Since 2013, Shire has been stepping up its strategy to become the world’s leading company for people with rare diseases. McKinsey senior partners Martin Dewhurst and Andy West recently talked with Shire’s CEO, Flemming Ørnskov, about the company’s efforts to transform and the importance of staying three steps ahead of the organization you’re leading. In this interview, part of our Biopharma Frontiers series on how the pharmaceutical industry is evolving and how leaders can adapt, Ørnskov discusses his vision for the future and the critical elements of leadership. An edited transcript of their conversation follows.