After a series of recent acquisitions, developing a diverse portfolio comprising four business areas; including OTC and branded prescription medicines, Mylan UK’s country manager, Jean-Yves Brault, takes a step back and analyses the new Mylan, while highlighting how it is fit for the future of healthcare.
How does Mylan position itself in the market today, and how has it evolved over recent years?
More than 50 years ago, Mylan was a generic and US company which has evolved massively and today is a global healthcare player.
Mylan’s European adventure started in 2007 when they acquired Merck Generics in Europe. Further acquisitions followed, mainly in Europe, and the two major acquisitions that affected the UK were the established pharma division of Abbott three years ago, and almost two years ago when Meda was acquired.
Now in 2018, we have a company in Europe that evolves along four main lines of business: our generic portfolio, our over-the-counter (OTC) portfolio, the hospital business and the prescription brand business. In most European countries, we have been going through an integration process over the last few years to incorporate the different businesses and work towards the goal of becoming one company.
How has the integration process been in the UK in particular?
Naturally, the speed of integration varies from one country to another. In the UK, the acquisition of Meda took place in August 2016, and by the end of 2017 we were fully integrated. The last year was our year of transformation, as we needed to redefine ourselves through the integration of Meda’s portfolio. We view this work on our identity as highly positive, as the aim of the integration was how to better serve our various customers in the UK with a new, diverse and broad portfolio and be closer day by day to our company’s mission to provide seven billion people with access to high quality medicines. I believe we were very successful in integrating the people, processes and resources that have joined the Mylan family. It was also essential to reassure and secure the business continuity as change always creates uncertainty, but this was well mastered.
How have you found the experience to integrate a whole new corporate culture to an existing one?
Clearly, Mylan’s culture had to evolve through the acquisitions, in order to make room for the new types of products and customers we were serving. We took this need to adapt as an opportunity to evolve and, today, we have strong teams across all strategic and support functions.
I see one of the biggest challenges of such an integration in moving from an internal focus of reorganizing everything at this level, to a global focus. Focusing on our internal capacities is not sufficient, we need to leverage on the internal part to become what we really want to be, a customer-, outwards-oriented company.
You have been holding the position of country manager for nearly two years now. What have been your set priorities and how have they evolved?
In order to live Mylan’s mission, to provide the world’s seven billion people with access to high quality medicines, we need to create a company that is as customer and patient-focused as possible. Concrete actions evolve around awareness campaigns and educational events we put in place to communicate with our clients. Last year, we established and recruited a great team, and while we are still working on our processes, this year is about execution and spending more time with our external stakeholders. Once again, taking the focus from the internal level to a broader outlook.
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How does Mylan fare in the UK today?
Today, Mylan is the third largest generic player in the UK. The British market is of course important not just in terms of population but the pharmaceutical market itself. Because of high generic penetration, we achieve high volume in the UK. Nevertheless, the UK is also amongst the lowest price markets within Europe. The level of competition is equally high. Overall, the UK market could be defined as a very challenging yet attractive model for a generic company. However, Mylan is not a purely generic company anymore. We therefore need to find ways to accelerate our portfolio and increase awareness, and this holds truth along our four business areas.
Where do you see most growth within your portfolio originating from today?
Growth is expected to come from our four lines of business (prescription brands, generics, hospital and OTC products) and is based on a strong collaboration with our external stakeholders helping us to propose the right value proposition. We are also excited with the growth opportunity that the future biosimilars will represent
It looks like biosimilars will be one of the next big trends. Is the UK ready to receive biosimilars?
The UK is actually one of the markets where new medications, be it generics or biosimilars, can be made available quicker. We view the country as a very positive environment to introduce innovation.
In the biosimilars space, the UK is one of the countries to be best prepared for adoption, further accelerated by the fact that some big molecules will lose their exclusivity before the end of this year. The positive outlook is enhanced by a real commitment from the National Health Service (NHS) to accelerate the transition from biologic generators to biosimilars. The UK is a role model in Europe to ensure high biosimilars penetration but there is still some need for progression. Ideally, we should have after Day 1 launch, 100% biosimilar penetration to ensure both proper savings for the NHS and better access to the British patients.
In the UK, data from the NHS Improvement (NHSI) suggests that £170m was saved in ten months from switching to biosimilars as of March 2018. The uptake of the best value medicine topped 90% of NHS trusts in one case.
Mylan is very much in line with this strategy. We want to create access to high quality medicines that prove to be a positive proposition for the entire sustainability of healthcare. We see biosimilars as having the biggest impact over the coming years in this regard. Every healthcare system battles with the same challenges: more patients, less tax payers, fewer revenues. Hence, better quality medication providing access to more patients or medication bringing a better value proposition to the healthcare economy must be the priority.
Mylan and partner, Biocon, recently received marketing authorization approval from the European Commission (EC) for our biosimilar insulin glargine, Semglee™. Three additional biosimilar applications are currently under review by the regulatory authority.
You mention the UK being a great market to launch products to. Are you worried this might change with the European Medicines Agency (EMA) having moved headquarters to Amsterdam?
No one yet has an answer on Brexit. We are an active member of the British Generic Manufacturers Association (BGMA) which is working very hard on behalf of generic and biosimilar suppliers to establish partnerships. The ultimate goal remains to minimize impact for patients as much as possible.
