Sylvie Bertrand, general manager of BSN medical Canada, an Essity company, highlights the value proposition BSN medical’s products bring to Canadian patients in chronic venous insufficiency, diabetic foot ulcers and lymphedema, and how the company contributes significantly to the sustainability of the Canadian healthcare system by focusing on the continuum of care.
Sylvie, can you give us an overview of the BSN medical Canada affiliate?
BSN medical Canada is primarily a commercial affiliate. We have 12 people working in our offices in Laval and a field force of 25 sales representatives, covering the whole of Canada. We are proud to be in an expansion mode, having recently added a position of a clinical support resource to our operations to strengthen our relationship with our customers. It will play an important role in raising awareness as well as supporting and educating key stakeholders, clinicians and nurses.
What is the strategic importance of the Canadian affiliate for BSN medical globally?
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The Canadian affiliate of BSN medical ranks amongst the top 15 subsidiaries worldwide and prides itself as very creative in its go to market strategies. We have demonstrated success in taking the innovative reach of the products within our portfolio one step further. That is, we aim to demonstrate improved outcomes cost effectively, giving a new dimension to the use of our products by incorporating them in certain programs. We are thus able to reduce healthcare costs and improve patient quality of life overall.
For instance, our offloading kit developed in collaboration with Canadian healthcare professionals, best illustrates our creative approach. Based on more than ten years of clinical experience, our kit includes several of our products, in an easy and standard application technique, simplifying application and containing all required educational support and resources. It is a form of standardization of a technique, in this case the offload of a diabetic foot, and an element of support for clinicians.
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Thanks to our creativity and shared experience, other BSN medical affiliates around the world have either launched an offloading kit or are investigating its implementation. Likewise, Canada was first in establishing loyalty programs for key partners in the vascular field, a platform now in discussion in other parts of the BSN medical world as well.
Your product portfolio is constituted of high quality branded products in wound care, vascular and orthopedics. Which of the areas is your main growth driver?
We have been observing several trends in key markets, not just for BSN medical but for the medical device market overall. Wound care is growing in volume as we are facing an aging population. It is further a field where we identify several opportunities for new product launches. The innovation required in this segment revolves around efficiency, such as healing time reduction. Another interesting field with potential is the vascular area. The opportunities here result from how underserved this market still is in Canada. One in four individuals suffer from some form of chronic venous insufficiency and should be wearing compression stockings to prevent health issues. In chronic venous insufficiency, prevention is essential before the acute phase starts. It is not a condition that can be treated at one moment in time, the physician has to accompany the patient over a long period of time. However, there is still little knowledge of the condition amongst physicians, which is why education amongst healthcare professionals is one of our main priorities in this area.
Next to the aforementioned areas, lymphedema is the third area gaining awareness. Although training in this area remains underserved as well, we are witnessing a shift in the payers’ attitude towards lymphedema related conditions. Across Canada, provinces are taking reimbursement into consideration, Québec having put in place a pilot reimbursement program of garments three years ago. Lymphedema garments are expensive as they are custom-made and cannot be off the shelf, as their application requires special knitting.
What is in the pipeline of BSN medical for up-coming launches in the Canadian market?
We will be launching several products in the near future, all adapted to the Canadian market. A key part of these will be strategic launches, within our therapy areas, fitting the needs of the Canadian patients and market. The Canadian healthcare system being a publicly funded one, the emphasis on cost effectiveness and outcome improvement are important, and we will focus on the launch of products inscribed into both axes.
In an increasingly financially stressed healthcare system focusing on cost effectiveness, what is BSN medical’s value proposition compared to other companies in the same market segment that might offer more cost-efficient products?
BSN medical’s value proposition comes from our integrated therapy solutions and our ability to demonstrate improved outcomes through cost analysis. This in turn is achieved by presenting data and creating an awareness for the benefits that accompany the use of BSN medical products through the continuum of care: fewer dressing changes, fewer nurse visits and accelerated healing time are all factors that reduce the overall cost in the healthcare system.
Nonetheless, decisions are often made with short-term objectives in mind, that is only taking into consideration the immediate cost of a product and do not have a long-term view towards value and outcome-based healthcare. It is BSN medical’s just like other medical device manufacturers responsibility to advocate for better understanding. At BSN medical, we work in collaboration with various advocacy groups such as industry organizations with MEDEC, or associations like Diabetes Canada and Wounds Canada as well as patient groups like lymphedema associations, such as the Canadian Lymphedema Framework.
