Interview with Markku Santonen, General Manager, Amgen, Baltic & Nordic Region

markku santonenMarku Santonen, before becoming General Manager of Amgen’s Nordic and Baltic division, worked with some of the biggest names in the industry. Most notably as Marketing Manager for Europe at Novartis and as Country Manager at Bristol-Myers Squibb in Finland. This year marks his 20th year in the industry. Today he confides in Pharmaboardroom the ways in which Amgen are tackling the changes in the industry such as reimbursement and the need for a reformed sales model.

Having experienced many years at big pharmaceutical companies, you recently moved to Amgen. Some analysts have pointed out that, with its vigorous focus on Wall Street, some ‘Big Biotech’ companies are starting to resemble ‘Big Pharma.’ How different is it today working for Big Biotech from working for Big Pharma?

We are the world’s leading independent biotech company, and you can feel it. We strongly focus on key therapeutic areas with new innovations to treat serious illness. That is the core of working for Amgen. R&D and science are key. It is at the core of our business.


How well does the pricing and reimbursement environment in the Nordics suit Amgen’s expensive product portfolio?

The Nordics represent a fairly diversified group of countries. Although the authorities are different, overall they have understood that there is a need for innovative medicines like Amgen is providing. Even if there are hurdles in terms of access, reimbursement, or health economic data, we normally have good access.

Ultimately, the patients will get the best treatment in all the separate countries. But the way to get there is different in each country. It is difficult to say which country presents a tougher environment. They are just different. I understand the policy directives within which the authorities work. Managing increasing health care cost is a crucial task, but there is always a need for innovative medicines.

The Nordic countries are well-developed and want to give the best treatment for specific patient groups. In our focus areas Amgen is the perfect candidate for that.

National reimbursement can be a challenge in certain countries, but for me it is also about having the regional perspective and being in the guidelines, and about managing regional hurdles. That is slightly different from dealing with separate countries like Sweden or Finland.


Could you outline in more detail how you manage these regional hurdles?

We adapted our organization several years ago to meet the new environment. It used to be more about demand generation; this is no longer the case in Scandinavia. We need to add value of the medicine to our stakeholders.

We need to have talented noses within our commercial and medical departments. The times are over that you have a detailed aid and sell something – that does not fly anymore. You need to understand the medicine and the value the medicine can add to a certain group of patients. That is the way we work at Amgen.


So it is a matter of realizing that old, traditional sales models do not work in these highly developed markets anymore? 

Indeed. We need to combine the market access, health economics, and the commercial part. You have to add value to the healthcare system, irrespective of whether you are coming from the medical affairs department or from sales or marketing. The role of sales reps resembles that of a key account manager today. Their role is not just to differentiate versus competitors but to identify any barriers in the identification and diagnosis of patients and solutions to bring better adherence to patients.

The environment has become much more complex. It is not easy, but it is the way in which the Nordics as a group are moving.


Can the Nordics as very mature and highly developed markets be an example of developing such new models?

The way in which sales reps work in Sweden has developed very quickly, and overall I think that the Nordics are quite advanced when it comes to developing new cooperation models between different stakeholders – between pharmaceutical companies, healthcare professionals and government players.

It is no longer about generating demand but about partnering and understanding the market access hurdles and the payer’s concept.


Is a changing role for sales reps the key to overcoming the threat of biosimilars in the Nordic context at the time some of Amgen’s biggest products come off patent?

The key challenge for us in the Nordics is managing the patent expiries of our first generation products while at the same time dealing with competition from biosimilars and launch the next generation of products.

Our products of course have a life-cycle and sometimes patents expire; that is the way it works in our industry. We support the role biosimilars can play in providing additional therapeutic options for some patients and the potential to help patients and payers reduce the cost of delivering lifesaving biotechnology medicines, provided they are safe and effective.

We have grown to become the first leading biotechnology company with approximately 18,000 employees worldwide. As such, we are required to achieve a high level of commercial excellence to ensure the continuity of the next generation of drugs. Our strategic focus thus remains on developing innovative, rare-disease compounds has remained unchanged since the beginning. Today we have a very strong pipeline with a focus on severe illnesses with a high, unmet medical need.


Can we see Amgen’s Scholars program in partnership with Karolinska Insitute as a testimonial to the value Amgen attaches to the quality of Swedish research?

Indeed it can be seen as such. Karolinska Institutet (KI) is one of Europe’s largest medical universities, and also Sweden’s largest centre for medical training and research. KI stands as a leading European medical university due to its top-quality research activities. Additionally, the Karolinska Institutet Nobel Assembly annually awards the Nobel Prize in Physiology or Medicine.

Amgen helped set up the Amgen Scholars Europe Program at Karolinska Institutet, which gives a selected group of undergraduates from the Institute the opportunity to conduct research during 8 weeks in the summer at KI.


What are your key ambitions for Amgen in the Nordics in the coming years?

Amgen is a global, world-leading biotech company. The Nordics represent a combined population of 25 million, so we cannot be the biggest market. But it is a highly developed market, and we are working hard to develop new ways to ensure broadest possible access to our medicines to the market in an environment of cost-containment, simply because we believe in our medicines and the benefit that they bring to many patients in the Nordics.

Furthermore the Nordics are important when it comes to running clinical trials, mainly Sweden and Denmark. The quality is of a high level, with good physicians and patient data.

Amgen has a very good pipeline. Between this year and 2016 expect to reveal data from 8 late-stage R&D efforts. This year aims to unveil Phase III results for talimogene laherparepvec in melanoma and trebananib or AMG 386 for patients with ovarian cancer. But our biggest program is AMG 145, a PCSK9 drug for lowering cholesterol that we plan to test in 26,000 patients, with results from four Phase III studies due out in 2014 .

We are already increasing the number of trials in both Denmark and Sweden, and I could see the increase continue in the coming years.

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