Anne-Laure Dreno, country president of AstraZeneca in Belgium, elaborates on the significant position Belgium and the local affiliate have for the group as a frontrunner in innovative areas such as creating value-based agreements for reimbursements, (clinical) research and development, and embracing the opportunities of patient data. Dreno also discusses her mission to align the affiliate with the global strategy of AstraZeneca to ensure patient access to innovation in key therapeutic areas through partnership with health authorities.
As we prepare for the next steps of the AstraZeneca journey, there is an increased focus beyond the pipeline on innovative approaches in areas like patient-centricity and access where we are aiming for value-based contracts, leveraging innovative technologies such as AI
Looking at your career history, you have a rather unique path compared to other industry leaders. How did you find yourself in the pharma industry with AstraZeneca?
I started my career more in the life science and water industry as an engineer. I moved into consulting later on because I felt earlier on in my career that while understanding the science and engineering is good, it is difficult to go far without the business aspect. It is interesting that in consulting I worked in nearly all industries except for pharma. However, moving forward it was important for me to come back to the life sciences and biology especially coming from a background where many of my family members were doctors. Eventually, my personal life brought me to Belgium where my path crossed with AstraZeneca in almost a ‘coincidental’ way.
Working in an industry that is meaningful has always been a major influence in my career which was one of the main reasons I first started in the area of drinking water as an engineer. Furthermore, I was also interested in combining the scientific and business elements of a career which helped my transition into AstraZeneca 14 years ago.
We also see that you have held many different positions throughout your AstraZeneca career.
It is true that I have had a very diverse experience with AstraZeneca which has always provided me with many opportunities in the company. I worked in many types of markets, mostly in Regional role in emerging markets like Russia and Africa, then look on a more local role here in the Belgian affiliate for several years before moving to the US in a Global Marketing role in Respiratory. After several years in strategic marketing, I wanted to move back to a more operational role which gave me the opportunity to move back to Belgium last summer as country president.
What was it like for you to take on the responsibility of leading the affiliate when you were appointed to your first country president role in 2019?
Especially with the current COVID-19 crisis, I am facing some unique challenges within my first year and I am still learning the ropes. Otherwise, it was an advantage knowing the country and affiliate having worked here before my time in the US. Nevertheless, as this is my first general manager role, there are many aspects that go into leading an organization that I did not realize beforehand. This involves being responsible to work with my team in setting the strategic direction of the affiliate to match that of the group while overseeing market access and government interactions. Furthermore, I am getting to know the environment even deeper and see what has changed in the country since leaving five years ago. This is particularly the case in government relations as when I left Belgium we were just creating the Pact of the Future with Minister of Health Maggie De Block, whereas today we must see how we can continue to position pharma as an essential industry and continue creating win-win solutions as the Belgian government is changing.
What else is interesting for me is that AstraZeneca, overall, is in a period of transformation as the group moves back to growth globally and more recently in Europe. With the turnaround initiated by our CEO Pascal Soriot, AstraZeneca achieved again the top ranking in the innovation index last year (IDEA index). As we prepare for the next steps of the AstraZeneca journey, there is an increased focus beyond the pipeline on innovative approaches in areas like patient-centricity and access where we are aiming for value-based contracts, leveraging innovative technologies such as AI.
How are the strategic changes carried out at the group level of AstraZeneca being reflected in the local operations of the affiliate in Belgium?
In Belgium, we have the chance to have the full AstraZeneca portfolio covering the three key therapeutic areas of Oncology, Respiratory, and Cardiovascular-Renal-Metabolism. We are very pleased that within the affiliate we are able to continue bringing access to these lifechanging medicines in the market quickly and effectively. As an example, as of May, we will be able to launch a new indication of our product Lynparza® in advanced ovarian cancer which will be a very important therapeutic solution for the Belgian patients.
In terms of patient centricity and innovation, it is important to note that in Belgium we have been able to secure the first outcome-based contract with authorities not only for the local government but also for all of AstraZeneca globally. This is an immensely significant signal that even though Belgium can sometimes be perceived as a minor market compared to the EU 5, we have a very sophisticated system and Belgium is leading the way in finding these innovative win-win solutions. This accomplishment attests to the significance that Belgium holds as a global healthcare frontrunner.