I believe that the most important factor in these discussions is to remain open for dialogue. No one has all the answers, but by analyzing issues and trying to find a solution, we are already moving a significant step forward. We let our products speak for themselves, and have been able to observe a slight improvement towards outcome consideration amongst payers, although it is a very long process. Changing standards of care and changing people’s habits takes a long time.
BSN medical is dedicated to the “continuum of care.” In each of our key therapeutic areas, chronic venous insufficiency, lymphedema and diabetic foot ulcers, prevention is one of the most important factors contributing to reducing healthcare costs. Close to 80 percent of ulcers come back after they are healed, unless the patient wears compression stockings. We believe that by promoting each phase of the continuum of care, we can contribute to lowering the cost for all parties involved.
Canada has an incredibly fragmented healthcare system. What challenges and opportunities does that bring for you?
The fragmentation of the Canadian system is due to the provincial distribution of decision power in terms of pricing and other healthcare related subjects. However, there is another dimension to the fragmentation: the purchasing is still centralized. This poses a challenge, as the decision power of a wide array of institutions is limited to a small group of individuals. This can have a highly negative impact on innovation, because consideration for cost of treatment and outcome fall behind cost per product considerations.
Nevertheless, even though the demand on Health Canada regulatory body is somewhat high which may slow the process, in its processing, it is known to be efficient, even more so than other regulatory bodies in different jurisdictions.
How do you engage with healthcare providers across the country?
BSN medical covers the whole of the Canadian geography with our sales representatives, something we consider essential to be able to serve all patients and not just certain group purchasing organizations. Another tier we leverage upon are key opinion leaders, with which we practice an open dialogue and communication. By publishing clinical newsletters and hosting webinars, we strive to educate on new trends and technologies, and maintain our channels of communication alive.
Medical education is another dimension in which we drive collaboration with healthcare professionals. We have for instance launched a webinar series on which information and online training for wound care and on vascular disease topics can be found. Our webinars are conducted by our own clinical experts as well as by hired field experts, physicians and nurses having expertise in those fields. The programs are not so much product geared but revolve much more around indications.
What will be BSN medical’s priorities over the coming years?
Because of the fragmentation of the healthcare system, the challenge for us is to find those areas where we are able to demonstrate value and then communicate accordingly. We further want to be a partner to our customers, but also by challenging them to change their standards of care. Finally, we are aiming at growing more than the market.
Founded in 2001 as a joint venture between Beiersdorf and Smith & Nephew, BSN medical has acquired several groups. In 2017 BSN was acquired by the global leading hygiene and health company Essity (formerly SCA). How do you as manager of the Canadian operations ensure you maintain a sound global corporate culture at BSN medical?
I have been with BSN medical for over fourteen years, and while much has changed in the organization, we were able to see the culture at BSN medical Canada evolve along and adapt. I believe an entrepreneurial mindset, together with clear communication of vision as well as an ability to motivate people to work successfully together have been required along the way.
What makes a company’s culture in the end are the people working for the company. When everyone has great products, your people are your key differentiation factor. At BSN medical, our culture focuses very much on people, and recruiting and retaining the right employees is essential to us. We recognize their contribution to the group and are therefore able to leverage on their knowledge to add value to our operations.
The merger with Essity is a perfect strategic fit, as we are united by the common goal and mission to sustainably develop, produce, market and sell value-added hygiene and health products and services.
You are part of “Women in Bio” in the Montréal area. Dominique Anglade (Minister of Economy, Science and Innovation Québec) said that encouraging more women for positions in higher-productivity, science-based fields ranked amongst her priorities. What can be done to motivate women to enter such fields?
There is room for improvement when you consider the number of women in high-productivity, science-based fields. The barriers women have to overcome are still too numerous, and some we sadly put in front of ourselves. I think we need to gain in confidence in our abilities as well as be exposed to possibilities. This can be achieved by supporting more platforms like “Women in Bio” for networking and for mentoring future generations. Still today, more of these positions are held by men, and women have to fight hard to remain true to themselves and their convictions. With making an effort in building up confidence, women will take part in the discussion circle. I guess it all comes down to positive climates in which people can exchange openly, without fear of judgment and respect for diversity of thinking and experience.
During my career in Europe I worked in Finland for three years, and the Scandinavian countries have a very inclusive way of management encouraging participation. It is an employee-oriented system, inclusive not only for women but all. In Canada, I believe we are moving in the right direction with still some way to go.
