Scott Curley, general manager of Astra Zeneca Hong Kong, discusses how his affiliate managed to achieve its successful product launch track record; shares his insights on the key specificities of Hong Kong and further explains why it is an important market for Astra Zeneca’s global R&D.
Having previously worked extensively in global product strategy roles, how have you adjusted to your new responsibilities since joining AstraZeneca Hong Kong as General Manager in February 2015?
I must first say my transition has been facilitated by the great welcome given to me by the team here. Hong Kong is an incredible country to live in with probably one of the best working environments for foreigners. As a Scot, given Hong Kong’s historical associations with the UK, there was a surprising amount of cultural similarities. The largest shock I have had to deal with would be the humidity and heat.
In my last role working as Global Head of Commercial and Marketing Operations for Brilinta™, my mandate had been to think very strategically about the brand’s global performance with Global Portfolio and Product Strategy (GPPS) oversight. In line with other top pharma companies, AstraZeneca identifies around 10 – 11 markets – the US, Japan, China, the top five EU markets, Brazil, Russia and sometimes Australia – that account for 80 percent of global business. This means that my job was to devise a strategy that first and foremost supports these markets. Coming to Hong Kong as general manager, my thinking had to become much more operational as I had to execute and deliver the global strategy in the local context with demonstrable results. The global perspective I have from my previous positions gives me an advantage when it comes to managing a country affiliate.
Another difference is that global roles are generally more strategic in nature where you do not have that many people working for you. My job was to influence but I did not have that much official leadership authority with the countries I was working with so I had to learn to lead in a matrix organization. On the contrary, when it comes to managing an affiliate, it comes with a certain degree of leadership authority and therefore responsibility for a much larger group of people. There is an increased sense of responsibility when you lead an organization of 130+ people and have P&L accountability more than $100m.
Globally, AstraZeneca has three strategic priorities. The first is to achieve scientific leadership by continuing to push the boundaries of science to deliver lifesaving medicines to patients. This means maintaining the quality and quantity of our research, especially in areas of high unmet need. The second is to return to growth by focusing on a few prioritized areas, including launching new products as early as possible, especially in the specialty areas where we excel CVMD, Respiratory and Oncology. For instance, we expect to launch our first immuno-oncology product globally this year, and our first biologic respiratory product is expected to come to market in 2018-2019, HK will launch soon after. Finally, the last of our three strategic priorities is to make AstraZeneca a great place for our employees to work and grow. My mandate as general manager is to localize the global ambition and deliver these priorities here in Hong Kong.
Given that Hong Kong is a rather small market, how strategic is it for AstraZeneca globally?
Hong Kong is of strategic significance to AZ. I am pleased to say that the Hong Kong affiliate has increased its profile within AstraZeneca globally in the past few years. Hong Kong had initially been seen as a next-tier market because of its size but I quickly realized when I arrived that the public healthcare system – under the Hospital Authority – facilitates speedy regulatory approval of innovative new medicines. This means that you can launch new products to help more Hong Kong patients much earlier than in the rest of the region. The phenomenal quality of the medical care and expertise in Hong Kong is also very attractive to patients in the wider Asia area. My job was therefore to figure out how we can push Hong Kong higher on the global agenda to ensure that we have all the support and dossiers required to take advantage of this fast approval process.
In addition to delivering new medicines to patients in Hong Kong and Macau on a much faster timeline, another piece was to understand then articulate the strategic value that Hong Kong can bring beyond the domestic market. What I realized when I arrived was Hong Kong was a gateway for patients with high unmet need from across SE Asia when it comes to innovative new drugs. For instance, previously, patients from outside Hong Kong with the means would travel to the US to receive treatment for high unmet medical need but there are huge time, costs, patient and cultural advantages to seeking that treatment here in Hong Kong wherever possible. Across China and SE Asia there remains unmet medical need, especially when it comes to innovative products and potential lifesaving and life extending treatments. Through the scientific exchanges happening between medical societies in Hong Kong, mainland China and SE Asia, as well as the global renown of the Hong Kong healthcare system, the industry sees strong referral patterns into Hong Kong for patients with high unmet medical needs. This applies particularly for conditions with a diagnostic companion, as the medical diagnostics sector in Hong Kong is very advanced.
