James Chiu, GM of Fresenius Kabi Taiwan, discusses the affiliate’s portfolio offering of parenteral and enteral nutrition in Taiwan as well as its move towards biosimilars. In addition, Chiu highlights the importance of the Taiwanese affiliate to the Asia Pacific region, product developments locally, and partnerships with domestic players.
Taiwan ranks within the top five countries globally for its nutrition market
Can you briefly introduce Fresenius Kabi?
At Fresenius Kabi, we call ourselves the ‘partner to healthcare professionals’ as we provide more than simply pharmaceutical products. We also provide clinical nutrition products (parenteral and enteral nutrition) along with various medical devices. Moreover, in the past few years we have enjoyed significant growth. For instance, from 2015-2016 we experienced 25 percent growth, 2016-2017 we had 38 percent growth and in 2017-2018 we had a growth rate of 32 percent. This is primarily due to our diverse portfolio, including clinical nutrition products, pharmaceutical products and medical devices.
Taiwan ranks within the top five countries globally for its nutrition market. Furthermore, we are well known for reimbursement, healthcare, quality and easy access to healthcare services. I believe Taiwan ranks so highly in nutrition due to both, the educational standards and influence from the US and Japan. As aforementioned we operate in two areas of clinical nutrition, first of all, parenteral nutrition, which is the intravenous administration of nutrition and sits within our pharmaceutical business. Secondly, enteral nutrition, which generally refers to any method of feeding that uses the gastrointestinal (GI) tract to deliver all or a part of a person’s caloric intake, and this is within our consumer business. Since launching our product we have witnessed substantial growth in the enteral nutrition business. Furthermore, with our oncology formulation, we are the leading brand in oncology nutrition.
In addition to nutrition, nephrology is another area we have seen significant growth. Dialysis is extremely prevalent in Taiwan compared to the rest of the world., We have developed a product that helps to delay dialysis for chronic kidney disease (CKD). Finally, as an affiliate, we not only use commercialized products from our global portfolio but also have multiple co-business development initiatives in Taiwan.
Your product areas include oncology, parenteral nutrition, enteral nutrition, alternative plasma, delayed kidney failure, and critical medical equipment. How are these areas balanced in Fresenius’s business operations?
We are highly focused on critical diseases across the entire portfolio and we have very few products targeted toward chronic diseases. This is where we differ from many other healthcare and pharmaceutical companies: our main focus is on critical and emergency care.
Asia has over 50 percent of the world’s ageing population, and this is expected to rise to almost two-thirds by 2050. Therefore, are you considering to capture this opportunity with more products aiming to support patients with chronic diseases?
As mentioned above, the majority of our portfolio is in critical diseases; however, we are looking to move into chronic disease areas on a more localized level, as we currently have a very limited portfolio in this area. Furthermore, we are keen to work with local partners in developing the chronic disease side of our business. Within the wider group, we have a program called the home care business where we send healthcare professionals to patients’ homes in order to provide support for their medical preparations. We are currently evaluating whether this feasible for us to bring to the Taiwanese market to support patients with chronic diseases and elderly citizens.
Fresenius Kabi received European marketing authorization for the Adalimumab biosimilar Idacio. While there is a lot of excitement about biosimilars, not many regulatory systems have embraced them with no approvals in China up to now). In this light, how has Taiwan been paving the way for biosimilar adoption in the market?
Moving into biosimilars is strategic for us as we progress toward more value-added products. We have started with Idacio, which is our first biosimilar product. Entering the biosimilar market is advantageous for Fresenius, as biosimilars can help to relieve some of the budgetary pressures that governments, patients and healthcare institutions face. Amgen has the first biosimilar approved in Taiwan and our product should be the second or third to gain approval within the next two years. Ultimately, we are looking to move toward value-added and branded products; up until recently, we have only been focused on generics. Furthermore, for biosimilars, we will be forming a dedicated business to professionally communicate the benefits and advantages of our biosimilar products to healthcare professionals. Currently, we focused on cost advantages as the tool to market generics.
Could you tell us about your product development strategy locally?
In Taiwan, we develop enteral nutrition products along with pharmaceutical products. These products are then shipped throughout APAC. In particular, enteral nutrition products go to places such as Singapore, Malaysia, and Hong Kong, whereas the pharmaceutical products are planned to export to places with a better reimbursement system such as Australia and Korea. The company has chosen Taiwan as we have well-trained healthcare professionals, the quality of production is high and there is excellent technology in the pharmaceutical industry. Furthermore, the company has begun investing in the affiliate to find a strong partner for the development of products to export for the global market.
When we met the Minister of Health and Welfare and the Minister of Science and Technology, both of them highlighted that Taiwan is becoming a destination for clinical trial investment for big pharma and medical devices. What clinical trial initiatives has Fresenius brought to Taiwan?
Ever since I joined the affiliate in 2015, we have conducted clinical trials for CKD because nephrology has always been a core segment of the business. For instance, we have taken part in a global study where 1,000 Taiwanese patients took part, and we are expecting to receive the results by 2021. Additionally, we have been conducting clinical trials for disease-related enteral nutrition products
What partnerships and collaborations do you have with the Government or any other key stakeholders in Taiwan?
In transfusion technology, we are collaborating with the Taiwan Blood Foundation; furthermore, we have close ties with them not only for business but also for corporate social responsibility (CSR). Moreover, we work closely with cancer patient groups, and in October we put on a running event for cancer patients. To ensure safety at these types of events, we collaborate with the wider medical community by encouraging nurses and physicians to take part and provide a safer environment for the participants. Fresenius Kabi is invested in going the extra mile for our patients by organizing events like this so that people can feel a sense of community. Therefore, we try to actively encourage patients to leave their homes and get involved in activities.
Talent is a big topic of discussion for pharmaceutical companies. How easy do you find it to acquire top talent in Taiwan?
I find it quite challenging to acquire talent in Taiwan as the market is very mature, and development opportunities are becoming more limited. We are in constant competition with markets such as China, Japan and so on. Furthermore, most healthcare companies can hire people with a specific skillset; however, as Fresenius’s business differs from many other companies, we need people who are well-rounded and can handle multiple tasks at the same time. I have found that candidates who come from a big pharma background are too specialized in their skillsets. At Fresenius, we require people to handle multiple tasks at the same time. This is why people from midsized companies and local distributors often turn out to be better, as they tend to be more entrepreneurial in nature.
What is your vision for the company over the next five years?
Over the next five years, I would like to have sustainable, double-digit growth across the entire portfolio. Furthermore, we currently have about 100 employees, and in five years we expect to double our staff and to provide them with greater development opportunities.