Switzerland is a crucial country for MSD’s global network, employing over 1000 people in local, regional, and global functions across four sites in Lucerne and a newly opened site in Zurich specialising in R&D, data management, and commercialisation. With 25 ongoing clinical trials per year, Switzerland is an important country for clinical research with a focus on oncology, immuno-oncology, and infectious diseases and the MSD R&D and manufacturing facility in Schachen plays a crucial role in manufacturing clinical supply for studies worldwide. AVP Managing Director of MSD Switzerland Ans Heirman outlines the challenges and opportunities inherent in the Swiss market; her key priorities in terms of talent development, stakeholder interaction, and building a strong company base; and MSD’s enduring commitment to launching innovative medicines and vaccines.
The world is changing very rapidly, COVID or not, and we need to constantly adapt, whether to a changing portfolio, a new business environment, or the next challenges related to access or digital transformation. There is a lot of learning and adaptation to do, and we need to do it better and faster than anybody else
Can you begin by introducing your career trajectory up to becoming head of the strategic Swiss affiliate of MSD?
I am from Flanders, on the Flemish side of Belgium. After training as a bioengineer, I did a PhD in Applied Economics around the topic of how to move science-based inventions into innovations; things that are really used by and adopted by society. That is where my passion truly lies, because so many things are invented in biology or in medicine, but then never really fully used.
After my PhD I started an academic career, but I missed the ‘doing’. I then went into consulting – which I loved – but even there you are still somewhat on the sidelines. In consulting you work with a lot of different companies but often the advice that you give becomes outdated very quickly due to the speed at which the world is moving.
Following that experience, I decided to find a company to work for where I could achieve a balance between scientific innovation and its commercialization; making sure that it gets to the people that need it. Having met somebody from MSD, I was struck by how it positions itself as a truly science-based company, following the science and going after unmet medical needs. I started in 2005 and here I am 15 years later; it is a great company to work for with plenty of opportunities to work with innovative products and cutting-edge science, great colleagues, and to learn a lot.
I spent many of these 15 years in Belgium in different roles and also worked at our global headquarters in the US in a marketing function. In the last three years prior to moving to Switzerland, I had the opportunity to take on my first managing director role in Norway. I absolutely loved Norway, both from a professional and personal point of view, but when my three-year assignment there came to an end and the Swiss managing director position became available, I jumped at the opportunity.
Managing Switzerland is a very different challenge to managing Norway for several reasons. Norway is a smaller subsidiary where MSD imports drugs for the local market, whereas Switzerland is central to the company’s European strategy as home to our European headquarters, a manufacturing division, and a very big logistics hub. Now we are also building up an R&D site in the Zurich area.
And of course, the country itself is different. Switzerland is a pharma nation where the pharmaceutical industry is an important part of the economy. Other big pharma companies also have global and regional headquarters here, which creates a very different and interesting dynamic to be part of.
What struck you the most about Switzerland when taking on this new role and how have you managed to onboard and bond with your team in an era of remote working?
I was lucky in that I joined in between the first and second wave of COVID in Switzerland, so I was actually able to meet a lot of people. One positive surprise was the amount of energy that my team showed in the middle of a pandemic with a constantly changing situation and a lot of uncertainty. When I entered the Swiss affiliate, we already had a very strong base, but we had a very long task list. This included making sure that all of our great medicines could continue to make it to the patient, which the whole organization rallied behind. MSD’s Swiss logistics hub has been working overtime not only to ensure full coverage for Switzerland, but also worldwide supply. Our people’s commitment to go that extra mile has been mind-blowing.
The second major impression was internal stakeholder openness. Of course, many of the first introductions were virtual instead of face to face, but this openness has ensured that I have had a smooth onboarding.
The third thing I have been struck by is the welcoming nature of the broader Swiss pharmaceutical industry including the other members of Interpharma, which has really helped me to get to know the specifics of the country.
What are the key priorities for MSD Switzerland in the coming years?
