The managing director of Stallergenes Greer Switzerland, Claude Fischlewitz, explains how he has gone about revitalizing the company’s presence in Switzerland, while expressing his ambitions to restore and firmly position Stallergenes Greer as the number one provider of total allergy management in the country.
Can you please start by providing some insight on how you initially came to work for Stallergenes Greer and what your priorities have been to date?
“How we go about differentiating ourselves, despite not having the same scale as some of our peers, is through the sheer diversity of our portfolio.”
Previously I was with Allergopharma, where over the span of four years, I grew the local business into the market leader that it is today. I then left that company to pursue the exciting prospect of revitalizing Stallergenes Greer’s operations in Switzerland. I was aware of the production challenges that the company had experienced in the past, but was motivated to get us back on track, to a new level of quality and a laser-focused ambition to reclaim our dominant position in the allergy business.
My priorities to date have been centered around reorganizing the Swiss subsidiary and setting up a new business model here. Given the small scale of our company, I have had a direct hand in driving our sales and marketing efforts, particularly when it comes to allergen-specific immunotherapy (AIT), which is one of our three primary business pillars.
In Switzerland, Stallergenes Greer also maintains additional business units; we’re the sole distributor of the Circassia device, which measures eNO (exhaled nitric oxide) for asthma and/or allergy patients, as well as SmartPractice products, which includes a palate of over 500 products that can be used to test any type of allergen. Since we’re a small organization, consisting of 20 staff members, I felt that it was important to streamline our functions and be less hierarchical in nature. As a result, I assigned one key account manager to oversee the sales and marketing activities of each one of these two business units. The result has been very positive, allowing us to be more responsive to the needs of our customers, as well as the doctors and markets with which we operate.
How is Stallergenes Greer currently positioned in the market?
Upon joining Stallergenes Greer in Switzerland, the company had been absent from the market for almost one year due to the implementation of a new software system which had severely disrupted the production and delivery process. Management had to essentially “reinvent” the entire organization by creating new functional verticals and procedures across the entire organization. It’s very unusual that a pharmaceutical company managed to survive in a market like Switzerland without any commercial activity for a year, but our dedicated teams, starting with our Chairman of the Board Fereydoun Firouz and CEO Michele Antonelli, were instrumental in persevering and getting us through this challenging period.
Our main competitors in Switzerland are Allergopharma, the current market leader, and ALK. Interestingly enough, Allergopharma has been a very strong driver in developing the Swiss market, where 70 percent of allergen therapies are administered through subcutaneous injections. This is likely because Swiss doctors tend to believe that injections are more effective than oral solutions (such as applications, tablets or drops), even though in terms therapeutic efficacy, clinical data sets have shown no significant differences.
How we go about differentiating ourselves, despite not having the same scale as some of our peers, is through the sheer diversity of our portfolio. Stallergenes Greer offers a unique one-stop shop solution for doctors looking to fully cater their patients’ needs. We offer SCIT (subcutaneous immunotherapy) and aluminum and aluminum-free products, along with therapies in SLIT (sublingual immunotherapy) in oral and droplet forms. None of our competitors boast such a diverse offering, which puts us in a unique position to further expand our presence.
How significant are the Swiss affiliate’s activities relative to what Stallergenes Greer is doing around the world?
The key markets for the Stallergenes Greer group are France and Germany, with Switzerland, Italy and Spain following closely. Much of the group’s success in Switzerland is of course due to the ease with which our products are reimbursed by insurance companies, and the sheer quality of the Swiss healthcare system which is one of the best in the world.
That said, it will still take us between three to five years to get Stallergenes Greer back to its position as the leader in total allergy management solutions in Switzerland.
What strategic importance does immunotherapy hold in the company’s portfolio?
Our immunotherapy solutions are what set us apart. From a medical and economic point of view, immunotherapy is a very important and particularly efficacious therapy. Unfortunately, however it doesn’t have a strong standing in the medical field.
Part of this is due to the fact that the number of young doctors entering the allergy field in Switzerland is quite limited (only two to four MDs become specialists each year). The other part, in my opinion, is because the burden of disease for allergies has not fully materialized in this market, and is often overshadowed by more terminal disease segments.