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I believe last year a significant percentage of innovative cancer medicine product sales came from patients visiting physicians here in Hong Kong from e.g. mainland China. As a guess, I would say as much as 50 percent of sales for innovative oncology medicines across the sector in Hong Kong could have been through patients visiting from non-domestic markets – not just mainland China but other Asian countries like Taiwan and Singapore.
Finally, from a global perspective, when our CEO Pascal Soriot joined in 2012, the global strategy was three-pronged: rebuild our portfolio from 2013 to 2016 through heavy R&D investment; return to growth with new innovative life extending molecules and product launches from 2017 to 2019; and deliver long-term sustainable growth from 2018 onwards to 2025 and beyond. His vision was to deliver around 10 molecules that would make a huge difference to the global healthcare community across our three core areas of cardiovascular and metabolic disease, oncology, and respiratory disease.
Bringing this ambition to life when I arrived, the Hong Kong affiliate set a target to launch 10 new molecules during my three years here. 2.5 years in, we have already launched nine so I hope to be able to exceed that goal before I leave! We have returned to growth with AZ HK delivering 17% growth in 2016 and our long-range forecast looks to continue this growth trend as we strive for sustainable growth through to 2025 and beyond. Ultimately, we are driven by patients first, then science – and only after that do we consider what would bring the greatest value to the organization and shareholders. Our priority is to meet the needs of the Hong Kong market and the patients here and with our new launches I believe we are making a meaningful difference here in Hong Kong and Macau.
With such a great track record in launching new products over the past few years, how do you evaluate the current market access, pricing and reimbursement environment in Hong Kong?
Hong Kong is still not as fast as the US or Europe but if you submit two registrations from two reference countries and deliver the necessary dossiers, obtaining approval is relatively straightforward. We are talking about 9 to 12 months after the US and EU approvals. Nevertheless, I believe all healthcare stakeholders – from the government to physicians to industry – have an obligation to work in collaboration to further accelerate the registration process, especially in areas like oncology, where patient needs are very time-sensitive and urgent.
Hong Kong is unique and blessed in a way because it has multiple healthcare sectors: retail, private, public (HA) and Macau. In the private sector, drugs can be accessed pretty much from the registration date onwards. In the public sector, the reimbursement process is still complex and to date, relies heavily on the pharma industry providing innovative pricing mechanisms. As manager of a local affiliate, my job is to make new medicines available to as many people in the local market as I possibly can. In Hong Kong, we provide various pricing access schemes for patients (PAPs). For instance, if there is a medication with proven progression-free survival rates to a certain point, we could offer the government a scheme where they pay for the drug up to that proven cut-off point – and we cover the costs of the drug thereafter.
We do need to run a commercial business in a financially sustainable manner but ultimately, the onus is on the industry – through individual companies as well as the Hong Kong Association of the Pharmaceutical Industry (HKAPI), where I am currently represented on the board of directors – to maintain good relationships with the government and to partner with them to ensure that as many patients have access to innovative new medicines as possible.
Hong Kong also has a renowned academic community with world-class experts. How is AstraZeneca partnering with leading KOLs and researchers in Hong Kong?
AstraZeneca conducts several globally-sponsored clinical trials in Hong Kong and there are also many local physicians that act as lead investigators, most notably internationally recognized though leaders like Professor Tony Mok, who is a lung cancer specialist at the Chinese University of Hong Kong (CUHK). AZ has around 5 ongoing clinical trials underway in Hong Kong, which is testament both to the strength of the clinical research environment here and the high regard our global organization has for Hong Kong.
As a company, we do place a huge amount on emphasis on collaboration with academia. We also sponsor research from external investigators, who can come to us with great ideas centered on our products. We then work with our global counterparts to ensure the proper protocols devised. Ultimately, if the design aligns with our strategic direction for the molecule, we will support further development of the project. We have around 5 ongoing externally-sponsored research programmes in place in Hong Kong as well.
