Guerbet's Alessandro Bocci - General Manager Italy & Iberia - describes the nearly 100-year-old company's firm position in the field of contrast media for radiology and its plans for developing a portfolio in artificial intelligence (AI). In addition, he outlines how the Italy, Spain and Portugal cluster made its way through the challenges of the pandemic to meet its turnover and profitability targets in 2020 and 2021.
What brought you to Guerbet 11 years ago and what has kept you at the firm?
I have experienced many angles of healthcare, from medical devices to vaccines, capital equipment, drugs, and now contrast media (substances used to increase the contrast of structures or fluids within the body in medical imaging – Ed.). Contrast media, from a regulatory perspective, are seen as drugs in that they enter the bodies of patients, but these products do not treat any particular disease.
In addition to working across these varying fields, my career has also taken me to roles in sales, marketing, customer service, sales operations, and general management, as well as to several different geographies. At Guerbet, I was offered the opportunity to become the country manager of Italy in 2011 – the first general management position in my career – and I have grown within the company, later taking on an expanded role covering Spain and Portugal.
While I spent some time in consultancy in-between my time at Novartis and Guerbet, it was the opportunity to take on responsibility for the long-term execution of strategic planning that truly interested me, and continues to interest me, about this role.
Having previously worked for large multinationals, how would you compare the ability to execute these strategies at a more modestly sized outfit like Guerbet?
Often in larger firms, strategies are imposed from above and fly over the heads of executives at a country manager level. However, at companies like Guerbet, we can make significant strategic contributions. Additionally, smaller firms foster a more entrepreneurial mindset, with greater freedom to pursue objectives anywhere we see fit. I would add that as a younger man, I was very comfortable working in larger corporations to learn how they worked. As I became more senior, the entrepreneurial freedom offered by smaller companies became more and more attractive.
Guerbet is four years from its 100-year anniversary but is perhaps little known outside of the radiology field. Could you outline its specialities and focus?
Frankly, very few people outside of the radiology field know us! However, we have strong brand recognition within radiology, where we have a 90+ year presence and a 100 percent focus. Our legacy is contrast media, both for magnetic resonance imaging (MRI) and for computed tomography (CT), which makes diagnostic examinations easier for radiologists. Alongside contrast media, the company has a wide portfolio of capital equipment, injectors, and medical devices, and also has a division dedicated to interventional radiology; the surgical procedures which are used to treat, for instance, liver cancer. Those kinds of interventions are mostly carried out by radiologists and are sometimes done by other specialists, but our primary targets are radiologists, whether they be diagnostic or interventional.
Additionally, through various licensing and partnership deals, we have recently been developing a portfolio in artificial intelligence (AI). Today, radiology is one of the most technologically advanced specialties in medicine, and AI is becoming widely used in the practice of diagnosing and treating many diseases. Telemedicine and teleradiology are already technically feasible, something that perhaps cannot be said for all of AI’s applications in drug discovery. Healthcare practitioners (HCPs) are able to send real time scans of patients in their hospital to colleagues across the world.
As Guerbet moves into areas beyond its core field of contrast media, will it look to do so through internal R&D as well as external acquisitions?
We will utilise both. The company is envisioning organic growth with some proprietary product development, keeping in mind that we already devote eight to ten percent of our total budget to R&D. Externally, we have already made two big acquisitions, including the diagnostic arm of Mallinckrodt, which was at the time as big as Guerbet, meaning the company doubled in size overnight. More recently, almost three years ago, we acquired an Israeli company that produces microcatheters for interventional radiology.
How has your cluster been performing in the last couple of years against the backdrop of deferred treatments and lockdowns caused by the COVID-19 pandemic?
The Italy, Spain and Portugal cluster has been performing well and was ahead of its targets both in terms of turnover and profitability in 2020 and 2021. The Southern European cluster, of which we are a part and which also includes Guerbet’s home market of France, was the global group’s most successful during this period and a clear sign that we are moving in the right direction.
While 2020 and 2021 were challenging years overall, we are already back to normal and the Spanish, Italian, and Portuguese authorities are putting plans in place to conduct the examinations that were deferred due to COVID. For instance, in Italy, there are incentives for personnel in public hospitals to take on additional shifts and work weekends or nights to clear the examination backlog.
This is also very useful for the economy from a healthcare expenditure point of view as the increase of preventative screenings will identify patients earlier and lead to savings on treatments in the long run. It will mean having fewer people in hospitals, fewer treatments, fewer surgeries, and fewer hospital beds occupied.
