Dom Meffe is one of those instant-likeables. Maybe it’s because he hails from the tight-knit, friendly hometown of Pittsburgh. Maybe it’s because he’s just a good guy … with a big heart for his family, his employees, his clients and his business. Maybe it’s because he tells good stories and draws interesting comparisons to his life and work. Maybe it’s because he’s someone you can relate to … who admits failures, has had tragedies in his life, and has done good. Or maybe it’s because he’s a survivor.

Cancer has inflicted a number of people in his family, including himself and his wife, and took his sister’s life. And this is what’s driven him to do what he’s doing now … own and acquire a growing number of nuclear pharmacies to better diagnose and treat chronic conditions such as cancer. In fact, only one year after founding Orlando-based Triad Isotopes, Meffe, 43, who has been a central figure in the pharma business over the past decade, is heading up what is now the fourth largest radiopharmaceutical services company in the industry. Triad has grown from 24 to 291 people with $90 million in current revenue and projections to double that in two years. That growth has come from 13 strategic M&As throughout the southeast … with many more planned over the next few years. And, Triad is among numerous specialty pharmaceutical companies (CuraScript, Axium, ACS and ICore) that have made their headquarters home in the nation’s newest emerging biotech hub of Orlando.

Putting Specialty Pharmaceuticals in Perspective – Addressing Cancer and Obesity; Running a Business That’s Like a High Tech Doughnut and Pizza Shop
Specialty pharma is a growing business, meeting growing healthcare needs and issues. Triad is in the nuclear medicine industry, which represents a small but growing segment of the specialty pharmaceutical industry. It’s estimated that 20 cents of every dollar spent on prescriptions is spent on specialty pharmaceuticals. Total spending on specialty pharma is expected to reach $70 billion in 2008. This growth comes, in part, from the estimated 125 million Americans who suffer from one or more chronic conditions – which includes the constant ‘in-the-news’ conditions of cancer and obesity .

Meffe’s company, which stands at the front of more than 110 independent nuclear pharmacies, focuses on three areas of nuclear medicine:

• Nuclear pharmacies that compound and distribute radiopharmaceuticals used in imaging procedures for cardiac and cancer patients. Specialized pharmacists create gamma-emitting radioisotopes that are non-invasive (as opposed to cardiac catheterization) and produce a better picture to show the functionality of the heart, for example. Triad has acquired 19 of these pharmacies throughout the Southeast.

• Cyclotron operations that produce special isotopes for PET imaging that assess tissue biochemistry and determine the presence and severity of cancers, neurological conditions and cardiovascular diseases, and if treatment is working. Triad has acquired five of these operations.
  
  To understand this complex business, Meffe tries to simplify it or draw comparisons to something most people can understand. “Our operation runs a little bit like a doughnut and pizza place,” he said. “Like bakers, our technicians are working in the wee hours of the morning compounding and manufacturing radiopharmaceuticals that have a very short shelf-life. Then, our drivers take over to quickly deliver the materials en masse to hospitals and clinics where the procedures are taking place.”

• While the above two areas are primarily diagnostic in nature, Triad recently added an advanced cancer treatment business to its lineup. Brachytherapy is an advanced cancer treatment (primarily used for prostate cancer) where radioactive seeds are placed in or near the tumor, producing a high radiation dose to the tumor while reducing the radiation exposure to surrounding healthy tissues.

It’s easy to conclude that, with all Dom’s been through – the personal tragedies and the joy of starting up a fast-growing empire – he’s got a big heart. And ironically, this is the human organ that his company helps most. If you talk to Dom, it would be easy to assume that he has some kind of medical degree. He talks like a doctor and works closely with them. But he doesn’t have a medical degree. He’s just spent decades learning the language and processes and understanding the effects of drugs on diseases.

Meffe is Central Figure in Major Pharma Industry Developments of Past Decade. M&A Takes on New Meaning in His Personal Life.
This former Chuck E. Cheese franchise owner – turned golf shoe manufacturer – turned pharmaceutical CEO has been around the block a few times. Meffe founded a pharmaceutical benefits company called MPN, which he later sold to Columbia HCA, which they then sold it to Express Scripts. Meffe goes on to become the head of Coram Prescription Services, Inc. in Omaha. He leads a management buyout in 2001, changes the name to CuraScript and moves the headquarters of the company to Orlando. In 2004, Express Scripts (which ended up with Meffe’s MPN company) acquires CuraScript for $335 million. Meffe remains CuraScript’s CEO, continuing to grow the business and acquiring Priority Healthcare in 2005. Prior to the acquisition, Priority Healthcare forms a joint venture with Aetna and opens a major specialty pharma distribution facility in metro Orlando. In 2006, Meffe retires from CuraSript, which, at the time, had 3,000 employees and almost $4 billion in revenue and starts up Triad Isotopes. During the initial CuraScript funding, Meffe meets an investor who ends up a principal with the private equity firm, Parthenon. Parthenon funds Triad’s start-up and is now involved in the company’s ongoing M&A activity. (Breathe now)

