted it. Even though I’ve worked in other therapy areas and enjoyed them, I have always considered the respiratory field my home. I love working in Respiratory, which is a particularly competitive field based on companies competing in a branded, authorized generic, and generic marketplace. Most importantly, I’m energized by a business that assists millions of people in the United States who suffer from asthma and COPD. I love the concept of potentially improving the lives of millions of Americans by helping them breathe easier.

(Pharm Exec): You’ve been primarily a sales leader, but how did you transition to business unit leadership?

Horncastle: My career followed the standard path that many of us who entered the commercial part of the industry in the 90s followed – successive roles in sales, market access, and marketing all with increasing levels of responsibility.

Sales leadership was my natural fit. Aside from being extroverted and competitive, leading a team in commercial delivery and developing people is what excites me most. However, sales leadership alone is not what developed me to compete for a business unit head role.

I grew the most when I moved to London and developed corporate strategy for two years as senior director in the office of the CEO. That was incredibly eye-opening and humbling as I went from a credible second-line leader in US Market Access focusing on near-term delivery to then authoring papers for our CEO or the board to inform the mid- and long-term direction of GSK.

Similarly, when I left London and lived and worked as a commercial leader and business unit head in GSK Canada was also a moment of growth for me. My experience in Canada leading and delivering within a different culture and healthcare system tested my learning agility and showed me that I had the ability to eventually lead back home in the US–our largest market.

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