Infirmary and ultimately leading to a position heading the Czech Republic and Slovakian organization for Janssen. Can you begin by introducing yourself to our readers and giving them an overview of your professional trajectory?
Indeed, I started off as a nurse in the North of Scotland where I specialized in burns and reconstructive plastic surgery. After getting married, I moved to London and this has been my home —to an extent—ever since.
Not long after I moved to London, I left nursing, and I joined the pharmaceutical industry. I started as a medical representative for a company that today is a part of Novartis. It is interesting to note that although some things have changed, many things about a medical representative’s daily job – or other roles within the industry – are the same today as they were then. The same can’t be said of many other industries where we have seen major change. I feel that our industry is entering a pivotal point where we must change and update our business model if we are to remain current and relevant.
Can Janssen be at the forefront of such changes?
We are trying to be! I believe that for the change to be relevant, much of the change must come from our stakeholders as it is their needs we are aiming to address. In the past in healthcare, many of our stakeholders have not seen the need to engage with us in a different way. However, today, with the challenges we see in pharmaceutical development and healthcare provision, there is a major need for change—both from stakeholders and the industry itself.
From a stakeholder point of view, I believe we have reached a crux in terms of the affordability of healthcare. This reality is pushing the stakeholders to think and work differently. If we want to be part of the solution, we need to work differently with them and show them where and how we can add value in providing solutions or being a partner in helping to address the problems.
For the industry, a key challenge is the fact that today many of the ‘easy’ diseases have great solutions and can be managed with approaches and medicines which already exist. As a result pharmaceutical companies must become increasingly innovative, and they are doing so—but it is costing us much more than it ever did before. There is significant pressure within our business model to evolve the way we do things.
The pharmaceutical community cannot change at a rate that is much faster than that of our stakeholders, but we also cannot be slow compared to them. Hence, I believe we must advance together.
In the Czech Republic, the sustainability of the current healthcare model has certainly been questioned. For instance, the burden of payment is now shifting increasingly to the patient, as the state finds that it does not have the capital to cover the expense completely.
During my career, I have worked in different parts of the world, and in differing roles—from local operating companies, to regional and global roles. People like to concentrate very much on differences, but I actually believe that there are many more similarities than differences between the countries. The Janssen and J&J approach to business acknowledges the fact that individual countries and markets have unique needs; however, we also believe that many of the issues and opportunities have a similar theme to them. I like to use the ’80-20’ rule: 80% of challenges are the same for the industry everywhere albeit they may be called something different or might take effect at a different time. We are all facing the challenges of affordability, access to medicines, uptake of innovation and how we can work better in partnership.
How each country and stakeholder respond to these challenges is the truly interesting bit. At Janssen, we try to address this reality through a more decentralized local model. The Czech Republic, as I have said, is a little different from Slovakia, or other countries, and so we try to take the best of our global and regional approaches as well as ideas from other countries and adapt them for the Czech unique requirements to really provide a truly local customized approach.
One of the challenges we have locally is that we are not one of the largest companies in the country. This represents a great opportunity for growth, but it also limits our ability to impact the local market, as we are not necessarily the ‘big player’ that local stakeholders are looking to negotiate and partner with. It also means that it can be difficult to recruit good personnel, as people often wish to join larger companies.
We look to be able to offer something a bit unique for people – our approach to business and the culture we have in the company. During my career, I have worked for a number of companies and the culture and way of working here do feel different. We have an aspiration to be the most trusted pharmaceutical company so our focus on ethical and compliance behaviors is very high. We work to the strong philosophy as laid out in the J&J Credo. At the same time, we seek to be creative, innovative in our operations, and we have the local autonomy to do this. Hopefully, this will allow us to compete more effectively and be even more successful.
When Focus Reports spoke with Mr. Martin Selles at Janssen Spain, he remarked that despite the challenge of weak IP protection in the country, Janssen had gone from 45th in sales to 7th in sales in only 10 years. Anna Romany in Hungary recently told Focus Reports that her subsidiary was the only company in the entire Hungarian pharma market to grow by double digits last year. What growth trajectory can we expect from Janssen in the Czech Republic?
During the last few years along with our competitors, we have faced many challenges in the marketplace, and this resulted in relatively flat business performance in the country. However, our pipeline as a company is excellent, and we are now at the point of launching many of these exciting new products into the Czech market. As such, we expect double-digit growth, which will put us among the top companies in the region in terms of growth rate. In a market that is itself flat or slightly declining this will be a great achievement and reflective of the products we are launching and making available for patients.
IMS studies have noted that in the Czech Republic, product launches are delayed by up to three years relative to neighbors like Austria. What is your strategy to overcome entry barriers?
