Amgen’s country director for the ELI cluster (Egypt, Levant, and Iran), Ahmed Kishta, dives into the dynamics shaping the Egyptian market, Egypt’s Vision 2030 and how Amgen is contributing to the health of Egyptian patients.
The effort to transform healthcare in Egypt has been tremendous during the last 5-6 years
Ahmed, you have been Amgen’s country director for Egypt, Levant, and Iran for about three years. Can you give us a quick recap of your career in pharma and why you decided to join Amgen?
I am Egyptian and a pharmacist by training. I started my career on the commercial side at a pharma company in Saudi Arabia where I spent nine years. Then I moved to Dubai for five years before returning to Egypt. Living in different countries, working with people of diverse backgrounds and for several multinational pharma companies including Eli Lilly, Abbott, Pfizer and Roche in various leadership positions across commercial, market access, pricing and communications have helped me to develop a broader view and increased my passion about the innovation being brought by the pharmaceutical/ biotech industry.
Amgen is a worldwide pioneer in biotechnology and our mission is to serve patients. We are proud of our 40+ years heritage as a biotech startup, our people, our culture and our dedication to our mission. Our innovation spans beyond just our products, it’s about how we do business every day. When I joined Amgen as country director for the ELI region three years ago, I had a clear vision of how our innovative biologics can transform the lives of patients and being here allows me the opportunity to do things differently in order to serve patients suffering from serious illnesses.
There is much talk about the transformation of healthcare in Egypt after the approval of a law in 2019 and the creation of different governmental bodies to regulate the market. What is your perspective on this?
I am proud of Egypt’s 2030 Vision because timelines matter. Egypt used to have quite a fragmented healthcare system; for example, the out-of-pocket market accounted for about 60-70 percent, access to innovation was suboptimal, and products registration was not fully connected to patients’ public access.
The effort to transform healthcare in the country has been tremendous during the last 5-6 years. The crucial part of this journey has been a change of mindset and the acceleration at which this change was implemented. The creation of the Egyptian Drug Authority (EDA) is a great example of the consolidation of the registration process. Similarly, having the United Procurement Agency (UPA) as a single entity that fulfils the medicine needs of the country in a more sustainable manner has been a positive development; it creates shorter access timelines for innovative medicines.
Egypt has the vision of improving its healthcare by enhancing its quality as well as increasing expenditure per capita by four times. The COVID-19 pandemic was a good example of Egypt’s resiliency and ability to outperform other emerging countries.
What has been the trigger of this transformation?
I believe it all started by having political will, a clear strategic direction and a commitment to improving the lives of all Egyptians. Moreover, the government became more open to listening to all partners across the eco-system including innovative companies, local manufacturers, regulators etc. to better understand the key challenges they face and co-create solutions.
A key priority for us at Amgen is to support healthcare initiatives that unlock and accelerate patients’ access to medicine, for example, Amgen Egypt launched multiple local public-private partnerships that leveraged digital solutions to address this. An example is a program in partnership with the National Health Insurance that resulted in tangible outcomes for patients by significantly reducing the time needed to approve innovative medicines. Another example is a digital program we launched with EDA to accelerate lot release of products which shortened the timeline from a few weeks to just a few days.
Also, key presidential initiatives had a significant impact on people’s lives, such as the following: For example, Egypt used to have the highest prevalence of hepatitis C virus (HCV), which naturally came with a huge societal and economic burden. The presidential initiative to detect and treat HCV in Egypt is a great success story as today, we have almost no new HCV cases. Another impactful initiative was for women’s health, where more than 15 million women were screened for breast cancer. This is in addition to initiatives covering lung and colorectal cancer and I hope these presidential initiatives expand to more disease areas that severely impact the lives of Egyptians. These early successes are an indicator that we are on the right way.
With a broader perspective of the company and its global operations. Why would you say Egypt is important to the global organisation?
Amgen has been present in Egypt for about 15 years and provides solutions for patients suffering from several serious illnesses including cardiovascular, osteoporosis, nephrology, oncology and haematology.
Egypt has over 100 million people that are striving for better healthcare, which the country has made a priority and is therefore increasing investments on that front. The overall pharma market has surpassed USD 6 billion annually and is growing double-digit. At Amgen Egypt, we have been showing similar growth rates by focusing on areas of high unmet medical need not just by providing treatments, but also by supporting the country in the early diagnosis and prevention of chronic diseases including cardiovascular disease.
With the transformation taking place, we are seeing an even bigger potential. Now when we speak with the authorities, be it the EDA or UPA, there is more willingness to collaborate to widen the reach and improve the quality of the healthcare system. Even during COVID-19, the authorities were committed to continuing to invest in health. The way the Egyptian government handled the pandemic was quite impressive and encouraging.
In order to qualify as a supplier to the healthcare system with medicines, is the government demanding a certain level of investment for companies- for example on the localisation of your products?
As with many other countries, localisation is a priority for the government. Around 85 percent of medicines consumed in Egypt are manufactured locally. Stakeholders in the government are aware that biologics are not easy to manufacture and accordingly Gypto Pharma was created to serve as a production hub for more advanced therapies.
From our side at Amgen, Egypt has been approved for inclusion in clinical trials for three of Amgen’s global pipeline. Our local team at Amgen is very proud of this, and we would like to see more Egyptian centres and hospitals being certified for inclusion in future clinical trials.
Is the Amgen biosimilars portfolio present in Egypt? If so, does it help you differentiate from other multinationals?
Amgen Egypt’s offering includes biosimilars. A differentiating factor for us is that we have that balance in the portfolio between innovative biologics and biosimilars. Our high-quality biosimilars can potentially offer more affordable treatment options that contribute to the sustainability of our healthcare system and allow for greater investment in new medicines for patients.
We recognized that biosimilars would become an important part of broadening patient and physician options for biologic treatments and foresaw that our expertise in developing and manufacturing biologics also would apply to biosimilars. We are partnering with the authorities to unlock access to patients in need.
Many of your colleagues have spoken in very positive terms about the so-called transformation of healthcare. But what are the challenges ahead?
I believe that having many initiatives and entities with built-in capabilities, budgets and strategies is a great strength. Now it’s important to make sure that all those initiatives are connected to the same objective, which is providing access to patients at the right time and for the right duration as per global guidelines. For example, if we look at a serious disease like atherosclerotic cardiovascular disease which affects millions of Egyptian patients and is associated with a tremendous social and economic burden, regulators and reimbursement bodies ought to consider early registration and access for the right patient population, since investment in health is a key driver for resiliency, economic growth and prosperity of any nation.
How are you measuring the success of Amgen in Egypt?
We measure success against our mission to serve patients, and for us this means that our products reach the patients who need them. The rewarding part is that Amgen’s therapies can affect the lives of broad patient populations. We help women with osteoporosis, people on dialysis, oncology and haematology patients, cardiovascular patients and so on.