Germany is emerging as a key growth and launch market for Ipsen, with the DACH region now ranking as the Group’s leading European affiliate and gaining momentum across Oncology, Rare Disease and Neuroscience. As Ipsen enters its next phase of growth, new launches, an expanding pipeline and a changing market-access environment are creating both opportunities and challenges, placing a premium on agility, execution and organisational capabilities. For Kothny, the ambition is to capture this momentum while preserving the advantages of a mid-sized organisation.
What brought you to Ipsen, and what have been your priorities in shaping the DACH organisation?
I have spent more than 25 years in the pharmaceutical industry, working mainly across commercial and medical roles. I started as a sales representative at Janssen-Cilag before moving to Roche, Wyeth and later Pfizer, where I spent more than ten years developing my career across commercial, medical and marketing functions. I also moved to the US for a global role and later became EMEA Director for Oncology. Over the following years, my focus shifted increasingly towards Germany. I was Managing Director for Germany and Austria at CTI and subsequently held oncology leadership roles at Baxalta, Shire and Servier. Before joining Ipsen, I headed the haematology franchise at Novartis in Germany.
What attracted me to Ipsen was the balance that comes with being a mid-sized company. We have the capabilities and resources to develop our medicines properly, while remaining agile, with fast decision-making and very direct communication. Whenever I consider a new role, I look at both sides: what I can bring and where I can continue to learn. I brought around 20 years of experience in oncology and haematology, as well as previous responsibility for Germany and Austria. At the same time, Ipsen offered me the opportunity to build my experience in rare disease and take direct responsibility for Switzerland, which I had previously covered at EMEA level.
When I joined, the organisation was emerging from a period of significant change, including the relocation of our DACH headquarters and the disruption caused by the pandemic. We had moved our DACH headquarters from Ettlingen to Munich in 2019, shortly before the COVID-19 pandemic, which meant that many colleagues had joined Ipsen without having much opportunity to meet each other in person. One of my first priorities was therefore to strengthen that connection and create a new dynamic within the organisation. We brought five new people into the leadership team and focused strongly on what I call a winning mindset: believing in what we deliver for patients, knowing the value of our medicines and taking responsibility for our results. We focus on the specialised areas of oncology, rare diseases and neurology, and within those areas our ambition is to compete at the highest level.
The other major priority was strengthening our launch capabilities. The organisation had not launched a major new medicine in Germany for many years, yet Germany is often among Ipsen’s first launch markets, so we needed to build the capabilities rapidly to become what I call a launch machine. Over the past three years, we have developed that expertise, and we are now launching new medicines and indications every year while continuing to grow and recruit. We are building on a strong foundation: Ipsen has been present in Germany for more than 40 years, and Ipsen Pharma GmbH today employs around 220 people in the country, with our headquarters in Munich. We operate across Oncology, Rare Disease and Neuroscience, supported by functions including Market Access, Medical, Communications and Finance, alongside our direct operations in Austria and Switzerland.
How is DACH contributing to Ipsen’s growth, and where do you see the main opportunities across the portfolio?
When I joined Ipsen, my vision was very clear: DACH should become a powerhouse for the Group. Germany is the largest pharmaceutical market in Europe, so I felt we should have the ambition to lead. At the time, DACH was Ipsen’s number-two European, and I am very proud that we have since moved into the number-one position. This reflects the momentum we have built over the past few years, with the German business consistently delivering double-digit growth. Ipsen grew by 23.5 percent at constant exchange rates in the first half of 2026 and subsequently raised its full-year guidance from more than 13 percent to more than 20 percent, while Germany grew by 17 percent. With the launches ahead of us, our ambition is to sustain that growth and continue strengthening DACH’s contribution to Ipsen.
For me, growth always starts with people and how we work together. Oncology is our largest business unit, and one of my first priorities with our new Oncology Business Unit Head was to strengthen Cabometyx (cabozantinib), particularly the combination with nivolumab in first-line advanced renal cell carcinoma. It had originally been launched during the COVID-19 pandemic under very difficult circumstances. We subsequently strengthened the commercial approach, expanded the team’s capabilities and sharpened our focus. Today, Cabometyx is our largest product in Germany, with more than EUR 100 million in sales and a 47 percent share in the relevant market. It has become a real success story and, for me, demonstrates the importance of knowing your medicine, believing in its value and taking responsibility for bringing it to patients.