Moreover, we are working very hard to organize comprehensive patient support programs to make sure we take into account the patient journey and enhance their experience. These are initiatives we are taking across the portfolio with a first immediate focus in the areas of oncology and respiratory. This is particularly important in a situation like today with COVID19 for a product like Fasenra for severe asthma patients who can now benefit from the self-administration so they can feel safe with an adequate treatment and support at home.
While the Pact for the Future did create an important relationship between the industry and authorities, considering Belgium’s current political situation the future is still unclear. How do you hope to position AstraZeneca as a partner in health to the new Belgian government going forward?
It is a very specific period in Belgium’s political landscape, and we do not know exactly what the next government will look like. Regardless, I am sure we will have a mutual interest surrounding patients which will allow us to find common ground with the future government. AstraZeneca truly recognizes its role in contributing to a sustainable healthcare system. We have a very keen understanding of what is the situation in Belgium and Europe and we absolutely want to continue partnering with governments to bring innovative medicines to patients.
While the pact of the future was a major step in the right direction, the pricing pressure being faced by the industry is increasing. I am hoping that with the next government we can partner specifically to build the infrastructure using data better. Value-based pricing solutions are only possible with having integrated data infrastructure and although Belgium has had quite a good initiative for health data, it is time to take it to the next level. Looking at countries like Finland and Estonia, there is much more room for Belgium to accelerate if we do not want to lag behind.
What is your assessment of the current capabilities of Belgium in regard to healthcare data?
Having a centralized system such as universal healthcare of course helps, however, the situation in Belgium is still extremely fragmented today when it comes to data. There is a lot of data available but in diverse sources such as sick funds, hospitals, pharmacists…If there is not a strong political willingness to create more data consistency, it will remain difficult to fully leverage. As an example, each hospital group could develop its own system which will create further integration challenges in the future. The General Data Protection Regulations (GDPR) is of course very important although it creates challenges, but nothing that we cannot overcome with creative solutions. It is up to us as an industry in collaboration with key stakeholders to bring forward these ideas and find ways to pioneer this data movement in Belgium.
Being a partner goes beyond just negotiating prices with authorities and selling drugs. In what ways is AstraZeneca playing an active role in Belgium’s life science ecosystem?
Looking at AstraZeneca’s footprint in Belgium, although we do not have a manufacturing footprint, our R&D and clinical trial activities are very significant in the country. We have more than 40 ongoing clinical trials in the country across our three key therapeutic areas. Despite the trend of centralizing trials in larger markets as a method of reducing costs, Belgium has an infrastructure and academic level that is so advanced it remains a key focus for the industry and more specifically for AstraZeneca. With these trials we are able to give early access to our innovative drugs to Belgian patients.
Furthermore, we locally support Externally Sponsored Scientific Research (ESR) in Belgium. There are 11 of these studies running in parallel to our own R&D. Additionally, as real-world evidence will be an important factor in creating value-based healthcare solutions in the future, AstraZeneca has several of these real-world evidence studies ongoing across therapeutic areas, one of which was designed by the Belgian team in oncology and has since been replicated globally.
We are also trying to leverage new technologies such as AI to accelerate studies and overcome some of the challenges we face in the fragmentation of data. This includes working in partnership with new technology partners and hospitals to leverage their data and better understand the patient journey.
It is very unique that Belgium is able to be at the forefront of all these new era conversations, and as the country president, I feel very lucky that my team has the capabilities to build the necessary relationships and take on these activities as a committed player in the life science ecosystem.
What are the objectives you are aiming to achieve with AstraZeneca in the next three to five years?
AstraZeneca Belgium has a lot of capabilities within the organization. Even if we are already very good in all these areas of innovation, I do believe we can take things a step further to be more fit for the future. I would like to further build our relationship with the local government and be a partner to drive a more favorable environment. We can always improve internally by embracing innovative processes through initiatives such as digitalization while at the same time being more engaged externally to establish trust with the next Belgian government as a partner of choice when it comes to these patient-centric approaches.
What advice can you offer to country managers who are coming to the Belgian market for the first time?
As a French national, when I first arrived in Belgium several years ago for the first time, I had this naïve and common idea that Belgium is simply like an extension of France. In fact, it a very different culture which can be quite complex. Therefore, it is important to take the time and really get to know the environment and market that you are in. While Belgium is a very innovative and adaptive country, I have to admit there is a complexity. However, there is a real openness to challenge and to create a transparent dialogue among different parties.