Dr. Erdal Bozdoğan, the recently appointed general manager of Takeda Turkey, leverages his 20 years of experience in the pharmaceutical industry and his expertise of emerging markets to document Turkey’s attractiveness for Takeda and how, as a doctor, his patient orientated mindset is “no longer a dream but a reality”, further highlighting Turkey as a crucial country for the company and their ever-increasing focus on specialty care.
With your extensive knowledge of different emerging countries, what is your assessment of Turkey as a typical pharmaemerging market?
“[Turkey] stands out for its well-established regulations, which contributed to establishing it as a role model among other emerging countries such as South Korea and Taiwan”
Looking at Turkey from a pharmaceutical and healthcare perspectives, the country immediately stands out for its well-established regulations, which contributed to establishing it as a role model among other emerging countries such as South Korea and Taiwan. This is despite the current challenging pharmaceutical pricing system which makes pharmaceutical products in Turkey among the cheapest in the world, yet the system by itself has been successful and transparent from the government perspective.
Turkey’s well-monitored pricing and reimbursement system is also particularly centralized, which enables a remarkable efficiency in providing access to the entire population. Russia, for example, has a fragmented, regional system with allocated budgets, which entails significant bureaucratic issues when it comes to the approval of innovative products – thus, patients cannot access them, or the access is disproportionally dispersed across the different regions. These same hurdles affect China, with its tiered regions which all have their own healthcare budgets, again fragmenting the fairness of the patient’s access to products.
Since 2013, oncology already stands as the largest item of expenditure for SGK (Social Security Institute) as a reimbursement agency – although the country’s population is still very young. Do you think that the current reimbursement model is sustainable, considering the country’s looming epidemiological shift?
When it comes to specialty care and orphan drugs, adjustments to the current system are highly needed, which includes giving a higher level of prioritization to life-saving drugs. Changes to the reimbursement system could easily provide the institution with a higher capacity to reimburse critical and lifesaving therapies: for example, some products that are still reimbursed in Turkey are typically available as OTC products in other markets.
In the meantime, we still have opportunities for alternative market access schemes and more effective reimbursement models by building systems and establishing clear guidelines that would enable the close monitoring of the use of innovative medicines and outcome-based funds. In this regard, I believe that Turkey could be inspired by the best practices implemented in the world’s most mature healthcare ecosystems, which are already coping with the issues related to the aging population.
Considering – on one hand – the great coverage of the population offered by the SGK and – on the other hand – Turkey’s stringent pricing and localization policies, how would you rate the attractiveness of the Turkish market for Takeda?
Turkey is a very important market for Takeda, while localization is one of our priorities for our primary care portfolio. As a matter of fact, nine out of 18 primary care products in the country are already manufactured in Turkey following Takeda’s acquisition of Turkey-based Neutec in 2015.
The rest of our primary care portfolio is composed of Takeda’s original primary care products, which we may start to locally manufacture in the near future, as part of the second phase of our company’s localization policy. Overall, our position in Turkey is to comply with the local requirements and contribute to the government’s vision with regards to their localization priority. Thus, Takeda Turkey is among the Top Ten pharmaceutical companies in therapeutic areas in which it operates in, and Turkey’s market attractiveness would still secure its position from a global pharmaceutical industry perspective.
Despite the current pricing pressures, we see the potential of the specialty care business here, which has tremendously developed over the past two years, with the affiliate established in 2010 and this business area created in 2016. Since then, in the past two years, we have successfully launched three products for four different indications. In the upcoming weeks, we will have a brand-new launch of another product in specialty care for five indications, specifically used to treat Crohn’s disease and ulcerative colitis. In light of all these successes achieved within just over two years, we have won many different accolades for the affiliate.
Could you share your insights and expertise on how to manage a successful oncology launch in Turkey?
You cannot be successful as a company without agility because you must think quickly when it comes to implementing bold decisions. However, this agility needs to be practiced in parallel with accountability to create the perfect team model. When I first started at Takeda Turkey, specialty care was a new area for the affiliate, whose focus previously was on different therapeutic areas. Therefore, I have helped the affiliate move to this area in the right direction.
When looking at our specialty care business mindset, we do not use traditional marketing techniques, thus our main focus is to ensure that the patient is at the center of everything we do. To fulfill our commitment, we started first our product studies with patients and then prepared a typical ‘Turkish patient journey’ even before we started working on our marketing and branding plan. Understanding the Turkish patients and their needs, in relation to their indications, is a key element. Therefore, we continuously survey our patients in the real world, analyze their day to day lives to increase the effect of our products and check what we can do for the patients and doctors. We want to understand the patient first, and this is the same for my style of management: to be successful you need to understand everybody around you.
Looking at our specialty product portfolio, the first two products we imported into Turkey were not in the market beforehand; one was indicated for treating a rare disease and another one for osteosarcoma, which affects around 70 children per year in Turkey. The patients and doctors could however access both of them through the Turkish Pharmaceutical Association’s (TPA) access scheme, and – as we were the only company in the country importing these drugs – we could have continued doing so through the TPA’s access scheme.
However, we voluntarily decided to follow the local regulatory and access pathway. The latter nevertheless required that we eventually import these products as a marketing authorization holder and be subject to the mandatory 41 percent discount inherent to Turkey’s reimbursement process – thereby sacrificing profits which could have been achieved through the TPA’s named patient access. This is an example of how Takeda’s commitment to patients led to our success. Although this is not the typical general manager mindset, I am first and foremost a doctor and I have a duty to care for the patient first.
How do you wish to establish Takeda Turkey within the country and become a recognized pharmaceutical player within the market?
I will strive to make Takeda a patient-centric company and to be recognized by our peers in the industry for achieving this because business should not always be about numbers. What I hope to achieve is a balance between the profits and the patients and commit this view to the heart of everyone working in the organization. This is not a dream for Takeda, but a reality!
What objectives do you hope the affiliate will reach in the future after having been so successful over the past years in Turkey?
Currently, Takeda is an important player in the pharmaceutical industry in Turkey and this role will be strengthened in the future. In May 2018, Takeda announced that the company has reached an agreement with the Board of Shire on the terms of a recommended offer to acquire Shire. This is an exciting step forward on Takeda’s transformation journey; it will create a global, value- based, R&D-driven biopharmaceutical leader headquartered in Japan. It will surely impact our business by bringing innovative products to the Turkish market and expand the access of patients to these treatments.
In this regard, we know Takeda will go through an incredible transformation in the next years with its recent acquisition of Shire; therefore, we aspire to be among the top recognized international companies in the country.
What would be your final message to our international readers?
My dream is to tirelessly develop a company that continuously commits to the patients’ needs. At Takeda, we strive to connect the dots and create good solutions, through our innovation and enthusiastic approach, to better serve our patients.