There are three. The first is related to people and our employees. The world is changing very rapidly, COVID or not, and we need to constantly adapt, whether to a changing portfolio, a new business environment, or the next challenges related to access or digital transformation. There is a lot of learning and adaptation to do, and we need to do it better and faster than anybody else. Therefore, my first priority is to make sure that we continue to develop the employee base that we have but are also able to attract the most talented employees. This commitment is reflected in the fact that MSD Switzerland has been recognized as a top employer for the ninth time. I care a lot about this because when we apply for top employer awards, we really dig deep into our HR processes, compare them with the best of the best in our industry, and constantly improve. For example, last year we implemented gender neutral paternity/maternity leave and now have one of the most forward-thinking policies in the industry.
Also, in terms of people, COVID has taught us that there is a lot of work that can be done from home in a very productive way. Therefore, we also changed our internal process and policies related to home working to make this something that will last longer. Even when COVID is over, there will be a lot more flexibility for people to work remotely and choose the workplace that fits them best.
The second key priority is related to interactions with local stakeholders. Our current portfolio and our upcoming pipeline contain great opportunities in oncology, HIV, other anti-infectives, including COVID-19 medication, and antibiotics, amongst others. However, these opportunities are meaningless if they do not reach the patients that need them. Therefore, one of the big challenges that we face in Switzerland, as we do everywhere, is making sure that soon after regulatory approval is granted patients can access these products. Working with key stakeholders in Switzerland, together with my team, to create an environment that brings innovation as quickly as possible to patients is therefore a key priority.
If we action these first two priorities well – cultivating the best employees in the industry and creating a good access environment which we can capitalize on with the MSD portfolio – we will be able to achieve the third priority, building a stronger base as a company here. This base is already strong with our different sites, over 1000 employees, and the hub in Zurich, but we want to ensure that Switzerland becomes an even stronger player within MSD globally and that MSD becomes an even more important player within the Swiss ecosystem.
MSD is present in a variety of therapeutic areas, which are those that are a priority today with products already on the market and which are for the future? How does this play into the access to innovation challenge?
The area that is a top priority for MSD both today and tomorrow is oncology. On an industry-wide level, this is a very exciting time in oncology with all the new therapies and new mechanisms of actions that are under development. For example, immuno-oncology products – where a patient’s own immune system is boosted to beat a cancer – have the potential to change the face of cancer care.
However, these products also pose an access challenge. Globally, MSD has more than 1,300 ongoing clinical trials in that area, and in many different types of cancer and as soon as we see trial success, we need to make sure that patients, who are not part of a clinical trial, can get access too. The challenge for healthcare systems is how quickly they can absorb these innovations and start using them to make a difference. We are working very actively in this area today to make sure that the new medications coming out of our pipeline every year can really make it to patients.
Another important area is vaccines, where we already have a very strong portfolio both in childhood and young adult vaccination. The next opportunity is to give more attention to adult vaccination programs, where we have a good amount of work to do both in Switzerland and globally and we have promising vaccines in the pipeline against pneumococcal disease, amongst others. However, the build-up of adult vaccination programs, ensuring that there is a focus on prevention not only in childhood but through the entire life of a human being is a key one.
Although Switzerland is a modern economy and progressive society, surprisingly it lags behind some other developed nations in terms of vaccine uptake. What are your thoughts on this?
I cannot pinpoint yet where this hesitancy comes from. We have good vaccination rates in this country when it comes to childhood vaccination. For young adults in HPV (human papilloma virus) vaccinations, we are in the middle of the class and can do more. But there is also a difference between Cantons, where vaccination rates are significantly higher in some than in others. Overall vaccination rates for adults are really low in Switzerland and we really need to work with all stakeholders to make life-long vaccination and disease prevention a priority.
Switzerland is home to two very strong oncology players in our industry, how do you make a compelling case for MSD to regulators and payers as well as physicians and society at large?
In the end, it does not matter to patients where a product or technology comes from as long as its value can be proved. We make our case through studies and data which displays the value of our products. The advantage that we have in Switzerland with its strong base of companies is that we can advance the field together. No one company can improve cancer care alone; it has to be done by a full ecosystem of different players. This strong base of companies in Switzerland, if emboldened by an enabling access environment, should lead to oncology products reaching patients more quickly than in other countries.
