GSK has undergone a number of changes in recent years. After driving a major transformation that began in 2017 to strengthen its R&D performance, the British multinational suffered the impact of COVID-19, spun off its consumer healthcare arm and returned to revenue growth. GSK country managers PharmaBoardroom has interviewed over the past year shared the trends that are shaping their regions.
Belgium: A GSK Vaccine Hub
GSK has made a major commitment to Belgium, particularly in the area of vaccines. “Belgium hosts three of our major vaccine sites, including the company’s global headquarters for its vaccines division. All GSK’s vaccines that have the ‘-rix’ suffix refer to their connection to the Rixensart site where the majority of vaccines R&D is conducted. Gembloux plays host to a vaccine distribution hub, and we export 90 percent of the vaccines produced there around the world,” Emmanuelle Boishardy, VP & GM of GSK BeLux explained.
Belgium hosts three of our major vaccine sites, including the company’s global headquarters for its vaccines division
For Boishardy, however, the importance of Belgium as a vaccine hub is undermined by the fact that the country does not have an adult immunisation framework or a fully updated vaccination calendar, something the GSK affiliate is pushing to change through discussions with the government that she claims can be difficult.
“[Vaccines] are vital tools with a return on investment (ROI) of four euros to every one euro spent,” she noted. “However, to many in government, they are still seen as a cost rather than an investment and the pharmacoeconomic assessment of vaccine value is still too narrow.”
The key, in Boishardy’s view is to educate and inform stakeholders about the broader value of vaccines, including for adults, yet there are several challenges, due to the organisation of the Belgian healthcare system. “Vaccines tend to be funded on a regional level, whereas our discussions with government and payers often take place on a federal level,” she points out. While she explained that an adult immunisation framework on a European and Belgian level is in the works, Boishardy argued that “there is still a long road to travel” and referred to COVID-19 vaccines as an example. “A framework was established in a moment of crisis, there is still no plan in place for the next winter season,” she lamented.
Greece: Progress and Significant Investment
When Antonino Biroccio, an Italian national who had previously worked in Greece came back to the country as VP & General Manager of the Greek affiliate, he noticed a number of positive developments within the healthcare ecosystem. “Significant progress has been made [in Greece]. This includes the creation and formation of a health technology assessment (HTA) body, improvements to the reimbursement procedures, and increased incentives for investing in Greece.”
I remain optimistic that Greece is transitioning towards a more sustainable, resilient, and inclusive healthcare environment
Biroccio believes that GSK has contributed to that progress through major investments in recent years. “GSK’s investment in Greece over the past five years is significant and entails a wide range of investing initiatives that contribute to the Greek economy and support the priorities of the National Healthcare System.”
GSK strengthened its position in the country, which has led to Greece becoming something of a hub for clinical trial operations and real-world evidence (RWE) generation, says Biroccio. “Greece is the second and third largest patient enroller globally for two of GSK’s clinical trials in lung cancer and multiple myeloma respectively, drawing on the high level of healthcare professionals that exist here.”
“I remain optimistic that Greece is transitioning towards a more sustainable, resilient, and inclusive healthcare environment,” he maintained, citing the significant funding injection from the EU Recovery & Resilience Facility (RRF), which he asserted “will go some way to supporting this.”
The Greek affiliate is looking to support further improvements in Greece, actively participating in dialogue with the Greek government around the sustainable restructuring of pharmaceutical policy because, according to Biroccio, there is still a distance to be covered, particularly with respect to pricing. “More value-based criteria in the negotiation process are crucial,” he contends. “A sole focus on price will lead, in the end, to more and more discounts, which companies cannot afford. We would like to see a reshaping of the clawback mechanism and more funding for pharma expenditure. This would help create the right data to drive better value-based decision-making, creating more efficiency, and ultimately improving patient outcomes.”
Egypt: Move to Speciality Care
Industry veteran Mohamed Eldababy, General Manager at GSK Egypt, noted the positive evolution of the Egyptian market with the introduction of universal healthcare and reforms regarding governance and approvals as well as the restructuring of government entities. “There have been advances with respect to the overall spending per capita on healthcare, as well as reforms in governance and approvals and massive improvements in capabilities and competencies,” he affirmed.
We are looking to bring in about 11 to 13 new innovative products in the upcoming three years
For GSK, primary care has historically been the most important part of its Egyptian operations, something Eldababy believes will change with an expected increase in healthcare expenditure and the ongoing expansion of universal healthcare coverage. “The future will look different. There will be more and more expansion into speciality care, and specifically more expansion into vaccines.”
This shift is already underway, Eldababy says, in oncology, for example, thanks to drives like the presidential initiative for women’s health and other initiatives for early diagnosis. And new specialty care product launches are already in the affiliate’s plans. “We are looking to bring in about 11 to 13 new innovative products in the upcoming three years, which is very exciting for the country.”
Emerging Markets: Latin America is Key
Luis Arosemena, SVP Emerging Markets, explained that the company’s emerging markets regional division includes some 120 countries. Of these countries, 16 are considered “Growth Markets,” accounting for 85 percent of the growth of the region. Five of these markets are in Latin America, making it a key region within GSK’s emerging markets.“One-third of the turnover generated by emerging markets comes from Latin America and the region is growing by double digits,” he confirmed.
It is helpful that the region has an institution like the Pan American Health Organisation (PAHO) to help countries build immunisation calendars and strategies
While Latin America has often been characterised by political and economic instability, Arosemena claims that “volatility is not only a Latin American issue” but an intrinsic characteristic of developing markets. This has led GSK to build certain capabilities, he contended, in order to “focus on the things we can control and be agile when changes come.”
Within the relative lack of stability in Latin America, Arosemena claims that there are institutions that transcend it, for example in Argentina. “Inflation and devaluation often take the headlines, but we know that the country’s healthcare system is quite mature and developed.”
Arosemena explained the drivers behind GSK’s growth in Latin America. “40 percent of our business is vaccines, another 40 percent are what we call general medicines, primary care products that we have in different areas such as respiratory, anti-infectives, and dermatology. Finally, we have 20 percent coming from specialty care which are HIV products, oncology and other biologics.”
With respect to vaccines, Latin America, he claimed, is an example of the value of prevention with an institutional set up that has supported the success of GSK’s vaccine portfolio. “It is helpful that the region has an institution like the Pan American Health Organisation (PAHO) to help countries build immunisation calendars and strategies. That is something that you do not see in Asia.”
As an example of this, Arosemena revealed that GSK’s rotavirus vaccine was first launched in Latin America and its new vaccine for the prevention of herpes zoster (shingles) has already been introduced in Brazil.