Janssen’s MD in Turkey discusses how true innovation is still recognized in Turkey, and how products that meet unmet medical needs are given early access to the country and reimbursement.
Based on current discussions, what is your expectation for how pricing reforms will transpire when they begin?
The government is highly interested in having innovative products in the market, also considering sustainable health budget and services. Their major challenge is to balance these needs. However, there should be a better way than always demanding concessions from certain stakeholders only; making a reasonable margin is essential to all for remaining in business. So, finding a middle point is key. From my personal point of view, fair pricing policies for innovative solutions deserve specific emphasis.
How does Janssen see Turkey within its portfolio of countries, and what are the defining characteristics of the market?
In Europe and the MEA region, we are one of the pioneer countries with our visional and structural journey for change, which we call “Aspire!”. It defines our vision and strategy for improving patient outcomes. We have different archetypes of countries within this region and Turkey is one of them. Outcomes depend on many more factors than just the product. We have to have proper diagnostics in place, and we have to drive for improved lifestyle behavior by patients, among others. In Turkey, the approach to improving patient outcomes is different to that in EU, but the idea remains the same around the world, which is to improve patient outcomes using every means available.
Business success is an important goal of “Aspire!,” but our innovative approach and our people who are the driving force behind everything, make all the difference.
Is Turkey an attractive investment destination for the company and how would such an investment complement other operations in the region?
Turkey is certainly an interesting market for potential investments. Keep in mind that Turkey is competing with several other emerging markets. In 2014, Johnson & Johnson was named among the top three health care companies with R&D investments of $8,5 billion. Additionally, over the past 10 years J&J has consistently ranked first in terms of productivity, with 13 new approvals. Since 2009, at Janssen Turkey, we have invested nearly 30 million TL in clinical trials in Turkey, and our investments are growing by the year. We have reached over 1.000 patients through clinical trials in 5 therapeutic areas.
Key factors that make Turkey attractive within the EMEA region include a large population of treatment–naïve patients, a competitive regulatory framework for clinical research in terms of approval timelines, and a large number of well-equipped clinical institutions and highly competent investigators. Recently, Turkey has been intensively involved in hematology trials, and we achieved several key milestones; for example, Turkey ranks third after the USA and Japan/Russia in terms of patient enrollment in clinical trials, which is an indicator of the favorable regulatory framework and high quality of investigators, which encourage Janssen to invest here.
Local production is a hot topic these days, in Turkey and elsewhere. We need to engage the government in a constructive dialogue to explore incentives for taking up technology transfer to Turkey. These incentives may be in the form of the availability of a supportive infrastructure. Janssen is highly interested in launching manufacturing operations in Turkey, but before that we must have a proper framework in place.
As for the 2023 Vision, 2023 is eight years from now. I think Vision 2023 goals may be achievable if the government can implement their 10th Development Plan and be receptive of feedback. After the upcoming election, we will have stability for the next four or five years, which means we can start focusing and working on these policies. As the Turkish the government is open to dialogue, and we are open to engaging with them in such dialogue to identify the right policies for an all around win-win situation.
What are some of the steps you are taking to bring your innovative solutions to patients?
In a way, the Turkish government has put something really relevant in place that has become very useful for innovation-driven companies. For example, we have been able to launch five new products over the last two years. We achieved this, first because we are scientifically competent and second, the government is working hard to streamline the GMP approval process, prioritizing products that represent an improvement over current therapies.
Regarding our launches, we have launched by far the largest number of new products compared to any other international company, all of which are innovative, break-through products. I personally believe that, this was made possible by a combination of external factors, and patient focus of both Janssen Turkey and our stakeholders.
How does the Turkish portfolio compare to Janssen’s global portfolio, and how will this portfolio evolve in the coming years with loss of exclusivity and new product launches?
