Biogen Switzerland’s Dr med Katharina Gasser outlines how her affiliate navigated the COVID-19 pandemic from an organisational and communication perspective, the increasing importance being given to mental health by the Swiss government, and the reimbursement and market challenges facing Biogen in 2021 and beyond.
2020 saw a lot of innovation, new thinking, and new approaches being developed. Change came fast, but our team did a fantastic job in first embracing the challenge and now helping to shape how interactions will look in the future
Could you begin by outlining how Biogen Switzerland finished 2020 and the challenges you and your team have had to overcome during the COVID-19 pandemic?
Overall, we had a good 2020. Our team remained energetic throughout and we were able to end on a good note from a revenue perspective.
However, even one year on, working from home remains a challenge. It has forced our employees to adopt a new mindset on their approach to daily work in terms of planning, work/life balance, and routine. As remote working has continued, we have had to be thorough in communicating the importance of these topics, ensuring that our staff do not become overworked and remain physically and mentally healthy.
Onboarding new colleagues is another significant challenge in these virtual times. It can be difficult to give a new staff member, who has perhaps never even been to our offices, a sense of belonging. To rectify this, we have virtual onboarding sessions and regular reach-outs to new team members on a one-to-one level to make sure that they feel welcome and can ask questions.
Meetings have changed across the entire organization. Although virtual exchange is more challenging than face-to-face, we have been able to utilise the tools available to us to create breakout groups for smaller discussions. Additionally, we have looked at broadening our discussions to integrate some more inclusive and sometimes humorous topics.
Virtual team building has also been a key learning from 2020. At first, I was very sceptical of its efficacy, but it has been excellent, with our staff adapting well and has helped to increase resiliency across the organization. Spirits are still high, although we have to admit that not everything is perfect, and we are all looking forward to meeting and communicating again in a live setting. The end of winter and longer days certainly helps!
From an information perspective, the past year has taught me that it is impossible to over-communicate. There should always be an emphasis on communication regardless, but in these virtual times ensuring a strong communication flow among different channels ensures that everyone feels included and has access to the information they need.
Communicating internally with your teams is one thing, but presumably you have faced similar challenges with external stakeholders. Could you outline how you have maintained contact with the likes of Swissmedic, the Federal Office of Public Health (FOPH), and healthcare practitioners (HCPs)?
We videoconference with health authorities in a more formal manner, which works quite well as it is an exchange for which all parties are thoroughly prepared and where everyone knows their part.
Our interactions with physicians have also been good. There are some challenges, such as connecting with office-based physicians who may have patient consultations that run over time, but we have learned to be flexible and use other tools. From email to the old-fashioned telephone and even face-to-face visits where allowed, with protective measures in place, – although visits in the hospital setting are understandably extremely limited – we have managed to maintain contact. Moreover, in some situations, we found that interaction has actually improved via digital tools. We have worked tirelessly to enhance our field force’s ability to get in contact with physicians and not put too much of an administrative burden on them.
Another pleasant surprise was how well our advisory board and focus group meetings have gone. Good infrastructure is usually put in place for these meetings to ensure that everything runs smoothly, and we have had many fruitful discussions in the past year. The only downside was a lack of informal conversations in the breaks or post-meeting, but in general, we have been very happy on this front.
A final piece of the puzzle is webinars. Compared to in-person conferences, webinars help us to reach a broader audience beyond Switzerland’s borders.
Overall, the number of interactions with our partners in healthcare in 2020 was no less than that of 2019. This is a hugely pleasing statistic and shows that, through the use of digital tools, contact and dialogue can be maintained. Today, we are now transitioning to a more hybrid post-pandemic world where digital and face-to-face communication models are combined.
2020 saw a lot of innovation, new thinking, and new approaches being developed. Change came fast, but our team did a fantastic job in first embracing the challenge and now helping to shape how interactions will look in the future.
How has this technological shift in external interaction impacted the profile and experience needed in your team?
It has changed the requirements in terms of capabilities, mindset, and skills. Our field force has embraced that and was willing to go on this journey, adapt, and learn. This has meant for some the need to upskill, but this might not be for everyone. Going forward, agility, tech-savviness, and communication will be extremely important. We also have to make sure that we train accordingly and that our material is adapted to these new conversational forms incorporating feedback from our teams as well as our stakeholders.
Continuing on this journey will require a lot of attention and thorough preparation.
The new FOPH director general Anne Levy has made mental health a priority area. Did that come as a surprise to you?
No, it did not. Unfortunately, the burden of mental health in Switzerland is quite high and has been for a long time. However, the issue is getting even more serious; the health insurer AXA published a study in October 2020 which showed a significant increase in mental health issues due to the COVID-19 pandemic, especially among the younger population, in Switzerland and other European countries.
