Ivan Kolev, country manager at Wörwag Pharma Bulgaria, explains how has the affiliate performed over the last years as well as shares an overview about the development of diabetes and its complications, and pain management in the country.
You have had two different stages at Wörwag Pharma; working in Actavis between these two periods. What are the factors that triggered you to come back in 2013 from a global player with a leading position in Bulgaria to a mid-cap and family-owned company like Wörwag Pharma?
Throughout all my professional life I have been looking for ways to complete my professional profile in order to, at the end, have a whole picture of the business. Indeed, I have walked through all the main steps in the pharmaceutical professional track from pharmacy manager and medical representative to marketing head and now country manager.
My return to Wörwag Pharma followed the explained rationale. Actavis/Teva is a huge enterprise with a unique positioning in Bulgaria but, by that time, I was quite focused only on the generics’ sales part of the business. Hence, in mid 2013 I had the opportunity to come back to Wörwag Pharma leading the sales as well as marketing management areas and it really gave me a broader professional perspective being after appointed as country manager.
Wörwag Pharma entered Bulgaria back in 1995 and it is already positioned within the top 24 pharmaceutical players in the market with quite a specific portfolio. What are the strategic cornerstones behind this success?
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The fact that we entered the Bulgarian market at quite an early stage in comparison to most of the pharmaceutical multinationals in Bulgaria has played a key role in our current positioning. Indeed, historically, Bulgaria was one of the first countries in which Wörwag Pharma started its international expansion. Additionally, I am proud to confirm that Wörwag Pharma has stayed here in the good as well as in the challenging moments and, in general, all stakeholders have strongly appreciated such commitment.
Furthermore, by that time and still today, we offer new niche medicines and approaches to target patients in the therapeutic areas in which we have expertise such as diabetes and its complications. It is interesting to mention that, even though we are a generic player in some areas, we have introduced some medicines in Bulgaria before than the originators being positioned as pioneers in those therapeutic areas in the country.
Indeed, the Bulgarian affiliate enjoys a stronger leadership positioning than some of its counterparts in the CEE region. What is the strategic relevance of the Bulgarian affiliate within the region?
In terms of headcount, we are now a team of 64 professionals in Bulgaria being 53 of those in the sales field force. As a benchmark, the Bulgarian structure is comparable to the existing one in bigger markets such as Romania, which is 3.5 times bigger than Bulgaria. The reason that supports this bigger structure is that healthcare professionals in Bulgaria are very accessible – As a consequence, our market access strategy and medical promotion have been key in our current positioning in Bulgaria but also within Wörwag’s global operations.
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In terms of sales, Bulgaria makes 15-20 percent of the whole turnover of the EU market, excluding Germany. Looking at profitability, we are positioned in the first quartile of profitable affiliates’ ranking of Wörwag’s international operations.
Having said that, I can confirm that the Bulgarian market is a key contributor to the overall success of the company. Looking ahead, we have always managed to grow at, at least, double-digit and we expect the same level of performance for 2017/2018.
Could you introduce to our international audience your existing portfolio in the country and your major therapeutic areas?
Our business in Bulgaria is quite well defined in three main pillars: diabetic and its complications, cardiovascular, and integral pain management.
Diabetes and its complications’ division is quite strong in niche areas such as diabetic neuropathy, and peripheral nerve diseases; this division is made up of medicines with a long legacy of more than 20 years in the market. Our cardiovascular offering is also quite niche and mainly formed by generics but, at the same time, it is highly well positioned being most of our drugs market leaders in their specific categories. Expanding on the third, our pain management portfolio is still under development and it aims to offer the entire spectrum of medicines in this area from the pain symptom to the inflammation, pain management and regeneration of the damaged nerve.
In terms of contribution, cardiovascular segment is our “cash cow” contributing 60 percent of our sales but we do not expect strong growth prospects in this front. Diabetes and its complications represents approximately the remaining 40 percent and it still has interesting room of development. Our pain management portfolio, as said, is still under development but we expect to be positioned as the only company able to offer an integral solution to patients and doctors in Bulgaria.
A therapeutic area in which Wörwag Pharma is uniquely strong is diabetes and its complications. What are your conclusions on the development of such a therapeutic area in Bulgaria?
I have to say that diabetes in general is quite well covered in Bulgaria. In fact, the prevalence of diabetes in Bulgaria is slightly less than the European average and way better than Asian countries. Putting the spotlight on the room of improvement, prevention and early diagnosis are far away from being the best benchmark in Europe due to very weak screening programs and prophylactic checks in Bulgaria.
In addition, and this also needs to be said, there is a significant number of patients that still need high quality diabetic treatments. Our estimations confirm that there are around 40-50 thousand diabetic patients in Bulgaria and Wörwag Pharma is fully in place to cover their need.
Obesity and late diagnoses are the main burdens on this front. What specific actions are you putting in place in order to develop them in Bulgaria?
We have been very active on this front – especially since beginning 2016 through the creation of the so-called “Diabetic centers”, which are not aimed to screen diabetes but patients suffering diabetic complications. Through this initiative, we have concluded that, in a major stake of the cases, diabetes is diagnosed as a consequence of its complications meaning that diabetes is not early identified.
Furthermore, through this initiative we have covered more than 10,000 patients over the last two years, which has enabled us to develop a quite reputable database. This database has helped us and government health institutions to better understand the trends of diabetes in the country. Nonetheless, we will stop the on-going of this program by the end of 2017 since diabetes complications are not a priority of the National Health Insurance Fund (NHIF).
I want to stress that we are still working in this area but in a longer-term perspective. We need to invest in several multicentre studies in order to show to the government the importance of properly treating diabetes and its consequences through value based arguments in terms of cost of treatment as well as patients’ life quality.
However, expanding on the role of the government in diabetes, the NHIF is very eager to cover symptomatic treatments. This approach is not improving the status of the disease on the patient but it reduces the pain sensation. In fact, aligned with the government in this front, this is one of the reasons why we are betting on pain management.
And, expanding on your latter point, how much developed is the treatment of pain management in Bulgaria and what is your commercial strategy in this arena?
Pain management in general is also very well developed in Bulgaria and, consequently, competition is really high as well. Our competitive advantage in this front is our complete and integral pain management offering composed by both OTC and Rx medicines. As an actual example that can showcase the development of this therapeutic area in Bulgaria, around 30 percent of the patients that go to visit a general practitioner are related to pain management.
Having said that, I want to stress that it is really important to understand patients’ habits to successfully navigate in any market and medical segment. Hence, in Bulgaria, patients avoid going to the doctor at a first stage and, therefore, self-treatment for pain management is really high.
This is the reason why our commercial strategy to develop our pain management portfolio targets both pharmacy chains and medical doctors. This combination of both channels is totally new for Wörwag Bulgaria, especially OTC, but it will help us to be closer to our patients.
What are the main objectives that you would like to accomplish in the upcoming years?
Firstly, as aforementioned, our medical promotion strategy has been key in our current positioning in Bulgaria and it will continue being in the future. Thus, one of my main objectives is to continue developing our sales force team in the country investing in new incorporations while forming our current team – we are a people’s company. Secondly, the development of our OTC portfolio in general and pain management in particular will be one of our growth cornerstones and there is still a lot to be done in this regard being closer to both patients and doctors. Thirdly, I aim to launch 2-3 new well-established and well-known molecules in Bulgaria to target still uncovered needs.