You could say his personal life involves a little M&A, too – his marriage to Kalani and the additions to his family. Meffe has a biological son, Alex (11). He and Kalani adopted Emily from China in 2006. They will soon adopt a boy (Kai) from Guatemala, and they plan to continue to grow their family.

“Family is everything to me, and I think that’s why I chose the industry that I’m in. The healthcare industry has a real family feel. It’s very personal. You touch and feel the lives you’re helping. Any company I’ve run has had this type of culture, and that’s no different from Triad, where we’ve branded ourselves as ‘Patient Focused. Community Driven.’ We want to have an impact on the lives and communities we serve,” said Meffe.

Meffe lives what he preaches. He is a member of the board of directors for Shepherd’ Hope, a not-for-profit organization that provides quality, non-emergency medical care to those in need. And his commitment to help goes beyond healthcare. Meffe and his wife started the Meffe Family Foundation and the Simon Scholarship (named after his grandfather), which sends aspiring, minority college-bound students to college each year who otherwise could not afford it.

Meffe’s Perspectives on a Flip-Flopping Future, Growth Strategy and M&A Tips.
Triad is facing an interesting future. The nuclear/PET market is a small percentage of the overall diagnostic market, but it’s growing fast. And, while analysts expect growth trends in the nuclear pharma market to result in the doubling of the market by 2010 (to $4.7 billion), the strongest growth is expected from areas outside of the traditional ‘bread-and-butter’ cardiology. The biggest growth (about 65% of the industry’s applications), according to Meffe, will come radiopharm therapy, which will involve new scientific discoveries and treatments for cancer and neurological conditions.

Unlike the major growth and acquisitions Meffe’s been involved with in the past, his plan for Triad centers on acquiring facilities in smaller, underserved markets (as well as some major markets) primarily in the Southeast, and building from there. The smaller markets give Meffe close to or exactly 100% market share and allow him to build critical density to have back-up for the specialized equipment and staffing.
In addition, Triad has launched The Center for Clinical Studies, which is dedicated to the advancement of nuclear medicine through academic-based research, publishing and training. This will allow his nuclear pharmacists, technicians, chemists and physicists to become more visible experts or advisors to the industry.

Meffe says when it comes to the numerous M&A deals and potential deals he’s been involved with (he’s turned away seven opportunities this year) that the most unfortunate thing is that you can’t count on people to tell the truth when large sums of money are involved. In terms of dealing with rapid growth, Meffe, who says the best-selling book ‘Freakonomics’ has reinforced his philosophy of focusing on data to rationalize a situation and not to get caught up in emotions. “Plus, you really need to put your ego aside. I’ve seen people’s egos blind them when they’ve encountered some success. Once you think you’re the sole reason behind the success of any initiative, you’re bound for failure. That’s why building a strong team is so important,” he says.

About Being in Orlando
According to Meffe, Orlando – which has been top-ranked for everything from being a top spot for business and entrepreneurs to a top place where people want to live – had the right mix for Triad. It’s the place to be for the specialty pharmaceutical business, he says. “If you’re a biotech manufacturer and you need to find a distributor, you only need to fly to one place – Orlando.”

Among the region’s top attributes are its top-ranked hospitals, life sciences-related R&D going on here, cluster of medical technology companies here with support from world-renowned industries such as simulation and lasers, and its standing as the nation’s newest spot for an emerging biotech hub. With the latter, Meffe’s referring to a trio of announcements made last year that includes the Burnham Institute for Medical Research’s new East Coast operation in Orlando, the University of Central Florida’s new College of Medicine and a new VA Hospital that will all be co-located in a new development called Innovation Way.

In addition, Meffe says “there are just really good people here. Orlando has a phenomenal reputation for being welcoming, and I was embraced and engaged from day one. There’s a real heartbeat … a buzz … here.” And there are other pluses, including the great professional service talent that’s here, top customer service that’s indigenous to the Orlando culture, and all the other big attributes – the quality of life, affordability, good schools and universities, and more.

For more on Orlando, visit www.orlandoedc.com. And for more on Triad Isotopes, visit www.triadisotopes.com.