By The HMI Magazine Staff – Adapted from reporting by Jon D. Markman for Forbes
A Different Path to Innovation
When Dr. Herriot Tabuteau founded Axsome Therapeutics in 2012, he didn’t follow the industry playbook. Rather than seek easy wins or rely on venture capital, Tabuteau committed to tackling brain disorders, some of the most challenging conditions to treat in modern medicine. He financed the company himself, supported by family and friends, while drawing on both his medical training and two decades of experience investing in biotechnology startups.
“If you do things exactly the same way as everybody else, you’re going to have the same outcomes as everybody else,” Tabuteau reflects. His aim was always to stand apart.
From “Broom Closet” to Nasdaq Powerhouse
Axsome’s first office was a tiny, windowless space in Rockefeller Center—affectionately called “the broom closet.”Today, that humble beginning has grown into a $6.1 billion company with three drugs on the market and five more in development. In the past year alone, Axsome generated $495 million in revenue, though it continues to reinvest heavily into research and clinical trials.
Tabuteau himself holds a 15% stake, placing him among the ranks of Haitian-born billionaires. With ambitious projections, he believes Axsome’s drug portfolio could eventually generate $16.5 billion annually, making it one of the world’s top 25 pharmaceutical companies.
Haitian Roots, Global Vision
Tabuteau’s resilience is rooted in his early life in Haiti, where his birth mother struggled to provide for him and his sister. At age nine, he moved to New York City’s Upper East Side with his father and adoptive mother. Surrounded by world-class medical institutions like Sloan Kettering and Rockefeller University, he was immersed in an environment of science and discovery.
After earning degrees in molecular biology and biochemistry at Wesleyan University and pursuing medicine at Yale School of Medicine, Tabuteau initially planned to become a neurosurgeon. But discouraged by the visible unhappiness of many of his physician mentors, he shifted paths—joining Goldman Sachs and later becoming a Wall Street veteran with a sharp eye for biotech innovation.
Bringing Wall Street Discipline to Biotech
Tabuteau’s two decades in finance taught him valuable lessons. He had watched countless biotech startups rise and fall, often because they relied on a single drug. His solution: build a portfolio and run clinical trials in-house to cut costs.
While Phase III trials can cost upwards of $50 million, Axsome often managed them for 30% to 50% less. This lean model allowed the company to sustain multiple trials even in its early years, though skeptics doubted it would work.
The Breakthrough: Auvelity
In 2022, Axsome secured FDA approval for Auvelity, a breakthrough antidepressant that can take effect in just one week, compared to the six-to-eight-week wait for traditional medications. The approval sent Axsome’s stock soaring by 65% in a single week.
Now projected to reach $500 million in sales this year, Auvelity is expected to become a blockbuster drug, with annual revenue exceeding $1 billion—and it has patent protection until at least 2038.
Smart Acquisitions, Bigger Ambitions
Tabuteau has also shown sharp financial instincts. In 2022, Axsome acquired Sunosi, a drug for excessive sleepiness, for $53 million. Within a year, he sold the rights outside the U.S. for $66 million while keeping U.S. control, ensuring steady revenue. Today, Sunosi generates more than $100 million annually.
Looking Ahead: Alzheimer’s and Beyond
Axsome’s next major hurdle is winning FDA approval for a drug aimed at treating agitation in Alzheimer’s patients. Current treatments rely on antipsychotics that come with severe risks, but Axsome’s drug could offer a safer alternative. Despite mixed trial results, analysts believe the urgent need for better options improves its chances of approval.
If successful, the Alzheimer’s drug could generate $1.5 billion to $3 billion annually, complementing Auvelity’s projected earnings and fueling Axsome’s long-term revenue target.
A Haitian Story of Resilience and Innovation
Herriot Tabuteau’s story is one of resilience, ambition, and global impact. From a challenging childhood in Haiti to the heights of Wall Street and now the biotech world, he has combined personal determination with scientific and financial expertise to chart a unique course. As he puts it, “We might be a small company in terms of size, but we’re not a small company in terms of fundamentals or in terms of ambition.”
For Haiti, and for the millions of patients worldwide who stand to benefit from his innovations, Tabuteau’s journey represents a powerful reminder: greatness can emerge from the most unlikely beginnings.
Credits: Adapted from Forbes, original reporting by Jon D. Markman.
