The future of healthcare calls for all stakeholders to partner up. The general manager for Johnson & Johnson (J&J) Medical in Mexico shares his view about the challenges the healthcare system is facing and his vision about how to transform J&J from being merely a supplier of products to becoming a trusted partner.

You were appointed general manager for the medical devices and diagnostics business units in Mexico in January 2014. What mission were you entrusted with for the division?

Today, Mexico is a country undergoing a significant transformation in terms of the healthcare environment. I don’t think the country is unique: when looking back at the economic crisis that started in 2008 it really shook the financial and the healthcare systems across the world. In Mexico, I think the healthcare system, which has been traditionally comprised of two components – pensions and social security on the one hand, and government-sponsored healthcare on the other – was critically affected and a different burden was placed on it requiring the government to take a different perspective on how future funding and entitlement programs will look like.

In order for a country to be viable economically you need to have two core elements: health and education. If you are not able to provide those in a satisfactory manner, you’re not going to be able to build a robust and productive economy that is able to compete on a global basis. Mexico has a very fragmented healthcare system that has been pushing for universal healthcare for ten years now. With the introduction of the national insurance scheme Seguro Popular, the landscape changed significantly granting universal access to both primary and catastrophic care to a large portion of the population that was previously without coverage, which was a great advance. The system continues to evolve and it is a very exciting time. My role here is to help J&J continue innovating and figure out how we can contribute positively to this continued transformation of the Mexican healthcare system.

How do you plan to make Johnson & Johnson Medical Mexico play a more prominent role in the Mexican healthcare system?

If you look at it from a very traditional perspective, we are a manufacturer and supplier of medical devices. However, this is not the future of healthcare; the next step is understanding our responsibility in the healthcare sector as a whole, and how we can transform J&J from being a mere supplier to become a trusted partner. The question is: how do we go from being a supplier of products into services and then onto solutions? To do so we must be able to understand the different needs and wants of all different stakeholders—our patients, the doctors, the payers, the administrators at hospitals, the health authorities and the government.

We also realize that there is a significant amount of distrust among the different stakeholders, and we really believe we can play a key role in bringing them together. We do this by defining a common language, because at the end of the day, it all boils down to who shares in the responsibility and bears the burden of the cost of healthcare. But, if we can all agree on some basic concepts—a superior clinical outcome and safer surgery, which comes through better products and timely intervention—we can improve the overall healthcare system. At the end of the day it’s all about quality, which cannot realistically be a blank check. We need to understand the economics of healthcare and make sure we provide the right solutions for the right diseases at the right costs. The bottom line is that we need to sit down with all our stakeholders to figure out how we can collaborate and how can we leverage standardized protocols that will really have an impact on clinical as well as on economic outcomes. It must become a win-win situation with the greatest benefit being to the patient.

When we met Enrique Álvarez, president of J&J in Spain, he told us they were increasingly using pharmacoeconomics to demonstrate value over cost. What does it look like here in Mexico?

The questions we are increasingly posing are: If, by using new technology, a standard surgery can be done in 30 minutes and have a three-to-seven day recovery period, what is the benefit of saving money and getting the same surgery for half the cost with less sophisticated technology but with a recovery period of 30 days? What is the cost of having that patient out for 30 days, and who is paying for it? Is it the patient or the family? When you do this type of study, it becomes evident that if you’re able to have a safe protocol and a safe surgery, there is a benefit in the short, as well as the long run.

The epidemiological profile of Mexico is changing dramatically. What do you think are today’s most important challenges and how can these be faced?

If you look back historically, Mexico was faced with infectious diseases. The great challenge of the healthcare industry was how to vaccinate against all these diseases. Today we are going from infectious diseases to chronic and degenerative ailments, which require either surgical intervention or maintenance drugs. Mexico is facing different challenges these days within the system. But the most important question is: how are we going to pay for this? Do we need to look for different treatments and care and alternatives to funding? I would say yes.

One idea that is also significantly important is that we need to be more proactive in the different stages of diseases. We need to work on intervention and preventive healthcare. We need to catch the disease in its early stages, because if we receive a patient at the latter stages, the cost to the healthcare system is exponentially higher.

Obesity is a major problem in Mexico. How would you assess the government’s commitment to combating it and how are you working with the local authorities?

Obesity has become a serious challenge in Mexico, more from the prevention side. It is a nut that we have not yet cracked. If you look at the statistics the situation is staggering: Mexico is number two in the world in adult obesity and number one in child obesity. There have been a number of initiatives implemented by the government, which include sugar taxes and food requirements for school cafeterias. At the end of the day, individuals need to be conscious of their weight and take responsibility for their health, but we also need to find ways to help them. It has to do both with education, and with government incentives and regulations. We need to find the happy medium of these two sides.

We are working with health authorities on a pilot program to set up obesity clinics, because treating an obese patient is not like treating a person with healthy weight.. We are also working on education and nutritional initiatives. We have to have a multidisciplinary approach in order to effectively combat the disease. There are two million morbidly obese people in Mexico. The system does not have the money to surgically treat all of them, so we really have to seek alternatives measures and solutions in combating this condition.

What is the strategic role of Mexico for the group?

At J&J we talk about the BRIC-M (Brazil-Russia-India-China-Mexico) block, so Mexico is definitely a key market. These countries are all at different stages of development in their healthcare systems. Mexico, because of its proximity to the US and its affinity with surgical techniques and standards, is a very important market to develop. Now, has it been the most successful? This is all relative because I don’t think that you can compare the healthcare system in Mexico to that in the United States or in Brazil simply because they have different philosophies and are at different stages in their development. However, I would still consider Mexico to be a country with strategic importance in all three sectors: consumer, pharmaceutical and medical.

Where would you like to see J&J five years from now?

I believe our role is in partnering: evolving from products into services to solutions. There is no doubt that the healthcare reform is on the agenda for the government –perhaps not number one, but definitely there – and my personal ambition for the company is to figure out how we will partner with the government to build solutions that increase access to quality healthcare. Improving access to a greater number of patients does not always equate to to improving quality. We, at Johnson & Johnson, believe in caring, one person at a time, to help billions live longer, healthier and happier lives.


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