Our focus also shifted to building entirely new capabilities in Rare Disease. The acquisition of Albireo Pharma strengthened our presence in rare liver diseases, while the launch of Iqirvo (elafibranor) for primary biliary cholangitis (PBC) brought us into direct competition with a company, which has more than 20 years of experience in liver disease. We therefore built a team with deep expertise in this field and developed the launch capabilities to move quickly, bringing Iqirvo to the German market several months ahead of the competitor. Within one year after launch, we have reached market leadership. I enjoy this kind of competition because it gives you a clear sense of how well you are performing. You need to know your medicine and its benefits, work closely with patient organisations and remain purpose-driven, which is especially important in rare disease.
Neuroscience, our third business unit, is another area with significant potential. Ipsen has more than 30 years of experience with Dysport (abobotulinumtoxinA), and migraine could now open a new chapter for us. In July 2026, Ipsen reported positive topline Phase III results from E-BEOND in episodic migraine and C-BEOND in chronic migraine, with both studies meeting their primary endpoints. E-BEOND was the first Phase III study to report statistically significant efficacy for a botulinum toxin in episodic migraine, while the two studies together make Dysport the first botulinum toxin programme to report positive Phase III results across both episodic and chronic migraine. Behind Dysport, we also have corabotase, formerly IPN10200, an investigational recombinant neuroinhibitor designed to provide a longer duration of effect and being developed across aesthetic and therapeutic indications. These programmes are allowing us to build another important area within neuroscience, with Germany potentially once again among Ipsen’s first launch markets.
What does Germany’s position as an early launch market mean for Ipsen, and what have you learned from bringing new medicines to patients?
One of Germany’s major advantages is the speed at which we can bring innovation to patients. Iqirvo is a good example: it received European Union authorisation in September 2024 and entered the German market less than a month later, while the AMNOG process ran in parallel, with the Federal Joint Committee (G-BA) conducting the early benefit assessment and the reimbursement amount subsequently negotiated with the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband). The negotiated reimbursement amount applies from the seventh month after market entry, which gives us the opportunity to make new medicines available very quickly. At the same time, Germany is a highly decentralised market, particularly in oncology and rare disease. In addition to the major centres, there are many office-based specialists across the country, so reaching physicians requires more people and resources, while access itself can be challenging. We therefore need a strong omnichannel approach, although face-to-face engagement remains a major driver in Germany and has returned strongly since the COVID-19 pandemic.
Launching successfully in this environment requires experience and rigorous preparation. You need to understand the market, the access environment and your customers, while getting your segmentation and targeting right. Ideally, you would start preparing around two years before launch, but our external innovation model means that this is not always possible. We acquire and license products at different stages of development, and in some cases we have had only seven months to prepare for a new indication. This is where experienced people become essential: they need to feel confident with the medicine, be able to move quickly and work closely with medical societies and patient organisations. Building these capabilities has been an important part of our development in Germany and of becoming the launch machine I mentioned earlier.
Being one of the first launch markets also gives Germany an important role within Ipsen, as other European teams naturally look to us for experience and learnings. The challenge is that some countries launch considerably later, by which point we are already dealing with a very different set of challenges. With Iqirvo, for example, I was part of the Global Brand Team and involved in shaping the broader launch strategy, but while some markets are still preparing for launch, Germany is already managing a more mature environment and competition in PBC. I therefore think we need to differentiate more clearly between early-launch and later-launch markets. Sharing what worked, including the learnings we experienced, is extremely valuable, but early markets also need to keep moving forward rather than repeatedly returning to the beginning of the launch journey.
How is Ipsen’s external innovation model changing the way you build teams and prepare for new launches?
I enjoy this model because it requires exactly the kind of agility we need. As new products and indications enter the portfolio, we cannot organise our teams around individual medicines alone. We need people with a broader mindset who can build expertise across a therapeutic area, learn quickly and adapt as the portfolio evolves. We want to give people the opportunity to build deep expertise while maintaining continuity in their relationships with customers. We are therefore building a launch team, particularly within Medical, around specialised disease areas rather than individual products, giving us the flexibility to move expertise where it is needed while maintaining continuity with our customers.