How are you partnering with the NHS in an effort to take costs out of the system?
The majority of our portfolio brings a good value proposition to the NHS. This helps the payer in better controlling healthcare costs. Every generic we introduce in the market provides healthcare professionals with a new option and creates more access for patients while taking off pressure on NHS’ budget management.
That is how we believe we can be perceived as a solution provider to the challenge of healthcare. As in every country, we would like to have unlimited funding for healthcare but that is not the reality. We strongly believe that Mylan is well positioned to be a solution provider and partner to the NHS, whose biggest mission is to treat UK patients well within a certain given budget.
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How was the process of bringing the first generic Glatiramer Acetate 40 mg/ml to market and what has it taught you?
Mylan’s Glatiramer Acetate 40 mg/ml is a generic for Copaxone®, a multiple sclerosis drug, and bringing it to the market simply multiplies options for patients. For its introduction, we needed the right pricing, willingness and trust from hospitals to actually orchestrate the switch in medication for the patients.
This is where we partner not just with one group of stakeholders but with most of them, from hospitals over procurement pharmacies to healthcare professionals and nurses. Our goal is to have a comprehensive approach of the disease, understanding its impacts on patients, the disease itself, its evolution and available treatments, so that when we introduce a new value proposition like our Glatiramer Acetate 40 mg/ml, we know we are doing just that. Communication hence becomes our biggest angle with us ensuring the value proposition of our product is well understood.
How is Mylan positioned within the UK generic market space?
We are ranked third as a generic player in the UK. At the difference to other European markets, it is difficult to measure precisely our actual sales as the system does not allow for exact retail numbers to wholesalers and pharmacies. Nonetheless, we can say that we are selling more than 400 generic products in the UK today and every single one of them generates savings to the system. The launch of our generic version of Seretide® for asthma patients three years ago is an example of savings generated to the system. Today, it is generating between £10-12 million in savings to the NHS, just by providing patients with another treatment option with the same molecule. The recent introduction of our Glatiramer Acetate 40mg/ml is another example of Mylan’s contribution to improving access for patients, providing more treatment options for healthcare professionals and helping the NHS optimise the available funds.
Where do you see competition originating from over the coming years and how does Mylan differentiate itself?
Mylan is equipped for novelties whatever line of business you consider. In the generic business, we see it evolving and not evolving at the same time. Several generic companies remain pure generic players, others, like Mylan have ventured into diversification, some have walked down the path even further. I see biosimilars as being tomorrow’s big game changer and those companies that will count biosimilars within their portfolio will most likely benefit from it.
In general, competition is good as it challenges companies to rethink the way they work and drive forward innovation while securing long-term sustainability which is beneficial for consumers. More innovation in turn entails a better value proposition. Raising the bar and adopting it is something we view as positive. Our people and the quality of our people allow us to position ourselves differently in the UK market. While employing around 500 employees in the UK, we have just short of 200 people entirely focused on our UK commercial business.
The second aspect that allows us to differentiate ourselves from competition is our engagement with external stakeholders. We are dedicated to understanding their needs and the future evolvement of those needs so we can continue to be a solution provider. Mylan wants to be part of the solution and this is only possible by taking in the right insights from our customers, stakeholders and patients. Our people enable this with a strong can-do attitude and a focus on solutions allowing us to believe we can be strong partners now and in the future.
Are payers perceiving companies and Mylan specifically as a solution?
I think that the trend is definitely moving in that direction. Thanks to our solid Market Access team we have a lively dialogue with payers, trying to understand the biggest challenges, communicating about our value proposition in order to identify opportunities to work and implement plans in collaboration.
We believe that this is precisely the kind of interaction that will conduct external stakeholders to recognize that industry can be part of the solution. In the end, there is one challenge that repeats itself over and over again: there are patients in need of treatment for a specific condition or disease. And then there is a pocket of money and a pocket of treatment options. As an equilibrium is the ultimate goal, and you need to match contents from both pockets, we should all work together towards reaching it.
What will be the strategic areas of focus for Mylan moving forward?
Our general strategy remains focused around growing our portfolio. Biosimilars will be one amongst many areas we will be exploring. Our core business of generics will continue to hold great importance to us. Mylan has some products within its prescription brands that still hold patent, others do not but have some very unique characteristics.
We will continue to support the therapeutic areas where we are market leaders such as Hormone Replacement Therapy (HRT), Pancreatic Enzyme Insufficiency (PEI) and Anaphylaxis. And we will continue to partner with patient associations to develop awareness and patient support programmes. Continuing Medical Education (CME) and educational programmes are an area we will keep heavily investing in, ensuring we support patients, practitioners and the NHS to the best of our capacities.
In the OTC business, we have seen rapid growth these last years, as there has been a trend to deprescribe products. This enhances access for patients while posing the challenge of adopting to change. There will be a process of adoption that has to be undergone, both for patients and pharmacies gradually evolving into the role of healthcare consultants. As in many countries the trend is towards more self-diagnosis and self-treatment, which is still quite low in the UK.
A few words to conclude?
Mylan has evolved into being a well-diversified company. We are dedicated to staying well connected to our stakeholders, whether they be healthcare professionals, policy makers, patient advocacy groups or patients directly. We continuously want to be part of all the challenges within the healthcare system, by being part of the solution, and to us, solutions come through value propositions that make sense.
