Anna Wienner, general manager of IBSA Hungary, gives an update on the recent activities and achievement of the affiliate since her previous interview in 2016. Furthermore, Wienner goes on to offer her expert insights into key trends impacting the Hungarian healthcare ecosystem in areas such as in vitro fertilization, market access, and the recent EU pharmaceutical serialization regulation.
The Hungarian government now wants to ensure broader access to the reimbursed IVF cycles for infertile couples, therefore the most significant development made has been an increase in government funding for IVF treatments last year
When we last met you where one year into restructuring IBSA here in Hungary. How different is IBSA today from the organization we met in 2016?
Most importantly, over the past few years, we were able to introduce new products and achieve new reimbursement authorizations here in the country. What is also significant, is that we were able to rejuvenate the IBSA team through a reorganization of the affiliate. The first success factor in reaching these milestones was to enhance the professional education of the team in order to change their way of thinking and be more scientifically centralized. When I first joined the affiliate, IBSA Hungary was not very strong in this aspect and there was a major need to introduce new education systems for our sales team in both Rx and OTC units.
Next, it was necessary to implement a fresh market strategy for IBSA Hungary. We selected certain choice-products on which to consolidate our focus and created a marketing approach based on the latest scientific publications. This allowed us to change our SmPCs in a positive direction – a notable achievement considering the difficulty in changing these figures.
With 2019 coming to end, how satisfied are you with the anticipated results of the year?
I am absolutely satisfied with our performance this year! We will end 2019 above budget and above sales targets. Despite having some difficulties with our Fx rate (CHF exchange rate), we were able to maintain – and even grow – the affiliate’s profitability. This is particularly important for the group overall because IBSA recently established its commercial operations in the US last year.
Now that you are finishing a three-year cycle as general manager, what are the top priorities you have set for the affiliate for the next three years?
Our first major priority is to continue the growth of our Rx business, which also applied to IBSA’s In-vitro fertilization (IVF) portfolio. Equally as important, we must also expand IBSA Hungary’s OTC offering. As a general manager, I am very proud that IBSA has many products in other countries which can be introduced into the Hungarian market. This will continue to create opportunities for IBSA Hungary to offer a large portfolio of products to patients and doctors across different therapeutics areas.
What does IBSA Hungary’s portfolio look like today and where do you see the most striking opportunity for development?
Our portfolio is divided into three areas: Rx, OTC, and IVF. IVF has a very special place within the affiliate because there are only a few IVF centres with limited professionals in Hungary which we work closely. However, the field is undergoing a major transformation in the country thanks to the National Health Program for Childbirth. The government realized that Hungary’s population is declining, so there must be direct action taken to support families in having more children.
There are many programs to assist families who have three or more children, and simultaneously, there is a current restructuring of IVF in the country. The Hungarian government now wants to ensure broader access to the reimbursed IVF cycles for infertile couples, therefore the most significant development made has been an increase in government funding for IVF treatments last year. I am pretty sure it will help those who would like to have their babies and become parents.
What challenges do you see for the growing field of IVF in Hungary?
For the time being, the greatest obstacle in IVF is the lack of professionals in the field. For the past 20 years, it was such a specialized therapeutic area that many doctors were not interested in pursuing careers here. Today, as the area is developing and demand is increasing, there is a significant need for a new generation of young doctors. While there are more professionals entering into the field, there is, of course, a learning curve which is needed to gain essential experience and skills. Therefore, there are still several years ahead of us before reaching goals.
Another challenge is the acceleration of the usage of financial resources to support these treatments. While an increase in funding was officially announced in 2017, the public procurement process takes time to gather all the necessary equipment.
What opportunity is there for IBSA to play a supporting role and establish itself as the partner of choice in IVF?
We have a wide portfolio in this therapeutic area that we will continue to expand and compete. IBSA already holds a leading position in the IVF market and is consistently within the top three players in Hungary.
What is your assessment of the regulatory and reimbursement condition of Hungary?
While there are many challenges in Hungary’s reimbursement system, one positive aspect that can be highlighted is the solidarity of all stakeholders in having the best interest of patients at the heart of this conversation. However, the duration and transparency of the reimbursement process must be improved. Today, it can be up to two years for a new innovative drug to gain reimbursement. Furthermore, only one-third of products which are submitted into the reimbursement scheme are accepted by NEAK which is unacceptable.
