João Madeira, General Manager, Spain – Viatris

João Madeira João Madeira, General Manager of Viatris Spain discusses the position of the Spanish affiliate and the challenges of a generous decentralised healthcare system. He also outlines some of Viatris’ successes in Spain, such as being the first company to launch an HIV selfdiagnostic test there.

… price erosion is such a big concern in the Spanish market … The pricing system for generics is forcing both brands and generics to compete so aggressively as to create an inefficient market.

 

Can you begin by speaking about your experience getting the Viatris Spain organization started?

During my professional career, I had already had the opportunity to experience the processes of integrating businesses and companies, however, the challenge this time around, with Viatris, was doing it whilst in a new country with new colleagues. In Spain, we have a team of 420 employees passionate about the philosophy and mission of the company. We have corporate offices in Madrid and Barcelona and with our sales force we cover the entire national geography.

We are a leading pharmaceutical company in the Spanish retail market (value/unit), currently holding a third position in units/year and the fourth in value. We intend to continue working to reinforce our commitment to patients and to help build a more efficient healthcare system in our country.

 

So, you have already laid the foundation of the Spanish affiliate. But what can you say about the strategy, for succeeding in the market and the opportunities you and the team have detected?

Our mission is to empower people worldwide to live healthier at every stage of life. At the end of the day, what connects all of the affiliates, all of the countries and regions, are the three pillars of Viatris’ mission: access, providing high quality, trusted medicines to patients, regardless of geography or circumstances; leadership, advancing sustainable operations and innovative solutions to improve patient health; and partnership, leveraging our collective expertise to connect people to products and services. Viatris is a key stakeholder in the pharmaceutical industry because we produce medicines for patients across a broad range of major therapeutic areas, spanning both noncommunicable and infectious diseases.

We work to ensure that Spaniards can enjoy better healthcare and more access to quality medicines. The fact is that Viatris is one of very few companies that has this level of capabilities. In Spain, for example, we were the first company to launch the HIV selfdiagnostic test, something important as we approach pride month. We have also launched a self-test that identifies if a person has produced sufficient antibodies after COVID vaccination. Our portfolio is wide and diverse, whether we talk about prescription medicines or OTC products. Moreover, the Fundación Viatris para la Salud, an independent, separately constituted non-profit body supported by the Spanish affiliate, works in Spain to empower people in terms of increasing literacy in healthcare-related topics.

 

A key element of the Spanish healthcare market is the decentralisation that empowers the different regions. Some of your colleagues have stated that, although it has challenges, it is an opportunity to try out different strategies. What is your view on this?

Healthcare is a key priority area on every country’s agenda. You can do pilot initiatives, yes, but we have an obligation to Spanish citizens, patients, prescribers, pharmacists, and all stakeholders. However, we acknowledge the fact that autonomous regions are different from one another. One example that has to do with our portfolio and is connected with the way Viatris provides access, is the changing dynamic of what can be prescribed as a brand or as a generic medicine. That changes from region to region. The clinical guidance or clinical governance is stronger in some areas and, of course, these are variables that you need to consider in the strategy.

Another example is the buying process for vaccines in Spain where we have 17 regions and five of them opted out of the centralised procurement procedure. So, what you have is 17 different processes and timelines as you look to offer the flu vaccine to the Spanish population.

 

The Spanish public healthcare system has been described to us as one of the most generous in the world. Do you share that opinion?

The statement is absolutely correct in terms of what the central government offers for all citizens in Spain. The flip side to this is that such a generous system tends to make innovation somewhat challenging. This is perhaps why price erosion is such a big concern in the Spanish market; it has implications for providers looking to have sustainable longterm operations in the country. The pricing system for generics is forcing both brands and generics to compete so aggressively as to create an inefficient market.

Nevertheless, Viatris will continue to have strong participation in the generic space since it is an important area that helps us be a key partner to the healthcare system. We estimate that our generic products help the government save EUR 50 million per year. Another important consideration is that the country has 10 times more people dying from low treatment adherence than traffic accidents. It is an area where all stakeholders should be engaged because people do have access, physicians are prescribing, pharmacies are dispensing, and companies are delivering the products; what is left is for patients to follow the treatments. It could help the country to significantly reduce the mortality rate.

 

Can you be more specific about the therapeutic areas where Viatris is succeeding and those that will play an important role in the future of the company?

Our objective is to establish ourselves in critical areas such as the cardiovascular area, pain or the NCS area. Regarding the impact of the products, we look at aspects such as mortality rates in developed countries. Cardiovascular mortality is an area of concern and the risk factors that contribute to it make it one of the most important areas of the company’s performance in Spain. High levels of cholesterol, hypertension, and diabetes are only three of the highest risk factors in cardiovascular disease, and we make a lot of effort in these areas, working daily with thousands of doctors in Spain to guarantee that patients have access to different therapies.

In addition, we are strong in the metabolic, pain and mental health areas where we have the largest expertise and widest portfolio, but we also need to include areas where we  have a strong footprint such as gastro, ophthalmology and dermatology, which have been defined as areas of interest by the company. Moreover, let us not forget that the pandemic had a strong impact on the non-communicable disease area, which is a key segment for Viatris.

Recently, Viatris partnered with Carenity and two advocacy groups voicing the concerns of informal caregivers to conduct a patient-centered research to measure the impact of COVID-19 on access to healthcare and quality of life, focusing on patients suffering from noncommunicable diseases (NCDs) such as metabolic, respiratory, and cardiovascular diseases, mental health disorders and cancer. This survey carried out on more than 5,000 patients found that 17 percent of them developed a new medical condition during the pandemic, 26 percent reported that the pandemic had a strong impact on the condition they already had, and more than half reported a negative impact on their mental health. For us, the significant improvements that have been made in the last 20 years in terms of treating chronic diseases cannot be lost.

 

How would you define success for Viatris Spain?

For Viatris Spain, success would mean continuing to inspire our employees to work daily to enable the Spanish people to have access to better healthcare, to high quality treatments and to be a key stakeholder in the Spanish pharmaceutical market.

I want the Spanish to see us as a company that is extremely committed to providing greater access to medicines for the entire population, with the larger goal of developing innovative solutions and motivated to use the collective experience it has, as well as the history and knowledge from the two great pharmaceutical forces that merged to become Viatris, to improve patients’ lives.


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