What are the challenges of putting together data sets in Switzerland, given the stratification of the healthcare system, especially compared to your previous posting in Norway, where things are more unified and seamless?
There are definitely some big differences between Norway and Switzerland in this area. Norway has a centralized cancer register, for example. MSD is part of a big project there called ‘Project Inspire’, where we were able to expand on the epidemiology data on cancer cases in Norway with treatment data, thereby putting in place the necessary base to move towards an outcome-based healthcare system.
In Switzerland, the data is more scattered and there is not a unified platform. I am convinced that data – not only from clinical trials, but real-world data that shows the uses and outcomes of products in real world patients – is an important element for the future. Data will be key to improving both cancer care and the efficiency of the overall healthcare system. As an industry, we need to work on connecting the dots and making data available in a safe way for research purposes as well as for healthcare efficiency optimization purposes, from which the entire society benefits.
What are your expectations for 2021 and 2022 in terms of product launches and what adaptations need to be made in terms of talent and strategy to ensure successful launches today?
There are big differences between how product launches used to be done and how they will be done in the future. Traditionally, it took a long time to prepare for a launch and position it correctly involving a lot of market research. Nowadays, things are moving much more quickly, and the environment is also changing much more quickly, meaning that our launches are much more continuous. For example, in oncology we had eight new launches in 2020 which needed to be done continuously.
Moving forward, one of the areas we are now looking at for potential new launches in 2021 is COVID-19 medication, which we did not have on our radar four or five months ago. MSD has been making significant efforts to rise to the COVID-19 challenge and although we have discontinued development of our two vaccine candidates – proof that innovation is a risky business – we now have two very interesting COVID-19 medications in the pipeline. One is for more severe patients and the other is an antiviral for mild to severe patients. Although we are still in Phase II and III trials for these products, in parallel we are already starting discussions with regulatory agencies, looking at how to scale up production, and thinking about logistics, meaning that timeframes are much shorter.
Do you find regulators easy to engage with and receptive these days or are they perhaps preoccupied with COVID-19 vaccine approvals above all else?
On one hand, I would say, what can you expect? We want everybody to be focused on handling the COVID-19 challenge. Therefore, it is natural that this takes up a lot of attention. The danger is that other areas that are just as devastating as COVID-19, from oncology to HIV, to diabetes, which should not be forgotten about. We need to make sure that these areas get still sufficient attention. I have no evidence that our portfolio is facing access delays because of COVID-19, but it is something we are constantly monitoring.
What is the benefit for your team of being based so close to MSD’s European headquarters and its manufacturing facilities? Are there any synergies to be leveraged?
Being in the same country is always an advantage. The fact that we are now building up this new R&D hub means that there will be 250 new positions created within Switzerland. The work of the facility will focus mainly on oncology and vaccines, looking at how we can accelerate our pipeline products’ development and speed to market. Having that in-country represents a competitive advantage because we are closer to the source.
Additionally, these researchers will interact with stakeholders in academia here and some of the experimentation in terms of data and real-life outcomes will be done here in Switzerland, where the teams are based. My team and I have more resources available to them via the international functions also located here.
What are some of the talent challenges and requirements that will need to be addressed in the next five years to build engaged and successful teams?
One trend I have been seeing that will continue is the hiring of more and more people from non-traditional backgrounds. This includes those coming from technology with a digital background who have experience in engaging with customers via very different channels. A more diverse team means we need to find ways to better connect.
For me, the most important characteristic in an employee is the capacity to learn quickly. Whatever your background, whether you are a pharmacist, doctor, or engineer, what you know becomes outdated very quickly. Capacity to learn new skills, new technologies, and new ways of interacting will be vital.
MSD has a real ambition to bring in these different talents and integrate them well. It is not easy, but it is necessary. Adaptation needs to come from both sides; pharma is (rightly) a very regulated industry with many non-negotiable rules, regulations, and values. When people come in from outside, we need to find ways to quickly onboard them on these non-negotiables as well as what they need to learn to be successful. On the other hand, people like me that have been with MSD for 15 years or longer need to let go of what we think cannot be done. Hiring from outside challenges us to look at things differently. Setting up a culture that goes both ways – integrating outsiders without stifling their creativity – is key here.
