Christian Rodseth, VP and managing director for Janssen's Greece, Poland, and Romania cluster, outlines the multifaceted strengths of his teams, the part of the Janssen portfolio he is most excited to bring to the region, and the policy measures needed to ensure that Greek healthcare remains sustainable and able to support innovation.
After almost three years in a global role with Janssen in the US, in September 2022 you returned to Europe to take on a new position covering Greece, Poland, and Romania. What excited you about this role and why was 2022 the right time to make this leap?
During my three years in our commercial organisation in the US, I gained immense respect for the outstanding Research and Development (R&D) process that we follow and the tremendous amounts of investment that we put into solving the world’s most challenging diseases. Throughout that period, I was constantly reminded of the impact that our R&D has on patients’ lives in the countries where Janssen operates.
Therefore, when the opportunity arose to come back to Europe, live in Greece, and lead this cluster, I jumped at it; it was not a difficult decision to make. I am now bringing in many of the learnings and experiences from my strategic role in Infectious Diseases, to influence the long-term thinking within the cluster, always with the aim of ensuring a better and more immediate positive impact on patients’ lives.
The timing was good, especially in terms of society and healthcare systems opening up again after the COVID-19 pandemic. It is exciting to return and be even closer to addressing the needs of patients.
What have been your first impressions of Greece and Greek healthcare?
I have been particularly impressed by the resilience of the Greek people. Janssen has had a footprint in Greece for 50 years and has overcome many significant internal and external challenges along the way, so it is clear that Greeks do not lay down in the face of adversity. When I look into the eyes of our people, I can sense the greater purpose of meeting the needs of patients, in line with our J&J Credo. Our people are constantly energised by the fact that patients out there are waiting for access to our innovative life-enhancing medicines. While the Greek healthcare system is not the most open to supporting innovation, we are united and committed to working towards greater access to health solutions for patients.
What is the logic of the Greece, Poland, and Romania country grouping, and why is your role based in Greece as opposed to the larger market of Poland?
Greece, Poland, and Romania are three of the top five markets in Janssen’s broader EU Mid-Sized markets region. These three countries represent a tremendous number of patients and therefore a significant priority of our operations in the region. Despite their diversities, they also share a common challenge of ensuring higher medicine access and funding for innovative therapies. Having a cluster like this, allows these three countries to share best practices and expertise, while jointly resolving common access issues, as well as standardising our approach to digitalisation in healthcare. My role is based in Greece as this is part of our talent development strategy. It allows me to focus my efforts on developing local talent in the market I directly manage.
What do you see as the main strengths of your Greek team today?
In a mid-sized market like Greece, people are exceptionally good at what they do. The environment they interact with forces them to learn a broad range of skills across the business. They are empowered to do a lot more than their equivalent roles in larger markets. My leadership team today, therefore, has expertise right across the business, from the very basics to the highly sophisticated challenges they have to confront. They boast significant experience over several years in multiple geographies, as well as the multiple disease areas that we serve.
I rely heavily on the expertise of my team, which has a deep knowledge of many markets, understands the needs of customers, and can implement efficient strategies to make a difference for patients living in the country. I am a firm believer that if people are united behind a clear vision and purpose, amazing things can and will happen. We also focus on empowering, engaging, and strengthening our middle management teams, which represent the heart of the organisation and contains many of our future leaders.
I feel really privileged to be leading the Greek organization that has been certified as Top Employer in Europe and Greece for the 2nd consecutive year, by the Top Employer Institute. This recognition demonstrates our commitment to our people and to creating an engaging and thriving work environment, where everybody can contribute at his/ her best.
Janssen aims to bring innovation to patients across haemato-oncology, neuroscience, immunology, pulmonary hypertension, cardiovascular diseases, and infectious diseases and vaccines. Is maintaining focus across such a broad spread of therapeutic areas something of a challenge?
This is perhaps one of the benefits and a comparative advantage of having such a strong pipeline. The significant investment that J&J makes in R&D, means that down the line we can impact more patients, across more disease areas. I would rather have this problem than not have strong and consistent innovation to bring.
