Focus Reports has been here a bit more than three months, and heard different opinions. Some said highlighted Turkey’s strategic advantages – population, age distribution, geography, political and economic stability -, while some were much more cautious when assessing Turkey’s market situation, potential for exports, and potential to develop as a hub. You are just coming back from Boston’s BIO International Convention as the representative of AIFD: how is Turkey seen from the world pharma community? How do you personally look at this strategic market?
At the International Biotechnology Conference which was held on June 18 – 21st in Boston, Turkey has participated for the first time with an official ministerial-led delegation and launched its first country pavilion.
I should first underline that we were delighted to see Turkey taking an active role in participating at BIO which is considered the “Davos” of our industry. We believe that these efforts are putting Turkey on the radar of the biopharmaceutical industry, and send a clear signal that Turkey wants to be a global player in this strategic industry.
When we look at the global trends in health outcomes and services, we can see that the world population is aging with an increased access to medicines. It is predicted that we will be more vulnerable to chronic diseases.
Today, new drugs and treatments’ role in the extended lifespan is undeniable. Many chronic diseases are now under control as a result of these innovative products and it is also proven in many studies that innovative drugs have an effect on reducing treatment expenses and contributing life expectancy increases.
According to a recent study, Columbia University Professor Frank Lichtenberg has found that the launches of new medicines accounted for 40 percent of the increase in life expectancy during the 1980s and 1990s alone.
A key question for industry – and for society – is how to sustain these incredible gains. Indeed, given these profound benefits, who could possibly be against medical innovation or innovative medicines?
In such an environment, Turkey’s increasing focus in health services is very important and its enthusiasm can easily be observed by the global pharma community at such occasions like BIO. Turkey is seen as an ambitious player in the field of health services especially in the last 8 years; with its ”Health Transformation Program” achieving huge progress in health services.
If I am to give some success figures; physician consultation per capita increased close to five folds since 1994. Infant mortality rate decreased by two thirds in the last 7 years and 40% increase in vaccination rate is observed in the last 15 years. So all these positive steps are closely followed by the pharma community and raise expectations for Turkey. Because if you are a country to achieve such a successful results in health services than this will give you a big opportunity to continue this trend in order to attain bigger goals and move to the next level which seems like Turkish government’s target.
In these times of uncertainty, how do you go about convincing headquarters to maintain its level of investment in Turkey?
As a result of all these developments I mentioned, Turkish pharmaceutical industry is today ranked as the 16th largest pharmaceutical industry worldwide and the 6th largest in Europe. Fundamentals – demographic, economic and healthcare structure – are strong and promising. So with all these dynamics Turkey is among Lilly’s priority markets together with China, Brazil, Mexico, Russia and Korea. Having said that government’s pricing policies, access issues and health and innovation strategies are closely monitored and evaluated for the future plans.
To what extent has market access been an issue for Eli Lilly’s development in Turkey?
With the “Health Transformation Program”, Turkey achieved progress in 8 years but continuation of this success can only be possible by following global trends in the healthcare sector, and offering the innovative drugs to our patients at the same time they are offered to the world.
Many developed and emerging countries focused on the pharma sector over a decade ago and gained substantial investments, in turn creating a competitive and a net exporter industry. Turkey needs to develop and implement a government-initiated industry strategy to compete with these countries
In my opinion in order to implement such a strategy, sustainable investment environment is a pre-requisite; if you provide a sustainable, transparent, stable and attractive investment environment, there is no reason not to be one of the global R&D and production hubs and a regional management center in the pharma community.
For this, two things are important: one is a long-term policy, supporting innovation in the field of health sciences and second one is a legal and administrative frameworks that will preserve the balance between public health, public authority and the pharmaceutical sector.
In order to keep that balance an up-to-date realistic budget for a sustainable pharmaceutical sector, and improvement of market access conditions for presenting innovative drugs to patients without delay is needed.
Today it takes an average of four – five years for a new innovative drug to come to Turkey.
It is important to prevent delays in market access processes (such as GMP, registration, pricing, reimbursement) and act in line with the timeframes specified in legislation.
If you think about the contribution of innovative drugs to patients lives, how they expend our lifespan, delay in market access is also a delay in treatment for patients which may have a longer and healthier lives with these treatments. We believe that health brings wealth to a country and governments targeting to be a global players in health services should focus on market access issues more strategically and develop policies accordingly.
Mr Tepebaşı, you are the first Turkish CEO of Lilly’s operations in Turkey – does this reflect a certain new orientation and business strategy of the company in Turkey, making an effort to really understand its market dynamics and stakeholders in order to tailor its business approach?
In order to develop a business approach, we need to analyze the market we are operating in very well. In Turkey with more than 73 million population although its mainly a young population, life expectancy is steadily increasing as a result, demand for medicines and healthcare services also increase. While the physician consultation per capita was 1.7 in 1994, it increased 5 times to 7.7 in 2011.
Paralel to these developments Turkey showed a major development in providing access to health services and treatments as a result of the “Health Transformation Program” that was implemented in 2004. In this process, while patients access to healthcare services increased, new services like Family Practitioners, has also brought structural changes to the system. Besides, while the number of chronic patients increased, awareness of the patients about their disease also increased due to the developments in the healthcare system; number of chronic diseases diagnosed increased together with the increase in patient numbers who have undergone certain treatment and accessed to medicines.
