After climbing through the ranks from sales representative to leading business units at Eli Lilly Canada, François Gilbert took the reins of Eli Lilly’s Puerto Rican affiliate last year. Among other things, he shares the reasons why Eli Lilly invests in strong commercial capabilities and clinical operations on the island, how the company works with all stakeholders to tackle the high prevalence of diabetes among Puerto Ricans, and his priority to bring Eli Lilly’s first-in-class and best-in-class therapies as quickly as possible.
François, could you start by introducing our readers to Eli Lilly’s footprint on the island?
Eli Lilly has been present in Puerto Rico for over 57 years. Over this time, our footprint has grown to include manufacturing, commercial and clinical operations. Our commercial operations employ over 40 people across all the functions found in any affiliate around the world: medical and scientific affairs, compliance, sales and marketing, human resources, finance and IT. We also have a clinical trials operations team assisting sites and investigators to ensure full enrollment throughout the course of clinical studies. It has been very exciting to get to know the entire team and work alongside the talented individuals we have here.
Eli Lilly is one of a handful of global companies with a local commercial affiliate. What makes Puerto Rico so important that Eli Lilly chooses to maintain a strong commercial presence here?
During its 57-year history on the island, Eli Lilly has built strong commercial capabilities and gained a tremendous experience of the local pharmaceutical market. As a result, we have been one of the largest pharma companies in Puerto Rico for many years, ranking first in 2017. The fact that Puerto Rico is FDA regulated allows us to quickly bring innovations to Puerto Rican patients. As soon as approval is granted, we can proceed with the registration locally. While the speed of market access can be faster or slower in Puerto Rico depending on the situation, we are very satisfied with the rate of adoption of new medicines across our portfolio. We wish to continue solidifying our leadership position by maintaining a robust commercial presence here.
Moreover, Eli Lilly in Puerto Rico has become a hub where local and international talents come to hone their knowledge and skills in the pharmaceutical industry, both on the commercial and production sides. Thanks to the long tradition of pharma manufacturing on the island and high-quality medical education, Puerto Rico boasts a highly knowledgeable, experienced and skilled workforce in the pharmaceutical field. Many of our senior leaders in the US and globally either come from Puerto Rico or have worked on the island during their careers. We are extremely proud of exporting pharma talents across the Americas and the world and are dedicated to continuing this legacy.
Finally, we have a growing number of clinical trials, research sites, and investigators who are world-class thought-leaders.
All of these elements combined along with attractive tax policies make Puerto Rico an exciting and unique market for companies to operate in. Lilly is committed to continuing investing in Puerto Rico and its talents.
Globally, Eli Lilly’s portfolio spans Diabetes, Oncology, Immunology, Cardiovascular, and Neuroscience. How is this portfolio reflected at the local level? What are the key therapeutic areas and growth drivers?
As Puerto Rico is FDA regulated, the picture is very similar to the US. Across the organization, our Diabetes franchise is a key contributor to the business, and the same is true here. The Eli Lilly Diabetes franchise is the largest across the island compared to competitors and covers almost all the classes of diabetes treatments. It has been and remains to this day our largest business unit.
This being said, in recent years, we have experienced significant growth within our Oncology franchise thanks to the approval and launch of many new therapies and indications. As this trend continues and accelerates in future years, Oncology may represent a larger portion of our operations.
According to the Health Department, with more than 450,000 diagnosed patients, diabetes is the 3rd cause of death of the island. How are you working with healthcare to make sure your solutions provide the best value for patients living with diabetes?
According to some sources, close to 16 percent of Puerto Ricans are living with diabetes, about double the prevalence in the US mainland. Our contribution to tackling this issue goes way beyond providing medication. We consistently partner with stakeholders such as medical and patient associations to do everything that we can to raise awareness about diabetes, educate the population and promote healthy habits to help prevent the onset of the disease. As a matter of example, last Sunday, we sponsored and participated in the 5K run organized by Banco Popular, one of the largest banks on the island, for the benefit of the Pediatric Diabetes Foundation, as the prevalence of diabetes among children is also an important issue here. We often support the frequent health fairs during which health centres provide free medical services that range from general check-ups to nutritional consultations, either at physical locations or with buses travelling across the island. We also organize many activities during Diabetes Awareness Month. For instance, last year, we published a Spanish ad in local magazines and newspapers to raise awareness and encourage people to speak with their doctor and lit up the Lilly del Caribe manufacturing facilities in blue, the international colour of diabetes, to spark questions and conversations about the condition. In addition, we provide a broad range of resources and tools tailored to the local culture in order to help people understand diabetes and make the right lifestyle decisions regarding their health.
Finally, we collaborate closely with physician groups and payers. There is a growing interest in linking access and reimbursement of diabetes treatment to desired clinical outcomes, which is something we are currently working on.
In March 2019, Eli Lilly launched an authorized generic of its own brand name insulin Humalog at a list price 50% lower than the original. However, prescriptions filled for the generic lispro remain much lower than Humalog. How are you trying to make the drug more widely available at the local level?
