Ger Brennan, MD (Human Health) of MSD Ireland, highlights his mandate to position MSD for success in an evolving healthcare landscape, the groundbreaking new report on Irish healthcare attitudes and perspectives MSD commissioned, the opportunities and challenges within the Irish market, and MSD’s commitment to putting patients at the center of their activities.
Ger, you were officially appointed MD of MSD Human Health operations in Ireland on September 1st earlier this year. What mandate were you given?
I have returned to MSD in Ireland at a very exciting time with a mandate as the new MD to continue the successes we have achieved to date and bring the business to the next level.
I feel privileged to have been given the opportunity to return and lead the Irish affiliate. Ireland is an integral part of the company’s expanding global presence and our Irish sites are highly regarded and renowned by our colleagues across the globe. Whether it is discovering, developing, manufacturing or marketing medicines, our Irish businesses are critical to the success of MSD at a global level.
I am quite fortunate in that I was part of the team here three years ago and so when I returned to MSD Ireland, I arrived already well-acquainted with the organization. My focus now is to work with the team to launch a very exciting pipeline of highly specialized and innovative products.
MSD has a track record of delivering effective products that have transformed millions of lives, and Ireland is an increasingly important hub for our R&D and pharma innovation. There are many exciting and promising advancements being made here, including the production of our oncology products in MSD Carlow, and I am delighted Ireland has played a significant role in ensuring its success.
I aim to position MSD proactively at the forefront of the changing pharmaceutical landscape and maintain our leading position as R&D innovators in Ireland. The clinical research we conduct here has increased significantly: we currently have 29 clinical trials running and over the next three years, we anticipate investing around EUR 25 million in clinical trials in Ireland.
Earlier this year, MSD commissioned the first ever report on public perspectives on the future of healthcare in Ireland, ‘My Healthcare, My Future’. What was the rationale for this initiative?
We commissioned ‘My Healthcare, My Future’ to help put the patient at the center of the healthcare debate in Ireland. Healthcare standards impact us all and are consistently top of the country’s agenda; yet despite being the core service-user, we felt the voice of the patient is often marginalized in discussions around healthcare in this country.
With the Irish Government’s recent establishment of a Committee on the Future of Healthcare, the timing was right to understand firsthand what the Irish public expects –now and in the future. The aim was to start a conversation. With this being the first time anyone has asked those who use health services every day what they think, it should make policymakers sit up and take heed. The findings and related report, which were launched by Minister for Health, Simon Harris, provide plenty of food for thought. Recurring highlights from the research include the need for improved communication between patients and healthcare professionals.
One finding that particularly stood out for me was that patients simply want to be treated with respect. Patients want doctors to take the time to help them understand what is wrong with them and to have the opportunity to ask simple questions. There was also openness by the general public to access more community-based services such as with the pharmacist.
MSD work closely with pharmacies around the country, for instance, with Ireland’s National Adult Literacy Agency (NALA) to develop the Crystal Clear Programme, which recognizes the critical role pharmacies play in helping patients understand their health issues and the steps they need to take to improve their health. A Crystal Clear Mark is awarded to pharmacies where there is evidence of and commitment to providing a health literacy-friendly service to patients. Our aim for 2017 is to promote clearer communications in general practices (GPs) also; it is really an investment in better health outcomes as people understand and feel more in control of their health.
Amongst the different specialty areas that MSD works in, where do you see the areas of greatest need within the Irish market?
In terms of primary care, one of our big areas is diabetes, which is undertreated and under detected in Ireland. We are committed to increasing awareness of the symptoms of Type 2 Diabetes among the general public so as to encourage more people to visit their GP, and encourage GPs to check for symptoms amongst ‘at risk’ groups.
That is why we have partnered for the third year running with the national charity Diabetes Ireland on the highly successful, ‘Diabetes Roadshow’, which involves a series of diabetes awareness days in pharmacies around the country. This year we organized 24 screenings in towns and villages across Ireland. The program has already helped over 2,500 people to either take steps to prevent Type 2 Diabetes or to get additional advice to prevent diabetes complications.
We have also seen some positive change on the policy front, in terms of moving diabetes from secondary care into primary care, and we partner with healthcare professionals such as the National Association of General Practitioners (NAGP) to promote early treatment of patients with diabetes.
Providing information to help patients take control of their health and be more empowered is very important for MSD. For the rheumatology area of our business, we have a programme called Vitality that captures patient-reported outcomes in real time. Patients can enter symptoms in the app and receive instructions in response. The programme has been designed to provide up-to-date personalized information for patients with rheumatologic and gastroenterological diseases, who have been prescribed MSD biologic medicines for their condition.
This resource has unique functionality and is hugely important for patients as it incorporates large amounts of complex information that has been simplified for the patient to make it easier for them to manage their own condition. Its personalization-focused technical design means the content accurately matches the patient’s disease and their needs leading to an improved patient experience and more successful treatment results.
