Chris Juliam, Managing Director for Takeda Italy, shares the strategy the company is pursuing in the country, the effects market-access issues are having on innovators and patients, and what new products the company’s pipeline holds for the future.
When we interviewed Takeda in 2009, you were ranked 20th in the market, now we’ve returned in 2015 and you have just taken the 16th spot, with revenue rising sharply in 2015 especially. To start off, can you tell us what strategy you have employed to achieve such remarkable success in Italy over the last six years?
The growth has been driven by our focus on becoming an agile specialty care player while still continuing to support primary care in a smart way. Although we have been reducing our resources in primary care, it remains a pillar of our business here as an important source of income. We need this income to support our R&D efforts and the launch of new products. So I would say that this gradual transformation from a focus on primary care to becoming a specialty care player is what has been driving our growth in the last three years.
In terms of what that shift means for our current portfolio, half of our portfolio is in gastroenterology, and a major part, roughly a quarter, is oncology which covers prostrate- and breast cancer and hematological cancers as well as bone cancer. In these areas we specialize, as Takeda is known for, in medicines which strike at the core of the disease in question and which have a serious impact on the patient’s wellbeing. Gastroenterology is still growing strongly, and in fact we have new products in the pipeline, for example our IBD drug Vedolizumab which will have a large impact when it is introduced. Our cancer segment is also growing, even in products which have been on the market for a considerable time. Finally, we have diabetes, which is performing very strongly in the Italian market, and where we just launched a new DPP-4 inhibitor, Tregaliptin. Besides these headline growth drivers in gastroenterology, oncology and diabetes, we also have smaller products supporting growth in areas such as surgery.
You mentioned diabetes as a major part of Takeda’s portfolio, and this is a highly relevant issue for Italy as 8.8% of the population suffers from the disease. How are you outperforming the market in this area?
We are indeed outperforming the market, and are very happy with the results we have seen here. This has been achieved through very strong clinical data on cardiovascular safety, and that was important for physicians to see as most diabetes patients have cardiovascular problems. So it was important to have a drug (Alogliptin) which was not only efficient in addressing the immediate symptoms but which was also safe in the longer term. I think that the value of Alogliptin has been recognized by the market.
Another important factor to consider here, which ties into that is that in Italy these products are only sold to specialized physicians, so for diabetes only products prescribed by diabetologists are reimbursed. This means that when we communicate the value of the medicines to the physicians who will be prescribing them to patients, we need to ensure that we can engage them effectively. To achieve this, in line with our move towards becoming a specialty care player, we have ensured that all of the department heads for our specialty care departments are themselves specialists in their fields. Italy is well known for its excellent doctors and physicians, and this means that when we communicate with them we need high-level people.
I also think clinical trials in-country are extremely important in demonstrating results, as key opinion leaders and investigators here are truly world-class. Unfortunately, the procedure for conducting them takes very long. This bureaucracy means that for several clinical trials Italy cannot compete. We are competing against countries such as Hungary and Belgium, where the approval comes very quickly. Research costs a lot of money, and because it takes so long to get approval here Italy is being left out. This needs to be sped up, to make the country more efficient in this regard.
One issue which still affects companies operating in the Italian market is the market-access time which stands at over two years. How has this affected an innovator like Takeda when it is seeking to launch new products?
Market access is indeed a sticking point in Italy. Not only does it still take a while at national level, but even once you gain approval nationally, regional approval can take up to fourteen months to complete. This means that in total it can take up to three years for citizens in certain cities or regions to benefit from new drugs. So we are quite excited to be launching Vedolizumab, as Italy is the last country in which it is set to be introduced.
It is certainly not just the company that is affected by this. We are getting phone calls from patients every day who see that the drug is available in other countries, and who want to get access to it. This is hurts us, because the patients often think it is the company which is holding the drug back, when in fact we are still awaiting approval to bring it to the market. It is not a good feeling to have a medicine which will improve patient’s lives, but to not be able to bring it to the market when it is already available in other countries.
It is clear that Takeda has a busy pipeline, you have just launched Tregaliptin, and are about to launch Vedolizumab. What do the product launches planned for the upcoming two years look like?
We are looking to launch an important breakthrough product in multiple myeloma in 2017. It will be the first oral proteasome inhibitor, and is used in combination with other products, but this will be the first fully oral treatment. We have just seen the first abstract on the initial data and it looks very promising. This would really cover a high-demand and as-of-yet unmet patient need. This is another good example of the very specialized treatment areas we are looking to enter and grow strong in. So it is very niche, but we have excellent results for it.
When we have met Takeda across the globe, one point managers emphasize is the role Takeda’s philosophy, Takeda-ism, plays in their success. How do you apply this philosophy to your operations in Italy?
These values are universal, and that makes it possible to apply them across the globe, and in every part of the business. The heart of the philosophy lies in integrity, fairness, honesty and perseverance. Especially in Italy, as this country was one of the company’s first affiliates in Europe, we host annual events around Takeda-ism and sharing best practices, where the employees give examples of how they have implemented these concepts in reality. In fact, we had one exercise where, across Europe, we put the answers we had gotten at these events together, and it was amazing to see how, whether you are in Japan, Italy, Holland or Colombia, they are applied daily and in the most creative and effective manners. It provides common roots to the company’s different affiliates, and you can really feel how that gives us a shared sense of purpose.
The other thing I would say is a strength among Takeda Italy employees is their engagement. We had a survey which showed that engagement in the country stood at 90%, so the employees are clearly very committed and involved in the company. They work with passion, and they have really driven our success. Fostering this comes down to trusting your people, encouraging teamwork and promoting shared success.