Finally, we have a global Open Innovation platform where we put our molecules online for any physician or researcher to explore. If they have a concept they want to explore, they can apply to AstraZeneca to obtain access to that molecule. If accepted, we will provide that molecule for free, provide scientific and research support and ultimately look to fund the further development of that project. Our first Open Innovation program from Hong Kong started running last year.
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AstraZeneca, is I believe embedded in Hong Kong’s healthcare and medical environment – and I would say the same case is vice versa: Hong Kong is an important piece of our global R&D landscape.
One suggestion for further improvement is that the government should further support more universities and research institutes in Hong Kong to have the accreditation necessary for their data to be used in filing submissions in mainland China with the Chinese FDA. Once this is achieved, Hong Kong opens even more – and the global industry will be encouraged to invest even more in R&D in Hong Kong.
At a time where the industry is exploring new paradigms of patient care, in what way can Hong Kong’s advanced medical care system and reputation as a tech hub allow it to act as a ‘testbed’ for new healthcare innovations in areas like digital health tech and patient empowerment initiatives?
Globally, AstraZeneca has a digital innovation center and we try to adopt and adapt applicable strategies to the local market. We have done some experimentation with things like lifestyle monitoring apps in areas like diabetic obesity. One of my global functions was as global head of digital in AstraZeneca for a few years. When I arrived in Hong Kong, I was a little surprised because despite Hong Kong’s global image as a ‘tech hub’, there is still some reluctance in the adoption of digital technology, especially in the biomedical field. There is good advancement in diagnostics capabilities but in terms of using the digital ecosystem to support patient empowerment and the entire patient care journey, there is not much of a centralized, integrated strategy either in industry or the public sector.
AstraZeneca Hong Kong has been trying to champion the incorporation of digital tools as an integral aspect of any brand strategy, communication and marketing, be it from raising awareness of a disease to assisting with diagnosis to supporting a patient through treatment to promoting ongoing compliance with medications. The key is to ensure that the entire digital strategy is fully integrated. Any brand manager can develop an app but the question is how widely used and effective is that app? Most recently, we have launched a hugely successful awareness campaign in ovarian cancer that reached over 800,000 views for a single awareness video on social media, which is stunning. Ovarian cancer is much lower in profile than say breast cancer, so we wanted to develop local awareness of this devastating disease.
Patient empowerment is very important and we see many potential touchpoints through which to communicate the right information with patients. For me, however, it is essential to figure out how best to support patients using these existing platforms. Another obligation we have as a company and market leader in our disease areas is to disseminate high-quality and correct, factual information in a way that is digestible and accessible for patients. Patients are now seeking more involvement in their own disease treatment but it is our responsibility to provide them the necessary tools and information to make informed choices.
As general manager, you also have a leadership mandate for the affiliate. Have you had to adapt your leadership style since coming to Hong Kong?
First and foremost, it was not about coming here as the boss to tell people what to do. That approach does not work. When it comes to my leadership style, I focus on things like leading by example and bringing fresh perspectives. I am not here to oversee the status quo; my job is to drive improvement and empower change from within to enable the organization and its people here to grow to become better equipped to compete so HK will be a ‘fit for the future’ biomedical company that AstraZeneca aspires to be.
I also need to be really open to listening, learning and understanding. A great cultural difference I found coming to Hong Kong was this concept of ‘saving face’. I found European management style to be more of calling people out directly to address issues head-on and avoid potential conflict later. I wanted people to feel comfortable to challenge or be challenged to foster a collaborative and open work environment. However, I learned that is not how business is conducted in Hong Kong and I had to learn to adapt my style and be subtler in my approach. The focus became more constructive and supportive instead of directly challenging.
I certainly do not know all the answers but together as a team, I am confident we can make AstraZeneca HK an even greater company and make a meaningful difference to patients’ lives, which is our driving ambition. On the Hong Kong affiliate level, this also means delivering stellar performance. Realistically, if Hong Kong was just a small market with average performance, no one will be interested in us. As we continue to raise our profile and demonstrate that we can punch above our weight, bringing strategic value to the global organization, the global organization will want to invest even more in this affiliate, which will ultimately benefit patients and the overall community in Hong Kong.
