Gwenael Meneux of AstraZeneca Hong Kong and Macau gives his initial impression of the HK market, outlines his unusual career trajectory and the new innovations AZ is looking to bring to patients in the region.
Gwenael, you have a very interesting and diverse background that is a bit atypical of pharma country managers, having started in fast-moving consumer goods (FMCG) with L’Oréal overseeing South American markets, before moving into consultancy, before joining the pharma industry. You have now been with AstraZeneca for ten years, moving through the French and mainland Chinese affiliates. What has been the driving force through this career trajectory?
I definitely do not have the standard pharma GM profile but I have been able to draw on my past experiences and expertise over the past decade with AstraZeneca. Two of my core personal motivations are embracing new challenges, and customer-centricity, which translates into patient-centricity within the pharma industry.
I started in sales and marketing with L’Oreal, which is one of the leading, cutting-edge FMCG players – and as a French person, there was a good fit between the organization and me. When I joined AstraZeneca, I was completely new to the industry so I had to discover, learn and adapt very quickly. I started initially in a ‘sales force excellence’ (SFE) role and after a few years, was assigned to projects beyond my immediate job scope, hence exposing me to new roles and responsibilities. For instance, while being a SFE director, I had the opportunity to lead a multichannel sales and marketing strategy for AstraZeneca France. This all fed into my later role as Commercial Excellence Director. I also had the opportunity to lead various HR initiatives, and was even assigned as acting HR lead during a period of vacancy. In general, I am very driven by curiosity. I love meeting new challenges and trying something new, and I try to never be 100 percent satisfied.
An essential aspect to this philosophy is having strong support from your team. I like to be surrounded by experts to learn from and work with.
The second part, customer or patient centricity, applies across different industries. Fundamentally, we need to have a deep understanding of the customer’s unmet needs before we can start to take action. I have a personal insight into this as well, because my father was a GP for 40 years. I saw firsthand his dedication to patients across those 40 years. He told me something that I have never forgotten: he might have saved thousands of lives but what he remembers is the few diagnoses he missed. That still preoccupies him even though he is retired now. When you put patients first, you will never be fully satisfied.
Prior to joining the Hong Kong affiliate as General Manager, you were Vice-President (Commercial Excellence) at the Greater China affiliate. Commercial excellence is at the core of AstraZeneca’s ‘return to growth’ strategy. What insights are you bringing to the Hong Kong market?
The final goal of commercial excellence or customer excellence is to gather all available resources to improve internal and external efficiencies so that we can focus on better meeting patient needs. This means collaborating with all stakeholders within the healthcare ecosystem, from physicians, hospitals, pharma and medical device companies, government bodies, patient groups and so on. This 360 degree collaboration is critical
During my two years in mainland China, I discovered what strong, win-win partnerships between industry and external stakeholders really mean. I think the Chinese government is really leading in this area so I hope to bring some insights and strategies here in terms of how to develop and apply this win-win mentality to existing and potential collaboration between the public and private sectors.
You have been in Hong Kong for a few months now. What are your initial impressions of the Hong Kong market?
Hong Kong has incredible healthcare assets to leverage. This is most clearly evident in the fact that Hong Kong has the highest life expectancies in the world despite only spending 6 percent of GDP on healthcare, lower than the EU-5 countries and of course, far less than the US. 6 percent is on par with mainland China as well but the mainland still faces a huge gap between patient need and healthcare delivery, and they are looking to increase healthcare spending as a result. Hong Kong therefore has very efficient and effective healthcare infrastructure and processes.
The public hospitals governing body, Hospital Authority, also has excellent patient data that has been collected over a few decades. This data is high-quality, clean, longitudinal and structured, so it would be a great resource for clinical and medical R&D, if it could be accessed.
The capabilities of healthcare professionals here are recognized not only locally but globally: we have several top KOLs in Hong-Kong with major influence in pre-clinical and clinical fields globally. Then you have the basic geographic advantage, which is Hong Kong’s position at the center of a major patient population in Asia that has great unmet medical needs.
Fast access to innovative medicines is also in the DNA of the healthcare system, which is very impressive.
Due to all these factors, AstraZeneca actually invests significantly into clinical trials in Hong Kong. There are 35 global and local clinical trials underway in Hong Kong at the moment, which is significant given Hong Kong’s population of just over 7 million.
From a commercial standpoint, Hong Kong is obviously a more mature, sophisticated market, so growth expectations would differ from say, a market like mainland China. However, at the end of the day, it is not only about driving double-digit growth, but also about finding genuine opportunities to improve the management and quality of care of patients in Hong Kong.
What are some of the potential areas for improvement within the Hong Kong healthcare system?
It is still early for me to give a detailed assessment. I would like to recognize the efforts of the Hong Kong government to provide early access to innovative medicines. Naturally, as with any standard regulatory approval processes, there can always be improvement in terms of reducing barriers to access, accelerating timelines and so on, but Hong Kong is already very efficient when it comes to regulatory approval.
In addition, Hong Kong also invests in ensuring that needy patients are able to access life-saving medications pre-market approval, whether through special importations programs or compassionate use programs. We clearly see in other markets, such as China, the willingness to start such initiatives but the implementation is still at very early stage. The priority the Hong Kong government gives to innovative treatments and therapies is really a backbone of the successful Hong Kong healthcare system.
On the other hand, as mentioned, Hong Kong is sitting on a huge treasure trove of data from the Hospital Authority but this is still not yet accessible for research. I think there is a contradiction here. The goal should be to leverage the potential impact of this data through collaboration with academics, researchers, Big Data players and industry stakeholders. I think we understand that data privacy is non-negotiable and fundamental, so it is important to develop the right pathways and processes through which stakeholders can access this data. But it is clear, even to patients themselves, that their data will be important for the development of next-generation medicines.
