Javier Aracil, country manager of Allergan in Belgium and Luxembourg, introduces the priorities and objectives as he set as he entered his first country manager position coming from holding key international positions in commercial, pricing, and market access within the company. As a newcomer to Belgium, Aracil highlights the particularities of the market and the opportunities he sees in bolstering the affiliate’s local position and partnering with the country’s healthcare stakeholders.
Belgium has played a significant role in all of Allergan’s European trials thanks to the skills of the medical professionals and quality of hospitals in the country
What were the initial priorities you identified for yourself when you took your first country manager position here in Belgium last year?
Taking on this first country manager position was a challenge, but of course, this new responsibility has been an opportunity given to me by Allergan to grow personally and professionally for which I am very grateful. Therefore, in this new role, I first created a 90-day plan to outline my initial priority of getting familiar with my new environment. This included getting to know the local team which was important for learning what the affiliate was proud of and where there was room for development. Next, I had to understand the local Belgian healthcare landscape as all markets have a unique system – even within Europe. Although I had a helicopter view of healthcare dynamics in different markets thanks to my previous position as the international market access director of specialty care, the only way to truly know a single market is by having your feet on the ground.
My arrival was a major change for the affiliate as we split the Belgian and Luxembourg operations from the BeNeLux cluster which included the Netherlands. One on hand, there is a greater possibility to focus on the particularities of the Belgian and Luxembourg markets, but at the same time, we lost the scale of resources working within a three-country group. Nevertheless, as part of my initial 90-day plan, we set a vision to be Allergan’s fastest-growing Other-European market within the next five years – a highly realistic ambition that was determined after analyzing the challenges and opportunities faced by the affiliate.
So far you have had quite an international experience with Allergan – working in Spain, the UK, and now Belgium. How different were the operations of the Belgian affiliate versus the Allergan you experienced in other markets?
Speaking first about the medical aesthetic side of our portfolio, this market was completely underdeveloped in Belgium when considering the maturity and GDP growth of the country. In the past, a majority of resources in this area were funnelled into the Netherlands. Therefore, our first step was to deliver the message that Allergan wants to invest locally and help our customers elevate their practice to the next level with our solutions. We created several opportunities in medical education for the aesthetic professionals in Belgium to showcase that Allergan is back in business.
Regarding our pharma business, I can say that the Belgian market is quite complex despite its small size. Nevertheless, last year we were able to secure the reimbursement of two major Allergan products locally; OZURDEX®, our flagship ophthalmology product for the treatment of uveitis, and BOTOX®, for the therapeutic indication of chronic migraine.
Chronic migraine is currently one of the most debilitating diseases we have today and BOTOX® brings a proven way to deal with this condition. To give some context, chronic means a patient has 15 days of headache or more per month and eight are defined as migraine. The approval of the reimbursement for BOTOX® therapeutic in Belgium was a huge milestone for local patients and for Allergan as this indication has been approved in other markets as of four years ago.
What was your experience with gaining reimbursement for these products in Belgium – a notoriously complex market – and what were the factors of success?
The core competency for this achievement lies in the experience of our dedicated market access team. Having submitted dossiers myself in Spain and overseeing other dossiers across Europe, my assessment is that Belgium is very rigorous with the information requested. While, this is very important to ensure that drugs which are approved truly have an impact on patient lives, the level of detail necessary in Belgium is very high compared to other European markets. For this reason, I am very proud of my team and our products in being able to answer these questions and achieve reimbursement for this important solution for patients.
How completely is Allergan’s portfolio represented locally in Belgium and what is the balance of therapeutic areas for the affiliate’s business?
As it stands, the Allergan portfolio is complete in Belgium for now. However, we have a very exciting pipeline coming up, particularly in the eyecare and specialty care areas where we are currently focusing on bringing new solutions for patients and doctors.
In Belgium, the balance of our operations is slightly different from other markets. Our leading business at the moment is medical aesthetics which is very closely followed by eyecare and specialty care. In terms of percentages, the split is about 40-30-30 respectively. With the launch of BOTOX® our specialty business is picking up momentum quite nicely and in the forthcoming years, we will be introducing innovations to fulfil unmet needs in key disease areas such as Non-Alcoholic SteatoHepatitis (NASH) and diabetic gastroparesis. Even in migraine we will continue our dedication and deliver innovation from a new class of drug, calcitonin gene-related peptide (CGRP), for preventive use. Moreover, in eyecare, we also have a solid pipeline to help doctors to deal with important pathologies that still have a big unmet need like Macular Degeneration and Glaucoma.
