Ana Dolores Román, general manager at Pfizer Ecuador as well as the first woman to lead the affiliate in the country, discusses promoting medical education, increasing patient access to innovations and being a leading light for the local pharmaceutical industry.
Besides being the GM of Pfizer, you are also the president of IFI. Given your expertise and knowledge of the industry, what would you highlight as the most significant changes on the Ecuadorian pharmaceutical market over recent years?
“At Pfizer, we recognize and value the significant contributions women of our company make every day. We are committed to strengthen women capabilities and to promote an inclusive culture across our cluster and in our region.”
The pharmaceutical market in Ecuador is divided into two major segments: the public and the private. The public sector has seen a transformation and huge investments in infrastructure with a lot of support from the government. I have had the chance to compare our health system with other countries in the region and it is safe to say that we have a satisfactory level of service. However, it is worth noting that if compared with other countries, GDP spending on health is still very low in Ecuador. Because of the different regulations that we have in place, pricing has been a priority over quality – although when it comes to the introduction of specialty drugs for therapeutic areas such as cancer, quality plays an important role. This is very important for us because as Pfizer our purpose is to innovate to bring high-quality therapies to patients that significantly improve their lives.
Ecuador is a market dominated by branded generics. Being president of the association of innovators, what is your assessment of the growth prospects for innovators in Ecuador?
I would say the Ecuadorian pharmaceutical market is equally split between R&D driven companies and branded generic drugs. However, if you take into account the number of units being commercialized in the market, then branded generics outnumber originators. It is important to emphasize that innovation is the core element for any R&D focused company. As Pfizer, we want to ensure that the country has the most important launches in Ecuador – especially if the given product has already been launched elsewhere in Latin America.
The incidence of pneumonia in Latin America is very high, for instance, and we have a very important product which is for children and adults. We are trying to ensure that adults have the opportunity to undergo immunization for vaccine preventable diseases. This is why we make use of vaccines as one of the most powerful tools to prevent deaths for certain diseases and, accordingly, reduce the costs of hospitalization. As I mentioned, our mission is to allow patients in Ecuador to have access to the most innovative therapies. To this purpose, it is absolutely critical to understand the process of our regulatory agency (ARCSA) to urge them to approve innovative drugs.
Globally Pfizer is the number one pharma company in terms of sales, but in Ecuador you rank sixth. How can you explain this discrepancy and what has been the company’s strategy to catch up?
If you analyze the Ecuadorian ethical market without milks (IMS), we are the number one pharmaceutical R&D company. The reason why branded generic producers rank higher is because they have a much broader range of products that they can commercialize, whereas we introduce to the market only those products that we research. However, in some therapeutic areas Pfizer is the undisputed leader in Ecuador, despite the tough competition – e.g. in the cardiovascular and men’s health segments. Also, it is important to highlight that we have had stringent price controls since 2017.
What is the ideal model of collaboration that Pfizer is proposing to the government?
I believe that this current government is very open to discussion and always keeps a place at the table for businesses. We try to make the government understand that our medicines are among the most powerful tools we have for patients to treat, cure and manage chronic and life-threatening diseases, we must continue to advance innovative medicines because of the precious and laborious R&D activity behind it. The importance of the quality, the results and the benefits that patients receive from our products is what really matters at the end of the day.
From a regional perspective, what is the strategic relevance of the Ecuadorian affiliate within the Andean region (Peru and Bolivia)?
We have strengthened our presence in the region through the creation of a cluster, which includes Ecuador, Peru and Bolivia. These markets are completely different one from another. We are a very small market, but there are advantages for being in such an environment. We can share best practices and we have a very good understanding of the market because of the proximity to the main stakeholders, to name a few. One of the objectives that Pfizer is giving special focus on is ‘doing things in the right way’. In terms of specificities, Bolivia is the smallest market whereas Peru and Ecuador are fairly similar. One aspect that we pride ourselves on is the corporate culture that we have in the three countries which all revolves around putting patients in the center.
In Ecuador, 90 percent of the pharmacies are located in urban areas and only 10 percent in rural areas, showing that there is a relationship between purchasing power and access to drugs. How is Pfizer reaching out to patients in the most remote parts of the country?
The availability of Pfizer’s products either through the public or private sector is something that we proactively try to achieve. We are working through different channels and we put a lot of effort into allowing patients to have access to our products. Not only in Ecuador but around the world, Pfizer works with governments, insurance providers, non-governmental organizations and others to explore new ways to improve access to today’s innovative treatments, while we work to develop the future medicines that patients and their physicians are counting on.
