Interview with Katia Trusich, Genreal Manager, Genzyme Chile

katia-trusich-genreal-manager.jpgGenzyme was first established in Chile in 2004 but only opened its sales office in 2008, what was the rationale for the opening of the office at this time considering that you had been present in neighbouring countries 10 years before?

The Chilean market is a very difficult one. We are one of the most competitive economies in Latin America, however, the health expenditure is still very low compared to other countries in the region. This makes it so that access to high-cost therapies, such as ours, is very challenging. Genzyme started to work in the country when the first incidents of rare diseases began to appear and were diagnosed. At that time there was not enough of a critical mass to establish ourselves, and this is why we waited for another fours years to open the sales office. By 2008 there was already some access for these kinds of patients to get treated within the system.
In the meantime, during those four years we were active in the country by providing donations, which is part of the Genzyme way of working, to provide support to patients who are in critical need when they have no access to reimbursement. It was only in 2008 that we were able to create a ministerial program to cover these patients, and at that point we made a commitment to the government to establish ourselves in Chile and to bring all the technologies that we have available throughout the world.

What have been Genzyme’s main milestones and achievements since 2008?

The work that we did with the government on this ministerial program for rare diseases is certainly a critical achievement. We have also been able to bring into the country 15 of Genzyme’s products from its portfolio, having them available to Chilean patients, in a record speed. We also had several products that were previously sold by other distributors which today are back under our control.
As for the main milestone, I am proud to say that since we established our office we have been able to provide the best service to our patients and to our clients. Additionally we have done a lot of work on medical education, which is the main challenge for rare diseases, because you need to make sure that doctors are fully trained to correctly diagnose patients and have an impact in the development of the disease. It is essential to have a patient diagnosed and treated at an early stage rather than at a later stage of the disease when there is less possibility to return the patient to health.

As a biotech company Genzyme conducts research and clinical trials in Chile, what was the driving factor behind this decision?

We have placed an emphasis in our collaboration efforts with research centers in Chile. The aim is to influence researchers to have a more commercial outlook for their projects. We currently have agreements with several institutions, such as the Catholic University, the University of Chile and the University of Concepcion, which are the three main universities involved in R&D. Our role is to support them and to speed-up their research so that it reaches a point where it can be brought into the market to provide new products for treatment. I believe this kind of program is very important and is quite unique, because not many companies are willing to have this kind of collaboration with researchers. This is one of Genzyme’s main strengths internationally which we try to implement locally here in Chile.

Specifically in Latin America, Genzyme has ongoing clinical trials for three products, namely Cerezyme, Fabrazyme, Aldurazyme. Are all of these being tested in Chile? What are the advantages of clinical trial research in this country?

As a matter of fact, we were the country to have the fastest approval, by far, for a clinical trial here in the region. We got the approval in 9 weeks, which I would say is definitely a record in Latin America. Chile certainly has available opportunities for clinical trials, but it does not always have the critical mass in number of patients, particularly when it comes to rare diseases and orphan drugs.

The government has acknowledged in its National Policy for Biotechnology Development that Chile must invest in biotechnology in order to maintain its competitiveness. From your past experience in InnovaChile and now as head of Genzyme how do you consider that the government is working to develop biotechnology in the country?

I used to have a very clear vision, although I am not sure exactly what the new authorities have planned for this period. I can tell you that when I participated in the presidential commission that drafted the report under which the national policy was developed, the strategy was very clear. In terms of biomedicine, unfortunately the commission did not foresee much activity and investment for the future, so this was not a sector that was highlighted under the national policy. I do know, however, that there are funds available for biotechnology, such as CONICYT and InnovaChile which provide funding for biomedical projects and I believe good projects with high quality science and a strong leadership always find support.

The Chilean government strives to provide accessible healthcare to its entire population through the GES plan, however, most diseases that are targeted by Genzyme are not included under the list of covered conditions. How has Genzyme ensured that it remains competitive given that the largest consumer does not make use of the majority of your products?

Some of the diseases that our products are used for are in fact listed under the GES plan. In particular, there is a wide distribution of our products for leukaemia, renal failure and dialysis, and transplants. It is important that we continue working on medical education to improve the system as a whole. This is also important for doctors to be aware of our products and of the alternative treatments to the diseases that can be provided. This education will be essential in benefitting our patients as well as for our growth in the market in the future.

Innovative companies claim that generic manufacturers in Chile violate patents and distribute copies of their products. What is Genzyme’s opinion of this debate? Do you fear biogeneric competition?

I think it is very important that Chile respects intellectual property and the commitments that it has made in regards to this. This is a country that is known for its open market and free trade record, and it is crucial that they respect the agreements that have been signed, such as the FTA with the US and with Europe. We also have to make sure that we maintain certain standards for our products. The quality of our products is central to the success of treating our patient’s diseases.

As for fear of the competition, I think that as long as you have a clear regulatory framework, competition is healthy. In Chile, there are already some instances of biosimilars being produced. The problem is that some of these products have already been approved by the Instituto de Salud Publica (ISP) for distribution without the proper legislation nor requirements in place, thus you can not guarantee the same efficacy of the treatment, So this is a very important issue that needs to be addressed.

Chile has a reputation in the region for having advanced universities and science research. What kind of public-private partnerships have been developed with university and research centres to foster R&D in medical treatments in the country?

There are definitely some unique examples of collaborations occurring in the country through consortiums of researchers and industrial associations or companies. We have very good researchers and scientists available here in Chile, many of which were educated in the US and in Europe. These consortiums aimed at developing the capacity of research in the country specific to the biomedical field. These were funded by a combination of public and private, as well as resources from the academic institutions, and are being effective in developing new products that can be commercialized and demanded by the population.

You just mentioned the high quality of researchers and investigators in the country, how does Genzyme attract and retain the best available talent?

We have a very complete technical team here that is composed of doctors and professionals with a scientific background. In order to attract the most qualified people we offer very competitive salaries and benefits to all of our employees. But we also like to think that people’s motivations are beyond the money, so we try to create a pleasant working environment. We really work and treat each other like a family here. Our structure is completely not stratified, so we maintain good communication and a creative environment where all initiatives are considered. I like to think of this as the “Genzyme way” an open and transparent way to work. We have expanded the office from 1 person, that being me, to our current number of 18 employees, which goes to show our growth in only 3 years. Our business is to make a difference in the lives of people and this includes the people that work for us.

What is your vision for Genzyme in Chile for the next 3 to 5 years? Where would you like to take the company by then?

I think the most important thing for us is to continue supporting the improvement of the national healthcare system so that more people get treated and more diseases are addressed in a sustainable way. By educating people and helping create a more efficient public structure then we will be able to open the market to new technologies and treatments so that they are available to all the patients that need them. It doesn’t seem fair under the current conditions that those who are unfortunate to have a rare disease are postponed by the system. This is why we need to create access to medicines and support the development of new policies that are more open and have higher standards of care for its patients. If we manage to make these changes then our growth and revenue will follow naturally.

What is your final message for the readers of Pharmaceutical Executive about the commitment of Genzyme to Chile?

There is total commitment of Genzyme in Chile, we have an international charitable programme saving the lives of 12 Chilean patients with no access to treatment, we are providing life saving therapies to chronic patients and, in many cases, being the only providers in the market there is no doubt that we have an ethical commitment to the country and its people; but not only a commitment to provide treatments, we truly believe in making a difference in the health system, of being pioneers in disease areas where there has not been any treatment in the past. It requires extreme drive to open a market when your areas of disease are still not well understood, the technologies are new and there is no financing to the available treatment. This is when it becomes challenging, this is where Genzyme is most valued by the health community!

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