Ana Kostova, Austrian country president for AstraZeneca, a global powerhouse in innovative drugs and R&D, discusses the opportunities and challenges of introducing innovative treatments into the Austrian healthcare system as well as AstraZeneca´s exciting pipeline, especially in the field of oncology. She also provides an insight into the future potential of the company in Austria and her aspirations as a young, ambitious leader.

You have been working at AstraZeneca for many years in a variety of different roles. What attracted you to the Austrian country president position?

I started at AstraZeneca 17 years ago, working at the Sofia branch as a medical representative and moved through the ranks in different sales and marketing roles at a local, regional and global level. Prior to this job, I was global brand director in the respiratory team in the UK headquarters. The country president position has always been a role I have aspired to do, and I see it as a logical career progression. All my past experiences throughout my AstraZeneca journey at a regional and global level allow me now to understand the mechanics and synergies of the company and enable me to apply them in Austria. I feel privileged to be here to help steer AstraZeneca´s Austrian branch into a positive future.

What were your key priorities when you started here in 2015?

AstraZeneca Austria at that time had gone through many internal and external changes and my key priority was to bring stability and consistency to the team – while in the meantime – reviving the dynamic company culture and creating a cross functional work environment built on team spirit. AstraZeneca globally was at an interesting crossroad as drugs were losing patents and stability was very important during this period. But we are back, bringing several innovative products to the market which will set new standards.

Thus far we have made huge progress and our internal surveys prove that right. Our staff is happy here and has a positive mentality towards our initiatives. We still are not done, as the job is never done, but figures show we are on the right pathway and are developing a strong coherent team.

How does Austria now compare to other AstraZeneca branches in the region?

We as a team are continuously working to raise the profile of AstraZeneca Austria and attract the attention from global headquarters in Cambridge, UK. Despite constraints faced by the industry through reimbursement reforms that have recently been put in place, Austria enhances innovation by giving companies opportunities for early launches.

For instance, we in Austria set ourselves the target to be the first branch of AstraZeneca in Europe to treat a patient with an innovative cancer treatment through reimbursement, and we did this! So, we will incessantly look for any opportunity to be a “first mover”, ensuring patients get the best treatment they deserve.

You mention the constraints placed upon innovative companies, particularly through reimbursement programs. How is innovation being rewarded in Austria?

Every innovation which brings benefit for the patients gets relatively quick access to the market. Negotiating with the reimbursement authorities is not easy and the problem lies in the strict regulations around pricing. If a drug is launched on the market and it is not the first product in its class, but second or third, the cost must come within a certain discount of the previous drug. This can be a hurdle for bringing the drug as early as possible to the Austrian patients. Nevertheless, the market launch speed is promising for us.

An additional challenge is the separate funding of inpatient and outpatient (primary) care. This weakens our arguments in regards to the pharmaco-economic impact of innovative drugs.


The pharmaceutical industry signed a contract with reimbursement authorities to claw back overspending in healthcare; contributing 18 million EUR (21 million USD) in 2015 and 125 million EUR (147 million USD) in 2016. Overall the pharmaceutical industry is an important partner and we must have a stronger voice, especially since we invest so much in the funding of the Austrian healthcare system.

Where do you see future growth for AstraZeneca in Austria?

We will continue to focus on our three core therapeutic areas; cardiovascular and diabetes, respiratory and oncology. AstraZeneca has a very deep portfolio with many established products introduced 15 years ago, which are still helping a lot of patients in Austria. Nevertheless, we are focused on our innovative portfolio and our current and future launches.

In cardiovascular, we have a very exciting product, designed for acute coronary heart disease, that has been on the market for a number of years. A year ago EMA licensed a new indication for prolonged treatment of high risk patients for up to three years, and we also have ongoing studies for new indications with diabetic patients. This indication is definitely exciting for AstraZeneca as an entire global company. Diabetes is an important therapeutic area for AstraZeneca as well, especially with the new class of SGLT2 inhibitors. We are the first company to launch a product in this new class and we have two further products to add to our portfolio.

In respiratory we also have a long tradition with products, which have already been on the market more than 15 years and interestingly it remains a dynamic area. Next year we are releasing a new biological product to treat the unmet need of severe asthma patients. In the meantime, AstraZeneca Austria is one of the first countries to launch a medical device that links the Turbohaler, an inhalation device, with a smartphone application, that allows doctors and patients to follow up the intake of the inhalations.

AstraZeneca in oncology has one of the richest and most exciting pipelines in the entire pharmaceutical industry. In the last two years, we have launched two new products; one in ovarian cancer and the other in lung cancer, both targeting a specific mutation. Austria was one of the first countries in Europe to receive these products, thanks to the processes in place for great innovative drug accessibility.

On top of these launches, next year AstraZeneca is introducing in Europe its first immune-oncology product for treatment of stage three unresectable, non-small cell lung cancer, a field with limited current treatment options. This drug is already available in the US for another indication and highlights AstraZeneca’s intention to be one of the leading companies in innovative cancer treatment. Furthermore, oncology is an area that continues to grow as new indications are continuously developed for already established products.

AstraZeneca is planning to release six new oncology drugs before 2020. How do you navigate the saturated cancer treatment market in Austria?

The oncology environment is split between the two systems of funding. Hospital budgeting is becoming increasingly important in the introduction of oncology treatments, as many of the new innovative drugs are accessed through their budget. Our team must find a path in this complex system to ensure the patients in Austria will benefit in the future from the most advanced innovation.


It is important to mention that in Austria there are highly skilled centers of excellence and over 400 clinical trials are currently ongoing in the country. More than half of them are in oncology which gives an opportunity patients and doctors access to innovation. We are trying to attract as much investment as possible from AstraZeneca´s headquarters to Austria, and the high quality and expertise of the universities and centers helps a lot.

AstraZeneca globally is very proactive in collaborating with different institutions and research centers. It is no coincidence that our headquarters are in Cambridge, one of the most vibrating hubs of the bio-research. We do the same in Austria and work to establish ourselves as a reliable partner for the scientific community.

How do you differentiate yourself to doctors, the chief prescription decision makers?

AstraZeneca Austria has 130 employees, with over half of them in sales. We do not just have our sales representatives in place, but use medical staff to talk about the science, latest trends and clinical studies. We have a specific field force linked with market access, having discussions with hospitals, pharmacies and regional payers. We are a reliable partner of the scientific societies and work together on different projects.

Looking forward now, what has motivated you throughout your career and what are your aspirations for AstraZeneca Austria in the future?

We are currently the 6th company in regards to revenue in the Austrian retail market. I am confident our new launches and rich pipeline will drive our growth and push us back into the top five in the near future.

My motivation comes from my values as a person, which are very similar to AstraZeneca´s and this has driven me forward. The company takes care of people and harnesses their full potential. I am keen to take challenges as they allow me to learn and constantly place myself out of my comfort zone. This gives me the opportunity to never feel stagnant, and fills me with energy each and every day to motivate my team.

My leadership team started around the same time I did, two years ago, and we are constantly working to develop AstraZeneca Austria together. It is a two-step process based around the theme of growth: firstly, develop and grow people and the team and secondly, growth in terms of product and sales numbers.

Our goal is to create a working environment of team support and fun, build AstraZeneca Austria as a place to be and establish it as a reliable partner in the Austrian healthcare ecosystem. I hope when 2020 comes around our vision will come true with a strong team and new products helping many patients so each of us can be proud of being part of AstraZeneca Austria.