As you are surely aware, in 2015 Minister of Health Maggie De Block signed a pact for the future with the pharma industry to increase transparency and predictability. As someone with a fresh perspective, what is your assessment of the relations between authorities and the industry?
I believe we are taking steps in the right direction for better understanding between the industry and health authorities as we are both working towards a common goal which is to give Belgian patients the best access to treatment possible. Sharing this mission is extremely important as it is the only way to achieve better outcomes in the future. However, this cooperation must be accelerated as the industry, Allergan included, will soon be introducing more and more new drugs which are highly targeted for specific diseases and patient groups. This rise in personalized medicine will require a new mechanism for evaluating products, meaning that risk-sharing agreements and pay for performance will need to evolve in the future. Moreover, this shift must be completed hand in hand with all stakeholders, because if the industry is left out of the discussion, it will be very difficult to find a solution which can fit for both sides and achieve our common goal, improve patient’s quality of life.
How can Allergan be a partner in health to the Belgian community?
We have a very strong position to act as a partner to the Belgian stakeholders based on several factors. First off, we are very open to having such conversations and Allergan is a company that is flexible when it comes to reaching agreements for the benefit of patients. This patient-centred focus is inherited in our values across all countries where we operate.
Additionally, we have an important ambition to go beyond the pill. This means we are not only focused on marketing a drug but evolving from a manufacturer of products to a being a partner in realizing holistic healthcare outcomes. Allergan aims to bring added value services to Belgium such as supporting centers of excellence for chronic migraine and aiding in capacity issues being faced by hospitals, particularly in the retinal field.
While Belgium may not be the biggest market compared to the UK or Spain, it does have a significant positioning when it comes to clinical trials. Is Allergan active in clinical development in Belgium?
Absolutely. Belgium has played a significant role in all of Allergan’s European trials thanks to the skills of the medical professionals and quality of hospitals in the country. Even as a country with a population of only 11 million, Belgium has an exceptional hospital network with internationally recognized researchers. For example, UZ Leuven is one of the most important centres in Europe for eyecare and UZ Ghent has renowned capabilities in neuroscience.
Are there other unique strengths that the country has that can define Belgium as a strategic market for Allergan?
From my point of view there are two important aspects – first is timing. We have many new solutions that will soon be launched in the market across all our business units which will give the affiliate an accelerated growth trajectory. The second factor is regarding the Allergan Belgium team. We have refreshed the affiliate and have set a clear path for our strategy to stick with our focus brands and prioritize. Although we are not the size of Germany or France, having a small team allows us to be agile and create a fast-paced, dynamic culture. Allergan give accountability to all its employees and offers the luxury to fail. If we continuously do the same year after year, we will keep getting the same results and cease to progress. Being a nimble team in a small market like Belgium, we have the support of international top management to pilot new approaches which could then be expanded to other markets. This includes the exploration of digitalization in our operations and creating new roles within the organization.
Allergan conducts their operations globally under the motto “Being Bold for Life” – how do you manage the affiliate and your team to be aligned with this corporate culture?
This value is of course represented across all Allergan affiliates but in Belgium specifically, we have really embedded this attitude in the mindset of the team. Therefore, we want to be dynamic in decision-making processes and we are empowering people to think outside of the box. In the affiliate, there is never a bad idea and we give the team accountability to go beyond their roles and explore what more they can do for the company and patients.
Belgium is often an incubator market for first- or second-time country managers who eventually move on to larger roles in a company. If this were to be the case, what would define success for your time as the country manager of Allergan Belgium?
Achieving success within my role as country manager will mean that the day at I move to a new position, I will leave behind a standalone entity that is fully operational and has embraced the mindset of being bold and having a winning spirit to continue supporting patients. If my team is empowered and has the capability to keep growing without me, I will have fulfilled my mission as a leader.
What advice would you give to a country manager who is coming to Belgium for the first time?
My first piece of advice is do not be afraid – the weather is not that bad! Jokes aside, Belgium is a great country to live in and experience. Next, it is crucial to take the proper time to get to know your team and customers within the first months of arriving in the country. This will set you up for a smooth transition and long-term success. There are many particularities about Belgium and investing the time to learn them is the only way to truly understand the uniqueness of the market.