Looking at Boehringer Ingelheim (BI) in Hungary, at first glance we see a company with a presence of already 20 years, which basically means an entry into this market right after the fall of the Iron Curtain… Can you provide our readers with a better idea of the role that the Hungarian operations now play within BI’s footprint in the CEE region?
For Boehringer Ingelheim, the CEE region mainly comprises all the so-called former socialist countries from the East block, as well as countries such as Switzerland, Austria and even new countries such as Israel.
From a regional perspective, for the prescription medicines business, we are fourth in the ranking. It is very important to point out that Hungary is one of the countries that is growing strongly in the region. The figures indeed show that business has gone up consistently over the past 10 years.
When Boehringer Ingelheim was first established in Hungary roughly 20 years ago, the company was still a minor player with only some importance in the field of pulmonology, but no other therapeutic areas.
Since roughly 10 years, we started to experience better growth and managed to move up in the rankings from 47th to the 17th position. From a small player, we have grown into a major and important player in the last 10 years alone. Our priorities in terms of prescription drugs lie in the areas of pulmonology, cardiology, stroke, Parkinson’s disease and rheumatoid arthritis. For the treatment of COPD, Spiriva is today the most important product. In the future, Pradaxa for stroke treatment will also come to the market.
We are dealing with patients in different phases of stroke, ranging from primary and secondary prevention to the acute phase. With Actilyse we are the only company delivering a very important product to be used in the acute phase.
Products such as Spiriva, Mirapexin, Asasantin, Actilyse and Pradaxa are all mentioned in the newest therapeutic guidelines. This means that we are not the only ones saying that these products are excellent, but that the professional guidelines also indicate that patients need to be treated with these drugs. This means that the role for Boehringer Ingelheim in Hungary is growing and growing.
Will this also imply a rise in the market rankings?
For sure! We have some very important innovative products in the pipeline that will be covering unmet medical needs. One of the basics of success is to have a good positioning within the therapeutic guidelines. Within COPD, Parkinson disease and stroke, we are present in these documents.
The current market in Hungary remains challenging however, whereas the government has recently implemented drastic austerity measures. Do you feel that the role of innovative companies such as Boehringher Ingelheim is recognized?
They recognize and know very well the importance of the pharmaceutical industry. It is a role that is being acknowledged, but it also remains a fact that there is lack of money in the health care and in the public budget as well. The question remains how to find a healthy balance. Getting access to innovative products has always been an issue in the country. In the past 7 or 8 years, obtaining reimbursement has always been challenging and always took time. At the moment, there is a very strict regulation stating that only budget-neutral products can enter the market.
It is a context that generates a lot of unpredictability. How do you cope with this, as you pursue your strategy?
We are a family-owned company and need not to reflect immediately on the changes in the market. We have to be very flexible and have a key advantage in having a strong pipeline that will cover some of the losses that we will face very soon due to generic pressures on patent-expired products. We know very well that we will lose some business in the very short term, which will be compensated with new and innovative drugs, which have good prospects due to the unmet medical needs that persist.
Pradaxa will be one of those new products coming in. Why is this so important?
Pradaxa is an extremelly important and innovative product. Now approved in more than 50 countries, Pradaxa’s launch in these different markets is either ongoing or has already taken place. It is a fact in the countries that there is a huge medical need for the drug. Generally speaking, we see a strong demand from the different stakeholders, including the patients, doctors and the insurance funds. Why is it so important? Because Pradaxa is the only oral blood thinning medicine which significantly reduces (ischemic and hemorraghic) stroke in AF patients by 35% compared to warfarin. Ischemia, a lack of blood flow is responsible for about 87% of all strokes. Pradaxa is the only approved blood thinning tablet that prevents 3 out of 4 atrial fibrillation related strokes.
When we talk about physicians, we understand that there is significant medical talent available in Hungary. And as Dr. Nagy of AIPM pointed out, a centralization of the healthcare system, in particular in the cardiovascular area, has given rise to increasing opportunities to conduct large-scale clinical trials here. Is this an opportunity Boehringer Ingelheim has been able to tap into in Hungary?
Boehringer Ingelheimis involved in many clinical trials in Hungary. The reason is quite clear: in spite of some financial difficulties, Hungary has a very well developed and professional healthcare system. Altogether, we now have around 28 clinical trials in Hungary, which are part of larger multinational trials.
How do you go about nurturing stronger relations with the Hungarian medical community?
Our aim is to build up very strong relationships. Worldwide, we are known as a very professional and ethical company. It is our goal to deliver all the information required for the correct and reasonable use of our medications. This information should always contain the benefits, limitations and risks of our products.
