Edouard Bieth, managing director of Tillotts Pharma in France, discusses the opportunities and challenges of opening an affiliate in the country and the uniqueness of Tillotts’ specialization in gastrointestinal drugs.
Tillotts has had products on the French market since 1998 but only set up an affiliate here in 2016. Why only come to France – a hugely strategic market – in 2016? What has been the journey from that time until today?
Tillotts Pharma was started in London by a chemist and pharmacist and then relocated to Switzerland in 1986. For a long time, our portfolio was very limited, consisting of a few products at an international level. One product was Asacol® (marketed as Fivasa® in France), a groundbreaking treatment that has become the gold standard for Inflammatory Bowel Disease (IBD) and another one, Colpermin®, a fascinating herbal product for the treatment of the symptoms related to IBS (Irritable Bowel Syndrome), a widely spread long-term condition of the digestive system.
However, new management – led by Thomas A. Tóth von Kiskér – came in along with Zeria’s acquisition of Tillotts in 2009 and developed the ambitious vision of establishing a well-balanced, innovative product-portfolio. Our aim is also to approach gastroenterologists and other gastrointestinal (GI) actors in a unique way with the goal of becoming the preferred partner in GI.
Our main strategies are to have more products on the market and to expand our international presence. The plan is to expand our product portfolio through our own development, in-licensing and acquisition of specialty products, and in parallel to expand our presence in Europe by establishing our own Affiliates, through which we market our products. Before 2009, the company exclusively sold its products through 3rd parties, leaving the important marketing of its products to other pharma companies. Although we have been part of the Japanese based Zeria since 2009, our roots and corporate values are firmly anchored in Europe. Employees at Tillotts, however, are truly international.
Over the last 10 years, we consequently established our own Affiliates throughout Europe, such as in Ireland, the five Nordic countries, Spain, the Czech Republic, the UK, Germany and finally we also established Tillotts Pharma France, headquartered in Paris.
France is the second biggest pharma market in Europe and the fifth biggest pharma market in the world. We are talking about huge opportunities. According to IQVIA (FY 2017), it is worth EUR 27.5 billion in cash revenue. The French market is very attractive for newcomers. The population is lower than Germany but on a similar level to that of the UK. Natality in France is quite elevated compared to many other European markets which is one of the market drivers.
The second rationale to come to France is that it is a stable market. When you want to establish yourself as a company in Europe, you have to get the basics right. This means having a presence in the top five EU markets, France being one of them. Since it is a centralized market, it is very straightforward when it comes to distribution and how to access the market. One more opportunity of the French market is that Health Care providers are highly educated. In France, we have a number of centres of expertise in IBD which are globally recognized, and physicians are open to new therapies and related services that pharma companies can support them with.
On the other hand, the French pharmaceutical market faces challenges as well: among the major Western countries, France is the only country where the pharmaceutical market, in terms of overall revenue, has not increased in recent years. In 2018, the French market remained stable for the seventh consecutive year, despite the arrival of innovative medicines, the financing of which was achieved largely by price reductions and the development of biosimilars.
In addition, the average timeline for patient availability, meaning the time period between market authorization (MA) and first prescriptions, remains long and is detrimental to patients, and frustrating for healthcare professionals and companies. Over the 2014-2016 period, the average timeline was around 530 days in France, whereas the 2001 European Directive aims for 180 days. Moreover, this average timeline has deteriorated from the average of 467 days over the 2013-2015 period. Improving post-MA delays is therefore a priority for France to better meet patient needs.
What have been some of Tillotts Pharma France’s major milestones?
Tillotts France was set up in France in January 2016. In the 2nd half of 2015, Tillotts acquired the ex-US rights to Entocort® from Astra Zeneca and in parallel ended the ongoing partnership with Norgine, who at that time promoted our Fivasa® in France. With those two products, we had the critical mass to be able to establish our French Affiliate. We were successful in re-launching the brand in terms of results and reputation. In the first year of the French affiliate, we achieved a turnover of EUR 4.3 million. In the second year (2017), we generated sales in excess of EUR 12 million, and in 2018 close to EUR 14 million, which means we have tripled the revenue in just three years – an impressive growth in a mature market. Tillotts Pharma France is now recognized by the GI community as an important player in IBD.
I am pleased to say that we have now reached the end of the first phase of the affiliate, namely its establishment. The first three years were indeed dedicated to setting up the affiliate and creating a presence in the market for our drugs. We are now about to start the second phase which is about further, ambitious growth and expanding our product portfolio. Part of that growth will come from new product launches: this year, we are expecting four new launches, and our main focus will be on continuing to build on the foundation within IBD and establishing Tillotts beyond.
How would you summarize your strategic priorities for 2019 in terms of launching products and adapting the organization?
It is all about the people, competences, the determination to be successful and to do the work with passion. It is also about the focus and the structure of the organization. An organization that we have adapted to meet the needs of our customers and ultimately patients through the development of three internal units. Firstly, we are a “exploitant” unit, led by a pharmacien responsable, dedicated to quality, products registration and market access. I work closely and transversally with my team for the P&R applications and I am the one to negotiate directly with the CEPS when it comes to pricing.