The first thing to mention is that Puerto Rican patients already enjoy good access to our existing insulins. We feel very proud of the level of access we have been able to establish for our insulins in Puerto Rico. Humalog and Humulin are covered by Medicaid, Medicare and most commercial insurers. In addition, patients who, for whatever reason, are in-between coverage or in a special situation, can call the Lilly Diabetes Solutions Center and get in touch with a Spanish-speaking agent who will help them find ways to access the insulin they need. The generic version of Humalog is a complementary tool to these existing solutions. Generic lispro is not available yet in Puerto Rico, but we are in constant communication with distributors, payers and healthcare providers to see where it could benefit more patients in the coming months.
In July, the FDA approved Baqsimi, Eli Lilly’s innovative treatment for severe hypoglycemia, a diabetic emergency that can occur in people with diabetes who take insulin and certain anti-diabetic tablets. In Puerto Rico, how successful has been the launch of the new medicine so far?
We are in the middle of the launch as we speak. So far, it has been extremely successful. Severe hypoglycemia is a scary condition and Baqsimi may present some advantages over existing treatment options thanks to its innovative administration method. Baqsimi is the first non-injectable form of glucagon for the treatment of severe episodes of hypoglycemia. It is administered into the nose and comes in a single-use dispenser. We have received extremely positive feedback for Baqsimi. Nasal glucagon generated a lot of interest at a conference organized two weeks ago by the Colegio de Farmacéuticos de Puerto Rico. We are actively working with health plans and payers to make it available to as many patients as possible. Fun fact, the “q” in Baqsimi refers to my native Québec as two companies from Québec, BioQuadrant Pharmaceutical Intermediates and Locemia Solutions, played an important role in the development of the nasal powder formulation of glucagon and the needle-free administration device respectively.
Eli Lilly has made headway in Oncology. Last year, Oncology revenue increased 12 percent due to the launch of Verzenio launch in the US. How has the Oncology franchise been performing in Puerto Rico?
Similar to the US mainland, we have experienced strong growth in Oncology. While Diabetes has been part of our history for many decades and a strong contributor to the enterprise, Oncology is also becoming part of our DNA. We already have a strong presence in lung cancer with Alimta. Last year, Eli Lilly made a few acquisitions of biotechnology companies in the oncology space such as Loxo Oncology. Now, Eli Lilly has a strong pipeline, which many analysts consider best-in-class across Phase II and III. The launch of breast cancer drug Verzenio and the coming launches of new anti-cancer medicines will help us reinforce this positive trend.
While the Hispanic population keeps growing in the US, it remains underrepresented in clinical studies. What is the extent of Eli Lilly’s clinical operations on the island and how has it evolved?
Eli Lilly has established and sustained excellence in clinical research in Puerto Rico for more than 20 years. Puerto Rico has the ambition to become a medical and life sciences hub in the region and has made significant investments in this direction, such as the Comprehensive Cancer Center of the University of Puerto Rico (UPR) which opened its doors last year. The quality of the medical infrastructure and the presence of world-class experts create strong incentives to invest in clinical research. As a result, we have increased our clinical operations across all our therapeutic areas, Diabetes, Immunology, Oncology, Pain, and Neurodegenerative diseases, with 45 trials, 115 investigational sites, and 350 patients enrolled as of August 2019. Eli Lilly is highly regarded within the research community because of its well-trained personnel, committed investigators, and a strong willingness to continue advancing clinical investigation in Puerto Rico.
What do you see as the role of pharma companies like Eli Lilly in developing pharma talent in Puerto Rico and supporting the economic sustainability of the island?
The first aspect is making sure that we continue to develop young local talent by partnering up with major universities like UPR across different faculties to cover our different functions, both at the commercial affiliate and our manufacturing site. We hire many students and many of them decide to continue working with Lilly. The other aspect is maintaining levels of investments in manufacturing and clinical research to contribute to the ecosystem and the economic recovery of Puerto Rico with the intent to bring innovation as quickly as possible.
We have talked about the past and present of Eli Lilly in Puerto Rico. Looking forward, what would you like to accomplish?
I think the future is very bright for the pharmaceutical industry in Puerto Rico in general and for Eli Lilly in particular. At the end of my tenure, I wish to be able to look back and say that we have been able to bring our newest therapies to Puerto Rican patients quickly so that they can benefit from the medications and live healthier lives.
On a more personal note, you have spent your entire career at Eli Lilly, starting as a sales rep and moving to positions of increasing responsibility in marketing and sales management before becoming general manager of the Puerto Rican affiliate. What makes you so dedicated to this company?
In my opinion, what makes working at Eli Lilly special is the people. Since I joined Lilly, it became a second family to me. Many of my coworkers and managers are now friends. Some of them are strewn across the globe but we still stay in touch. What makes working in Puerto Rico special is also the people. Puerto Ricans are very talented and loyal individuals who are passionate about their work and community. Seeing this passion drives me every day. Having the opportunity to have a positive impact on the community fills me with pride and has also been a lot of fun!
