2025 Annual Dinner Q&A: BioCryst CEO Jon Stonehouse on building a biotech success st

BioCryst Pharmaceuticals CEO Jon Stonehouse said his nearly 19-year tenure leading the rare disease biotech company has been marked by multiple "near-death experiences" that ultimately forged a resilient culture capable of generating $600 million in annual revenue. 

Speaking at the NCLifeSci Annual Dinner Sept. 15 at the NC Biotechnology Center, Stonehouse reflected on the company's evolution from a struggling startup to a profitable enterprise ahead of his retirement in December. 

The 65-year-old executive joined BioCryst in 2007 when the company had about five employees working above a coffee shop in Cary. The Research Triangle Park-based company now employs hundreds and manufactures Orladeyo, the only oral medication approved for preventing hereditary angioedema attacks. 

The 2025 NCLifeSci Annual Dinner was sponsored by Avantor, EisnerAmper, HIPP Design + Consulting and JLL.

From Alabama roots to North Carolina success 

BioCryst was founded in Birmingham, Alabama, in 1986 by two University of Alabama scientists who built the company around structure-based drug design. The technology involves understanding protein structures to design drugs that fit precisely into target sites. 

Stonehouse said the decision to move operations to North Carolina was driven by talent acquisition challenges. 

"We always had great success recruiting chemists and biologists to Birmingham, but getting people in regulatory, clinical and manufacturing was much more challenging," Stonehouse told NCLifeSci President Laura Gunter during the interview. "With the CRO business in North Carolina and companies like Glaxo here, it made sense." 

The company officially moved its headquarters to North Carolina in 2010, though research operations remain in Alabama. 

Surviving multiple setbacks 

BioCryst faced what Stonehouse called a "trifecta of bad news" in 2012-2013 that nearly killed the company. The Food and Drug Administration halted a hepatitis C program over safety concerns, a separate drug program was suspended due to compounding facility problems and a planned merger fell through. 

The company laid off about 65 employees, retaining just 35 split between Alabama and North Carolina locations. 

"In January 2013, I didn't know if we could make payroll by June," Stonehouse said. "What was fascinating was that all 35 people could have gone anywhere — their phones were ringing off the hook — but they stayed." 

Those employees bet on the company's hereditary angioedema program, a rare genetic disorder that causes episodes of severe swelling. After an initial drug candidate failed in late-stage trials, a backup compound eventually became Orladeyo. 

Commercial breakthrough during pandemic 

The company received FDA approval for Orladeyo in December 2020, launching the product during the COVID-19 pandemic with a sales force hired entirely through video calls. 

Wall Street analysts initially expected modest sales, projecting $30 million in revenue for 2021. The company generated $122 million instead, surprising investors with what Stonehouse described as proof that small biotech companies can successfully commercialize their own products. 

"This year, we're going to do close to $600 million in revenue in the fifth year since approval," he said. 

Culture and remote work philosophy 

Stonehouse attributed much of the company's success to a culture document he wrote in 2013 called "the one pager" that emphasizes values including "laughter" and "ownership." 

The company gives equity to all employees, unlike most of its publicly traded peers, and operates with mostly shared office space rather than individual offices. 

COVID-19 accelerated the company's embrace of flexible work arrangements, with Stonehouse saying mandating office attendance causes companies to "lose good people." 

"This idea that I'm going to make you come in five days a week is BS," he said. "Humans have free will, and COVID changed their mindset." 

Transition and future outlook 

Chief Commercial Officer Charlie Gayer will succeed Stonehouse as CEO on Jan. 1, 2026. Stonehouse will remain on the board of directors as a major shareholder. 

The outgoing CEO said he plans to potentially serve on additional boards and pursue advisory roles while spending more time with three grandchildren and personal interests including kiteboarding and deep-sea fishing. 

BioCryst's success story reflects broader growth in North Carolina's life sciences sector, which now includes more than 840 companies employing over 210,000 people statewide, according to industry data. 

"Money goes to places with great innovation, great ideas and great people, and we've got that down here," Stonehouse said. "I have tremendous confidence that this will be a thriving area for years to come." 

The company received its first major validation in 2009 when it became the first to receive an emergency use authorization from the FDA for an unapproved drug, supplying the influenza treatment peramivir during the H1N1 pandemic. 

Stonehouse credited North Carolina political leaders including former senators Kay Hagan and Richard Burr for supporting that effort, which helped establish BioCryst's credibility despite limited commercial success. 

For biotech entrepreneurs, Stonehouse emphasized the importance of patient focus, particularly in rare diseases where companies develop personal relationships with people affected by their targeted conditions. 

"The thought of giving up and letting these people down is one of the worst feelings in the world, and it's a huge motivator to keep going," he said.