Janssen’s Managing Director for Turkey, Demet Russ, discusses her return to the country after 25 years abroad, having worked for Johnson & Johnson in different local, regional and global roles in Germany, Belgium, France and the US. She explains how Janssen Turkey’s vision “We are here for the better” is built on its mission to deliver innovative therapies to patients. Russ also highlights the importance of collaboration with patient associations.
It is important to look at healthcare as an investment, rather than a burden on the public budget: an investment in the population, their health and quality of lives
Can you briefly introduce your background, long career with Johnson & Johnson and how the decision to come back to your home country came about?
I am Turkish by origin and received my bachelor’s degree from Boğaziçi University. After graduating, I started my journey abroad, gaining a graduate degree in Germany and then an MBA at INSEAD in France. My first career step was at McKinsey & Co. where I worked on projects across several industries and sectors, including financial services, high-tech, transportation, infrastructure, retail, and healthcare. During that time, I discovered that my passion was healthcare and the pharmaceutical sector.
I joined the Finance team at Johnson & Johnson in 2005 in Germany and for the next 15 years, I worked in seven different roles across four countries, including at a regional and global level. After a regional role in Belgium, I moved to France as Finance Director and then went to work with global R&D in the United States, leading our R&D operations finance team. My last role in finance was as CFO for the EMEA (Europe, Middle East and Africa) region. I was able to support the business during an amazing period of growth thanks to our innovative portfolio.
In January 2020, I was appointed to my current role as Managing Director for Janssen Turkey. Alongside this, I am a member of the Board of AIFD, the Association of Research-based Pharmaceutical Companies, where I sponsor the Innovation Policies Workgroup. I came back to Turkey after 25 years and, having benefited from the public education system, I have always felt indebted to Turkey, so I am happy to be here to bring innovation to access of Turkish patients.
Coming back to Turkey after 25 years, what type of organization did you encounter and what have been your priorities since taking on the role?
In Turkey, I found an energized organization that is in a healthy growth phase thanks to our innovative portfolio which brings solutions to unmet medical needs. The therapeutic areas we are focusing on are oncology, hematology, immunology, neuroscience, pulmonary arterial hypertension, and rare and metabolic diseases.
Janssen Turkey has a strong clinical trials footprint, the number of clinical trials grew by 50 percent in the last three years, and we invested a total of USD 50 million in the last decade. We are among the top 5 companies by R&D expenditure in Turkey with 47 ongoing trials currently in over 200 centers. We are playing a critical role between society and innovative treatments with our increasing clinical research investment. The organization knows that its role is to bring innovative medicine to patients but also support the development of an innovation ecosystem. On top of that, we produce about 70 percent of our local volume in the country and are currently working to localize two new products.
Janssen has been active in Turkey for 22 years and the country is a major strategic healthcare market for Janssen globally. Janssen has brought 40 innovative therapies to the country’s healthcare market. I made my latest career move because I wanted to work more closely with patients, and I am proud that we touched the lives of more than 60,000 patients with our core products in 2020.
How strong is Turkey’s healthcare system as it relates to its capacity to introduce innovative therapies and what are some of the areas that the overall system can improve on?
First of all, Turkey has a strong healthcare infrastructure and universal health insurance coverage that provides accessible, high-quality healthcare services for all. The healthcare system proved its resilience during the pandemic.
I believe it is important to look at healthcare as an investment, rather than a burden on the public budget: an investment in the population, their health and quality of lives. A recent analysis shows that every dollar invested in healthcare creates a return of two and a half dollars for the economy. The COVID-19 pandemic exemplifies this because, according to an analysis from The Economist, a vaccinated person could have saved the economy USD 2,900. Those are all global studies but certainly apply to Turkey. During the pandemic, it has become evident how investments on innovation pay off eventually.
A well-established innovation ecosystem is therefore critical to continue attracting investment into Turkey’s healthcare, but a predictable business and regulatory environment are also required, along with mechanisms that can expedite the access to innovative medicines. Currently, during pricing and reimbursement decisions, new drug budgets are considered in isolation. However, we know that when a patient is well treated, there are benefits and savings to the whole healthcare system. We should reconsider policies that allow efficient use of funds across the whole system so that innovative treatments can reach patients with unmet medical needs.