The new Cabometyx indication in neuroendocrine tumours is a good example. We had around seven months to prepare rather than the two years you would ideally have, while also moving into highly specialised areas such as lung neuroendocrine tumours, where we needed to build expertise and relationships very quickly. This meant bringing people up to speed, establishing advisory boards and engaging with experts within a compressed timeframe. I enjoy that dynamic because you are constantly learning, but it also creates a challenge: moving quickly while giving people enough time to understand the medicine, the clinical evidence and the safety profile, particularly when German physicians were not involved in the studies. Our teams need that depth of knowledge and confidence to engage professionally with customers, so the key is to combine speed and flexibility with the expertise that a successful launch requires.
How will the GKV-BStabG and the planned location-based exemption affect innovation and launch decisions in Germany?
Germany is right to address the financial sustainability of the statutory health insurance system. At the same time, the measures need to remain proportionate and predictable if Germany wants to preserve its position as a leading market for pharmaceutical innovation and early patient access.
We invest significantly in research and development, contribute to the economy and, most importantly, bring innovations that can improve outcomes for patients and help them remain active for longer.
From January 2027, the law introduces an additional manufacturer rebate of 8.5 percent for affected patent-protected medicines, bringing the statutory rebate to 15.5 percent. This reduces predictability and will become an important factor in investment and launch decisions, particularly for specialised medicines developed for very small patient populations.
An important part of the political discussion is the location-based exemption that is currently being developed. We welcome the objective of recognising companies that contribute to Germany through research, investment, skilled employment and pharmaceutical value creation. The decisive question will be whether the criteria are transparent, legally robust and accessible to different innovation models.
Today, medicines are often developed through international research networks, scientific partnerships and acquisitions. A modern location policy should therefore recognise clinical research and other meaningful contributions to the German innovation ecosystem, rather than focusing too narrowly on a single type of domestic footprint.
I am particularly concerned about the impact on specialised medicines developed for very small patient populations. While it is positive that the specific AMNOG framework for orphan medicines has been retained, the EUR 30 million threshold remains an important transition point. Once the threshold is exceeded, the medicine enters a full reassessment based on the available evidence, even though the underlying limitations of evidence generation in very small populations remain.
This is not about reducing scrutiny. It is about ensuring that the assessment recognises the best evidence that can realistically be generated in very small patient populations. A proportionate framework should combine rigorous evaluation with sustainable conditions for patient access and continued innovation.
For rare and ultra-rare diseases, where development is already challenging and patient populations are very small, this raises difficult questions about the sustainability of future investment.
Ojemda (tovorafenib) illustrates what this can mean in practice. It is an orphan medicine for children with paediatric low-grade glioma, a rare brain tumour with significant unmet need, and became the first medicine to complete the European Union’s new JCA (joint clinical assessment) process. We are now going through the German reimbursement negotiations. Our objective is to secure sustainable access for children who may have very limited treatment options.
The combination of evidence requirements, pricing pressure and the specific economics of very small patient populations makes sustainable access particularly challenging. We need a framework that supports patient access while maintaining viable conditions for the development of future specialised medicines.
Germany remains one of Europe’s most important pharmaceutical markets, but we cannot take its position as an early-launch market for granted. Like every internationally operating company, we assess launch sequencing in the context of different national access systems and internationally connected pricing environments. Pricing and reimbursement decisions in major markets can have implications beyond national borders and therefore influence broader launch strategies.
We chose to make the medicine available in Germany and remain committed to working towards an outcome that supports both patient access and the long-term sustainability of innovation. But these decisions are becoming more critical. If Germany wants to preserve its position as an early market for innovative medicines, the framework needs to combine rapid access with predictable, proportionate and internationally sustainable reimbursement conditions.
What aspects of AMNOG have improved under the new framework, and where do concerns remain?
There are meaningful improvements in the GKV-BStabG, particularly the removal of the AMNOG price guardrails and the abolition of the 20 percent combination rebate.
Under the previous framework, the outcome of the benefit assessment and the comparator could place significant constraints on the reimbursement price, even where a medicine brought additional value
The removal of the guardrails restores greater scope for reimbursement negotiations to reflect the available evidence and the medicine’s value in the relevant treatment context.