So when you look at this picture, you can see the importance of providing innovative medicines to patients, developing training programs to physicians on their areas of expertise and support programs for patients needs.
As Lilly we try to analyse the market dynamics and listen carefully to understand patient needs and work with health care partners to provide meaningful benefits for the people who depend on us. Our major aim is to create value for all our stakeholders by accelerating the flow of innovative medicines that provide improved outcomes for individual patients.
Let me explain this through an example: According to WHO analysis, exposure time of people to chronic diseases like diabetes will increase with effects of changing nutritional habits, more inactive lifestyle, and extended human life expectancy. For Turkey, when you look at the diabetes prevalence there is a huge increase in the last 10 years and it reached to %14 in 2010. Following these results government has developed a detailed action plan for the prevention and treatment of diabetes.
Since providing the first insulin to the health community back in 1923 diabetes has been Lilly’s core area of treatment. When you evaluate all these dynamics about diabetes policy and treatment in Turkey and Lilly’s devotion to diabetes, you can develop your approach according to these needs. As Lilly, we provide a consised diabetes strategy with several programs; for physicians to support their knowledge of diabetes treatment, give timely and effective support to patients with diabetes through professional trainers and try to analyse cost of diabetes complications through academic studies to show how governments can manage the increasing healthcare costs better.
After 2 and a half years heading the affiliate, what is your assessment of the subsidary’s current strengths and weaknesses?
All these changes in the health system, also bring forward some particular issues. Under these conditions, sufficiency of the resources reserved to meet the increase in demand and rational use of these resources both become crucial. Developing a point of view that appreciates the sources used not only as an expense item but also as an investment made in the future of the society is essential. As we look at the tendency in the whole world, we see that similar practices are being put into force; patients access to healthcare services increased widely on the one hand and certain restrictions in pharmaceuticals industry with some concerns are imposed in many countries by the governments on the other.
The problem in Turkey is that the government focuses on the drug prices in order to meet the increasing demand. However advancement in quality of medicines and healthcare services in a sustainable way can be possible by setting up a sufficient budget and using the sources in a rational and effective way rather than cutting the budget. In order to use the limited resources rationally and effectively, structural reforms should be prepared especially in pricing, regulatory, reimbursement, financing and chronic disease management and these reforms should be practiced for long-term. What is important here is to be able to bring an entire approach to the matter.
As Lilly I can say that by using our strengths and working on our weakness, we are trying to adapt ourselves to this unpredictable environment.
Our main strength is our workforce. We have a very dedicated, hard working people who operate in line with Lilly values; integrity, excellence and respect for people. We operate our business with absolute integrity and earn the trust of all, set the highest standards for our performance and for the performance of our products, and demonstrate caring and respect for all those who share in our mission and are touched by our work.
Our second strength area is our patient focused approach. I strongly believe that we can come over every environmental challenge by focusing on patients needs and listen to them carefully.
Since 2009, the Turkish healthcare environment is going through major changes so we are trying to adapt ourselves to this change by working on our weakness. Without losing our focus from patients, we try to better understand the needs and adapt our programs in line with these needs or try to introduce new projects in order to serve our mission which is to make medicines that help people live longer, healthier, more active lives. Here agility is also very important as well as efficiency. So we try to focus on agile actions and develop strategies accordingly.
What is the strategic importance of Eli Lilly Turkey’s clinical activities for the group and waht is Turkey’s potential to develop as a mangement or production hub?
Lilly has a strong vision on R&D and innovation. We are committed to discovering, developing innovative medicines that improve outcomes for individual patients. So here in Turkey we strongly believe that we can contribute to Turkey’s efforts to increase its role in R&D investments. We believe that by increasing focus on this area. Turkey can be a global R&D and production hub and a regional management center.
As Lilly we already work to achieve this. We are focused on clinical trials and with our latest investments we are in third place in terms of investments to clinical trials in Turkey. Our affiliate has become a regional hub for clinical trials. We currently conduct 29 clinical trials in more than 200 centers in Turkey. And Lilly’s Middle East, North Africa region is also managed from Lilly Turkey. Our aim is to increase this number in clinical trials in order to help patients access to innovative medicines faster.
As Lilly Turkey we also target to support our employees to develop their leadership skills that will lead them to international assignments. In this area during the first half of the year our five more colleagues have been assigned to international / regional positions. With these new assignments, number of our colleagues working for international / regional positions has reached to 13.
What are the objectives set for Eli Lilly Turkey to grow in the next five years?
I can summarize our main objectives as: drive value through unparalleled customer experiences and business discipline, speed the next generation of Lilly products to patients and lead boldly with our actions, attitudes, and culture to drive our business. These three area of focus.
Our mission for Turkey is to improve outcomes for individual patients by bringing needed medicines and health care solutions tailored for Turkey.
What is your final message to the readers of Pharmaceutical Executive?
Health services are among the most important topics in the 21st century as a result of aging populations, extended lifespans, and socioeconomic changes around the world. While the need for health services is increasing, innovative drugs will help prevent diseases and reduce treatment costs, and therefore innovative drugs and treatments in the pharma sector will gain more importance.
So as Lilly, we strongly believe that we will make a significant contribution to humanity by improving global health in the 21st century. Starting with the work of our scientists, we will place improved outcomes for individual patients at the center of what we do. We will listen carefully to understand patient needs and work with health care partners to provide meaningful benefits for the people who depend on us. Our reputation is a reflection of how well we deliver our promise.