Janssen Global has been doing a lot of licensing arrangements and small acquisitions and partnerships. As regards free-for-all products on the market, we have the same portfolio as any other country. But now we are focusing only on innovative products. For products nearing the end of their lifecycle, we channel our resources to innovative alternatives and start investing in more value-adding opportunities. Therefore, we focus on researching and developing groundbreaking molecules, rather than competing with generic companies. As I mentioned before, we have launched five new and innovative products over the past two years, and we have several more in the pipeline undergoing regulatory review. The main focus of Janssen is to improve the outcome of Patients in need. We will continue to invest in R&D in those areas where we identified an unmet medical need.
How can a model like Janssen’s open innovation platforms help stimulate on the ground Turkish innovation, and what is the potential for innovation in an emerging market like Turkey?
An innovation center is about its people. You find people on the ground to build a solid foundation and funding, and you cooperate with them. The education system in Turkey is outstanding. Unfortunately, many talented people leave the country. The question is “What would it take to attract these people back to Turkey?” We have so many young, well-educated people in this country, who are really a huge asset. We are always on the lookout for having an innovative hub or center in Turkey. Once we find this opportunity, we would love to see it integrated with our network at Janssen.
After spending three years in Germany, you returned to the Turkish affiliate in 2013 as the new managing director. What have been the key priorities and initiatives of your mandate so far, and what do you envision as being the most challenging going forward?
The first thing that we did after my arrival in 2013 was to discuss a vision for Janssen Turkey with our employees. We didn’t just make up a generic motto; we actually put our heads into thinking our needs and opportunities for sustainable results. “Together we develop innovative solutions for a healthier Turkey.” This is our vision. It covers all of our stakeholders, our passion for innovation, and our aspiration for delivering value-added solutions. We then took this vision, translated it in to a strategy for our core therapeutic areas like Oncology, Hematology and CNS and defined activities to execute this strategy.
A key part of Janssen’s credo is that you have a “responsibility to the communities in which we live and work” and “must be good citizens”. What CSR activities is Janssen Turkey undertaking to uphold this goal?
On a global level, we have invested enormously in the anti-Ebola efforts. Johnson & Johnson swiftly responded to this critical public health issue by commencing work on a vaccine to cure the Ebola virus. We have taken steps to make sure that this drug is used in Africa by patients in need. Fortunately, Ebola is not an issue in Turkey, but we’d have the vaccine in hand were it to happen.
Another concrete example of our global responsibility is our multi-drug resistant tuberculosis treatment. This issue is under control in Turkey, but has reached disastrous proportions in Africa. Over the past 40 years, there have been no research efforts into tuberculosis, although it is a very serious disease, particularly in South Africa. Now we are providing an innovative drug and supplying it free to the regions in urgent need.
Being a part of the Johnson & Johnson family, our role is to live up to our Credo and apply its values to our daily business activities. In Turkey, what we have been doing recently is perhaps not conventional CSR. At Janssen Turkey, we believe that it is not enough to just donate money and then step out. Everybody can do that; this is not our role. We have a responsibility for public healthcare and global wellbeing, and thus in Turkey we are supporting collaborative value-adding projects that increase disease awareness and improve patient access to treatment.
A key example of our efforts is our collaboration with the government and the medical community since 2006 for establishing and improving community mental health centers (CMHC). Currently, there are approximately 80 CMHCs, and the government is planning to open about 160 new ones across the country. As Janssen Turkey, we continue supporting community mental health centers with know-how, tools and training programs who all are leading to a better treatment outcome for schizophrenic patients.
You have been with Janssen for 20 years, and have experience in a big five market, Germany, as well as a pharma-emerging market. What are some of the aspects of Janssen’s German operations that you have tried to implement here, or that could be applied in Turkey?
Despite the different cultures of the two countries, the important underlying factors remain the same: the Johnson & Johnson credo and our core values. Speak to any of our associates across Janssen offices around the world, and you will see that we always share the same ideas and the same vision. The particulars of running our business are naturally country-specific, but the overarching question is the same: what can we do better for our patients anywhere in the world? This is driven by our credo and by our heritage. What I see as a major commonality is our shared desire to find solutions for patients not only by our products but by our solutions that go beyond the medicine. And toward this vision, I am working with a well-engaged and resilient team of colleagues who are open to learning new things and able to rapidly adapt to an evolving environment.