Switzerland has a very competitive talent ecosystem, with many companies and the full pharma value chain represented. What is MSD Switzerland’s value offering to potential employees?
MSD focuses on science and patients, so potential employees that truly share this culture and vision will find a good fit here. From there, it depends on what you want for yourself or your career. MSD has many opportunities for growth; I started in marketing but had the opportunity to take many different types of roles and directions.
This is especially true of MSD Switzerland, where people are able to take on a variety of different roles without moving countries, given our significant footprint here across a local affiliate, manufacturing, R&D, and European headquarters.
What are going to be some of the biggest challenges in terms of product launches for MSD in Switzerland and, given the aforementioned infrastructure, is Switzerland going to be one of the priority countries for product launches?
Rather than ‘challenge’, I would say that the ‘opportunity’ is that we already have an extremely strong base here in terms of our operations, the products we have on the market, and our industry ranking; MSD is actually the second biggest pharma company in Switzerland in terms of sales and sales is a good proxy for the number of patients benefiting from our products and vaccines
The challenge/opportunity is growing from this strong base, making it even stronger. We have a lot of new oncology launches coming up based on products we already have today and where we are working on expanding them for use in other types of cancer, in monotherapy or innovative combinations with other treatment Doing that quickly and well, achieving reimbursement for the different indications as they come along, will be a challenge.
The second area of focus is vaccines. Comparing our vaccine footprint and the use of vaccines in Switzerland to other countries, there is work to do, in particular, when it comes to low rates of adult vaccination. There is no easy fix for this; rather, work needs to be done with several different stakeholders on prevention, getting vaccines approved by Swissmedic, ensuring they are directly available, and setting up effective adult vaccination programs. This is a very complex task.
The third opportunity/challenge is in specialty care. MSD has some interesting new launches coming up for COVID-19 medication in the short-term, but also in the longer term in antibiotics, in HIV and other areas.
Antibiotics is an area that unfortunately not a lot of companies are very active in. Why is MSD looking towards this seemingly unprofitable field?
Not many companies still have antibiotics activities for obvious reasons, although MSD has never walked away from the field. The whole world has mobilized against COVID-19, but resistance to existing antibiotics represents a much bigger threat. The unmet need is there, and I am proud to work for a company that has maintained a commitment to antibiotics.
However, in all honesty, antibiotics is a corporate social responsibility program for MSD. From an investment point of view, where the world is now in antibiotics, how the pricing is looked at, and the lack of commercial sustainability, it’s a very tough business. This is something that we need to solve together with policymakers if we want to have more investments, which we need as a society. There needs to be a discussion on different access and pricing systems to attract more investments in antibiotic R&D from other companies.
Putting policy reforms in place will take time but the reality is that we have no time to lose when it comes to fighting anti-microbial resistance. We need to act now. Therefore, MSD and a group of more than 20 leading biopharmaceutical companies launched the AMR Action Fund in 2020, a groundbreaking USD one billion partnership that aims to bring two to four new antibiotics to patients by the end of the decade. MSD has committed USD 100 million over ten years into the Fund to help bridge the gap between the innovative early antibiotic pipeline and patients.
What would you like our international audience to take away about MSD in Switzerland?
We have an important footprint in Switzerland. As well as our new Zurich hub, we have four locations in the Lucerne area, where we continue to have a strong Cantonal commitment. Indeed, we recently signed a new lease agreement for a ‘one roof building; that will bring all our Lucerne sites together in one location by 2025. Our commitment to Switzerland is based on the environment that the country offers pharma companies like MSD and the great talent available here.
The other key point is our focus on oncology, vaccines, and diseases with high unmet medical need and our commitment to work together with all stakeholders to enable access for all people who need our products and vaccines. Access has slowed in Switzerland in recent years, which is a challenge, but from a ‘glass half full’ perspective, key decision makers here are available and open to discussions on finding workable solutions. I have been really struck by this in my first six months on the job. This is a strength we can really build on.