Ms. Kelly, you have been General Manager of this affiliate since the creation of Astellas in 2005, and have overseen, since 2006, the local implementation of Astellas’ VISION 2015. How has this company evolved under your tenure?
When Fujisawa merged with Yamanouchi to form Astellas in 2005 it marked the successful coming together of two specialist companies that were leaders in their field of expertise . I headed the Fujisawa sales team in Ireland, before becoming General Manager of Astellas, Ireland. Following the announcement of VISION 2015 in 2006, we were able to ensure that our strategy in Ireland aligned with the global strategy.
Prior to the merger, I believe that we were very inwardly focused in Ireland. In 2006, we became a truly global organisation—and with that came a lot of change. In fact, I suppose that since then, the one thing that has been constant is change!
The organisation grew considerably. We acquired marketing authorisations in Ireland and became quite independent, with legal and financial responsibility for our own business. Our team also grew significantly. The people that we hired during this period are who drive our company forward today.
Through VISION 2015, Astellas developed a very clear position on where it was going, based on the aim of becoming a category leader in several therapeutic areas—which was very brave and optimistic at the time. The good news is that we have achieved category leader status in two key areas of the business and we are absolutely on target to achieve our goals for 2015.
Urology was the first area where we sought category leadership. Here in Ireland, we focused our efforts and achieved leadership by 2008. In transplantation—the other major area of our heritage—we had been a category leader since the beginning in 2005.
As we were transforming our portfolio of products, we had a number of legacy products that were very useful to us. As a small market, we needed something that could fund the opportunities of the future. Some of our legacy products, were able to do that.
We talk about Ireland ‘punching above its weight’, as Astellas in Ireland, we punched above our weight for the Company within Europe from the beginning. Very often, our success has been thanks to some of our legacy products. These products are still important to us today. However, because of our strategy to become much more focused on therapeutic categories, our portfolio has shifted. This is quite important, because many of the price cuts that we have had to contend with in this market were levied on those legacy products. As an organisation, we are in a good place to move forward.
We have seen new franchises come in, like Anti-Infectives, Pain Management, and Oncology. Oncology in particular is an area with which we have both eyes fixed upon the future. Astellas has a very exciting pipeline in Oncology, with at least 12 different molecules in development. The first of these should be launched in Ireland in 2014. It will be an important treatment indicated for a real area of unmet need.
Unmet need is central to Astellas’ vision: we strive to meet unmet needs, rather than simply launch products into the marketplace.
Astellas CEO Yoshihiko Hatanaka has said that, several years into the VISION 2015 strategy, Astellas’ ‘strategies’ have now become its ‘strengths’.
Absolutely—and in Ireland, we have had to make some hard decisions over the years to reach this position. Just this year, we undertook a major project to restructure and reshape our organisation. Our strategy has become our strength. Our broader portfolio puts us in a far stronger position in today’s market.
A critical aspect of the agreement that the industry has entered into with the state is the provision of access to new medicines for Irish patients. Astellas will be at the forefront of providing those medicines: we are very excited that we will have the opportunity to launch five products over the next three to four years.
How important is the stability offered by this agreement to Astellas’ decisions to continue to invest in Ireland?
I think that it’s critical. The people in this industry gave a huge amount of their time outside of work to negotiate with the Government and achieve a compromise. This means that in return for lowering prices pharmaceutical companies have been assured new medicines will be approved under the HSE’s drug schemes once they have been proven to be cost effective. Fundamentally, this will lead to better access for patients. The industry and the state have a very strong relationship in Ireland, and I think that this relationship is quite pivotal when we note the fact that not only do we provide medicines for patients, but we also make an important economic contribution to the country.
Stability is key because as businesses, we have to focus on the future. In our case at Astellas, we are looking to launch several products over the next few years. If we did not have stability in the marketplace, we would not have the confidence to invest to get these products out there.
Boehringer Ingelheim’s Colin Edwards told us that the period leading up to this agreement was a time of intense learning: in terms of how to present effective health economics arguments, and in terms of realising that just because a medicine may ‘add value’ and save costs in the long-run, that does not mean it is ‘affordable’—he gave the analogy of a Mercedes. What lessons has your own team taken away from these negotiations?
Affordability is an important part of our discussions. We all know that it is a bit of a ‘fifth hurdle’ in terms of access to patients.
For this reason, it is vital that everything we bring to the Irish market is geared toward a serious unmet need—because if the drug only falls under the category of ‘this would be nice to have’, it will be difficult to get it reimbursed in this climate. Our entire approach is now based around need and affordability.
Ireland has an aging population, and that population is going to steadily require more medicines. At the same time, less and less people may have the resources to pay for treatment out of their own pocket. We will have to be fiscally responsible, and part of IPHA’s agreement with the state is to hold meetings with the various stakeholders involved in pharmaco-economics. I believe that this channel of dialogue is a great opportunity to talk about affordability.