Considering that the voices of patients and patient groups are important when taking decisions about the innovative medicines you mention, how strong is the patient community in Turkey and how does Janssen collaborate with it?
The patient associations have done a great job during the pandemic and Janssen works with them to improve health outcomes. For example, we supported an awareness project at the beginning of the pandemic called “Living with a Chronic Disease in a Pandemic Setting” realized by Association of Patients and Patient Relatives (HAYAD). Another example was our collaboration with Cancer and Patient Rights Platform composed of six associations working on cancer and a patients’ rights association named OnkoVan which ensures the safe transfer of oncology patients to hospitals on sterilized vehicles so that their treatment would not be interrupted. These are great examples of joint efforts to achieve better outcomes but, evidently, there is more room for collaboration and coordination.
Together with clinicians, academics, the government and the industry, patient associations can play a key role in the Turkish health ecosystem to create a more sustainable pharmaceutical industry that achieves global competitiveness. We have seen how those groups have helped shape the agenda in other countries, even taking a seat on reimbursement bodies in some cases.
You mentioned Janssen’s big investment in clinical trials, which dovetails with Turkey’s Vision 2023 mission of achieving global competitiveness in healthcare. How is Janssen working towards the country’s ambitions and how challenging is it to bring clinical trials to Turkey?
I very much welcome Vision 2023 and the 11th Development Plan which outlines healthcare as a strategic sector and industry. It is important to acknowledge that the pharmaceutical industry is global; look at COVID-19 or any chronic disease as an example, finding a treatment or solution requires significant investments in R&D. On average, it takes 10 to 15 years to develop a drug, the cost of drug development, considering the failures, is estimated to be more than USD 2 billion; innovation does not happen overnight.
In the case of COVID-19 for example, if Johnson & Johnson had not already invested in infectious diseases treatments before, we might not have been a part of the public health solution in this time of crisis.
Clinical trials make up more than 60 percent of all R&D investment, therefore putting a focus on them is wise. The 11th Development plan aspires to make Turkey a regional and global leader in clinical trials and the country has taken significant steps to support a clinical research environment. We have the right infrastructure and experienced clinicians available to succeed.
Over the past few years, there have been improvements in the efficiency of clinical research regulations which expedite the process; we are starting with a good base. The question now is how we can do more so that the ambitions of Turkey are met.
At AIFD, we believe that the country can increase the clinical trials volume by three times to enter the global top 10. Last year, together with IQVIA, we conducted a study and prepared a report with a roadmap that includes 12 major areas of focus, including: creating an essential patient database, creating a researcher network that can collaborate improving R&D regulations, and giving incentives to companies so that they can conduct more clinical trials.
Who should be financing that patient database, should it be a public-private partnership?
Turkey has a fantastic data infrastructure. I have worked and been a patient in several countries and never seen such a connected system. It is an efficient system that has been on display during the vaccination program. The existing data infrastructure can be used to create real-world evidence benefiting the development of the innovation ecosystem.
Coming back to Turkey after 25 years, what do you expect to achieve with the Janssen organization?
When I joined the company, I conducted sessions to listen and learn from employees. I asked them about their proudest moment at Janssen and the common answer was the impact that their work has on patients’ lives. One of our product specialists shared the moment when a physician told the relatives of a cancer patient that our medicine gave the patient additional years of life; we are all patients at the end of the day. During my time in Turkey, I want our employees to have many more proud moments like this.
To achieve this, I have three concrete goals: helping patients in Turkey access state-of-the-art innovation; developing every member of my organization to their highest potential, helping them achieve their dreams and goals; and contributing to establishing an innovation ecosystem in Turkey through direct investment, such as clinical trials, and collaborations with the industry.
We have a strong expression while we are aiming to achieve more: “We are here for the better”. This is a strong purpose that we are all in line with. We are all here because we know that what we do has a huge impact on patients. With our actions we help patients realize their dream of a healthier life; this is what fulfils us. We put patients at the centre of everything we do.
What has been your approach to diversity and inclusion within the organization at a time when the subject is being raised across all industries?
We, at Janssen are proud to work for an organization that provides everyone with the opportunity to succeed regardless of who they are or where they come from. In Turkey, our workforce is about 50 percent female, including the leadership team. We do not have to begin working on diversity and inclusion but rather continue building on our strength.