Ms. Hoeppner, in addition to your role as general manager of Astellas, we understand you also have leadership role within the industry as a board member of the Association of Pharmaceutical Companies in Switzerland (vips). What are some of your key priorities in this capacity?
“Swiss culture is generally tuned towards innovation and quality, and Switzerland is ranked the most innovative country in Europe and the world by many indexes. This mentality very much affects the way medicines are prescribed and consumed.”
As a general manager, my top priority is to be able to make meaningful and reliable forecasts such that my team and I can develop and execute effective strategies. Thus, one of the fundamental goals which guide my activity in vips is working to ensure that we have a high degree of transparency and stability in terms of the regulatory environment. Moreover, as a company it is also very important to be well involved in the association because it is critical to have a good understanding of what is happening and what may happen in terms of changing regulations and administrative approaches.
Switzerland also has a unique position as a relatively small market from a regional standpoint, substantial fixed costs to enter the market, and the high cost of living in Switzerland. Thus, while this is an innovation driven market, the relationship between sales and total cost of sales is less favorable than in other markets. One of my aims as a general manager and vips board member is to work to improve this margin, in large part by advocating for policies which can reduce costs, improve access, and see the value of the innovation we bring to patients fairly recognized. In particular, I see room for improvement in the timelines it takes to get marketing approvals from Swissmedic, which is entirely independent of the EMA as well as reimbursement.
In what areas is vips advocating for faster approval timelines from Swissmedic?
As an association, vips is working with the authorities to benchmark Swiss approval timelines versus timelines under other regulators to see where there are significant gaps which can be closed. One of the most salient issues is that Swissmedic does treat applications for additional indications similar to the first indication, and thus getting additional indications approved in Switzerland takes longer than under the EMA or FDA whom have a much shorter process for such applications.
That said, Swissmedic’s independence does offer opportunities in some instances, where they have very efficient fast track mechanisms. At Astellas, we have had very good experiences in oncology in particular, where these mechanisms have allowed patients to access innovative treatments very quickly after our applications for marketing approval.
Considering the market access from the patient perspective, Switzerland deserves recognition as patients who need access to a medication can get it, according to pre-defined criteria, before the reimbursement process is complete. Compared to other countries in Europe this is a real strength of Switzerland, because there are solutions in place to help patients in difficult situations.
Where are some of the other areas where you see room for the Swiss pharma community to optimize the environment?
Pricing is also a key area of concern, and there is a bit of a philosophical discussion at present how to assess the therapeutic value of products. In the past reference pricing was used to a greater extent, and given the exchange rate volatility we have seen over the last years we have significant concerns about Swiss pharma prices being so directly exposed to the Euro. We’re confident the solution will be a significant improvement to the status quo, there will certainly be some aspects which need to be looked at closely – particularly around mechanisms used to assess therapeutic value, how therapeutic categories are defined and the comparative products selected.
Finally, I would like to highlight a particular issue with the system by which an innovative product can be added to an additional funding beyond a diagnosis related group (DRG). Swiss hospitals may receive an additional payment from the insurer if they treat a patient with a higher priced drug drug beyond the DRG – at present getting payment for a new higher priced drug added to the list can take years. I would like to see an “interim funding” solution introduced, such that the use of innovative products can be supported in hospitals while the process for calculating the final additional payment is underway.
How would you describe the Swiss cultural approach to the pharma industry?
As home to two of the largest pharmaceutical companies in the world, Switzerland is certainly very open and generally supportive of the pharma industry – 30 percent of the country’s exports are pharmaceutical products.
The industry also looks on Switzerland in a very positive light, in large due to the very high quality of infrastructure, reliability of utilities, and great supply of talented professionals, which all make Switzerland an attractive place to do business for pharmaceutical companies, whether they only carry out administrative functions here or invest in research and manufacturing as well.
Considering the market, quality and innovation are factors that patients and physicians consider very important. Swiss culture is generally tuned towards innovation and quality, and Switzerland is ranked the most innovative country in Europe and the world by many indexes. This mentality very much affects the way medicines are prescribed and consumed.
However, Switzerland is also a very diverse country, with four linguistically defined regions and a 20 percent expatriate population. This also means that the approach in the different areas should be rather different and regionally adapted.
As a manager, how do you manage the diversity of skills you need to have the right approach in each area?
It is essential to have teams native to the region that they are working in whenever possible. This can be challenging in Ticino especially, because the region is rather small and one may choose having one or two people cover the entire portfolio for the region, or have reps based primarily in another region cover Ticino with a narrower portfolio but then being more specialized.
It is also important to recognize you must take into account these regional variations e.g. when setting objectives, or having group meetings to discuss performance. For example, we consistently see that physicians and patients in some parts of Switzerland are more open to innovation and we often see higher penetration of innovative products in those regions; and we have to adjust our ambitions accordingly.
Coming to Astellas, how would you assess your affiliate’s current position in the Swiss market?
I started my career in the pharma industry directly after graduating from university, and I was the general manager for Fujisawa’s Swiss affiliate before Astellas was created in their merger with Yamanouchi Pharmaceutical Co.
Back in 2002 Fujisawa’s presence here was very minimal, and most of our products were present in the market via licensed partners. We started bringing some of these products, which were in the areas of dermatology and transplantation, back into our own organization before the 2004 merger, at which point we gained access to a key product which enabled us to establish our presence in urology, today a key therapeutic area for our company.
We have leading products in transplantation, overactive bladder, and now prostate cancer, and today we are ranked 24th in the Swiss market according to IMS data. We have very strong relationships with the relevant physicians, medical associations and leading researchers at the hospitals which participate in clinical trials.
With this solid base in multiple therapeutic areas, what will be the key tasks you must focus on to drive growth over the next few years?
Our priority is still focus on driving growth in our existing portfolio, with leading products in the area of prostate cancer as well as urology still being relatively new to the market.
From a pipeline point of few, Astellas’ aim is to be true innovative leaders in medicine, and focus on the therapeutic areas where we can bring substantial value to patients through our innovation. Over the next few years we will be working to further establish our innovative footprint in products related to transplantation, chronic kidney disease and oncology, where we have late stage products in development. This means learning yet more about what physicians need from us to better treat and inform their patients, providing that support, and providing what support we can to help patients better deal with their diseases.
We have also reached the point that it is time for us to invest significant resources in updating the way we do business to better incorporate new solutions. Digital multi-channel marketing, data-management and analytics, and innovation in terms of our sales approaches and models – tying services to our product offering for example – are all high-potential areas that we have yet to explore in a substantial way.
At present, we are looking at the skills and experience we need to acquire from a HR perspective to advance in these areas. To this end we have recognized that we very much need to invest in employer branding towards our goal of acquiring the best talent. This is because although we are a top 20 global pharmaceutical company, in Switzerland we are mainly known in the defined therapeutic areas. Thus, increasing our visibility among the pharmaceutical community here in Switzerland and communicating the reasons which make us a preferred employer are key priorities.