An Van Gerven took the reins of Pfizer’s BeLux affiliate just 9 months ago after a diverse range of roles at the company over the course of 12 years. She highlights some of her key priorities and explains Belgium’s strategic importance for Pfizer - a country where it has its only Phase I clinical research centre outside of the US - as well as production and distribution sites, and she also discusses the country’s access challenges.
You have had a diverse range of responsibilities at Pfizer, but this is your first time as a country manager. What was the transition like and what have been your priorities in your first nine months on the job?
It is my first country manager role and it is in my home country, which made the transition easier. When I started in September, the first thing I saw that was needed was more of a connection among our team members. People were coming back to work on site and we had just refurbished the office with the idea of encouraging them to do so. But (re-)establishing a connection also means making sure that people can be themselves at work and grow. That was one of the first things I wanted to address. Bringing innovations forward is our mission and can only happen with the right teamwork behind it.
With respect to the business, I like to highlight the connection between Health and Wealth in society. We make an impact on health thanks to our medicines and vaccines, but we also bring wealth to Belgian society with the jobs we create and the investments we make. These two elements go hand in hand because a society can only be wealthy if it is healthy and the other way round. That is something we saw clearly during the COVID-19 pandemic, and it also counts in any other disease area.
On the health side, what is clear is that patients’ level of access to medicines in Belgium is deteriorating. If you look at the latest EFPIA Patients Waiting to Access Innovative Therapies (WAIT) indicator, Belgium is somewhere in the middle in terms of the time patients have to wait to receive innovative medicines, but we are at the tail end of Western Europe. Thus, if we connect health and wealth, Belgium can be and must be more ambitious.
We have a lot of potential here and especially at Pfizer: we have a pipeline richer than ever and are all fully geared up to launch a lot of innovation for patients. That is why our ranking on the WAIT indicator is so frustrating and unacceptable. This was the first reality check for me when I started here. I was coming back to Belgium, known to be an innovation-driven country, but when I look at what the country is investing in health I can only wonder if we are investing it in the right way. The medicines budget, for example, is only 16 percent of the Belgian health budget and yet always under scrutiny. Whilst health should be looked at as an investment, it is now looked at as a cost and an area for savings…
That was quite quickly on my radar and as vice chair of pharma.be I have been working with the organisation to address it.
As the company’s first ex-US affiliate and home to four key operational sites, Belgium is a crucial country for Pfizer. Why does Belgium continue to hold so much relevance?
Pfizer was established in Belgium more than 70 years ago when the company was looking to create a base in Europe. They came to the Brussels area because it is in the heart of Europe. From there, we grew very quickly because of the country’s high level of expertise. The highly skilled workforce made it easy to build a presence here and today we have a vast footprint in Belgium based on that expertise, which motivates us to reinvest here time and time again. In December, for example, we announced an investment of EUR 1.2 billion in our Puurs site.
In Belgium, we have four sites: our headquarters; the Puurs production site; a Phase I research centre, which is one of just two at Pfizer with the other one being in the US, and in Zaventem we have one of the biggest Pfizer logistics centres in the world, which handles two-thirds of Pfizer’s global distribution.
Regarding clinical trials, we can leverage the strong Belgian ecosystem because clinical trials are very much linked to academia, and we are connected to top-notch scientists here. In addition, historically we had favourable regulations and approval times for clinical trials, but also this point needs urgent attention as we tend to lose this advantage to other countries.
Therefore, what Pfizer started in Belgium all those years ago is still delivering today because of the company’s systematic investment and commitment. However, we need to stay competitive because there are many other countries that are facilitating major pharmaceutical industry investments to anchor this industry locally.
You mentioned access in Belgium and how the country has fallen behind its European counterparts. Have the fast approval mechanisms introduced during the COVID-19 pandemic had any impact on speeding up access?
The European Medicines Agency (EMA) fast-track procedures and rolling reviews have helped to improve access, but then once you have EMA approval, you must then face the local situation. In Belgium, it takes 550 days for medicines to get in the hands of patients. That is huge and time is life…
Another issue is the evaluation of the value of medicine. In Belgium, discussions are mainly about budget and costs of medicines while they should rather be about value and investment in patients’ health. If a medicine provides value (to the individual and also to society), it is worthwhile investing in it: as I said before, health and wealth are connected. That is something we need to realise more in this country.
