AbbVie’s GM for Egypt & Levant, Ali Sleiman, explains the factors behind the stellar growth that has made the cluster one of the company’s fastest-growing global markets in 2021. He also discusses the favourable environment created by Egypt’s healthcare reforms and how they have quickened regulatory approvals and access, leading specifically to the launch of three AbbVie products in one year.

 

Can you begin by introducing yourself and your career journey to AbbVie Egypt?

Currently, I hold the role of General Manager for the Levant & Egypt at AbbVie– a cluster of eight countries in the MEA region. Egypt is one of the markets with the highest potential in the cluster which also includes Lebanon, Jordan, Iraq, Libya, Pakistan and several other countries as well. We have offices in Cairo as well as in Beirut and Amman with different operating models across the cluster.

I have been here with AbbVie for three and a half years now. Prior to that, I was based out of Singapore working for another multinational pharma company. My responsibility was to manage the General Medicine and Endocrinology business across all of Asia, excluding China. During my tenure in Singapore, I also became head of business operations for Asia as well.

 

What has AbbVie’s growth trajectory in the region been and specifically, how is the company positioned in Egypt?

When it comes to the Levant and Egypt, we have a growing business and some of our products are market leaders in their respective therapeutic areas.

As for Egypt, since 2019 we have taken major steps to strengthen our presence in the country and prepare the grounds for the launch of some of AbbVie’s most strategic products. Our pipeline remains robust allowing for a continuous stream of innovative medicines that have a remarkable impact on patients’ lives, elevating standards of care.

Since then, we have experienced an accelerated growth trajectory in Egypt. In fact, last year we grew over 35 percent organically – making AbbVie one of the fastest growing companies in Egypt, and the Levant and Egypt cluster one of the fastest growing markets for the company globally.

 

What has driven such stellar performance in Egypt?

This growth has been driven by both our new product launches, in addition to the growth driven by our established products. Currently, we are in the process of launching three innovative products from our pipeline. I consider this an impressive commitment from AbbVie that also speaks to the level of positive change that has come from the Egyptian Drug Authority (EDA).

In addition, a critical and equally important driver of growth is the team we have put in place in Egypt. We made sure to expand our local workforce and build engaged and diversified teams across our businesses. Early this year, AbbVie became one of the best employers in the countries we operate in, in our cluster (Egypt, Lebanon and Jordan). In fact, we became one of the few pharma companies in Egypt to be certified as a “Great Place to Work” and this has attracted more talent.

The third important strategic direction we took was to streamline our distribution network to cope with the high demand and the growth that we have experienced. In addition to the new launches we are executing, we need to make sure that AbbVie has the right partners so that our products can reach patients throughout the country.

Finally, the reforms in the country have also been favourable. These changes came at the right time and AbbVie’s increased focus on Egypt has been driven by the reforms that have been happening here, including the creation of the Egypt Drug Authority (EDA), the Egyptian Authority for Unified Procurement (UPA), and the rollout of Universal Health Insurance (UHI). Whether it be because of our participation in the local pharma association or our engagement with local authorities, AbbVie has become an active part of the conversation, and all of this has helped strengthen our presence in the country.

 

Egypt’s current healthcare transformation has been unanimously praised by your industry colleagues. What has been your experience working with regulatory and procurement agencies? Do you expect that these changes are here to stay?

With the Egypt 2030 vision, it is clear that there is a direction towards which the different authorities in the country are moving. The changes that were made by the EDA have been very beneficial for the pharma industry and the country’s healthcare environment overall. The leadership team at EDA is forward-thinking and quick to adopt improved and accelerated pathways which will help to bring innovation into the country at an accelerated pace. Most notably, the recent adoption of Reliance Pathways has sped up market access for innovative products. There is a recent report from IQVIA which shows that Egypt has become the fourth fastest market in the MEA for registration, reimbursement, and launches. Looking back three or four years ago it was a different story.

Furthermore, the status of Egypt in some international regulatory associations has significantly improved. For example, the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) has granted observer status to Egypt – which says a lot about the reforms implemented The World Health Organization (WHO) categorized EDA at maturity level three, compared to the FDA which is at four.

These are all impressive advances in Egypt which are not only experienced by local players but are now acknowledged by international bodies.

 

One thing is to gain regulatory approval another is for a drug to be available to patients. What is your experience of access in Egypt?

Of course, moving from gaining regulatory approval to commercializing innovative medicine is an area that can be improved further. However, I have personally experienced the successful launch of three products in a year which was something that had not happened for AbbVie in Egypt before. I want to point out that the first product to come out of the Reliance Pathway was an AbbVie product, again highlighting the great effort made by the UPA to accelerate access and bring innovative treatments to Egyptian patients as early as possible.

