Dr. Herriot Tabuteau, a Haiti-born physician turned entrepreneur, has built one of the most closely watched biotech companies on Wall Street. As founder and CEO of Axsome Therapeutics, Tabuteau has steered the company from a modest three-desk office in New York to a $6.1 billion Nasdaq-listed firm with three drugs on the market and five more in development.
Launched in 2012 without venture capital, Axsome focuses on neurological and psychiatric disorders, some of the hardest conditions to treat. “If you do things exactly the same way as everybody else, you’re going to have the same outcomes,” Tabuteau said. “We wanted to have outcomes that stand apart.”
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Axsome’s breakthrough came in 2022 when the FDA approved Auvelity, the first rapid-acting oral antidepressant, now on track to generate $500 million in annual sales. The company also markets Sunosi, a sleep disorder drug acquired in 2022, which now earns over $100 million annually. Analysts expect both to reach blockbuster status, with revenue exceeding $1 billion each.
Tabuteau’s business model departs from industry norms. Instead of betting on a single compound, Axsome built a portfolio of drugs, while running its own clinical trials at up to 50% lower cost. Despite skepticism, the strategy has positioned the firm to challenge larger competitors. Shares have surged 35% in the past year, outperforming the broader biotech index.
Born in Haiti and raised in New York, Tabuteau trained as a physician at Yale before shifting to finance with Goldman Sachs and hedge funds. That mix of science and Wall Street expertise now underpins his ambition: steering Axsome toward $16.5 billion in peak sales, a target that could place it among the world’s top 25 pharmaceutical companies.
“We might be a small company in size,” Tabuteau said, “but we’re not a small company in fundamentals or ambition.”