Compared to other companies with much smaller portfolios, our breadth necessitates a very conscientious approach to resource allocation, early investment to fully understand the unmet medical needs we are confronting, and then establishing of strong partnerships early on. Only with these strategies in place can we make the dream of access for patients a reality. Fortunately, our rich pipeline requires us to make wise, short- and long-term decisions. A fantastic amount can be achieved when focused in the correct way. Additionally, we place great importance on working cross-functionally, bringing together our experts from the commercial, medical, market access, and regulatory affairs teams to identify and implement rapid access solutions.
Janssen has set the ambitious goal of reaching USD 60 billion in sales by 2025, an eight billion increase on the 2021 figure. Are the fundamentals in place for this massive global growth to be reflected at a local level?
Absolutely, which is credit to what our teams have been doing in these markets across the globe. In Greece, Romania, and Poland, many patients are getting similar, if not better, access to medication than in many other Western European markets. While some companies’ strategies in mid-sized markets are focused on older, off-patent assets, we have worked hard to bring true innovation to these countries and their impact on patients’ lives has been acknowledged by payers, governments, and physicians alike.
Despite the fact that Greek patients benefit from access to innovative medicines, we face significant challenges when it comes to investing in innovative therapies. The public pharma budget has stagnated for almost ten years now. This has led to six out of every ten medicines being paid for by the innovative pharma industry today. This reflects how invested we are in supporting access to innovation. Having said that there is a tremendous risk that the government is taking by not investing sufficiently in pharmaceutical healthcare to meet patients’ needs. It is not a sustainable model and requires government stakeholders to increase their participation in terms of contribution to a sustainable healthcare system.
How sustainable is the Greek system in terms of being able to support innovation?
We have reached the upper limit of what is bearable and are starting to see pharmaceutical companies making tough choices on not launching new products in the Greek market. This concerns me deeply because it means that patients who previously had access to innovation may not in the future.
A thriving, innovative industry means that patients are getting access to new and novel treatments, with which their life expectancy will be longer and their quality of life much better. Unless we can build a trustworthy partnership between all stakeholders, Greek healthcare is facing a dire situation. However, having seen the power that multiple stakeholders working on the same problem can have in other markets, I truly believe that by acting collectively, we can achieve great outcomes. Janssen and J&J have been committed to serving Greek patients and society for many years and will remain so, particularly via constructive partnerships and collaboration with all institutional stakeholders.
We have proven to payers, the government, and patients that the value we bring is truly innovative and lifesaving and should be rewarded as such, allowing the company to continue to invest in ground-breaking R&D. In the next few months, I hope we will see an acknowledgement from the Greek authorities of the burden that the pharmaceutical industry is currently carrying and a realisation that investment in innovative therapies will lead to a healthy population, society and thriving economy. An effective Healthcare system is a sustainable Healthcare system for all.
Given the high price tags that innovative treatments, especially cell and gene therapies like CAR-T, come with, is it incumbent on the industry to bring forward new pricing solutions for healthcare systems with limited budgets?
It is important to remember the impact that innovation has already had on society. HIV patients, for example, can now live normal lives with a normal life expectancy thanks to investments made in innovative treatments. True innovation should therefore be rewarded. Ultimately, we are looking for a value-based approach to healthcare matched with investment that meets the growing needs of patients. A predictable, sustainable and ideally capped mandatory paybacks in Greece is therefore vital to the sustainability of the pharmaceutical industry
At the same time, we need to have the right type of guardrails when it comes to the rationalisation of current spending. A healthy system would reward innovation and when patents expire the generic industry should enter the market, creating opportunities for savings and room for new innovation. Without this cycle, where innovation is not appropriately rewarded, the risk to access greatens. For a company like Janssen, with an extremely innovative pipeline, this is a real priority.
Outside of the pricing debate, is there sufficient infrastructure and expertise within Greece to absorb cutting-edge therapies like CAR-T?
