Novartis Slovakia’s Marianthi Psaha discusses the upcoming shift in Slovakia’s healthcare landscape, the importance of a healthy dialogue between the public and private sectors, and the responsibility of the pharma industry to continuously strive for the highest standards of compliance, integrity and performance.
You have been Country President for Slovakia and CPO Head for just under a year and a half; what have been your main achievements in that period and what are your priorities moving forward?
My time in Slovakia has coincided with a lot of changes in the healthcare industry, especially in the past six months with the new government in place.
I have to say that Slovakia has achieved many successes in the field of health care and patient treatment. There are things that are inspiring for other countries as well. Slovakia has a big potential to be a leading example across the EU countries because of the country size, its ability to run pilots, analyses & real outcomes measurements. But on the other hand there are still things that could be done or should be done better. At this point Slovakia could learn from the experience and best practices of other countries. What I perceive as a big positive is that the people in Slovakia really want to improve things. And personally, I´m very glad to have the opportunity to offer my experiences and to be a part of the on-going changes.
From the perspective of the pharma industry and as a country head of one of the leading players, it has been good timing in terms of opportunities to start constructive discussion with the key stakeholders. This is the way how we, as an industry, but namely we as Novartis, can deliver real added value, to improve patient’s outcomes and last but not least the sustainability of the system. As a member of the supervisory board of the national industry association – Association of Innovative Pharmaceutical Industry (AIFP), I have an opportunity, along with my peers, to help shape the environment.
There has also been a lot of discussion about the reputation of the industry. With respect to Novartis locally, we want to be seen as an innovator, partner for Slovak patients and the authorities as well. We really want to make a difference for patients and be seen to be making a difference. People in pharma leadership positions have the responsibility to turn around the industry’s image from being pushers of pills, to organizations with the ability to actually change and improve patients’ lives. To do this, partnering with the government and authorities is essential.
We, as an industry, also have an obligation to ensure that all our professional practices are governed by the highest standards of compliance, integrity and ethics. We continuously challenge ourselves in all that we do to ensure a sustainable future of innovation for patients, society and Novartis.
Furthermore, since I´ve joined Novartis Slovakia we are really putting a lot of emphasis on new product launches. We recently launched our new heart failure drug in October 2016. This has involved a lot of preparation and a lot of discussions with the authorities and health care professionals to find the best solution to make the treatment available for those who could really benefit from it.
What is the size of Novartis Slovakia and what are the key elements of your portfolio?
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We employ almost 250 associates across all 3 divisions (Innovative Medicines, Sandoz and Alcon). This allows us to be active in almost all therapeutic areas with a strong footprint in Oncology, Ophthalmology, Neuroscience, Respiratory, Dermatology and Cardiology.
The depth and strength of our pipeline enables us to change the practice of medicine, and to bring more breakthroughs with real benefits to patients and society.
How are you dealing with the implementation of the changes to Novartis locally?
Slovak people are highly educated, very open and they welcome every change that leads to the improvement of their work, the company and the society. In order to embrace the change, communication is key. For anything you want to change, it is very important how much, how often and how openly you communicate. Once people understand why, they are ready to act. We now publish newsletters, are active on the blogs front, and we organize monthly and quarterly meetings in order to translate what the global changes mean on an individual basis. A medical rep in Košice or Trnava – smaller cities in Slovakia – might not know who the new global leader is, but definitely need to know what it means for them, what they need to learn, and how they need to develop in order to be successful for today but also for the future.
How do you assess the relationship between the industry and the state?
I think that there is now more openness towards partnerships between industry and government. The industry needs to show that we have a lot of know-how and can help government, while the government needs to trust us. We need to be in a position to repay this trust by driving innovations, bringing added value for the patients, education, local investments and last but not least social responsibility. But first of all transparent communication and partnership.
But this is only the halfway we have to go. The other half is collecting, measuring and evaluating the outcomes that will prove that this way is reasonable. At this point, together with patient´s education and preventative activities, I see also a great opportunity for partnering of public and private sector. As the ministry of health today puts a lot of efforts to improve transparency, we need to have enough relevant and publicly available data that are a key pillar of this process. Furthermore, we need to switch to the higher level by investing in projects of transnational significance, e.g. patient registries or Real World Evidence data that will offer the government the possibility for transparent and sustainable evaluation of the national health care system´s performance and effectiveness. And this is the way how we want to perform.