The reasons why sometimes we may face delays to get approved products to the market are the issues facing importations; the process mandated by financial institutions for importation has simply become lengthier.

 

Which therapeutic areas is AbbVie currently focused on?

We are in the process of launching an important product in oncology which will address an unmet need in Egypt. The product is indicated for patients that have no alternative solutions for treatment. Therefore, it is a critical product to bring into the country as quickly as possible.

In immunology, we have newly launched products that elevate standards of care in rheumatology, psoriasis and atopic dermatitis. Access to immunology products have been granted by the UPA a few months after the launch, which allowed patients to have accelerated access to our innovative medications.

 

While of course, patient access is a key priority for the industry, launching innovative medicines in emerging markets often means defining a considerably lower price point. What is your view of price negotiations in Egypt?

For AbbVie to be launching a product in the market means that were able to get appropriate pricing. Now, of course, having a unified procurement authority means they have a stronger ability to negotiate. However, this has expanded our reach in the public sector which is one of the key drivers of our growth. The change has positively impacted Egypt and significantly improved the public health sector. This has also resulted in an improved procurement and tendering process which is more transparent and easier to navigate.

The authorities do appreciate the value of the product beyond the direct price. They are working hard towards incorporating pharmacoeconomics and health technology assessment into the negotiation process. Although these practices are not in an advanced stage yet, however, there is an active effort towards incorporating them at the earliest.

 

AbbVie has a very innovative product portfolio covering a number of therapeutic areas and indications.  Do you consider intellectual property (IP) protection to be an area of concern in Egypt?

At this stage, AbbVie is committed to launching products and we feel that the discussion about IP protection is moving in the right direction. Still, IP protection is something that we must always be on top of. As a member of the board of trustees of the Egyptian Foundation for Pharmaceutical Research & Manufacturing, the local industry association, it remains one of the key areas of discussion with relevant stakeholders.

Nevertheless, H.E. the Prime Minister recently launched Egypt’s national IP strategy. If anything, this speaks to the level of importance that the government is putting on IP protection. They do see it as an important factor of economic growth and a driver towards the sustainable goals of Egypt’s 2030 vision which is encouraging for innovators like AbbVie.

 

What can you tell us about talent in Egypt?

During my tenure in India, there was a lot of talk about reverse migration. Indian professionals, some of whom have never lived in the country, were coming back to contribute to the growth and progress of their country. We are seeing the same currently playing out in Egypt as last year we saw a bit of this reverse migration where we had many Egyptians coming back from the Gulf countries with highly valuable international experiences. Even myself, I have come back to the region after being in Asia for some years which attests to how attractive the market has become and its potential for career development and growth,

 

AbbVie recently became the second largest pharmaceutical company in the world in terms of revenue according to the 2022 Pharm Exec Top 50 Companies ranking. Can we expect Egypt to become an increasingly strategic market for AbbVie in this part of the world and how will you ensure the brand resonates locally?

We are ambitious about the prospects of Egypt, and we see the country moving in the right direction. It is the second fastest-growing country in the MEA region and is projected to become the first. With the products that we are currently launching, we expect AbbVie to increase its ranking in the country’s pharma sector. As I mentioned before, last year’s growth says a lot about the potential that we have in the country. Some of the major steps we took as of 2019 have set the grounds for significant and continuous growth for AbbVie in Egypt.

AbbVie’s patient support programs in most of our countries are industry standards. In Egypt, AbbVie focuses on aspects of engagement that include education about different diseases, adherence to treatment, dosing and efficacy. We also run patient support programs that ensure accessibility to our medicines.

In addition, AbbVie is a founding member and an active player in the local pharma industry association, and I am a trustee on the board.  Along with our peers in the industry, we are working on developing partnership programs with the different agencies with the aim of building capabilities, defining best practices, and increasing exposure to some of the most stringent international regulatory bodies like the FDA and EMA. Part of partnering with the local authorities in this way is to bring best practices in terms of procurement, tendering, and health technology assessment. By helping this knowledge and expertise develop locally we can see why the regulatory status of the EDA is improving.

 

Are there any final comments you would like to share with our international audience about Egypt?

There is still a lot of potential in the market, and I see that Egypt is transforming rapidly. This can be seen in the increasing adoption of innovative products, biologics, and new treatments – all of which are changing quickly. The pace of reform in Egypt’s public sector is impressive and, in some instances, outpaces that of the private sector.

The positive outcomes of increasing patient access to innovative products are becoming more and more apparent. This is a good time for Egypt as shown by the changing classifications of our local regulatory environment. If the economic and regulatory factors remain supportive, we can expect to see a continuing positive trend and progress, especially in a critical sector such as healthcare.