Jose Viera-Colon, Region Director Caribbean for Allergan, highlights the opportunities and obstacles related to leading the company’s commercial operations in Puerto Rico and countries like the Dominican Republic. He also gives insights in planned product launches in CNS and eyecare and explains Allergan’s approach to ensure product affordability for Puerto Rican patients.
You have been at Allergan since 2007 and regional director since 2014. Can you give our international readers an overview of the region you are heading?
I am heading the Caribbean region, which is a quite interesting market due to its complexity and diversity. The two main markets are Puerto Rico, which as part of the US is FDA-regulated, and the Dominican Republic, the largest market in terms of patient numbers.
Additionally, we are seeing a shift in other islands such as Trinidad & Tobago, Barbados, Jamaica and Curaçao, which now have much stronger healthcare systems. This means that many patients, who 20 years ago would have gone to cities like Miami and San Juan for treatment, are now staying in their home countries as more physicians return after residency abroad in Canada, the UK or the US.
I like to refer to the region as a small giant, as it consists of small island markets, which have seen significant growth in the last ten years while improving their healthcare systems, medical education and hospitals. Allergan has tripled its sales within ten years in the Caribbean.
Where do see the challenges in the region for Allergan?
All the islands have their own customs and regulatory guidelines, so we must register all our pharmaceuticals and devices separately in each market. This makes the launch of products difficult, as it can take between six months to two years to register a product in countries like the Dominican Republic, Trinidad or Curaçao.
Registration is a roadblock as it is a complex topic in most countries, which is also a disadvantage for patients, as they may not have access to branded medicine in their home countries. We need to spread awareness of this issue as it can have consequences for patients who could benefit from more treatment options.
What makes Puerto Rico strategically important? Why does Allergan prefer on-site commercial operations rather than remote management, as with some other companies?
Puerto Rico is an important market and its population is larger than at least ten to 12 states on the US mainland. Moreover, we have a developed and mature healthcare system, with commercial payers, Medicaid and Medicare, which makes it a key market for biopharma companies. Despite the political landscape and governmental challenges, the private sector is very strong and vibrant in Puerto Rico.
Therefore, Allergan has managed its Caribbean operations from Puerto Rico since 1965. The market has grown at a double-digit pace in both our therapeutic and cosmetic franchises thanks to innovation and access in formularies, making our products affordable to patients. Puerto Rico accounts for 80 percent of the revenue in the region. Another factor is the excellent quality of medical education on the island, as well-prepared physicians graduate from Puerto Rico each year.
Globally, Allergan’s portfolio spans around the areas of medical aesthetics, ophthalmology, CNS and gastroenterology. How is this reflected at the local level?
Eyecare has been our main growth driver, as glaucoma is a common disease in the Caribbean. This is prevalent as most of our population has African or Native American roots and these groups have a higher risk profile than other groups. Ophthalmic products are, and always will be, the backbone of our business, as we have an ageing population, which will further contribute to the high demand for eyecare solutions and innovation.
Our second growth driver is Botox, especially for therapeutic needs, such as chronic migraine, muscle spasticity and over-active bladder. Botox has helped thousands of patients improve their quality of lives.
You revealed that in 2020, Allergan will launch new products in Puerto Rico in the CNS and eyecare treatment field. Can you give our international readers more details about the envisioned product launches?
We will be launching in Puerto Rico in late 2019, VRAYLAR, which treats acute manic or mixed episodes of bipolar I disorder in adults. VRAYLAR is an FDA approved product that meets an important need in the market. Bipolar disorder is challenging to diagnose, in fact, the average time for the right diagnoses is five to ten years in the US, which means that during this time patients may try and fail various medications. VRAYLAR will give psychiatrists a new tool to help improve the overall mental health of patients.
In eyecare, Allergan is working to develop sustained release drug technology. If successful, this approach could help physicians address a key challenge when managing chronic diseases like glaucoma. Patient compliance and medication adherence continue to be a significant obstacle for many. This could be a great step ahead in terms of compliance and patients’ adherence to their regimen, which is a constant issue for eyecare specialists. The value of innovation in preserving vision has a significant positive impact on the entire healthcare system.
Wendy Perry of PIA told us that the industry and other stakeholders need to work together so that the discounts that pharma companies give reach the patient and not only benefit the pharmacy benefit managers (PBMs). How is Allerganmaking treatments more affordable for patients?
Pricing and reimbursement are key issues in Puerto Rico, as there are differences between insurance plans in terms of reimbursing drugs and treatments. Allergan has a social contract with patients, which was communicated by our CEO Brent Saunders a few years ago. This social contract outlines our commitment to responsible pricing and continued investment in developing new technology that can benefit patients.
Moreover, Allergan offers patient assistance programs for in-market brands to help patients cover the out of pocket costs and continue the therapy successfully. We need to work in partnership with PBMs, Medical Plans, Pharmacies, Drug Wholesalers and Medical Societies to ensure pricing and value goes together.
Could you highlight some of your corporate social responsibility (CSR) initiatives?
I personally care deeply for Puerto Rico as one of the local Puerto Ricans leading a global biopharmaceutical company on the island. Hence, we have been very active collaborating with Fundación Hospital Pediatrico. We are also actively supporting the medical societies to educate patients, caregivers and healthcare professionals.
After Hurricane Maria, Allergan was focused on ensuring the continuous supply of eyecare products with product donations, so patients could continue uninterrupted treatment. Our employees are committed to their communities and we want to see a successful and healthy Puerto Rico.
At Allergan we have a big heart and have been bold in times of need.