For instance, one approach is through Fundación Promesa at IFI whose objective is to complement the efforts of the public and private sector by facilitating access to medicines, amelioration of health and support national institutions in the event of emergencies.
Another approach is through our social responsibility initiatives with patients. For example, in October 2017, Pfizer and the Latin American Union Against Cancer of Women (ULACCAM) and 20 other groups of patients of Latin America joined efforts to launch an information campaign on metastasic Breast Cancer (mBC) through 3 materials directed to mBC patients: “My Doctor and Me” guide, “Topics of Conversation with My Doctor” booklet and “Me and mBC” manual. We received the endorsement of the materials from patient’s organizations as CEPREME in Quito, Esperantra in Guayaquil, as well as the SEO (Ecuadorian Oncology Society). Print materials were distributed to mBC patients through the organizations.
Pfizer is highly involved in promoting medical education in the country. What is your assessment on the level of medical education in the country and how if Pfizer contributing in this regard?
In Ecuador, we have Centro Cientifico Pfizer Ecuador, which is a free digital platform directed to physicians. It was born on April 2015 and the mission is to promote the creation and development of sustainable initiatives in education, science, research in the field of health, in favor of the growth of these sectors for the benefit of the Ecuadorian medical community.
As part of Centro Cientifico, we have ELITE (Education for Leaders that Transform Ecuador) and CENIT (Ecuadorian Contest for New Researchers) programs, which support the construction of medical-scientific knowledge of health professionals of all specialties through a virtual platform study that focuses on update of the prevalent diseases in Ecuador and the promotion of research to respond to public health problems. Both programs directly affect the improvement of patient care and public health. It is important to highlight the importance of the partnership with the Academy.
To date, we have more than 1000 pharmacists and biochemists participating in ELITE and 38 research protocols in CENIT and more than 170 researchers. CENIT research papers increased in number but above all in quality, raising the level of local research and, at the same time, further encouraging the production of scientific publications that contribute to the improvement of the public and private health of the country.
How do you assess the gender gap in the pharmaceutical sector in Ecuador and what has been your experience at Pfizer as a woman?
I could talk about this for 12 days, but I will try to keep it short. I truly believe that it is vital to have the passion for equality. In Ecuador, one in ten CEOs are female, which means the situation is improving. In order to achieve gender equality, women and men need to be open to work together because they can provide diversity of thinking and operating.
At Pfizer, we recognize and value the significant contributions women of our company make every day. We are committed to strengthen women capabilities and to promote an inclusive culture across our cluster and in our region. Diversity is deeply connected to what we are implementing in all our business units. It is the source of innovation and competitive advantage. We need to continue working together to make a positive difference in our patient’s lives, families and society.
Our strategy imperatives for driving gender equity are 1) Promotion of an inclusive environment and encourage greater representation of women in management positions; 2) Exhibition of women role models at all levels in the company to promote their growth; 3) Initiatives, resources and tools to promote women’s empowerment, leading at every level. This goes hand in hand with our internal policies and code of conduct which promote the diversity and inclusion in our company, such as equal opportunities in selection processes and promotions, pay equity, zero tolerance of discrimination and violence, reporting compliance channels, flex time and flex site, and work-life balance benefits.
We are making significant progress in our cluster (Ecuador, Peru and Bolivia) For example; women represent 58 percent of our colleagues in the cluster, 60 percent of our leadership board and 50 percent of Pfizer’s directors in Latin America. In Ecuador specifically, our internal engagement survey in 2017 reported that 100 percent of colleagues agreed with the statement “my manager cares about me and respect me”, 98 percent “can report unethical conducts without fear”, 97 percent agreed that “Pfizer have fair and transparent selection processes and promotions” and 100 percent will recommend Pfizer as a great place to work.
What are your ambitions for the next five years?
Even if we do not have OTC products in the market, we are the leader in many fields, especially when it comes to reputation. Personally, I am trying to become a role model not only for the pharmaceutical companies but more broadly for the problems that affect Ecuador and to ensure that we can link the health to the consumers and find opportunities for the country to emerge. In the next five years I would like Pfizer to maintain its strong footprint and become as reputable as it is globally. Another crucial aspect is the continuous talks that we need to carry on with authorities.
Due to the rapid change of technology and innovation, we are moving from a pricing perspective of medicines to an integral value proposition of treatments in the healthcare system. Big data will meaningful help scientists, spurring interest to develop medicines and better define which patients will benefit most from specific treatments. This presents an unprecedented opportunity to have a life-changing impact on a growing number of patients. In the same way, access for healthcare systems remains a challenge for millions of patients worldwide and that is my bigger ambition for working at Pfizer.