Secondly, we have the Tillotts commercial department, which is dedicated to sales and marketing. Our sales force is comprised of experienced professionals with an in-depth knowledge of science and specialized in GI. We train them in what is going on in the GI field, for example, the types of procedures, diseases, and guidelines. For this, we have developed a Tillotts Pharma Academy, which is an internal academy where all employees can go online, test their knowledge and upgrade their level of expertise. Every year, we organize an exam for our regional managers in gastroenterology at the Cochin hospital in Paris. This is in addition to the standard certification required by the national health authorities. The reason we have this extra exam is that we want to be specialists in the area. We are a very specialized company, and we need to embrace this internally in order to be recognized for it externally.
The third internal department of Tillotts Pharma France is quite new and unique among the commercial affiliates of Tillotts Pharma and in the Pharma world. It is called Tillotts Education. It is composed of people who are the ‘experts of the experts. It functions like a medical department that is dedicated to providing service to the gastroenterologists. Because we want to be the preferred partner of all those involved in GI, Tillotts Education is dedicated to providing medical education and high-quality scientific programs to the GI community. As an example, we have a Tillotts France YouTube channel, which is committed to communicating important information and guidelines in IBD management to the physicians. It comes from a global Tillotts vision implemented locally here in France. Tillotts Pharma France is unique in offering this kind of initiative 100% dedicated to gastroenterologists.
Why do you think this program is good for the Pharmaceutical Industry?
I believe in the meta-product approach to making our brands unique. Promotion is an equation made of three components: product attributes, corporate reputation and service quality. In the current context of the pharmaceutical industry, I strongly believe it is important to develop the last 2 aspects. The pharma world has changed and our customers too. They expect more science and education. If you want to gain their trust, I believe this is the way forward.
When we first entered the market, Tillotts was not known, so we first needed to build our reputation as reliable partner for healthcare specialists and we decided to go with this approach right from the start.
How challenging has it been to build your brand name and corporate story to those prescribers? And how do you differentiate yourself from competitors?
We differentiate ourselves with our GI expertise. Tillotts France may be young but the expertise within GI has been established on a global scale over decades through our collaboration with scientific experts, academia, patient organizations etc. We are dealing with competitors in the GI field who are not as specialized as we are. Having better-educated and focused people is what differentiates us in these aspects. Our entire organization is dedicated to providing the best information about our products and a unique continuous medical education to the caretakers involved in IBD and beyond. For example, Tillotts Pharma France has been the first company involved in gastroenterology to organize a program named “MICI au Grand jour” to collect the most interesting clinical cases in IBD. This program targets, in particular, the young interns at different hospitals and will be rolled out for the second time in 2019.
Tell us more about the collaboration you have with Professor Peyrin-Biroulet, a renowned expert on Crohn’s disease in the Hepato-gastroenterology department of the University Hospital of Nancy.
Before returning to France, I was working for Tillotts as a global marketing manager at the HQ in Switzerland. I was responsible for the global marketing of the GI sectors. This is when I met Professor Peyrin-Biroulet and worked with him on different projects. He was the ambassador for the UC&ME educational program that aimed to improve medication compliance in IBD for patients. When I was appointed as a Managing Director of Tillotts Pharma France, I asked to continue our close collaboration, to help establish Tillotts Pharma France as a trusted partner in medical education. Professor Peyrin-Biroulet has given us a lot of input on how to approach the market and the different stakeholders and he is leading the first epidemiological survey done in France about UC management in private practice, which Tillotts rolled out in 2018.
One of the critical junctures in Tillotts’ development trajectory was the 2015 acquisition of the ex-US rights to Entocort® from AstraZeneca in a USD 215 million deal. When we interviewed CEO Thomas A. Tóth von Kiskér, he explained how the company is always on the lookout for other assets of the kind to in-license or acquire. What role can the French affiliate play in scouting for such opportunities?
We, as an affiliate, now have a high level of expertise which helps throughout the product journey: registration, reimbursement, pricing, distribution, customers access, brand promotion. We have built a strong domestic reputation which in combination with the Tillotts worldwide heritage makes us unique. Today, our second phase of development is the launch of new products not only in the field of gastroenterology/hepatology but also in other specialty diseases. Tillotts is actively seeking partnering opportunities with companies involved in these fields. We are flexible in the form, whether a fee-for-service, co-promotion, distribution and marketing, in-licensing up to the acquisition of products, business units or even companies.
As an example, a partnership with Tillotts Pharma France could be very beneficial for any company planning to launch new products in IBD or gastroenterology.
A few words to conclude?
As I mentioned, we are very ambitious because we know our strengths and where we stand. Our uniqueness is not only with a special approach towards the market and the organizations we work with at a domestic level. It is also about company values and management style.
We have a great global executive team that encourages entrepreneurship. They support us in the development of our own story and want to develop high talent regardless of age in the company. I joined Tillotts after enriching experiences at Big Pharma companies and after four years at the global office in Switzerland, they believed in my skillset and gave me the opportunity to establish and to run Tillotts Pharma France, becoming the youngest Managing Director of a pharma company in France.
Unique values like passion and entrepreneurship are part of our Tillotts DNA. We are always on the look-out for highly talented people who have this mindset; they will thrive at Tillotts Pharma.
