Shire France’s General Manager, Andrew Obenshain, speaks optimistically about the leading market conditions in France, the corporate culture of a multinational company in a niche market, and building a rapport with government and patients.

As an American working in France, what are your key observations about the differences and similarities of these two work cultures?

My firsthand impression is that the education level in France is extraordinarily high. If I were to compare and contrast a college graduate in the US versus one in France, I would pick the French graduate, given the quality embedded in the overall education system. The talent here is incredibly well-trained, articulate and has a strong work ethic. However, it is unfortunate that the opportunity to cycle through different jobs is less in France and therefore people have more limited work experience. That being said, there is a current trend towards creating more flexible work rules to allow more fluid opportunities for people. A new labor framework is currently being reviewed by the Hollande government, so I am optimistic things could evolve in a positive manner.

Overall, I have been impressed by the quality of the workforce in the country. I find the people here very talented. In fact, if we look at Boston and San Francisco, both considered to be strong biotech hubs, there is a significant amount of French talent there. I believe that the French mindset transfers well in these fields of engineering and technology, which could account for this trend.

As with any expat experience, one is typically within the corporate culture of the company as opposed to the “home culture” of the location. Given Shire’s international presence, the corporate culture reflected within our walls carries that international flare as well, which has made the transition much easier for me. Apart from my French not being completely perfect, I have not had any major challenges in dealing with government and partners. I believe that it’s more of a perception than a reality that you need to be French to be in a position of leadership in a company based on French soil.

Could you also please describe the cultural differences that you observed between your previous company, Sanofi, which is a largescale multinational corporation, and Shire, which caters to a very specific market niche?

One of the hallmarks of Shire is fast decision-making. Things move quickly. In my first six months for example, we shifted teams internally and announced a significant strategic decision to combine with Baxalta. What has truly impressed me is the way our teams have embraced the change. The people at Shire are invested in the company and are very adaptable for the well-being of the business. The reactivity time is a testament to the strong culture within the company. Employees embrace change and there is a very practical approach adopted by employees here.

While we were founded in the UK, the company has matured in a way that is very international. Even my colleagues in Boston now are much more attuned to the needs of the market in France, especially because this is the leader for the European market.

What objectives were set forth for you at the onset of becoming general manager for Shire France and Benelux last September?

We view France as one of the best markets in the world for orphan diseases, whether you are a patient or a medical professional. If I were a patient with a rare disease, I would want to be in France because this country is a center of excellence globally. An example of this is the treatment of Short Bowel Syndrome. There is a reference center in France sees more patients than any other center in Europe and thus is gaining more experience and expertise than any other center. This level of expertise instills great confidence for the patient and in turn, this could enable France to be recognized as the number one center of excellence for this condition.

Our ambition is to make France the second ranked market in Europe. This spot is currently taken by our UK Local Operating Company, given the fact that our company shares historical roots there, but France definitely has the potential to assume this position given the tremendous opportunities available throughout the country. We really want to position France as the emblem of what it means to be a company that truly takes care of rare diseases as there is much more we can do here than other countries.

Shire’s portfolio is immense and contains a multitude of different pathologies. Which areas and products are represented exactly by the French operations?

We have three products in Lysosomal Storage Disorder and two in Hereditary Angioedema, and these two areas represent the bulk of our business. ADHD products are also fundamental to our business, but to a much smaller degree than our European colleagues.

Between now and 2020, we have at least ten products that are due to launch.

Market access will be a priority in these projects because, for us, it is not only the clinical value of the product that we are interested in, but also the real life data. We want to know how exactly our products are impacting the patient. And we want to work with the government well in advance of these launches so that we can have a mutual understanding of the value of these products and their impact on the healthcare system.

How would you describe your relationship with the French authorities and the regulatory nuances in this environment to gain market access?

The AMF telethon and other events happening regularly in France have had a tremendously positive effect in creating public awareness for orphan diseases and I would like to say that this awareness is far higher than in any other country. This has presented multiple advantages for us, however, this is not to say that there has not been pricing challenges for us or some difficulties in promoting the innovation that we offer. There is a pathway carved out there and we know the rules to market, but there are challenges present too.

An example of one of our biggest constraints is that, when we bring a new orphan drug to market that only has a few hundred patients in France; very often the government will ask us to provide a registry for these treatments. This is clearly a cost to us, even though there are also benefits to both the company and government. This enables us to understand our patients better, as well as for the government to understand what they are paying for. However, it is not an easy task and entails operational challenges akin to a full scale clinical trial that aims to include every patient.. . This is not a challenge that is unique to us, but one that we have to maneuver with tact and strategy.

In terms of our market access team itself; our main requirement is to get more people to assist with our highly accelerated company initiatives. We launched one product last year; we will be launching one this year and we have very ambitious goals to accelerate this in the future. We therefore need more people.

As we launch more treatments in rare diseases, we will need to continue our emphasis on continuous data generation and articulating the value of our medicines to the patient and the healthcare system. Unlike traditional pharmaceutical companies, we will not have armies of representatives. Rather we will have highly trained account managers who can help hospitals structure themselves to treat patient groups who have previously had limited treatment options.  It is easy to imagine a future organization where medical and market access expertise accounts for over half of the employees versus less than a quarter today.

In terms of development, patient care is at the crux of relevant topics in terms of rare diseases. How does Shire build these relationships and connections with its patients and patients’ associations?

First of all, it is important to note that as a pharmaceutical company, we work in a highly regulated environment so we work with patient groups through grants and donations, supporting specific initiatives and ensuring that there is patient education and at-home coaching throughout the treatment.

One of the ideas we sponsored recently was a program to encourage patients to coach other patients. In rare diseases, it is often the patient who is the best educator for the disease, as physicians have such limited experience.

We have also invited patients to our employee meetings so we can hear their experience first-hand. At one meeting we experienced a rap performance by two brothers both living with Hunter’s disease. It really energized employees and provided a personal encounter, reminding us of the impact our medicines can have.

Given the nature of orphan diseases where there is a strong reliance on research partners to be up to date with the latest innovations and needs of the markets, what partnerships does Shire have in France to expedite this process?

France is an incubator for knowledge. We are actively looking for ways that we can invest more in France overall. Right now, our path is really through education programs. We are very interested in being more integrated in the culture of innovation of France itself. Historically, Shire has been a company dedicated to ADHD and we have evolved over the years to shift our focus towards rare diseases.

Being in the rare disease field differs greatly from a large pharmaceutical company, such as my previous experience at Sanofi for example, because there is a much closer relationship to KOLs. Everyone is truly invested in their work and what products are about. The main priority is to get that product to the patient and everything else comes second. Therefore, the mindset is entirely different because we have an “all hands on deck” type of philosophy here. This is a perfect example of the fast decision-making business approach that Shire has and that I enjoy profoundly.

What are the key factors that entice you to stay in France and inspire you to meet the 2020 goals at Shire?

In the rare disease field, France is one of the best places to be. For Shire itself, we take pride in the fact that we have one of the most robust pipelines in this sector. The rare disease market has grown about nine percent in the past few years and I have a lot of confidence in our products. I am extremely optimistic about the potential growth for our company in the market and France has been very receptive to us. France has a young and educated population, it is an incubator of high-level talent, and its GDP is forecasted to rise in the next few years. I am more than confident that we can achieve our ambition to be the leader in rare diseases in France.

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