Antonio Leão discusses Lilly Portugal’s sustained growth record in recent years, its ambition to introduce two new innovative treatments to the market every year until 2022, and their empowering approach when tackling market access hurdles. In suggesting improvements to the predictability of the pharmaceutical framework, Leão, soon to reach 30 years working for Lilly, highlights what makes Portugal such an exciting destination for clinical trial investment, Portugal’s excellent human resources, and potential for growth.
Could you provide our readers with an overview of Lilly’s operations in Portugal?
“As we approach 2022, we intend to introduce two new therapeutic entities to the market every year. Several in our new therapeutic areas. Lilly plays an important role in the development of the country and in helping patients here in Portugal, and therefore it is critical for Lilly that Portugal progresses.”
Lilly is present in Portugal in both hospital and retail sectors. Both segments are growing, although retail develops marginally slower than the hospital market. The total market is worth roughly 2.9 billion and if we look back to the crisis period, the retail market was severely hit and lost approximately a third of its total value. Only now is it starting to regain some of what has been lost. On the whole, there are good signs for the industry for the future, and for patients who require access to innovative treatments.
The hospital market in Portugal is growing by five percent, and Lilly is investing significantly in this sector—to complement our overall commitment to Portugal. We have over 100 people building our team. We have an exciting pipeline for further entry into this segment, as well as in our preexisting operations in diabetes care where Lilly is a market leader.
Tell us more about the Lilly pipeline for 2018.
We have one of the best pipelines in the industry built on innovation and meeting patients’ unmet medical needs, with medicines ranging from diabetes to oncology, pain and autoimmune management. Indeed, this is the future direction of Lilly. In the past, we were known as the mental health and antibiotics treatment specialists, and given changes in patients’ needs we have shifted our focus.
As we approach 2022, we intend to introduce two new therapeutic entities to the market every year. Several in our new therapeutic areas. Lilly plays an important role in the development of the country and in helping patients here in Portugal, and therefore it is critical for Lilly that Portugal progresses. Furthermore, we have a partnership with Boehringer Ingelheim in our diabetes segment which is evolving very well, and diabetes itself is growing in the region of 20 to 30 percent year-on-year.
Having led the affiliate for six years in Portugal, how have your goals evolved?
My top priority is to make sure we help our patients to live longer, healthier and more active life’s. At the same time, we want to improve efficiency in Lilly, which will have a knock-on effect on productivity in Portugal. We have several new opportunities in the country in which we invest heavily. For example, our entire diabetes portfolio has been reimbursed, which helps for sustainable and robust growth. Our entry into the autoimmune platform, pain and oncology therapeutic areas will allow further growth consolidation. As Country Manager, bringing new drugs to market is a key goal, and we are already in negotiations with INFARMED to bring the new pipeline to the Portuguese market and ensure that patients get the best market access to our innovations, as efficiently as possible.
What is the strategic importance of the affiliate?
Firstly, let us make clear the challenges that every affiliate faces within a multinational company. MNCs worldwide take advantage of opportunities that present themselves across the globe, and as a result, we are in a global fight for investment into Portugal that spans all areas, from R&D, clinical trials to investment in new products and social responsibility initiatives
Today our country is politically and economically stable, and therefore there is minimal risk of investing here. Secondly, our prices are low—when in comparison to other European countries—still when compared to other countries across the globe we are of high importance to Lilly global and in the top 30 percent of the affiliates globally. Our quarterly results reflect the growth of Lilly worldwide—which recently exceeded expectations also thanks to blockbuster product sales recently launched, also in our new therapeutic areas.
The prevalence of diabetes in Portugal is high. What is Lilly doing to combat the disease?
Bringing innovative treatments that helps to improve patient care is high up on our agenda for Lilly in all the therapeutic areas, but particularly in diabetes. Lilly is one of the founders of diabetes treatments around the world: we were the first company in the world to produce and commercialize insulin and diabetes is a critical therapeutic area. We are a central player, whereby patients benefit from our innovations and payers understand the value of the solutions we bring to the market. Furthermore, doctors and other healthcare professional appreciate the possibilities that we convey, so we work together to reach the goal of ensuring patients live more active and healthier longer lives.
What is your assessment of the market access environment in Portugal?
We see visible signs that things are changing for the better. That said, if I could change one thing in the pharmaceutical market access framework to improve in absolute and relevant terms, it would be increasing predictability. We cannot keep waiting up to two years to bring critical medicines to Portuguese patients. Eliminating barriers and increasing transparency would mean that our patients receive innovation at the same time as our neighboring countries across Europe. Naturally, I recognize the efforts of the new president of INFARMED and believe that Lilly’s position in this environment is strong given our sustained commitment to bringing innovative products to the market.
For example, recent laws have to help to drive forward innovation and stipulated timings for evaluations and decisions. The new law states that drugs must be evaluated in 180 days, plus 30 business days for contract negotiation. All in all, this adds up to a stipulated approval period of roughly eight months. It remains to be seen the real impact of these changes, however.
How do you position Lily in this challenging market access environment?
I discuss Lilly Portugal’s strengths to make a case for Portugal. Among the 100 employees at the team in Lily Portugal, roughly 15 percent of the staff work in international roles. There are very few affiliates worldwide that have a higher number, in relative terms, of more educated and more international thinking people. What’s more, due to the flexible nature of the Portuguese workforce, many people work their role while also lending a hand in other projects, which gives them a broader development of different and critical strengths
I often say that we make more with the same—this affiliate is productive and efficient, still we can keep improving. This, coupled with the positive attitude of the Portuguese people in the face of obstacles, and the stable economic and political climate, makes for a strong case I can discuss with headquarters. We may not have as much money as the big five, but when you consider flexibility, resilience, creativity, and overall capabilities, the Portuguese affiliate is an attractive and growth-oriented affiliate.
Finally, something we often overlook is Portugal’s passion for work. In the healthcare and life sciences field, this is even more evident, and we try to use this passion and channel it into overcoming challenges and ultimately bringing innovation to patients.
What is the scope of Lilly’s clinical trial operations in Portugal?
It is increasing year on year, and we always fight for more. Nonetheless, it is not enough. As we speak, we have phase three and phase four trials underway where we see success. Clinical trials are a bright area where we can deliver more both as a country and as an innovative company. There was a time when clinical trials were a ‘given’ in this sort of mid-sized state, but nowadays several other nations and cheaper countries have since caught up.
In order to improve, the message is clear, from government policy to economic regulation to the legal environment regarding patents, we need more transparency and more predictability to better serve patients, payers, and doctors across the healthcare spectrum.
Portugal faces a brain drain, and pharmaceutical companies compete for the top talent. What do you do to attract new candidates, and retain your current team?
Lilly’s reputation is a crucial motivation for attracting prospective candidates in Portugal. That said, we try to improve every day and do not rest on our laurels as a successful MNC. We collaborate with universities across the healthcare spectrum and operate a flat hierarchical structure where I know everyone by name, and where topics such as gender, race, and background never factor into conversations. Having spent almost 30 years at Lilly, I can say with confidence that Lily is a pioneer of diversity. It makes no business sense to discriminate against any orientation because business is about competencies and efficiently satisfy the patients’ needs.
We know that talent attracts talent and therefore we create an environment in which our people feel encouraged to evolve. As a result, we have a very low turnover. Also, we give a lot of autonomy to our people. Autonomy breeds responsibility, and at Lilly, we believe that people enjoy working in such a way.