I have been impressed with the level of healthcare practitioners in Greece, with many people at the cutting edge of research. From a human capital point of view, Greece is a pleasant surprise, and Janssen is supporting this via medical education programs which ensure that the innovation we are bringing forward is used in the most appropriate manner.
Having said that, for both our upcoming CAR-T and oncology and neuroscience therapies, there is still work to be done to create sufficient supporting infrastructure. Bringing disruptive technology to market creates an opportunity for collaboration on implementation. While this will not be plain sailing, we have plenty of use cases from elsewhere on ensuring that diagnostics, treatment, and aftercare are all being done correctly. We are here to support in further elevating scientific infrastructure and expertise by sharing our knowledge and experience.
It comes down to partnerships. In Greece, my team and I are constantly focused on understanding needs throughout the entire patient journey, identifying where areas for improvement exist, and how we can keep advancing the healthcare system and services together. Ultimately, we hope that this ensures Greek patients have EU-like levels of access to lifesaving therapies.
An important part of displaying the value of innovation and ultimately facilitating access is clinical trials. How developed is Janssen’s clinical trial footprint in this part of the world today?
We have a strong clinical trial footprint in Greece, which we are planning to further increase in 2023. Clinical trials can foster early access to innovative products, meaning that more patients can benefit from earlier access to innovative therapies. Moreover, the level of care that a patient gets through participating in a clinical trial is very high, and physicians are exposed to cutting-edge therapies. I would encourage the Greek authorities to continue to create the right environment to attract more clinical trials to be held here and for wider populations to benefit because many markets are not as fertile as Greece in this aspect. We will always be there as partners.
Greece has weathered the financial crisis years as well as the COVID-19 pandemic and is set to receive EUR 30.5 billion from the EU Recovery & Resilience Facility (RRF). What are your hopes on how this funding will be spent, and its impact on pharma and healthcare in Greece?
We are of course aware of the macroeconomic pressures on countries like Greece, not least from the ongoing energy crisis which we hope will lessen somewhat in Spring. Additionally, we acknowledge that security and stability are crucial for all governments.
Having said that, investment in health should not be forgotten. A healthy nation is a productive nation and people living healthy and normal lives are of great benefit to the economy. It is promising that almost 1.5 billion Euros from RRF is attributed to health, providing a real opportunity for the Greek government to address health inefficiencies while building on its successes in the digitalisation of healthcare. The reality remains that innovation is underfinanced by the state, so of the funding that is available, whether it comes from the RRF, from elsewhere in the EU, or from local budgets, we must have investment in innovation, particularly in pharmaceuticals, at similar levels to the rest of the EU. Without this, the system is unsustainable.
And are you optimistic that the arguments you are making both as Janssen and as part of the national pharma association are being well received by government stakeholders in Greece? Does the fact that elections are coming up play into this?
I am cautiously optimistic. There is always a cautiousness around change in an election year, but we are working hard in various partnerships to be heard and to let people understand that a vote for a government should be considered a vote for healthcare as well. The industry stands ready to partner with the Greek government to (1) make the Greek healthcare system more sustainable, (2) to invest in and foster research and innovation and (3) support the digital transformation of the Greek healthcare system. We want stronger healthcare investment by the state, rationalisation of current investment to avoid waste and reallocate funding to innovation, as well as the acceleration of the digitalisation of the healthcare system. A lot of good work has already been undertaken around electronic prescription in the outpatient setting and the development of electronic health records which can be developed further to improve the system and ultimately patient access. J&J is a tremendous partner across many markets on the digitalization of health and has been able to prove the value of innovation through real-world evidence, which we are also committed to do in Greece.
What would success look like for you at the end of your tenure?
Success would look like more and more patients having access to necessary medicines and health solutions, benefitting from true innovation. Being successful on that front, more patients will wake up for another day to spend with their families and loved ones. Extending and enhancing the quality of people’s lives remains our greatest purpose, promise and reward. We strive that that will be our legacy and we are all in, united to make disease a thing of the past.