At Astellas, our emphasis is now on the pre-launch phase, whereas five or six years ago we would emphasise post-launch promotion strategies. Today, our scientists, medical staff and marketing people work in collaborative project teams 18 months to 2 years prior to the product’s expected date of approval to address economic questions. As Mr. Edwards noted, there is a big difference between cost-effectiveness and affordability.
Your Czech colleague Lubos Chadim has noted that while other companies have diversified their operations, Astellas has instead become more focused, selling non-core businesses like OTC. Mr. Chadim said, “Diversification may be good for financial stability, but it will rarely put you on top.” Do you agree?
Definitely. I think that one of Astellas’ greatest assets is that we are a small enough organisation to quickly adapt. We are able to approach our business very flexibly and I believe that makes us considerably more efficient.
Having a focus on category areas is the right strategy for an organisation like ours. Moreover, our portfolio focus also keeps people focused. Especially in a small affiliate like Astellas Ireland, everyone has to do more than they would if they were in a larger affiliate—focus helps us greatly in this respect. It is not good enough to be financially fit; I think you have to be operationally fit as well.
Astellas’ ‘Changing Tomorrow’ mantra ensures that the patient is at the centre of every strategic decision. As General Manager, how do you proliferate this ethos in Ireland?
Part of Astellas’ strategy from day one has been to focus on the patient, keeping them at the centre of everything we do.
With that said, we feel a great deal of responsibility to all of our stakeholders. We talk about ‘Changing Tomorrow’ not just for patients, but also for prescribers, our shareholders, and our employees.
We are always thinking about what more we can do to help people. For instance, this year marked the third year that we have held our Changing tomorrow™ Healthcare Awards in Ireland, where we recognise outstanding contributions by healthcare professionals to their patients—whether through innovation, leadership, commitment, hope, or social responsibility. Initiatives such as these really add value and give people a sense of what this company stands for.
Equally, we offer a lot of educational programs for healthcare professionals. Education is a very strong part of partnering with our customers, and supporting them. For instance, we have a particularly active collaboration with both the urology and the transplant community. This has always been part of our DNA.
Astellas runs internal Changing tomorrow Awards at a European level for employees. People sometimes feel that small affiliates cannot compete with big ones, but just last year, I am proud to say that our team won an award in innovation.
What had been your innovation?
It was a very simple idea, but it really made a difference to people. Our medical team noted that, for one of our urology products, they were receiving an unusual number of queries regarding administration. The medical team spoke to our marketing colleagues, who in turn spoke to our sales people. A project team was put together, and we went out and met a number of our stakeholders. We identified that there was an issue regarding peoples’ understanding of how to mix the product—a very simple problem.
In response, we hired a number of nurses, and provided a service wherein doctors had access to a network of trained people that could show them how to use the drug. The number of queries dropped dramatically.
This was something that a small group of people came up with on their own, and it cost very little money—but they put their heads together, and they changed tomorrow for those patients. Now, other affiliates around the world have begun to implement this program.
Two of Astellas’ three European manufacturing plants are located in Ireland. What is your understanding of why the company chose Ireland for these investments, and how do they fit into Astellas’ global strategy?
Ireland is a very important manufacturing location for us. At the time of the merger, Fujisawa had a plant in Ireland, and Yamanouchi had a plant here as well. Obviously, there was a lot of divestment of plants around the world during the merger—but we were very proud of the fact that both of the Irish plants remained open.
There were a number of reasons behind this decision, and the attractive corporate tax rate is only one of them. The former Yamanouchi site, here in Dublin, is a bulk manufacturing plant, and the site in Kerry is a finishing facility, so they complement each other. We also have very skilled, very experienced people working at both plants.
Where do you hope to stand by the end of VISION 2015?
Firstly, I hope that here in Ireland, we will have contributed more than we were asked for. I would like to continue to punch above our weight, and I believe that we have an opportunity to lead in the organisation. Other affiliates can learn a lot from us now, because we have just developed a very structured reimbursement process and health technology evaluation process, and I think that is a good thing. I think we should share our experiences with our European colleagues—because in some countries, this kind of structure may be on the horizon, but hasn’t arrived quite yet.
One of the great things about Astellas is the openness of the organisation. We share a great deal with each other. During the last week, a Turkish colleague visited our office to learn about a product that we have already launched that his affiliate is yet to launch in Turkey. On the other hand our Nordic colleagues have come over to help us in an area where they had themselves been successful.
There is a lot of sharing of information, and I would like the Irish affiliate to continue to contribute in a positive way, not just in terms of the bottom line—although we are certainly contributing there as well. We want to help grow this great company across Europe and the world.