We mainly focus on having “correct” communication, which is the secret of success of all our launches. The information that we provide can be trusted by the healthcare professionals.
Over the years, we have seen the company partnering up within the industry. One of the key ongoing partnerships is with Eli Lilly on the diabetes front. How does this partnership benefit your operations here?
Lilly is a very professional company in the field of diabetology, an area in which Boehringer Ingelheim also has limited experience through its older product Glurenorm. Moreover, we have been working with Lilly on the promotion of Cymbalta in the past too. This relationship and the common interest has created a marriage for the next 20 years, within which we will introduce at least 4 New Chemical Entities (NCEs). All of these products are very important in battling diabetes, and our expectations are that this will secure for the alliance one of the strongest diabetes portfolios globally.
The number of diabetes patients in Hungary is constantly growing. The disease is set to become one of the biggest worldwide, and Hungary is in the same shoes in this sense. There are roughly 500,000 diabetes patients in Hungary today, which are not all treated with the latest innovative medicines. There is a strong need to treat these patients better. Our new product, a DPP-4 inhibitor, has just received EMA approval and will be introduced very soon. This product has proven advantages in terms of efficacy and side-effects.
The pipeline is further full of promising drugs, which is why we are optimistic that Boehringer Ingelheim’s growth and success will continue. Growth should also not only be measured by income, but by the fact that we can treat more and more patients. The patient benefit is the real success for any pharmaceutical company.
4 NCEs, so a marriage with 4 children! At the same time you have also been building a family here within your organization, by attracting talent continuously. How do you manage to attract and retain human capital?
It is no secret. Boehringer Ingelheim is a family-owned company which creates a particularly friendly atmosphere within the organization. We are looking for people who are willing to work with us, are willing to learn, are able to adjust their behaviour when necessary and are motivated by themselves.
Perhaps we are indeed doing something well, as the team has been very stable. I am very proud to have been working with this management team for many years.
It has also become more and more exceptional to see someone working for 11 years for the same company in the industry. What makes you this loyal? What keeps you motivated?
Boehringer Ingelheim is a well developed company. If you ask yourself after working for a number of years in the same position, what you will do tomorrow and how your job will look like in 1 or 2 years down the line, I see a number of interesting challenges for myself. We have a good future in our current therapeutic areas and should not forget that oncology will be our next significant therapeutic area, where we will provide a number of new solutions. Once again, this area shows a strong medical need to receive more successful and reliable therapies. It is quite reasonable that the pharmaceutical industry invests so much money in the research of new oncology products. While many small successes have already been achieved in the past years, more efforts are needed in this area and we are one of those companies that has joined to this league recently.
If we would have another talk in 5 years from now, what will the ideal situation look like?
We will further grow in the prevention of stroke, where we have a very important role to play. The current golden standard therapy will be replaced by our medication. The new oral anticoagulant Pradaxa offers significant benefits over the old medication. In 5 years from now, Pradaxa will become a very important trademark that all doctors will know about. For all patients where there is a logical medical need and a reasonable use possible, Pradaxa will be provided.
By that time, we will also launch the second or third anti-diabetic drug together with Lilly. We will have gained a rather strong market share in that area by then.
We will also have at least 2 new oncology products on the market. It is hard to say how many more patients we will have, but the quality of life and the life expectancy of the patients treated with our drugs will be much higher than today.
The role of Boehringer Ingelheim in terms of up-to-date treatment will grow further, while we will maintain our position in certain therapeutic fields. Especially in the treatment of COPD, we are now the market leader and are proud that Spiriva is the number one product in the retail and the pulmonology business. BI does not have this leading position with Spiriva in any other market. In terms of market share, this comes down to 21%, and we are treating round 40.000 patients. That is a great success, which is to thank to a long term investment in the field of COPD. It is the result of very diligent work that does not come by chance. It was the first time in Hungary that a pharmaceutical company went so much into detail in ensuring that COPD was properly distinguished from asthma by the general practitioners (GPs). We have played a key role in providing information on the therapeutic area as a whole, rather than a product in particular.
Do you have a final message on the commitment of Boehringer Ingelheim to Hungary?
Hungary is a very interesting country to be in, with a very difficult pharmaceutical market. In my view, this is the most restrictive pharmaceutical market in Europe. However, a huge medical need remains. We are now facing a very tough economical time, as the impact of the European economical crisis is much higher on smaller countries such as Hungary. We still depend largely on the bigger markets. Anyhow, it is a market that works well, facing the need for new medications. Boehringer Ingelheim is the company that has to offer a lot of new products and solutions that will increasingly cover the country’s medical needs.