GE Healthcare Italy’s Marco Campione discusses patient access to innovation, synergies between pharma and medtech in companion diagnostics, and partnering with the Italian healthcare system.
You have been working at GE Healthcare for 18 years now, having risen up the ranks through various departments. What was at the top of your priority list when you became CEO for the whole division in June 2012?
I am an engineer by education and joined GE in 1998, working in different countries and on different sides of the business. Since GE Healthcare is involved in both pharma and medtech, we are a member of the respective associations, Farmindustria and Assobiomedica. When I became CEO in 2012 I had one key priority, which was to put this division on a steadily growing path in terms of investments, employment, as well as revenue and profits. I pursued a fairly aggressive agenda despite being appointed in the middle of the financial crisis, which ultimately turned out to be an economic crisis. The first few years were certainly not easy but we have achieved fairly good results so far.
To achieve this position, I put a considerable amount of effort into establishing GE Healthcare as a trustworthy partner for the four legs working in the Italian healthcare system: healthcare professionals, institutions, patients, and the industry at large. We are working hand in hand with these four entities to provide valuable solutions to Italian patients.
How does patient access in Italy vary between the technology-focused diagnostic and treatment solutions that GE offers, and the access situation for innovative pharmaceuticals?
The situation for medtech companies is fairly different compared to the situation for innovative pharmaceutical companies. Medical device equipment simply requires the CE mark, a regulatory trigger for any vendor to bring devices to the market. This mechanism works very well in Europe; unlike the US where the commercialization of medical devices is FDA regulated, posing a significant problem for patient access to new technology. On a European Commission level, there are debates whether Europe should adopt the American approval process but I am certainly against it because it will postpone the access to innovation. While in theory, the European access procedures sounds straightforward, the reality is very different. 80% of the Italian medtech market is either public or subsidized by the public. This makes it extremely complicated for any hospital in any given region belonging to the Italian state to have the same access of medical devices. Although our constitution guarantees equal access wherever you are in Italy, it looks very different in reality.
On the pharma side, it is not sufficient to have EMA approval; you also need to have AIFA as well as the regional and sometimes even a specific hospital’s approval.
This is not the case with medtech as it is mostly purchased from public tenders which are subject to the state of the economy. As a result, there are regions in Italy that have stopped investing in medtech because they could not afford this innovation. For example, the public hospitals in the South could not afford innovative medtech and therefore, we have seen a rise of private institutes to keep up with the demand. We are in a country where healthcare is supposed to be free for all, which is not the case in the real world. On the contrary, people are moving towards private out-of-pocket treatments, because of long waiting lists and restricted access to good healthcare in public hospitals.
To conclude, access is a problem for medtech as well as for pharma although this problem is not regulatory driven but economically driven by the entity that is actually purchasing the device.
How do you adapt your strategies to these economic changes?
I have the privilege to work for a big diversified company that is not too affected by cyclic economic downturns. We understood that as a company we could be a real partner to our counterpart, the national health system, which is experiencing a growing degree of challenges. The healthcare system in Italy is asking for help, being squeezed by growing demand, finite resources, poor quality and the worst economy for 50 years. That is why we developed the outcome-based approach to help the national healthcare system with very particular issues, entering risk- and profit-sharing agreements. Companies like GE, that have a sound financial background can afford to enter these kinds of agreements to help the country’s health system effectively. While it is challenging to operate in such a fragmented ecosystem it is exciting at the same time to become a real partner to the public.
GE Healthcare is involved in both the pharma and medtech businesses. What is the breakdown of your activities in Italy?
Globally, diagnostic imaging and services is what GE Healthcare is traditionally known for. Worldwide, we make USD 8 billion in turnover from this segment, USD 4 billion from mobile diagnostics and monitoring, USD 2 billion from IT and digital solutions and USD 4 billion from life sciences. Italy is extremely relevant for GE; it is amongst the top seven countries of GE in terms of revenue and number of employees.
Seven out of the Top 10 blockbusters in the world today are biopharmaceutical drugs. Those seven are 100% manufactured by GE Healthcare equipment. In general, GE Healthcare is the partner of choice for biopharmaceutical production.