In our EMEA region, market access has been a major focus for Janssen for the last 7-10 years. As a result, we have a very strong market access function and highly capable people with a strong track record of success in terms of not only gaining initial access for our products but also in terms of being able to keep them available on the market. In the Czech Republic, the review of medicines and their prices and reimbursement is continuous and ongoing and so companies have to work to maintain their products in the marketplace.
In this vein, something that I believe the Czech authorities should consider more is working together with the industry to take account of the relative size and impact of countries such as ours on the region as a whole. Most pharmaceutical companies that operate internationally will consider the region in total and work to ensure that access for their medicines is open and fair and this includes taking account of access, pricing and reimbursement mechanisms. With the marketplace challenges our stakeholders are facing both, they and the industry need to consider more innovative approaches and mechanisms to ensure that the access to innovative medicines can continue. The authorities must question whether they want new innovative medicines on the market, but at the same time it is up to the industry, of course, to prove that these medicines add value. The effects of not addressing this will not be seen immediately. However if over time innovative products cannot gain access, this will be to the detriment of patients.
Why does Janssen continue to commit to this market, given the challenges that you have described?
Johnson & Johnson has a global commitment to healthcare. Perhaps we are unique in this sense as we are not only a pharmaceutical company, but a company focused more broadly on healthcare.
We also have a commitment to innovation. We want to bring innovative, value-based medicines to the market; medicines that tackle areas of unmet need. I believe our R&D colleagues have done a spectacular job over the last 5-10 years in really challenging our pipeline. We are setting the bar high in terms of bringing differentiated products to the market. If these products truly bring value to patients, we would hope that we are allowed access and compensated fairly for that differentiated value. To be successful in this we need to work closely with our stakeholders and have a strong and mutually beneficial partnership with them.
How would you appraise the openness of the Czech authorities to engage in this dialogue, and in this partnership, with industry?
I have not been long in this market, but I believe that they have exceeded my initial perceptions, in terms of their willingness to work closely with the industry, and this is continuing to improve.
In the past, the industry has perhaps not done itself a lot of favors in terms of how we have worked, and I can see at times why our stakeholders might be skeptical. We need to raise the bar in how we work and in what our stakeholders expect from us.
Janssen is strongly committed to educational efforts for healthcare professionals around the world. To what degree is Janssen involved in improving the level of care here in the Czech market?
We are certainly committed to education, and the majority of the money that we spend locally in working with stakeholders is spent on this area. We want to have a professional partnership with our stakeholders, and therefore, we want to spend our money supporting the right activities and education is certainly one of them.
I am a firm believer that if you develop strong, innovative products that add value, you don’t need to ‘sell’ them. Rather, you should educate your customers about the products, the benefits they can bring and how to best make use of these benefits. We work with very intelligent stakeholders, which means that they can be challenging and tough – you can’t “pull the wool over their eyes” or fool them. We must treat them with respect, and appreciate the fact that they will ultimately choose what is most appropriate for that particular patient. If I am a patient, I want to know that the doctor is prescribing the best medicine for me and not acting on the promotional arguments of a particular company.
It is quite troubling to look at certain reputational surveys and see that the pharmaceutical industry is ranked near the bottom. We contribute to saving people’s lives, and improving their health; yet we are ranked alongside industries that often do quite the opposite. This is something that we must work to change.
Do you find that the industry is unfairly stigmatized?
When I look at the people who work in the pharmaceutical industry, and when I think about why I joined the industry, I do believe that this stigmatization is unfair. However, I believe, also, that past behavior has not helped. Consequently, we cannot blame our stakeholders, or the public, for judging us in a certain light. We are making an enormous amount of effort to improve upon that, and I believe perceptions will change.
We all need to hold ourselves to higher standards if we are to change the negative perceptions of the industry. These perceptions are similar across the world but perhaps even more heightened in our market, but things are definitely changing.
A former colleague quoted on your online CV noted that there are “many managers in the pharmaceutical industry, but very few leaders.” What do you believe constitutes the difference?
A manager is someone who checks that people are doing their work.
A leader is someone that provides a vision. We employ great people in our company, and I don’t believe that I need to micro-manage them. If you employ the right people, with the right mindset, and the right culture, you do not need to keep checking up on them, they will do the work and do it well – it’s who they are. You can’t teach people good ethics, or proper behaviors; people are either innately driven, or they are not. For me, leadership is about bringing all of this out in people, and facilitating their growth.
When I think back to the managers that have given me the greatest direction, it has not been those that have asked me whether I have completed this or that task. It has been those that wanted to know what ideas I have, and those that have challenged me to do more.