Alira Health featured in Fortune Italy

From Fortune Italia, January 2019. Translated into English from Italian. 

The Place to Grow is the World


By Morena Pivetti

(L to R) Piergiulio Lauriano, Carlo Stimamiglio, Gabriele Brambilla, and Giacomo Basadonna, MD, PhD, FACS


With headquarters in Boston and offices in Milan, Barcelona, Munich, Paris, and San Francisco, Alira Health is a global healthcare advisory company that boasts strong Italian DNA. This is not a case of brain drain, but rather talented young people who think globally and have chosen the world as their horizon. Now, with a new initiative to focus it’s growth in Milan, Alira Health has begun a campaign to support the internationalization of Italian healthcare companies.

The leader of Alira Health, Gabriele Brambilla, is a 38-year-old Italian from Vimecarte and the CEO of what he describes as a start-up. He, along with his French partner, COO Benjamin Chambon, took ownership in 2014 from the owner and founder, Claus Michelfelder, with a leveraged buy out transaction. Since then, the company has gone from 18 employees to more than 120, quintupling its staff, with a CAGR of over 50%. They expect to reach 500 employees in the next three years.

Alira Health’s other Italian brains include Chief Medical Officer, Professor Giacomo Basadonna, the manager of the San Francisco office, Partner Carlo Stimamiglio, and the manager of the Barcelona office, Partner Piergiulio Lauriano.

Goals for the future?

Alira Health’s goal is to help shift the focus of the U.S. and European health systems to value-based care by constructing a methodology that rewards the effectiveness of therapies and devices and leads to performance and risk-based contracting.

Alira Health’s mission is to help healthcare companies (from pharmaceuticals to biomedical devices, and from research to medical trials) to innovate and develop, leveraging its five operational areas: innovation, regulation, clinical services, strategic management consulting (due diligence, corporate strategies, portfolio rationalization), product strategy (marketing access, pricing and reimbursement, health economics), and investment banking (mergers & acquisitions, licensing).

This story of Italian success has a main stage in Boston, a city that saw a large influx of Italian immigration at the end of the 19th century and, in the North End, still has a district that still preserves the Italian Heritage. Gabriele Brambilla is an example of immigration by excellence, not of necessity. “The strategy that Ben, at the time managing director of the Paris office, and I, same function at the office in the Boston suburb of Framingham, outlined in 2014 when we decided to acquire the then CMC, was to build an advisory company that provided a variety of services under the same umbrella to follow customers throughout the corporate and product life cycle. We wanted the company to be fully accountable, and to establish long-term partnerships with our customers. So, in January 2017, with a rebranding, we were born again as Alira Health.”

How did Brambilla come to Boston?

“CMC recruited me from SDA Bocconi,” he recalls. “They didn’t offer me a salary, but a budget to open an office in Milan: break-even in six months or I would lose my job. I accepted the challenge and we grew until 2008-2009, but then the crisis came. I’ve always believed that in difficult times you need to make courageous decisions, so I convinced Michelfelder to use the same formula as the first job: a fixed budget and a six-month deadline to open an office in Boston and reach break-even. My analysis of the global market of healthcare suggested that it was the right place to start. It was the right decision: Boston exploded, and in Boston, our success exploded as well.”

Alira Health has expanded its expertise into the entire value chain of healthcare by building an integrated team of scientists, strategists, bankers, and doctors who work together to support every aspect of the business and help companies to compete on a global stage. “Our customers are changing healthcare,” Brambilla says. “They discover, create and bring to market new devices, drugs and treatments for patients, and we are the accelerator.” The Boston-area headquarters engages directly with innovation. “We have our own research lab, placed in the center of the office and surrounded by glass walls, where we research, develop, test and release new products.”