You recently installed a 3D mammography unit at the Radiological Research Centre of Molfetta, near Bari. You said at the time that reducing the risk of breast cancer in Italy was one of your main priorities. How are you working as a business to build partnerships and collaborations in the area of breast cancer, for example?
In general, our three care areas of attention are oncology, neurology and cardiology. Amongst those three areas, oncology is certainly the biggest. Within oncology, breast cancer represents one of our main areas of expertise. We have developed an entire ecosystem beyond just installing a mammography system. We call it the “One Day Breast Experience”, which we developed together with hospitals, healthcare professionals and research institutes to make the hospital and breast cancer screening experience for women as smooth as possible. The unit we installed at Molfetta can detect very small lesions on the breast in 3D and avoid any subsequent exams. This is really transforming the clinical pathway of any given patient. It is possible to detect and to treat cancer much earlier.
In the same vein, we are also working a lot with pharmaceutical companies because we believe that the future will be companion diagnostics. This means that every single treatment that pharmaceutical companies develop in the oncology segment and beyond will have to be accompanied by dedicated companion diagnostics, a mix of in-vitro and in-vivo diagnostics. Most of the big pharma companies are cooperating with us in this effort either in the field of neurology, oncology and cardiology. I believe that in the future these kinds of partnerships will result in a greater patient reach and outcome.
In addition, we have several projects in the pipeline, ranging from Phase 1 to Phase 3 trials, also in cooperation with big pharma players. In particular, we are very active in the early detection of Alzheimer’s disease, working hand in hand with pharma companies to find the right therapy.
How do you evaluate the relationship between the pharma and medtech industries?
There are great synergies between pharma and medtech these days. We do not compete but rather complement each other. This is a fact that the Italian government has not yet fully understood. There is too much attention from our government on the medtech industry to introduce bills and measures that significantly penalize the industry, especially small and medium sized enterprises. Nevertheless, large companies are also affected, making investments in the country an unattractive undertaking. This is my biggest complaint in Italy because I want to attract more investment in Italy, not less. The quality of Italian healthcare professionals and Italian engineers deserve better attention; it is an invaluable resource for our country.
What opportunities do you see for the increased digitalization of healthcare in Italy?
It is a huge opportunity. Healthcare is by far the least developed industry in terms of digitalization, which means it holds a lot of opportunities in terms of productivity, operational excellence, and standardization.
Patients nowadays are everywhere, which means that the concept of ubiquitous information is extremely important for any clinician to take more confident decisions and ultimately help patients. In addition, we will see a growing shift towards homecare where patients will be monitored and an alarm will trigger if something is wrong. This is certainly not science fiction, because the technology already exists today. It is a matter of vision and subsequent implementation by the Italian government. Concretely, we have pockets of fantastic practices that are not shared, because too often hospitals and regions are competing instead of sharing best practices.
Moreover, we will soon launch GE Health Cloud in Italy; a cloud-based solution that will link medical devices around the world, process data, and store patient records online so they can be accessed from anywhere.
I think we are really at the beginning of a new era of which we cannot even fathom its limits. We are the leading front, being a healthcare company that also has IT capabilities of this scale. We have now 2000 software engineers, analysts and scientists in that area – we really want to become a big software company, helping to develop algorithms and to work on predictive analytics that help the healthcare ecosystem to predict insurgences of new diseases, to map population health and many other things.
What is your outlook for the Italian health system and what role will GE Healthcare play in it?
I want to promote GE and Italy and I am very proud that GE in Italy is one of the predominant countries in the world in terms of employment base as well as revenue generation. We are proud to be Italian in GE.
GE Healthcare is pervasive; we are present in every single hospital. We touch people and every day our products are used to save or improve people’s lives, which is something that I am really proud of. We are working on personalized medicine and early diagnosis in oncology, neurology and cardiology, something that will become more and more crucial.
As patients become increasingly informed, health will transform into something people consume. Thus, while we were previously a B2B company, we are almost becoming a B2C business. I believe that the innovations that are coming are fantastic for the lives of all of us.
Hopefully politicians will soon understand that innovations are an investment, not a cost. Especially digitalization is a way to be more productive. The government has started to understand our importance in the system to be a trusted partner, solving some of the most pressing issues the country faces.
