Even for the most seasoned pharma commercial exec, an opportunity along the lines of “hey, any interest in running China?” doesn’t come down the pike very often. So when that question was posed to Radius Health chief commercial officer David Snow during the back half of 2011, he wasn’t exactly sure how to respond.

Then a VP in charge of AstraZeneca’s Cornerstone unit, which houses some of the company’s later-stage products, Snow had little idea what the overseas gig might entail.

“I knew I wanted the chance to be a general manager or a president,” he recalls, “but I had no idea that a market like China was one of the possibilities. When it was offered, I didn’t know a lot about China, to be honest.”

But to China he went, for a job leading AZ’s somewhat-troubled operations in the region. Over the course of the nearly three years that he spent there, Snow grew the company’s presence to include four business units promoting 29 brands. AZ China also added 3,000 employees and christened a new factory, headquarters, and clinical-development program. Big results followed: Sales surged past the $2 billion mark, from $1.1 billion at the start of Snow’s tenure.

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To hear those who know Snow best tell it, such a result was entirely predictable. “He started with the observation that there were a number of second-tier cities, based on population size, where pharma development wasn’t what it could or should be,” says Bob Ward, president and CEO of Radius Health, who first worked with Snow at Bristol-Myers Squibb in the 1990s. “By changing and expanding the way [AstraZeneca] did business in those second-tier cities, he transformed the growth rate of the company [in China].”

It’s not a surprise, then, that when Snow signaled a desire to return to the U.S. — he grew up in Alabama, where his father, Phil, was the beloved longtime host of the Auburn Football Review — Ward was first in line to propose a professional reunion. Snow formally joined Radius a year ago, becoming the up-and-coming company’s first commercial employee.

Snow’s decision to downsize from a jumbo-size job with one of the pharma world’s Goliaths to one at a company that won’t launch its first product until mid-2017 (the company’s PDUFA date for abaloparatide, designed to reduce fracture risk in postmenopausal women with advanced osteoporosis, is March 30, 2017) makes plenty of sense in the context of his professional arc. “Perhaps my peer group would think I’m crazy for making some of the choices I’ve made,” he quips. “But they’ve all paid off handsomely in terms of experience.”

The opportunity to build the firm’s commercial operation from the ground up appeals to Snow for a number of reasons, among them the recent dearth of new entries in the osteoporosis category. Radius said this week that clinical-trial data found the drug lowers the risk of fractures as well as the market leader. “There’s only been one new drug during the past six years, even as the prevalence of the disease continues to grow,” he notes. “One of every two women will experience a fracture in their lifetime. It’s not hard to get people to rally around a vision of osteoporosis as a large category with substantial unmet need.”

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Nor, one imagines, is it a challenge to sell other execs of Snow’s stature on Radius’ potential; in recent months the company has added industry veterans from Amgen, Merck, and Eli Lilly, among other pharma A-listers. Other assets in the pipeline include an abaloparatide transdermal patch for use in treating osteoporosis (the aforementioned abaloparatide product is an injectable) and RAD1901, for the treatment of breast cancer. In the best-case scenario, Radius will launch three products within the next five years.

That means that Snow, as the company’s commercialization guru, will likely continue to work at what he calls “China speed” for the immediate future. “Some people might look at the kind of experience I was so fortunate to have in China as kind of an apex experience, like something that can’t be duplicated,” he says. “But what we’re doing here at Radius could affect the lives of millions of women dealing with osteoporosis. There’s a difference in scale, but it’s every bit as consequential.”