But let’s go back to the Italian blood that flows through the veins of the company. Professor Bassadonna, Chief Medical Officer, after graduating in medicine in Milan in 1982, left for the United States where he specialized in organ transplantation. He worked at several prestigious universities, including UC Davis and Yale. He now teaches at the University of Massachusetts. “I met Gabriele in 2008, I was a client of his, and we became friends,” recalls Basadonna. “I suggested him to hire a team of clinicians under the lead of a chief medical officer. I thought it would be useful.” The idea has proved to be fruitful, and in 2012, Basadonna sold his company to a private equity fund in the U.S. and joined Alira Health. “We solve regulatory problems, we define clinical trials, and much more. It’s a young and dynamic company, continuously improving, which gives me the opportunity to stay in the academic environment, to transfer clinical knowledge to the companies, and place them at the service of patients”.

In San Francisco, Alira Health’s office is strategically located in Silicon Valley, home to many digital health companies and many institutional investors (venture capital and private equity). The office is in the hands of Carlo Stimamiglio.

“I manage the transaction advisory division that operates in M&A, in strategic transactions on medical technology, and in raising capital,” Stimamiglio says. When I ask how the office in Milan is performing, he answers “For us, Italy has always been a smaller market, but in 2017 we decided to start investing. The goal is to work for the top ten Italian companies in the pharma space. Right now, we work with seven, and in 2019 we hope to start working with the other three.” Projects from Italy represent less than 10% of Alira Health’s global revenue, but Stimamiglio says that, “we hope that the desire and the need for internationalization lead us to become their strategic partner. We’re ready to assist in any way.”

In the spring, Alira Health will organize an event in Milan dedicated to companies that want to enter the U.S. market, connecting them with delegates from the most important associations in Massachusetts: the heart of the device and pharma industries. Delegates include MassMedic, MassBio and the Massachusetts Life Science Center.

In Milan, 2017, in collaboration with SDA Bocconi, Alira Health launched the largest healthcare consulting case competition in Europe. In just its second year, the competition drew participation from over 120 teams, with more than 500 students participating from around the world. The finals in November included 10 teams from the top business schools in the U.S., Asia, and Europe. A team from the London Business School won the top prize.

In November, Alira Health acquired Clinical Insights, a start-up based in Milan that operates in the data analytics space for pharma and device. This new addition can support all five of Alira Health’s business areas.

Italy doesn’t lack the “brains,” or clinicians and scientists. What is your opinion on the Italian pharmaceutical and medical devices then? “Pharmaceutical and biomedical sciences are very strong, especially in the manufacturing sector,” Brambilla says, “Companies are export-oriented and the leader of the trade surplus is Italy. The companies are mainly family-run businesses; they are in the hands of the seniors, there are not many young people. In Italian companies, people tend not to give shares to those who don`t belong to the family.” In Boston, however, Brambilla and Chambon have distributed a third of the share capital of the holding company to chiefs, partners, and managers in order to create a sense of belonging and entrepreneurship. Italy lacks willing venture capital to fund the research and development of new technologies. “Our initiatives are designed to stimulate the interest of financial institutions,” Brambilla says, “Italian Venture capital funds dedicated to health don’t reach 400 million euros, which is very low. In Boston, the average size for a healthcare-dedicated fund is 400 million and, in the city, there are more than 40.”

Even Barcelona outclasses Milan.

“Had it not been for the crisis caused by the secession, Barcelona would have won the challenge for the EMA,” says Partner Piergiulio Lauriano. “After London, Berlin, and Paris, it’s the fourth largest city in Europe for venture capital in digital health and drugs, and it`s third for the number of start-ups. In digital health, they are light years ahead: the clinical history of Spanish patients is all online, in electronic folders accessible by any doctor. They have an integrated platform for clinical trials, and a scientific incubator, Biocat, for the health cluster. Italy is very strong in manufacturing and clinical practice, but for everything else, Barcelona is an example to follow”.

What does Gabriele Brambilla suggest to the Italians in the pharma and device spaces?

“Companies should look at foreign markets and remember that their growth is linked only to their hard work and their genius. The Italian political system does not support the industry and its entrepreneurs in internationalization, as France and Germany do. It’s weak in finance; it doesn’t invest enough in the specialized education of young people, its technological capital is discounted compared to other countries. It’s a strong opinion, but it’s the truth. We, at Alira Health, can assist the Italian entrepreneurs in the acquisition of new positions in the global competition.”

The Italian blood is certainly not lacking initiative.

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