Interview: Torge Doru – Managing Director, Ferring Romania

Doru Torge, General Manager, FerringThe general manager of a speciality biopharma business challenges lawmakers to regard health spending not as a cost but as an investment and reveals how women’s healthcare and fertility treatment can become showcase examples in making Romanian healthcare sustainable.

Back in 2011, when we asked you about Ferring’s priorities in Romania, you identified the need to bolster your service offering in the areas of fertility and obstetrics and to forge ahead with assembling a gastro portfolio. What headway have you made in achieving these objectives?

Since 2011, we have been able to complete our product portfolio and, alongside continual advancements that we are making in obstetrics, we have managed to establish strong product lines for specific therapeutic areas such as infertility in which globally Ferring has established a robust reputation as leader and pioneer. We are actually, right now, ranking world number one for the numbers of patients treated for this affliction and are immensely proud to finally be applying our expertise in this domain to the Romanian context. In obstetrics, meanwhile, one of the more eye-catching milestones has been that we were the first company to launch labor inductors in the Romanian marketplace.

Furthermore, we have found ourselves able to consolidate portfolio gains in the gastro segment and to introduce a showcase product called Firmagon that ranks as one of the most successful molecules designed for treating patients suffering from prostate cancer. Sadly, overall access to this medicine remains somewhat limited as the authorities have not yet proved able to finalize the update of the reimbursement list so only those patients able and willing to pay the full cost have access to this particular treatment despite the product’s clear comparative superiority in terms of survival rates, efficacy and lack of serious side-effects.

Currently we have 14 products on the market and have recently received price approval for a new product to treat gastroenterology so that patients suffering from Crohn’s disease and ulcerative colitis will soon have a new option to choose from. Ensuring both a quality service and maximum patient availability to our products remains of paramount importance to Ferring and can be said to comprise our main preoccupation.

Now that you have achieved greater alignment between Ferrings global service offering and the products and services released on the local market what sorts of adaptations do you have to make when engaging with Romania?

As an R&D driven specialty pharma company, Ferring’s overarching mission is to introduce innovative products and services to markets round the world, but we are always also very attentive to developing tailor made solutions that individualize our customer needs. In Romania, we often find ourselves having to adapt to the unevenness and inequalities of market access so need to identify workaround solutions that rectify this distortion.

To give you a specific example, one encounters dramatic differences in the levels of expertise and know-how that you find at a university hospital in Romania and a country hospital. Practitioners in the small rural hospitals may suffer from a shortfall in expertise because the number of cases they are confronted with are far lower and they lack equivalent exposure.

To improve this scenario and foster a more equitable healthcare provision Ferring offers up information to the university hospitals so they validate the results based on experiences and the practical knowledge and then ensures that that processed information is transmitted and shared across the county hospitals. In this way we strive to leverage the university hospitals as launch pads and standard setters that will help raise the level and expertise of the rural medical community. We believe that private industry, the government and public healthcare apparatus have a shared responsibility to improve levels of accessibility and ensure that patients are offered the same treatment options and quality irrespective of their geographical placement.

Ferring also goes out of its way to offer local practitioners the opportunities to meet specialists from other countries where there are guidelines and KPIs in place. This is another adaptation to the needs of the nation and local medical community. We firmly believe that Romanian practitioners don’t need to face the same hurdles that their counterparts in other countries faced five or six years ago. Being a latecomer can actually be an advantage in some respects in the sense that you can learn from the experiences of others and can avoid the missteps while concentrating on adopting only those methods that work best.

Public expenditure in the area of fertility has tended to lag behind the needs of the nation as other therapeutic areas attract all the attention. Ferring meanwhile has been endeavoring to promote the idea of the overarching sustainability of investing in fertility. Tell us about this.

The authorities are finally beginning to realize that treating infertility can bring cascade benefits to patient and society alike. In terms of patient satisfaction, in this particular instance, treatment to a single individual results in more than one happy customer: that is both the parent and any children subsequently born. On top of that there is also a significant economic reward to be reaped. Studies demonstrate, for example, that for natural births the breakeven point is 37 years, for assisted reproduction techniques it rises to 40 years old and, for the age range of 40 onwards, the rest represents value additions to society both in quantitative and qualitative terms. Besides the ethical aspect, there is an economic dividend to harvest which ensures a high return on investment because with every new birth you have a new potential addition to the labor force. The authorities have therefore belatedly started to address the regulatory framework in a more enlightened way and one that broadly aligns with European legislation and thus a new nationwide fertility program will soon be commencing.

Historically fertility has received far less attention than it should have, but I am confident the current administration now clearly understands the potential to be gained from targeted investment in this domain. In other words, The Health Ministry has finally woken up to the fact that this is an area where return on any investments made can be maximized to the greatest extent. The therapeutic area of fertility can become a showpiece example of how healthcare provision can be rendered sustainable. The important aspect looking forwards will be to convert this new awareness into results and to implement the program in an effective and coherent manner.

What scope is there for patients to assume greater responsibility for managing their health needs with regards to fertility?

Advancements in patient awareness and autonomy need to be made and screening needs to be mainstreamed to the point where it becomes a standardized and periodic practice that habitually builds a picture of an individual’s healthcare status thus allowing for preventative healthcare. Patients need to break out of a mindset where they wait until they are in their late 30s to consult an obstetrician when everyone knows the fertility success rate is already rapidly decreasing. Efforts must be made to co-opt the patient in management of their health, but this can only be achieved if they are better informed. The government must play its part too by allocating serious investment to this area and ensuring that women over the age of 27 have access to a gynecologist as a matter of course. In the long run, these sorts of up-front investments will pay off multiple times over.

We are at the inception of this process, but I am confident that the new dialogue that is currently underway between the government, patients and the private sector will end up driving the field of fertility to a success rate that is more akin to the rest of Europe.

Ferring is looking to improve access to modern treatment in Romania. Historically we are active in sensitive therapeutic areas and, by being a family owned company we are much closer to the patient than many of our competitors. Our values strongly correspond to real human needs and this is how we can really make a difference to society for it is our passionate commitment to improving healthcare on the ground that drives the business. We are also staunchly committed to making healthcare more sustainable in Romania and identifying formulas that are successful for the payer, patient and practitioner alike.

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