Physician and pharma industry veteran Iris Zemzoum is returning to Europe after leading Novartis Asia Pacific, Middle East and Africa through the COVID-19 pandemic. As Novartis looks to further hone in on innovation after spinning-off generics and biosimilars division Sandoz, Zemzoum will face a unique set of challenges in her new geography.


Leading the Diverse APMA Region

After training as a physician in her native Germany, Iris Zemzoum began forging her path in the pharma industry with several local leadership roles at Bristol Myers Squibb and Janssen before heading to Novartis where she became president of Asia Pacific, Middle East and Africa (APMA) in 2020, with a central focus on cardiovascular disease (CVD).

“The urgency to address CVD in this region continues to grow as population growth and ageing threaten to double the disease burden by 2050,” she said in a 2022 PharmaBoardroom interview.

Managing a vast region with such a diverse collection of healthcare frameworks and access levels was a demanding task. “There is no denying that the APMA region is faced with numerous healthcare challenges, with access being one of its most pressing issues. APMA is a region of extremes – GDP per capita ranges from USD 800 in Yemen to USD 60,000 USD in Singapore, and the number of institutional payers ranges from 1 in Australia to 80 in South Africa.”

Zemzoum was quick to take the region’s lack of uniformity into account. “Acknowledging the diversity of the healthcare landscape across the region, we have segmented our markets around strategic access archetypes rather than a purely geographic approach,” she asserted. “We’ve considered how innovative healthcare is funded, the barriers faced along the patient journey and how long it takes for approval of innovative medicines. This enables us to leverage access synergies within archetypes, customize access solutions, and tailor approaches to the unique needs of the communities in our region.”


Patent Cliffs and Biosimilar Snags

Zemzoum’s new geography may appear to be more uniform than APMA, yet Europe is also a large region where Novartis has a huge footprint — apart from its headquarters in Switzerland, the big pharma has over 60 sites on the continent encompassing R&D, manufacturing and commercial operations and employs over 31,000 people.

Europe also presents a distinct set of issues. The EU is revising its legislative framework for pharmaceuticals, attempting to balance access and affordability while boosting scientific research and innovation, yet Novartis along with much of the industry, debates that the reforms stand to just the opposite. “We believe the proposed legislation will neither improve the stagnating competitiveness of EU life sciences, nor achieve the objective of more equitable access to medicines,” the firm said in a statement.

Meanwhile, Novartis is facing other obstacles. While its 2023 financial results shone with USD 45.4 billion in net sales and the company took a major step towards concentrating its focus on innovation by spinning-off Sandoz, Novartis is bracing itself for the end of patent protection for its best-selling heart failure therapy Entresto in 2025.

In Europe, the company has recently been accused of shady dealings by Italy’s antitrust regulator along with Genentech after it allegedly coordinated commercial strategies to delay the launch in Italy of Byooviz, a biosimilar of the ophthalmological drug Lucentis, developed by Genentech and sold in Italy and other countries by Novartis.

And, in another European setback for the big pharma, the European Commission decided last year to revoke the conditional marketing authorization (MA) for its sickle cell therapy, crizanlizumab, within the European Union’s (EU) 27 territories and the European Economic Area (EEA) following a review of additional Phase III data.