How do you evaluate the ease of market access in Slovakia?
The thresholds in Slovakia are very strict in terms of the value that drugs need to demonstrate. We can do more in terms of reimbursing drugs based on their outcomes rather than only on their budgetary impact.
Right now, the government is evaluating where the system’s inefficiencies lie and attempting to correct them. This is a positive step but how it will be implemented remains to be seen. It could be simply a cost-slashing or alternatively a value-creating exercise. If the people that are now in power have the genuine will to make sustainable changes from purely cost cutting towards outcomes based assessment then it is positive and Slovakia could become a pioneer in this approach across Europe. But if these actions are merely a political game, then it is not.
Today, to be an innovator, a partner for government, and a leader of change, requires different capabilities than those needed ten years ago. Our people now need to be highly professional, able to lead a constructive discussion with authorities, to understand pharmacoeconomics, outcomes, and to know how to transform science knowledge into value for the system. It is a totally different profile than in the past and these capabilities are not found on the market easily.
What do you see as the emerging trends in Slovakia and to what extent is Novartis embracing them?
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I would highlight digitalization as an emerging trend; people are becoming more and more digitally adept and equipped. People assume that older medical professionals would never use the internet, but they do. There is a lot of untapped potential in terms of using digital technology; educating doctors, facilitating patient education, and improving outcomes for patients.
This is an area that we want to focus on. For example, we are looking into medical devices that will help people control their asthma better, in terms of controlling their levels of medication as well as tracking how often they take the drug and their breathing levels. One of the positive examples from Slovakia is the project of Centre of Excellence for Serious Diseases and their Complications Research initiated by Novartis and co-funded by EU grants, realized with local partners. During its pilot phase the project focused on the improvement of complex patient’s management with the utilization of information technologies and telemedicine services.
What other features of the local market are strong?
Slovakia has developed a strong reputation in clinical trials – with Novartis as a key player. The data produced is of outmost value in order to have real data on how a therapy works and what are the benefits it provides.
In addition, the fact that the government is now willing to make real reforms and changes that will benefit the patients. This and the openness to partner is something that is different and presents a unique opportunity. The new Minister of Health Tomas Drucker has a passion and a drive to make things better, which can only work to Slovakia’s benefit. He has put a strong team in place around him who are willing to drive change and to listen.
In addition to partnering with government, what is Novartis’ role in partnering with patient associations?
Partnering with patient associations is a key strategic pillar for Novartis because it helps us to understand the lives and needs of the patients and offer the best treatment options.
We focus both on educating patients about the disease as well as how to prevent it. For example, in Multiple Sclerosis (MS) there is little that can be done to avoid the illness, so we work on educating patients on how to live a better life. On the other hand, a lot can be done to prevent Chronic Obstructive Pulmonary Disease (COPD), so the education focuses on prevention and healthy lifestyle. We are involved with patient associations in almost every therapeutic area that we are active in.
Most of the MNC country directors in Slovakia are Slovakians; you are one of the exceptions to the rule being Greek-Canadian. What do you bring to the table as a non-Slovakian?
I think that the most important point is my experience from other countries that have already undergone reforms. For example I have lived through all the reforms that are currently being discussed during my time in Greece; reforms perhaps felt even more painfully due to the crisis. Therefore, I know how it feels and I know how beneficial it is to actually be there at the table and engage in discussion with the government. These elements are beneficial to the industry as well as to the patients and the system.
For myself and for my family the transition to Slovakia has been relatively easy given the great acceptance and hospitality we have received from the people of the country. Everyone has made an extra effort to welcome us and make us feel at home from day 1. We are truly thankful for this.
Do you have a final message that you would like to share with our global audience on Slovakia and Novartis Slovakia?
Now is a great opportunity to lead change and help put reforms in place that will make a difference to the lives of patients in Slovakia. Increasing life expectancy even slightly could be the difference between seeing your child or grandchild graduate or not. If companies have the opportunity to make a difference in this area, I think they should be part of this reform for the sake of the patients.
