Rui Ferreira Dos Santos, country manager for Spanish pharmaceutical company, Almirall provides readers with an update on the company’s new medicines and how their global strategy to become dermatology specialists manifests itself in Portugal. Rui also sheds light on the challenging yet rewarding pharmaceutical landscape, where new managers can learn, excel and thrive.

 How did Almirall perform in Portugal for 2017?

 2017 was a good year particularly for Almirall, namely in what concerns market access activities. We had a positive result for the second product that we have in our focus area of dermatology. Indeed, over the course of the past three years the global focus has shifted towards dermatology, and in Portugal, the trend is no different. Of course, our mature products are still critical to the affiliate’s success and with that in mind an agreement with a local company was signed, being Almirall 2017’s business centered on dermatology reinforced through approval of another medicine in actinic-keratosis therapeutic area.

Unfortunately, we are still waiting on the approval for Sativex®, an ongoing process that started at the end of 2012. The Sativex® story was ended by mid 2015 with INFARMED’s recognition of the added-value that Delta9-tetrahydrocannabinol (THC): cannabidiol (CBD) oromucosal spray (Sativex®) in the management of multiple sclerosis spasticity. Sometimes INFARMED’s operations can be unpredictable or tediously slow, and Sativex® has been an example of this. It is difficult driving forward the Sativex® medicine, despite that we have observational data, clinical trials and evidence-based-practices from across the EU. Furthermore, discussions started early this year in Portuguese parliament regarding cannabis usage for medicinal purposes. We are moving forward again, and expect that multiple sclerosis Portuguese patients could also benefit like the rest of Europe. Almirall focuses on bringing innovation to the country and providing for the unmet needs of Portuguese patients, while continuing the sale of our mature products in the market.

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 What is on your plate for 2018?

We will expand our presence in dermatology, bringing Skilarence® dimethylfumarate (DMF) which is used for the treatment of adults with moderate to severe psoriasis. It is already marketed in Germany and more recently in other EU countries

We expect to receive good news in the near-term especially given that the currently available alternatives in the country are not adequate for treating patients, and the further option is biologics.

It will be our first launch in psoriasis reinforcing our presence later with Ilumetri (Tildrakizumab), a selective IL23P19 inhibitor. In essence, we will become specialists in Portugal and worldwide for dermatology and other specialty areas through these positive indicators which we expect will lead to an expansion of the Portuguese affiliate.

What is the strategic importance of the Portuguese affiliate?

The Portuguese affiliate is very important to Almirall global operations being one the first affiliates of the company (since 1993). We also returned to growth and experienced a revival in 2015, and rode out the difficult times during the recession.

During the darker period of operations in Portugal, from approximately 2010 to 2015, we had to tighten our belts while simultaneously concentrating our efforts on the most important innovations. Today we make clear our ambition to become a leading player in dermatology and other specialties, and at a local level, we want to show this by offering medicines in this field.

In dermatology, there is a broad spectrum of products, from OTCs to aesthetics to medicines, and in Portugal, our niche is the skin medicines for the time being. We have been active in business development locally and in HQ, and are always on the lookout for opportunities to expand our presence. For example, globally we recently signed an agreement concerning an innovative molecule that will be our third offering for the treatment of actinic-keratosis. This product currently enters phase three of development. Equally, at a local level, my ears are pricked for opportunities to expand and collaborate. We will need to increase our human resources offering, to build on the efficient yet barebones team model that we have in Lisbon. We have exciting years ahead of us and are revitalized by recent launches and future ones.

How do you advocate for investment from HQ, given the problematic market challenges here?

There has been a paradigm shift in investment and notably, the way in which investors bring money to Portugal. Now Portugal is becoming more and more competitive and the recovery of the economy enhances higher possibilities of investment in addition to credibility and confidence of the investors.

All affiliates face specific challenges of their markets, but in reality, although it is difficult to explain to headquarters some of these challenges mainly in what concerns market access, we have support in what we do. We know that Portugal is historically a ‘cheaper’ country, but despite being a small country there are still opportunities for growth and investment.

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What makes Almirall the partner of choice?

See the example of the recent partnerships established with Athenex and Sun Pharma. Partnerships is part of Almirall DNA in several markets.

We are already well recognized on the market, but we intend reinforce on our status as an innovative company that makes the difference for the patients; as our tagline says: feel the science.

Put simply, what we try to do is to deliver the best scientific, evidence-backed data relevant to Almirall, but useful to others, to show that we are committed and on-hand to help deliver to any patients’ unmet needs across the country. We want to show that we are here to collaborate and we are team players.

As our CEO Peter Guenter refers; “We are an outlier in the market in that we have a portfolio of products. Some of our competition comes to psoriasis from immunology, whereas we’re rooted in dermatology, which is a very relationship-driven community. Our R&D engine is entirely dermatological, and that is important: it demonstrates that we are here to stay, and we are focused.”

To what extent is Portugal a training ground for new managers?

 We cannot avoid talking about Portugal without pointing that Portuguese are often cataloged as friendly, welcoming people living in a warm country with excellent food, wine and a fantastic quality of life. However, we face the same issues in the marketplace as bigger countries. The advantage in Portugal is that you can get to grips with the problem and get to the root of the matter more efficiently, and new GMs, for instance, are in closer contact with KoLs, stakeholders, and managers across the country. Even down to the doctors in regional hospitals, new managers can engage with these people on a daily basis and build a network of relationships from day one.

The challenge and barriers that managers face serve as useful learning tools. This exposure is a fantastic learning platform for a new GM, as although the structure is reflective of big countries, one can familiarize oneself more easily, get to know the ropes and develop, nurturing skills to further one’s career in perhaps a bigger market. Starting a career in Portugal is a faster learning curve, but I must warn these new managers that they may find it hard to leave!