The study reported that six percent of participants reported mental health issues pre-pandemic; a number that rose to 15 percent after the first months of COVID. This may be due to the very challenging situation at school or university, not being able to go out, having no sports or leisure activities, and simply not being able to be a normal young person. That is one of the areas where, unfortunately, mental health issues have seen a quite devastating increase.
The study also looked at the incidence of mental health pre-pandemic with 30 percent of participants saying that they experienced some mental health challenges on at least one occasion in their lives. This shows that mental health, especially depression, is a big public health challenge that we do not yet have enough to tackle.
Therefore, I am really pleased that Biogen decided to go into this area. The company has entered into a collaboration with Sage, a leading player in brain health disorders. Major depressive disorders and postpartum depression are highly prevalent disorders that are seeing an uptick during the pandemic and we believe that Sage’s lead asset, which is currently in Phase III trials, has the potential to be a first in class oral therapy for both. This is still ongoing, and we hope that this clinical trial is going to have a positive outcome.
We are all very excited to move in this direction because it represents another area of high unmet medical need, besides all the other areas where Biogen is currently doing clinical research. Additionally, having a strong partner in this area in Sage bodes well for the future.
Depression is linked to other diseases for which Biogen already has a portfolio in Switzerland. What synergies are there to be leveraged now that mental health is such a national priority?
We are excited about the potential to bring together Biogen’s leading capabilities in neuroscience with Sage’s deep expertise in psychiatry. Major depressive disorder is a common co-morbidity of multiple neurological disorders in Biogen’s core therapeutic areas. There is a tremendous unmet medical need in depression, and we are optimistic about the potential to help transform the treatment of depression and address the stigma often associated with chronic use of antidepressants.
Another item on the FOPH’s agenda is budgetary constraints, as Switzerland looks to rein in domestic healthcare spending as well as channel funds towards fighting COVID-19. What are your expectations for Biogen Switzerland on this front in 2021?
Biogen is a strong partner with the Swiss innovative pharma association Interpharma, which is engaging in discussions around patient access schemes. The aim is for innovative treatments to reach Swiss patients more quickly post-marketing authorisation from Swissmedic. This part works quite well, but the reimbursement discussions and negotiations that follow after often take far too long.
Interpharma’s proposal – this is not something that individual companies can do by themselves – is to bring ideas like innovative pricing schemes, pay for performance tools, and new ways of getting reimbursement forward to ensure that innovation gets to patients on day one after marketing authorization. Currently, this is not the case and there are even dossiers that are still being discussed two years after gaining marketing authorization.
We think that Switzerland, as home to one of the best healthcare systems in the world, should be faster. Interpharma also has several workstreams on that and we reach out to different stakeholders, including the FOPH, to ensure this issue – which has been in discussion for a long time – moves from theory to reality.
To push back a little, obviously it is important to work as a group, but different companies have different portfolios, some of which are better placed for pay for performance solutions etc. Will there come a point where individual companies will have to bring forward solutions that are tailored to their own portfolios?
A very important aspect to consider, and one that will probably soon become even more important, is health technology assessments. Health economic data and the quality-of-life piece need to be taken into consideration. For mental health treatments, this means their impact on patients’ productivity at work and on their longer-term healthcare needs, family, and society as a whole. There needs to be a more holistic view, not just a therapeutic cross-comparison and international reference pricing.
Healthcare expenditure in Switzerland has been stable at around 13 percent over the last few years and has not increased. Moreover, originator treatments generate CHF one billion in savings annually. While we do not always have to think about completely new models, we cannot just look at one piece of healthcare.
How does your biosimilars portfolio play into this conversation and how is this side of Biogen’s business progressing in Switzerland?
Biogen Switzerland has two biosimilars in the TNF alpha space but we are still at the beginning of a much longer journey. Switzerland still has a very low uptake of biosimilars, so we work hard to increase the overall biosimilar share and make it better known that Biogen – not a typical biosimilars company – is present in this segment. Because of our atypical profile, it can be even more challenging for us than for others!
We are collaborating with other companies and stakeholders to change the perception around biosimilars. We want biosimilars to be seen as a high-quality addition to healthcare that creates savings and therefore room for innovation.
Looking forward to the rest of 2021, what are your targets as GM of Biogen Switzerland?
My focus is on Biogen’s fantastic pipeline, submitting dossiers to health authorities, and hopefully bringing life-changing medicines to patients. Looking back on 2021 in December, I would love to see that we were successful in bringing innovative medicines to patients. I want the organization to be ready to embrace this challenge. Even in this home office setting, we need to stay energetic and curious.