Japanese-headquartered Takeda has been undergoing a transformation in recent years, becoming the global leader in rare diseases with the acquisition of Shire in 2018 and divesting ‘non-core’ assets in OTC and consumer goods. Here, four country and regional managers that PharmaBoardroom has spoken to in the past 12 months discuss how global shifts have been playing out in their geographies and the items at the top of their agenda sheets.
Belgium: Change Management
For Michael Nesrallah, in his first country manager position having previously led commercial support functions for Takeda’s US Specialty Business and served as VP and franchise head for the company’s IBD line, change management has been key to ensuring the Belgian affiliate is future fit and ready for the upcoming wave of product launches.
Change – such as our organisational refocus on high-priority treatments – is never easy, but it comes with a lot of opportunity
Michael Nesrallah
“We have put a lot of thought into resource allocation, making sure our people are aligned to where the highest unmet need is and where the opportunities to help as many patients as possible are,” he begins. “Given the large number of launches that we have coming up in the next few years, as well as our existing inline portfolio, this has required a significant adjustment but has given our teams a high level of excitement as we realign to optimise the business and ultimately help as many patients as possible.”
“At Takeda, we feel that giving our people the opportunity to work on new and exciting projects is incredibly important. As a leader, talent management is my most important role and there is a continuous emphasis on attracting, developing, and exciting the best talent. Change – such as our organisational refocus on high-priority treatments – is never easy, but it comes with a lot of opportunity.”
LatAm: Dengue Vaccine Rollout
Latin America – along with Asia – is home to many of the world’s most endemic countries for dengue fever, making Takeda’s recently approved dengue vaccine a “top priority” for Maria Gabriela Pittis, head of South Cone, Andean Region, Mexico & Central America and Caribbean.
Right now, the dengue vaccine is my top priority and I need to make sure that we are ready, have the correct capabilities and plans in place, and are interacting with the correct stakeholders, including public sector payers
Maria Gabriella Pittis
“As Takeda, we have a unique opportunity to impact people’s – not just patients’ – lives and fight this challenging and devastating disease,” she explains. “On a personal level, having always been working in rare and highly specialised diseases, this also represents an opportunity to learn more about vaccines, a completely different area. This is a new challenge, a learning process, and opportunity to interact with different stakeholders.”
“Prioritisation will be key. Right now, the dengue vaccine is my top priority and I need to make sure that we are ready, have the correct capabilities and plans in place, and are interacting with the correct stakeholders, including public sector payers. For example, we need to collaborate not only with Ministries of Health but also with Ministries of Environment, which also carry out anti-dengue campaigns. This broader spectrum across which we can have an impact is truly fascinating.
Pittis adds that “Different countries will also need different approaches. In Argentina, for example, dengue is only present in certain areas and therefore a full national immunisation program would not be necessary. However, in Brazil, Mexico and Colombia it is endemic across almost the entire country and a different strategy will be needed. Regardless, in all countries we will need to sit down with authorities, medical societies, NGOs, and various ministries to understand how to address dengue in a holistic way. It is not only about adding the vaccine to a national program but working collaboratively to make this a real success.”
Egypt: Adapting to Universal Healthcare
Egypt is currently undergoing a generational reform of its healthcare system as it attempts – for the first time – to fully regulate quality and ensure that even the poorest segments of its 100 million-plus population have access to decent treatment.
As part of our commitment to equitable healthcare, partnerships are vital to delivering high-cost drugs to patients that cannot otherwise afford them
Samy Khalil
For Takeda’s Egypt’s Samy Khalil, “Improving access for a big country that is going through an ambitious healthcare reform requires a unique strategy.”
He outlines, “We made sure to align our operations with the country’s vision to improve its healthcare system’s accessibility. Egypt is the second largest market in the Middle East and Africa (MEA) region after Saudi Arabia, and the fastest-growing market, but its landscape is very different from what we see in Saudi Arabia or the United Arab Emirates.
Khalil underscores the importance of building “tailored approaches” in Egypt, given its particular context. He explains that “Looking at the Egyptian pharma market before the transformation, 70 percent was paid out-of-pocket and only 30 percent reimbursed. The goal for the future is to overturn this and get everyone under the umbrella of universal health insurance. This will, of course, not happen within a day. You will always have a portion of the population that will have to opt for out-of-pocket, and Takeda wants to tackle that along with its partners. There are NGOs and other players that want to support patients in Egypt, not only the government. In this regard, we are proud of local programs, Takeda Patient Assistance Programs (TPAP), where we support patients within our therapy areas using an innovative tailor-made approach. On the other side, we need to support the system as it tries to help rare disease patients.”
He finishes, “As part of our commitment to equitable healthcare, partnerships are vital to delivering high-cost drugs to patients that cannot otherwise afford them. At Takeda, we believe that we all have the right to life-saving treatments – and should not be determined by where we live.”
Greece: Fighting Clawbacks
Cornelia Zanetti, a recent implant into the Greek market following stints in Germany, Switzerland, and Singapore, highlights the country’s punishing clawback and rebates, which she feels are damaging the system’s sustainability and its ability to absorb future medical innovations
Greece has the highest clawbacks on pharmaceuticals worldwide meaning, as a pharmaceutical company you need to pay back to the Greek state up to 70 percent of the revenue earned, sometimes 1.5 years after the patient has received the product
Cornelia Zanetti
“Currently, the big challenge we are facing in Greece and industry-wide is the high and unpredictable clawbacks,” she begins. “For us, it is difficult to predict how much of the revenue we make today we need to pay back over one year from now. The clawback system was introduced during the economic crisis in Greece in 2012 and I agree that during challenging economic times, all actors – including the pharmaceutical industry – should contribute to improving the economic situation.”
“Greece has the highest clawbacks on pharmaceuticals worldwide meaning, as a pharmaceutical company you need to pay back to the Greek state up to 70 percent of the revenue earned, sometimes 1.5 years after the patient has received the product. This makes it difficult to predict and puts the Greek industry at risk of being unsustainable in the global context, thereby putting Greek patients at risk of continuing to receive innovative treatment.
“Greece today is an economic wonder with growing GDP, but healthcare expenditure – especially the budget for pharmaceutical medicine – is very low and not increasing in line with overall growth. In Greece the public spending per capita for medical treatment in 2020 was EUR 243 whereas in Southern European countries it was EUR 274 and across the EU it was EUR 321. To ensure continuous access to innovative treatment in Greece it will be important to increase public spending in line with other countries with similar economic growth and situation.
“At Takeda we always have the patient first in mind and try our best to foster patient access to our life-transforming products despite this challenging situation with very low prices for innovation. Till now we were able to launch all innovative treatments for Greek patients. This is hard work for the team to convince our Headquarters internally to continue investments in Greece and launch our products here.”