This should be a top priority also because mainland China is improving its healthcare data systems at breakneck speed. At the moment, the data is still scattered across the country and not uniform across different provinces and cities, but when you consider that even a second-tier city on the mainland could have twice the population of Hong Kong, the scale of data is already there. In addition, China also has a very strong ‘test-and-learn’ behavior. Perhaps the first batch of data will not be perfect but subsequent batches will improve very quickly.
How can AstraZeneca Hong Kong advocate for closer public-private collaboration?
I hope AstraZeneca can be a facilitator or catalyst to drive collaboration across the whole ecosystem. As an example, in China, AstraZeneca launched a Commercial Innovation Center in Wuxi city through very strong partnership with the Wuxi municipal government in addition to other players, including device companies like Omron and Philips Healthcare, and with well-known Big Data service providers like Tencent and Alibaba, to develop integrated, smart patient solutions. We chose Wuxi city because the mainland government has a strategy to develop Wuxi as a global Internet-of-Things (IoT) hub. With the Hong Kong government investing significantly in ‘smart city’ solutions, I believe there are also many attractive opportunities to foster such ‘360’ ecosystem collaboration and partnerships here.
For successful collaboration, all partners must have the same long-term objectives so that all actors are aligned from the beginning. I understand sometimes there are concerns that pharma companies may be using these initiatives to push their own products. To allay these fears, pharma companies must be willing to work with other companies, even competitors. AstraZeneca is very committed to working with our peers and other stakeholders in the industry to participate actively in industry projects to bring more innovative solutions to patients.
With AstraZeneca having one of the most innovative and exciting pipelines within the industry, what new innovations can we expect to see from AstraZeneca in Hong Kong?
AZ strongly believes in the mission of pushing the boundary of science to bring innovative medicines to meet patients’ needs as fast as possible. We have the grand ambition to launch up to ten new molecular entities, as well as develop 20 more indications, in Hong Kong by end-2021. Hong Kong is one of the most active markets when it comes to product launches globally for AstraZeneca, partly because of the government’s support for making new innovations accessible quickly, and also partly because AstraZeneca is committed to meeting patient needs, even if that means launching in more ‘niche’ therapeutic areas or indications with smaller patient populations.
A prime example is AstraZeneca’s vaccines portfolio in Hong Kong, because vaccines is not one of our core focus areas, but we see a high unmet need in Hong Kong. For this reason, we have Flumist, a flu vaccine that we had previously in market till 2013 that we plan to relaunch. It is quite innovative because it is a nasal spray targeted at kids We expect the impact to be significant, not only in children but also in the elderly population, because based on our data from other markets, when you vaccinate kids, you protect their grandparents.
Of course, in line with global strategy, we continue to focus on the three core areas of oncology, cardiovascular and metabolic diseases, and respiratory diseases.
For oncology, we understand that it is very competitive both clinically and commercially. The goal has always been to offer new innovative products that bring differentiated and significant results for the patients, even in smaller indications. For instance, I am very excited about Durvalumab, which is the first immuno-oncology medicine for locally advanced, Stage III unresectable non-small cell lung cancer (NSCLC) following platinum-based chemoradiation therapy. Currently, treatment options for patients with Stage III NSCLC include only chemotherapy and/or radiation therapy, so this molecule will give new hope to patients at earlier stages of the disease.
Another very exciting product is Benralizumab in the respiratory space, which is also our first respiratory biologic drug, so an injectable instead of an inhaled product. It is for patients with severe uncontrolled eosinophilic asthma. It is easy to forget that asthma can also kill people, but a chronic condition like asthma will take its toll on sufferers after a few decades.
These will complement our already strong existing portfolio, with flagship products like Tagrisso, Forxiga and Lynparza driving growth in Hong Kong as well. Tagrisso is an irreversible tyrosine kinase inhibitor (TKI) of epidermal growth factor receptors (EGFRs), indicated for the treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive non-small cell lung cancer (NSCLC). This product helps around a few hundred lung cancer patients every year in Hong Kong. Forxiga is a first in class, oral, once-daily SGLT2 inhibitor for patients with type 2 diabetes, and we are also exploring potential benefits in reducing disease burden of cardiovascular disease in diabetic patients, chronic kidney disease and heart failure. Lynparza is for women with advanced ovarian cancer. Here we are committed to serving a high unmet need. While not very prevalent in Hong Kong, the death rate is quite high, especially for patients with late-stage ovarian cancer, so this is an important product for us.
Finally, this is the first General Manager position for you. What do you find most exciting about your new role?
As General Manager, it is very exciting to oversee the full patient pathway, from early, pre-clinical partnerships with top KOLs to driving the sales and marketing organization, drawing upon my previous commercial experience, to managing relationships with healthcare practitioners and even our internal colleagues, and so on. I have discovered and learnt many things about running an affiliate. The role of the General Manager is very dynamic, which is great because I enjoy being busy!
AstraZeneca also has a great and supportive environment for its employees. If you show motivation, entrepreneurial spirit and smart risk-taking, your leader will put you in the driving seat and empower you! We are all encouraged to act like it is our company. We have a comprehensive talent development program that looks at different capability and leadership skills. The company also provides people with opportunities to grow through talent exchange program in the International region (UK, MEA, AA, China). People in HK have opportunities to work in China/International to learn from larger scale operations. To conclude, I am really enjoying my current experience in Asia: these are markets with high patients unmet needs, where the fields of possible in Healthcare are almost infinite.