How did your teams react to the pandemic, and do you see a new paradigm of HCP interaction emerging?
HCPs today are busier than ever and the modalities with which we approach them have changed since COVID. Nowadays, we are all much more used to having interactions via video chat, webinars, instant messages, exchanging digital files or materials, as well as in-person visits. We are now in a new era of communication, although it must be remembered that the countries in my cluster are ones where personal relationships still have value. In such countries, where we enjoy shaking hands, having a coffee together, and talking about our family or football, a multichannel approach is clearly the way forward.
Italy’s National Recovery and Resilience Plan includes EUR 18.5 billion to be spent on health; what are your thoughts on how these funds are being allocated?
Within this total, significant funds are being dedicated to radiology equipment such as new MRI and CT scanners as well as new ultrasound machines, showing the central importance of radiology, both for prevention and cure. We have a lot of equipment in Italy per capita but the obsolescence rate is very high, meaning that an improvement in the overall technological level will immediately result in an improvement in patient care.
We are also expecting a big impact in terms of greater interconnectivity between patients, general practitioners (GPs), and hospitals. Any measure which leads to increased accessibility for GPs, where today there is a bottleneck, is a step in the right direction. Today, a GP has 1,500 people to assist and there is physically no space for everyone in the agenda of a single GP. Therefore, to have new technologies at their disposal and for citizens to have rapid access and exchanges, and to be referred maybe to specialist care or to diagnostic care, or to be enrolled in a prevention program in a faster and more efficient way is crucial to allow a wider portion of citizens to benefit.
How well prepared is the Italian healthcare ecosystem for the implementation of next generation equipment?
Improvement is needed. However, our HCPs have a very high level of professionalism, especially in radiology with the radiologists, radiographers, and nurses as well as all the administrators working to back them up. Generally, the level of all these professionals in Italy has gone up a lot in the last few years. I also must praise the Italian society of radiology (SIRM) which is doing a great job in advancing the level of the radiological community with clinical as well as management training. Today, the head of a department of radiology in Italy is doing a job much more similar to mine than to that of a doctor. They are managers, managing millions of euros in investments, dozens of people in their department, and thousands of patients coming through their emergency rooms and hospital wards.
What are you most excited about in Guerbet’s future?
Guerbet operates in a scientific environment, so our future outlook is closely linked to the advance of our new projects in terms of products and clinical development. We will be doing our job if we bring clinical advancement to healthcare. The company is about to, after many years of development, bring forward a new drug for MRI which will see the light in Europe next year after all the regulatory clearance. This will be great news in the field, where very few new contrast agents are launched per year. Pre-regulatory approval, I cannot go into detail about this product’s features, but the clinical study we submitted for marketing authorization is solid. We are therefore optimistic about bringing improvements to the market.
Guerbet also has many plans related to interventional radiology and digital radiology. Future optimism comes from both clinical and technological advances, which need to go together.
What role will Italy play in global clinical development and clinical trials?
A significant one. We have several investigators in Italy, drawing on the high level of expertise of Italian doctors. Along with their Spanish counterparts, Italian doctors feature on all our advisory boards and clinical papers and are of a level comparable with any international equivalent elsewhere in Europe or in the US. Moreover, we have many centres of excellence in both Italy and Spain.
What opportunities are there for young talent to develop at a company like Guerbet?
Guerbet is, of course, not a huge pharma multinational and cannot offer quite the same career opportunities. However, we have a good selection of people as well as programs for talent development. We see many people progress in the organization, based on the results they are able to produce.
Over the years, I have seen many people develop within the company, taking on growing roles and responsibilities. This was the case for me, as my role has expanded from Italy-only to include Spain and Portugal, our CEO David Hale, who moved from being CCO, and several others at all levels of the firm.
Do you have a message to your counterparts in other geographies about Italy and what it has to offer internationally in the life sciences?
This is a country with all the fundamentals to be a leader in healthcare, including great HCPs, hospitals, and levels of care. Italy also boasts a very strong, diverse, and collaborative industry which works under the Farmindustria banner, with a good mix of local, European, American, and Asian companies. These companies range from commercial affiliates to manufacturers, and from big corporations to family-owned firms and by working closely together, we can offer a lot to both patients and to the overall Italian healthcare system.
Why does working in radiology continue to motivate you?
It is pleasure to work in radiology. No medical procedure or medical diagnosis today occurs without the help of radiology, whether that be an ultrasound, a CT, an X-ray, or an MRI. Those of us working in radiology have the feeling of being at the centre of healthcare, because from radiology, you are directly linked to all clinical and surgical specialties.
