Cristina Campos, CPO Head and Country President of Novartis Portugal talks about the challenges surrounding market access in Portugal, as well as the affiliate’s strong investments in the country to help alleviate the economic burden that is faced by all companies here.
Between 2011 and 2012, the industry contributed €600 million to the restoration of Portugal’s healthcare system, around the same time you became country president. What was your reaction to this decision?
My initial reaction was to understand why we needed to contribute that much. In perspective, we are already contributing a great deal to the healthcare system, and the cost of drugs and per capita spending in Portugal are amongst the lowest in Europe. The question was whether the industry should continue to be the main target of austerity measures in the health care sector, as this was not sustainable.
What strategies need to be employed by stakeholders to ensure a healthier relationship between industry and government?
The common interest for all healthcare stakeholders is patient health, and the common vision is to ensure the sustainability of the Portuguese Health System and access to medications. If all are aligned on these, it will be easier to have a friendly dialogue. The key is collaboration; everybody interprets Portugal’s issues from different angles rather than coming together with a unified, long-term vision.
In what way can Novartis demonstrate the value of drugs for faster reimbursement?
We try to position Novartis as a respected and trustworthy partner for regulators. Operationally, the company is trying to involve the authorities at an earlier stage; but first we need to agree and align on the needs of the population before creating solutions. Therefore, the process of engagement starts earlier. We also try to foster investment in clinical trials. If we provide access and opportunity to try drugs in advance more often, it will be easier to see the benefits of having innovative medications in Portugal in real life sooner rather than later. The earlier we diagnose and treat patients, the better the prognosis for long-term quality of life and societal health will be.
How does Portugal compare to other countries for approval or drugs?
In terms of speed, Portugal is less attractive than other countries for innovative drug launches. We have longer periods to approve reimbursement. The average is almost 500 days, depending on whether it is an ambulatory or a hospital product.
What can be done to ensure that pharmacies are well stocked, given the threat of shutdown in recent months?
As an industry, we are trying to collaborate frequently with authorities. New legislation will allow for more controls in place to ensure that products are available here. In terms of pharmacies’ stocks, Novartis is aware of the issues at this level. The entire sector is experiencing a contraction, and pharmacies are no exception. We are trying to build partnerships with pharmacies, to help them adapt to this changing environment and deliver together the best services to patients. Novartis has also reorganized itself internally so that we can work more closely with pharmacies.
What is the importance of clinical research for Novartis Portugal?
This is one of the affiliate’s major priorities at the moment.
Novartis Portugal is building capabilities internally by bringing the right people into the organization as well as upgrading the current skills of our workforce. This will allow us to have the best medical team in the industry.
The aim is to overcome process barriers that are currently in the market to speed up clinical trials in Portugal. We want to ensure that Portugal becomes one of the most attractive countries for clinical research. Novartis is already succeeding in this regard, and currently has 20 ongoing clinical trials enrolling 400 patients in Portugal. At the moment, we are therefore one of the biggest sponsors of trials in this country. This is almost double in size and scale compared to a couple of years ago. I believe we can still do much more, and for that we need the Government to ensure some stability and simplified processes to quicken the approval of clinical trials. This will allow the subsidiary to be seen not only by international headquarters as a reference for other countries but most importantly to make Portugal a more attractive country for clinical trials with benefits for patients, hospitals and physicians.
What is the strategic importance of Novartis Portugal in relation to the entire organization?
For Novartis, every patient counts regardless of the country. In terms of the specificities of the Portuguese organization, I believe that Portugal is seen as extremely agile and dynamic. We have one of the most engaged teams in Novartis worldwide. This affiliate was ranked as the best pharmaceutical company to work for with more than 250 employees in Portugal. That demonstrates the commitment and passion of the organization, and renders us an extremely credible candidate to pilot new commercial models, for instance. Many of this affiliate’s developments have been used as a learning tool for the rest of the organization and have often been scaled up for bigger countries in this region and further abroad.
Moreover, the talent attraction and development in Portugal is exceptional. There are many who are recruited and developed in Portugal whom Novartis Portugal grooms to be exported to headquarters and other affiliates, and they become extremely successful and key people in the organization worldwide. The defining characteristic of Novartis is innovation, and this subsidiary is constantly trying new commercial models, making digital transformations, realigning the organization, and building new capabilities. This is reflected in everything we do and that is why we are seen and perceived as a highly innovative organization.
Is there a burden of responsibility in terms of commitment to the Portuguese population as the number one player in the market?
With all five Divisions, Novartis serves more than one million patients and consumers in Portugal. We see this as a huge opportunity, and our aspiration is to be seen as the most respected and trustful player in the sector. From quality and compliance standards to the excellence of the delivered programs in the market, there is a huge burden of responsibility.
Given our big scope and diversified portfolio and pipeline, Novartis Portugal has an obligation to be a role model in terms of positioning the pharmaceutical industry as a respected and collaborative player in the Portuguese economy and society.
What strategies will you implement in the near future so that Novartis can continue its position at the forefront of innovation?
Firstly, Novartis will continue to invest in clinical trials and everything related. We currently have around 30 people working on our medical team, and about 20 PhDs and MBAs in the entire affiliate. Most of them are in the medical department, and we want to continue to invest internally as a means of shaping the market and ensuring better access to clinical trials. Secondly, we will not give up ensuring that Portuguese patients have access to the best therapeutics available like everyone else in the world. We will strive to prove that our drugs are here to give better benefits to patients. This mandates the need to invest in clinical trials and work in collaboration with regulatory authorities, academia, medical societies and patient advocacy groups. Thirdly, we want to make the organization more agile, flexible and efficient. This will require a transformation in the way we work, mainly through pushing for innovation and digital sophistication, not only internally but also with customers.
What indications will the affiliate focus on the most?
The beauty of Novartis is its diversity. The company has everything from innovative, life saving products to generics in a number of disease areas. There are more than 130 products in the Novartis pipeline, and we aim to launch more than 13 new molecules in the next five years within the fields of neuroscience, cardiology, respiratory diseases, and oncology just to name a few. There is no one specific area; Novartis looks for unmet medical needs, which exist everywhere.
What would you like to have achieved in the next five years?
I would like to achieve the same level of access to innovation in Portugal as the European average. We still have very low access to innovation, particularly with specialty drugs. The penetration of hospital products in Portugal has historically been one of the lowest in Europe. If we turn around this situation and reach more patients, we will achieve our strategy.
I strongly believe in the future of Portugal, but there is no future without innovation. I think we need to ensure that everyone involved in the healthcare sector is actually aware and sensitive to the fact that we need to cooperate to find solutions.
One of the best examples as to why Novartis believes in the future of Portugal is its investments here. We have around 500 employees in Portugal, and have recruited more than 70 in the last two years while many other companies downsized. We invested in a new building worth €14 million, where we have located all Divisions together in the same place, further demonstrating our commitment. We want to be here, and we believe there is a future and will collaborate with those who think similarly.
To read more interviews and articles on Portugal, and to download the latest free report on the country, click here.