I also welcome the abolition of the 20 percent combination rebate, which we challenged because we considered it an additional burden on top of the existing AMNOG process. It was also difficult to implement in practice, particularly in oncology, where medicines such as Cabometyx can be used in combinations and across different indications, making it difficult to determine from routine claims data precisely when a particular combination has been used.
These corrections are important, but they should not be interpreted as fully offsetting the broader additional burdens introduced by the law. The higher manufacturer rebate and continued cost-containment pressure will still influence the economic environment for innovative medicines. These changes show that some of the practical shortcomings of the previous framework have been recognised, which is encouraging. However, they come alongside broader cost-containment measures that continue to put considerable pressure on innovative medicines. Some of these measures affect Ipsen less directly than companies with larger portfolios, but the overall direction raises a more fundamental question for the industry: to what extent does patent protection preserve the economic value of an innovative medicine when additional pricing and reimbursement mechanisms continue to erode that value?
Germany needs to manage healthcare expenditure, but it should do so in a way that remains predictable and proportionate, particularly for specialised medicines, paediatric indications and very small patient populations. This is essential if Germany wants to remain an attractive market for early patient access and pharmaceutical innovation.
What defines Ipsen’s culture in DACH, and how are you creating an environment where people can grow?
What I find attractive about Ipsen is the combination of professionalism, resources and agility. We have the capabilities and the firepower to develop our medicines properly, while remaining a mid-sized organisation where every team member is visible and can make a real contribution. There is a strong sense of trust and team spirit, people take responsibility and we are very results-driven. We are also a diverse organisation, with strong female representation and colleagues from different countries and backgrounds, which brings different mindsets together. As we continue to grow, I want us to do that carefully, because every hire matters. We take the time to find the right people, retain them and develop together. Receiving our first Great Place to Work certification across Germany, Austria and Switzerland in 2024 was an important milestone in that journey, and I also believe the working environment matters. When you invest in people and create a place where they feel good, it changes the energy and the way people work together.
How can companies better support women in leadership, and what advice would you give women building their careers?
I still believe childcare is one of the biggest barriers for women in Germany. Women are often expected to manage their careers while carrying much of the responsibility for childcare and family life, and this can lead to burnout. I have seen many talented women hesitate to pursue more senior roles because they are unsure how they will manage both. As companies, we therefore need to give women the freedom and flexibility they need. At Ipsen, this includes the possibility of working from home when necessary, a dedicated area in the office where colleagues can bring their children if needed, and access to support services when something unexpected happens. We need to create an environment where women can develop their careers without feeling that they have to choose between their professional ambitions and their families.
My advice is to believe in yourself and not feel that you have to be perfect before taking the next step. Mentorship has also been very important to me, so I would encourage women to look for people they find interesting, ask them for advice and build relationships with mentors at different stages of their careers. I have always looked for people I could learn from and who believed in me, and that support has helped me throughout my career. At some point, however, you also have to be brave enough to take the opportunity and make the jump.
Where do you want Ipsen Germany to be in the next two to three years, and what will success look like?
I think we are entering a very dynamic period, with new areas to build in haemato-oncology through the acquisitions of ImCheck Therapeutics, bringing IPN60340 (ICT01) in acute myeloid leukaemia, and Kartos Therapeutics, adding navtemadlin in Phase III development for myelofibrosis. At the same time, we are expanding Neuroscience through migraine with Dysport (abobotulinumtoxinA) and corabotase, while in Rare Disease we want to double the business. Beyond 2028, our focus remains on steady, innovation-driven growth. We’ll build on our balanced portfolio across our therapeutic areas to help more patients, expand more access, and acquire key assets that address unmet needs worldwide.
It will be a game-changing period, so we need to be very clear about our priorities and build these areas quickly while remaining a mid-sized company. We do not want simply to double our headcount. We want the right people, with the right capabilities and the energy to drive these areas forward, while maintaining the winning spirit, team collaboration and sense of purpose that have defined our organisation. Ultimately, success means combining innovation, responsibility and people-focused leadership to create lasting impact for patients, healthcare systems and society.