National regulatory bodies often counter that companies are in part responsible for this delayed access scenario due to the sometimes less-than-robust data they provide. What is your take?
EMA approval covers the efficacy and safety check, so if the EMA has taken its decision based on the data provided, one could assume that it testifies to the robustness of the data in question. Challenging them afterwards on a local level unnecessarily slows down the process. And that is in my view not the right discussion to have. What we should be discussing, as I mentioned earlier, is the value of the medicine in the local context.
Beyond Pfizer’s COVID-19 breakthrough, the company has undergone a huge portfolio transformation. What can you tell us about Pfizer’s post-COVID pipeline?
At Pfizer, we learned a lot from the pandemic. If we were able to do what we did for COVID-19, we have the responsibility to do the same thing for other disease areas, like respiratory diseases and cancer for instance. We are trying to use the experience we have gained and the competencies we have built and apply them to other disease areas. That is our ambition beyond COVID-19 and it has resulted in a sort of renaissance with respect to our pipeline where we match technology with science. We currently have no less than 19 new products or indications for which we hope to receive approval in the coming 18 months.
One significant learning from our COVID-19 experience is that a lot of things can go faster. Let us take the example of Research and Development and more specifically Clinical Studies. We already reduced our operational cycle times by 2,5 years, and now we want to reduce them by three more years by applying artificial intelligence to data, for instance, but also by monitoring patients from a distance instead of only having them come systematically to a research unit. The ability to work from a distance enables us to include patients much faster because the patient pool is much bigger, whilst guaranteeing the same level of quality of data.
mRNA technology is another example. It has delivered outstanding results for COVID-19, and we are determined to bring the full potential of this technology forward in different disease areas.
Are you planning any product launches in Belgium in 2023 and 2024?
We aim to have six products launched in Belgium. That is huge, so we are gearing up with the team to be as smart, fast, and rigorous as we were with COVID-19. We do not want to only be fast; we want to deliver the quality that people expect from Pfizer but in a reduced timeline.
You spoke about a need for dialogue with the authorities. How is Pfizer looking to develop that dialogue?
We regularly share what is in our portfolio, but it is not enough. We need to talk and collaborate further. Let us take the example of ATMPs, which are very complex innovative treatments. The current framework is not adapted to them because they usually represent a major investment upfront, but potentially generate major savings each year afterwards as the patients might no longer need other treatments. This is not always how payers look at it. This is why we have supported some roundtables to bring stakeholders together to start that discussion. Just making assumptions is not good enough for patients. We need to make it happen and it can only be the case if we talk to each other. That means horizon scanning, upfront sharing of data, and trying to think about a context or a framework that can benefit patients.
Pfizer was successful but also took a huge risk with COVID-19. What are the core values that drive the company’s culture and enable it to take risks like that?
At Pfizer we have four core values. Courage is the first, and COVID-19 is a good example of that. In that case, we went for it and made it happen. That is courage and we apply it to both big projects and smaller ones. Our second value is excellence. We have the experts in-house and we have learned a lot of the new competencies needed to go at lightning speed because we know patients are waiting. Equity is another important value. We do not just work for the happy few, but we also address the needs of all patients. Health literacy is an important element of that. And finally, our fourth value is joy because if you work hard, you need to celebrate your successes. That goes back to the well-being of the team I mentioned earlier.
Looking forward to the next few years, what would you like to accomplish during your tenure as Country Manager?
We are lucky to have great people at Pfizer and their well-being and ability to grow is the basis for everything else. You can have all the plans of the world, but if people are not inspired to contribute, you will get nowhere. We have a good set of expert colleagues and good connections across our cross-functional teams. We need to reinforce that and keep on going in that direction.
A second priority is delivering hope to patients, which is why we get up every morning. I think with our pipeline we can deliver that hope to patients in Belgium and that is why it is so important to address access.
What keeps me ticking is bringing hope to patients and looking after our people and their growth. Those are two fundamental things that are most important to me.