Allergy immunotherapy is a causal therapy, which doctors prefer over simply providing symptomatic treatments. Causal therapy helps to restore the imbalance between T2 and T1 cells so that the body doesn’t recognize the allergen as a host and elicit a reaction. During regular immunotherapy, whether that’s sublingual or subcutaneous, you achieve positive results with 60-80 percent of the cases.
That being said, allergies are highly pervasive, chronic diseases, with roughly 30% of the Western world sensitized and half of that number exhibiting symptoms. If you break that down into the number of people that actually undergo state-of-the-art immunotherapy treatment, you’re left with just eight percent of the population. Because of that, unfortunately the awareness of the disease is just not there yet. But my main priority at the moment is to set about changing that.
Which marketing channels have you found to be the most effective for your products: brand equity, market presence, or overall raising of awareness of allergies?
We use multiple channels to target our audience, including: medical journals, sales reps, advertisements and participation at GP and Pediatric congresses. However as in many markets, pharmaceutical companies aren’t allowed to conduct direct-to-consumer (DTC) advertisement when it comes to product promotion. Therefore, we try to use our limited resources to target more specific audiences: general practitioners, pediatricians, and boilerplate allergy specialists.
Early on in my role I realized that in Switzerland there is only a small group of allergy management specialists, of which more than half are over the age of 50. Given this significant shortage of specialists, I decided to expand our promotional efforts to also target general practitioners and pediatricians, who treat simple hay fever and general allergy symptoms, particularly among younger children. Pediatricians play an important role in catching allergies when the symptoms first appear. In fact, when children at an early age are monosensitized, it’s much easier to administer treatment as you’re only dealing with one type of allergy. However, if left untreated they could become polysensitized, in which case treatment becomes more complex as it requires administering multiple products at the same time. That is why we believe that pediatricians are important to target and educate about the risks, benefits and methods of treatment.
We also place a lot of emphasis on raising awareness and education. One of these areas is on the event of an anaphylactic shock. In some rare cases, allergy immunotherapy can lead to anaphylactic shock, which often discourages professionals from wanting to offer treatment to their patients. We are actively looking to overcome this fear by educating doctors and their staff on how to manage rare cases of anaphylaxis. I recently hired a sales rep (who also happens to be an ambulance driver) to provide the training which has been very successful, and has even resulted in a ‘pull’ from doctors who are interested in taking part in our initiative.
Across your product portfolio, where do you forecast most growth coming from over the next few years?
We forecast considerable growth coming from both the oral and subcutaneous segments. This represents quite a change from when I first joined the field. Back then, the Swiss allergy market had been flat for over a decade and there had been literally no new growth. However, concerted efforts on the part of Swiss allergy companies has reversed this trend, and helped the market progress at a rate of 15% a year. Nowadays, we interact much more intimately with the medical community, maintain a high level of visibility at conventions and have been rolling out a range of different initiatives to raise awareness.
How are you then preparing to capitalize on this growth?
It’s difficult because it seems like the burden of disease has really reached critical mass, with very few people talking about allergies compared to say oncology or cardiovascular diseases. But its impact should not be underestimated. For example, there’s an abundance of clinical data showing that kids suffering from allergies who undergo immunotherapy see their school grades improve by at least a half a point. Allergies can produce a huge strain on a child’s ability to concentrate, which further validates the importance of medication interventions. Antihistamines, intranasal steroids, and symptomatic treatments are effective, but to a much lesser extent than immunotherapy, which can eradicate symptoms for up to 12 years.
On a more personal note, how has your medical training impacted your management style and overall outlook as a pharmaceutical executive?
Having a medical background helps you tremendously. Personally, I believe that pharmaceutical companies experience the biggest success when run by someone with a medical, and not a business background.
That said, allergy was a new disease area for me when I first joined the field. But I simply looked at it from the patient’s perspective, made my differential diagnosis and then built my strategy off of that. I’ve applied the same process to how I lead Stallergenes Greer. In the beginning I had to establish a baseline, so I interviewed all of our staff and tried to generate a differential diagnosis. I found this to be very effective; it’s a simple medical approach that very much applies to business as well.
Medical professionals look at this business from an ethical point of view, which always puts the patients’ needs first. I think that this is a critical asset, as unfortunately, over the last couple of years, our industry has largely been driven by shareholder values and CEOs focused on shortsighted gains.