Oncology is another critical area and we have some promising treatments for melanoma and lung cancer patients. Hepatitis C is also important and in Ireland, we are working very closely with the Department of Health to support the elimination of Hepatitis C by 2026.
For me personally, one of the greatest unmet needs is Alzheimer’s disease, and we have a product that has moved into phase III, so we definitely have a very exciting pipeline ahead.
Our global CEO, Kenneth Frazier, has always said that we are not going to shy away from the most difficult diseases; innovation for us means going after the most unmet medical needs.
How important is it for pharma companies to provide a complete package of care that goes beyond the pill?
This is a critical aspect of patient wellbeing. Especially for a new drug like one of our immunotherapy treatments, you need to establish the entire ecosystem around that. This was something that also came out very clearly in the ‘My Healthcare, My Future’ research: if you do not build in that complete package of care, patients are left on their own to manage their disease.
Another good example of MSD’s broader involvement within the Irish healthcare landscape is our strong support of the progress being made by the Health Service Executive’s (HSE) eHealth Ireland initiative to revolutionize HSE’s digital infrastructure. For example, we’ve worked on a pilot Lighthouse project providing an integrated e-health record system to patients within the rheumatology space at two Irish centers. Again, we came at it from a patient engagement angle to find out what patients would like from an e-record system and to discuss their concern on issues like data protection.
This is part of our focus on the total package of care and it is why here at MSD we engage a team of patient support managers dedicated to identifying gaps in existing patient support.
We see that the partnership between Sanofi Pasteur and MSD on the vaccines front is coming to an end. How will that affect MSD’s vaccine business in Ireland?
We are looking forward to the return of our vaccines business in 2017. Vaccines are a great example of the value that medicines can bring to saving people’s lives. We need to increase the awareness of the value of vaccines – seeing that measles is returning to the UK, for example, when it had previously been eradicated, is concerning.
How would you evaluate the Irish market access environment and its openness to innovation, particularly after the recently negotiated Irish Pharmaceutical Healthcare Association (IPHA) agreement?
I think the IPHA Agreement is quite fair: Irish medicine prices are set to be an average of 14 EU Member States, and on course to save the State over EUR 140 million in its first year, and there are projections of around EUR 785 million worth of savings to the Irish government over the next four years.
The other side of the balancing act is ensuring that we allow for sustainable innovation. The development of a drug, from ‘bench to bedside’ is lengthy, often taking longer than a decade, is highly complex and expensive. With complex regulatory procedures and compliance, bringing new innovative medicines to patients can be challenging.
Governments across Europe are under economic strain from increasing healthcare expenditures and Ireland is no different. A strategic approach to these decisions needs to be taken.
Before taking on this role, I was AVP of Global Marketing (Immunology) within MSD so I spent a lot of time working with regulators on value outcomes across Europe, Russia and Turkey. I think Ireland needs to move towards a discussion of value; for example, the establishment of a Medicines Policy that would create a sustainable funding plan and that recognizes the long-term value of therapies beyond the cost of the treatment could be considered. The ‘My Healthcare, My Future’ report uncovered the important finding that patients are happy to pay for medicines if the value is there.
Looking broadly then, what would you say is the strategic importance of MSD’s Irish affiliate to the global organization?
MSD definitely recognizes the value that Ireland brings – just look at our footprint here. We have around 1800 employees across the country. Over 60 percent of our top 20 global products are manufactured in Ireland, which sends a very striking message of MSD’s commitment to Ireland.
In addition to being MD of Human Health, I also lead the MSD Country Council for Ireland, which comes together on a regular basis to build a collective approach for MSD in Ireland; both internally back to our global organization, and externally, out to stakeholders in Ireland.
We are also extensively involved in the local community. For instance, we are a very strong supporter of the Irish Cancer Society. We have a strong tradition of volunteering, and recognise that we have a responsibility to do our bit for society, the environment and our customers. Our teams are actively engaged in numerous volunteering initiatives around the country. All levels of the organization are encouraged to take time out to volunteer. For instance, I participated in the Junior Achievement Ireland (JAI) programme, which is dedicated to equip young people with STEM skills, by teaching a class of schoolchildren for two hours every Tuesday for six weeks.
As MD then, what would you like to achieve in the next few years?
Our vision is to be the most trusted partner in healthcare for patients and employees. I want to continue the success that we have had in the past few years and maintain that through the challenging and new environment that MSD is going to move into.
Speaking personally, my previous international experience within MSD has taught me how to navigate my way through various challenges. I genuinely get a lot of energy working with the people here and I am very proud of both the MSD organization here and globally. I am looking forward to working with the team and the wider community to address Ireland’s current healthcare challenges and cementing MSD’s position as a leading healthcare provider.