It is true however that the authorities must analyze the value and cost-efficacy of new products while balancing how to allocate their budget for reimbursement. Therefore, the industry must also support NEAK in this decision making. Within the past decade, the health expenditure budget has been stagnant in Hungary and about 25 to 30 percent of the budget comes from pharma industry via payback. In the future, pharma companies will have to contribute even more to gain reimbursement and risk-sharing agreement approaches will play an even greater role in helping ensure patient access for new therapies.
What aspects do you see as the most important in having an effective market access strategy in Hungary?
There is no panacea when it comes to navigating market access. The best we can do as an industry is put ourselves into the shoes of the regulators and NEAK. If we can have the mindset of how to find the best balance between one another to create win-win situations, then there is a strong chance to achieve reimbursement. This is a strategy we have used in IBSA, and in the end, both stakeholders have come out winners.
What impacts has the new EU serialization regulation that was implemented this past February had on the Hungarian pharmaceutical market?
Serialization was a major project to launch in the EU for regulators, and for market authorization holders, an equally large investment. This new policy created significant challenges for manufacturers to put the proper data onto boxes and into the EU database. To create the necessary financial resources to implement this system for different stakeholders was a worthy effort. Additionally, the biggest challenge was to connect this system with the end-users – the pharmacists. For context, Hungary has more than 2300 pharmacies.
In Hungary, the pharmaceutical supply chain is closed, therefore falsified medicines have historically never been an issue in the country. All Hungarian wholesalers buy products from the manufacturer directly, and if there is ever a shortage, they buy products from other certified wholesalers within the EU. Nevertheless, within HUMVO, the Hungarian Medicines Verification Organization, we are proud of Hungary’s performance in adopting the new regulations. Hungary is ranked the sixth lowest for alert-rate in the EU and fourth for the scan-rates with adjustment to the market size. For example, Estonia is number one in the EU, which makes sense considering the small size of the market which makes it easy to reach a completely digital infrastructure.
Now it is time for improvement from the manufacturer side as there were many false alerts caused by scanning issues. With the help of IT service providers of pharmacies’, HUMVO was able to resolve the issue and now false alerts are primarily coming from manufacturers due to the lack of uploading or incorrect uploaded data. We are now in the stabilization phase of embracing this regulation and we are hoping to conclude this transition quite soon without jeopardizing the supply chain of medicines for patients.
Arturo Licenziati president of IBSA, once said: “Small companies can prosper only if they are smart, that is if they adapt, gradually, to situations that are often insignificant and unprofitable for large pharmaceutical companies”. What is it that makes IBSA Hungary a smart company?
First and foremost, our flexibility. We are a very fast organization and we can react to changing market dynamics quite easily. Given our linear structure, we are able to be non-hierarchical and efficient. Having started my career as an anesthesiologist in the intensive care unit, effective decision making has always been an important value of mine. Of course, we continue to operate in line with the ethical and regulatory guidelines of Europe.
Capacity to attract and retain talent is, of course, central to the success of any organization but may be a challenge for smaller players such as IBSA. What can IBSA offer as an employer and what message do you send to potential candidates?
In my opinion, it is very important to have internal growth prospects. Our colleagues must have clear visibility for their career path in IBSA and have the appropriate opportunities to progress within the company. In the past three years, we have had several of our team members in Hungary promoted within IBSA and I am very proud of this.
For those interested in joining the IBSA team, they must be scientifically oriented with strong sales skills, and of course, be hard workers! We do not have the same size team as big pharma and IBSA Hungary is a lean organization, so there is a key responsibility for each of our members to play a significant role in contributing to our success.
What keeps you the most motivated within your career?
I absolutely love challenges – especially those that have proven difficult to overcome in the past! If I can see that there are in fact opportunities, it is exciting to work alongside my team to find the creative solutions that will lead us to success. This is a key motivational driver for me.
What final message would you like to deliver on behalf of IBSA?
For the entirety of the IBSA team, our most important mission is to improve the health of patients in all our therapeutic areas.