Metodija Chadikovski, general manager at Roche Bulgaria, explains the importance of conducting high quality diagnostics to successfully target the right drug to the right patient as well as the affiliate’s commitment to developing the solutions that Bulgarian patients will need next.
Could you please introduce yourself as well as your professional background to our international audience?
My education is as a medical doctor and I started my professional career as a medical surgeon, where I worked for two years before joining Roche back in 2000. The reason why I decided to join the pharmaceutical industry was because, by that time, the Eastern European countries were not well organized from a healthcare standpoint and such a situation was very limiting for my aspirations to help more people with quality care.
Hence, when I joined Roche, I started as a sales representative and I followed the traditional career path development. At the beginning, I had my internal debates about whether I wanted to come back to the medical surgery arena but I found a really good friend with strong experience in Roche that became my mentor and helped me to successfully drive my career in the company. I will always be grateful for the opportunity to work with him; he taught me all about business basics as well as communication and leadership skills.
Then, after six years working in the Macedonian affiliate in different positions and departments, I got the opportunity in 2006 to open Roche’s operations in Montenegro from scratch. It has certainly been one of my proudest accomplishments, I was parachuted there without any structure and we managed to over achieve our objectives; we made something out of nothing. Indeed, it has been a successful story and, currently, Montenegro is one of the countries with the highest sales per capita for Roche.
After that amazing experience, I returned back to Macedonia in 2009 as general manager, which is something that I always wanted. Nevertheless, after two years, I was already eager to accept new challenges and I had the proposal to go to Bulgaria, which is a bigger affiliate. Thus, in July 2010, I got promoted to general manager of Roche’s operations here and it has been a really positive change both in my professional and also personal life.
How has your former experience as a medical surgeon affected the way you approach business?
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The courage to make decisions in a short time frame and with limited resources is an extrapolated legacy from my former experience as a medical surgeon. In CEE countries in general and Bulgaria in particular, all the information needed is not always available but dealing with such a situation is a must for any executive and we need to take decisions in this frame.
Putting the spotlight on your affiliate, Roche is positioned within the top three players in the Bulgarian pharmaceutical industry. What are the main points that define Roche’s positioning in the country?
In Bulgaria, we are present in both pharmaceuticals and diagnostics; the latter being way smaller in terms of revenues and size. We are positioned as the oncology market leader in Bulgaria and, considering that cancer is the therapeutic area in which more public health funds are allocated, we are the company that is receiving more funds from the National Health Insurance Fund (NHIF).
Additionally, what is really unique about the Bulgarian affiliate is that we are acting not only as an affiliate but also as a wholesaler; we are working as a full stretched Bulgarian company being able to participate in government and private tenders on our own. It was a strategic decision and, actually, we have a hybrid distribution model being direct or indirect depending on the customer segment. I am proud to confirm that, last year, Roche was within the top 200 companies in terms of revenues in Bulgaria.
What have been your main areas of focus in order to drive the affiliate to its current positioning?
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It has been a combination of two main axes: the right product portfolio and a highly-talented team. These two cornerstones have driven our success in Bulgaria making our medicines more accessible to the population, which is one of our main duties and is aligned with Roche’s mission as well as vision of making innovation accessible to all patients that need them.
Your industry peers have shared a strong satisfaction about the level of professionalism and loyalty of their teams in Bulgaria. Aligned with one of your areas of focus, how easy or complicated have you found it to build up the best team here in Bulgaria?
The level of professionalism in Bulgaria is really remarkable. However, the level of loyalty has changed from the old generation to the new generation of “millennials”. We have an outstanding team of professionals with more than 10 years with us but, at the same time, we are experiencing challenges when retaining young talent. In general, the new generation is continuously looking to different ways to speed up their professional development, without any attachment to the company they are working for – professional promiscuity is a fact.
We are fully aware of this trend and, therefore, we believe that we have to adapt our HR strategy in this regard. We are developing some interesting initiatives such as “Reverse mentoring” in which a millennial will become my mentor for a period of time in order for me to learn from them.
Roche is known for being one of the most innovative companies in the world and has launched many products in the past few years. What would you say is key to a successful product launch in the country?
Everything related to product registration and reimbursement processes is about doing your homework in a clear way and well enough in advance; pre-launch activities are key to success in Bulgaria and in any other market. In this matter, it is not just about having the right product but also the experienced professionals that will ensure all dossiers fully comply with the regulatory guidelines such as the Health Technology Assessment (HTA).
What are your product launches for the upcoming years?
We have been really active in enlarging our product portfolio over recent years. Currently we have two products to target hematology diseases and a product for treatment of Idiopathic Pulmonary Fibrosis (IPF) that are in the final stage of the reimbursement procedure. Furthermore, and looking ahead, we aim to expand our offering with all new products of Roche to target MS, and immunotherapy, among others.
Obviously the biggest issue in Bulgaria is funding. When it comes to oncology it is even more complex because new drugs have proved very effective but also very costly. How do you collaborate with health authorities to ensure that the right patients get access to the right drugs?
Roche is globally well known by its personalized healthcare (PHC) products or so called targeted therapies. In this regard, we are continuously and heavily investing in prior diagnostic activities – not only in terms of volume but also quality – in order to ensure the right drug is prescribed to the right patient.
In fact, quality of testing is a challenge and if compromised it could lead to wrong prescriptions. This could ultimately increase the costs in the healthcare budget and hurt the patients, so it is where Roche Bulgaria is putting very strong efforts for over 12 years now. At least, we have the duty to ensure that all patients using our medicines are certainly benefitting from them. As a key figure to show the impact of this type of activities, there are scientific-based studies that state that two percent of investment in diagnostics influences 60 percent of the clinical decisions, so this saves toxicity to patients and late healthcare expenditure
Internationally, Roche has introduced some very innovative pricing models. Is the infrastructure in place in Bulgaria to embrace this type of new pricing schemes and how is Roche contributing in this regard?
The industry, not only Roche, is really active in this front through the Bulgarian Association of Research Based Pharmaceutical Manufacturers (ARPharM). Bulgaria has the need to enhance its current system of managing healthcare expenditures through developing digital capabilities such as E-Health, which will bring not only transparency about the NHIF’s funds allocation but also reliable data about the healthcare outcomes from every medicine. Nonetheless, even though the industry is strongly supporting the government in this arena, it is a challenge to implement electronic capabilities in the country.
Concretely, as you said, Roche has experience in innovative pricing models such as combination pricing and multi indication pricing but, unfortunately, the country is not yet ready to embrace them.
Patient-centricity is the talk of the town in 2017. But what does it mean in Bulgaria and what is different in the way patients are considered in the country?
I believe that Bulgaria is at the forefront of the rest of Balkan countries in this regard. I have to say that patients’ associations in Bulgaria are really well organized and considered as a partner among all the rest of healthcare stakeholders such as public health institutions and the industry. In fact, patient’ organization are certainly embedded in the Bulgarian healthcare system and they are continuously proposing best practices identified in other European countries to be implemented in Bulgaria.
Moving ahead, what are your priorities to develop Roche in the country?
Globally, Roche is already developing the healthcare solutions that patients’ will need next and this is also reflected in our affiliate. Therefore, my main and foremost priority is to launch successfully our pipeline in Bulgaria in terms of timing and broad market access in all therapeutic areas in which Roche has expertise.
