Pierre Fabre Benelux General Manager Kristel de Bisschop discusses the challenges and opportunities inherent in taking charge of an important affiliate against the backdrop of a group-wide transformation push and a global pandemic. de Bisschop also touches on key product launches in both oncology and dermatology, the synergies between these two business arms, and how COVID-19 has led to a greater uptake of digital tools that could have a long-lasting and positive impact.
Your background is in dermo-cosmetics, but since March 2020 you have been overseeing the entire Pierre Fabre group, including pharmaceuticals, for Benelux. Could you begin by outlining your career trajectory up to this point?
In 1992 I started as a training manager at L’Oréal’s Cosmétique Active division. After a few years, I moved to the marketing and sales department and in 2000 was appointed Cosmétique Active medical rep director.
In 2004 I was offered the opportunity to join Pierre Fabre as director for the Eau Thermale Avène brand. After 12 years at L’Oréal, building awareness and market share for this global brand in Benelux was a significant challenge which I was excited to take on.
During the following 12 years, I progressively took on responsibility for other brands at Pierre Fabre Dermo-Cosmetics, including drugs for dermatological indications during which time I was able to garner more experience around pharmacoeconomics and market access procedures.
In 2019 I became the GM of Pierre Fabre Dermo-Cosmetics and, in line with the implementation of the Pierre Fabre group’s global transformation, I now manage both business units (BUs) Medical care & Dermo-Cosmetics & Personal Care of the Benelux subsidiary.
What were some of the main challenges you faced taking on this enhanced role in the midst of a global pandemic?
Implementing a new organisational focus in line with the transformation plan would be a major challenge for any new GM but doing so remotely and without face-to-face contact made it especially challenging!
At the outset of the COVID-19 outbreak, our first concern was for our employees as in the field they have daily contact with healthcare professionals and therefore enter high-risk zones. We had to switch to working from home and had to make some of our staff unemployed for a few weeks. However, they showed great understanding and resilience and were quickly able to start working again remotely.
This meant that our way of working had to be adjusted very quickly and thoroughly. For our marketing department, this meant developing tools adapted for remote visits with healthcare practitioners (HCPs). The challenge was how to maintain a dynamic dialogue remotely, which we were thankfully able to overcome.
In the oncology department, our medical science liaisons (MSLs) have worked hard to keep in touch with oncologists and provide any information necessary regarding treatments against the backdrop of COVID situation in terms of drug-drug interactions etc. Additionally, our key account managers made themselves available to hospital pharmacists to guarantee the supply of BRAFTOVI and MEKTOVI, our new combined treatment for melanoma. We cannot afford for a patient to not have access to their treatment; therefore, it was crucial to maintain our deliveries.
Pierre Fabre’s global transformation plan includes greater integration between the dermo-cosmetic and pharmaceutical business lines with country managers such as yourself increasingly managing both arms. What are the benefits of this integration and what challenges have you faced?
Through this transformation plan, we are able to build more synergies between our dermo-cosmetics and medical care activities. Pierre Fabre is unique in that our expertise spans both medical and natural remedies. When both activities are led by one person it becomes more straightforward to identify where you can develop synergies and have a truly holistic approach to health.
As an example, when patients are given treatments for skin cancers, there are very often side effects on the skin. It is vital that our entire oncology department is aware of those side effects, their impact on patients’ quality of life, and how treating these side effects with the emollient creams that we also offer can help. If a patient’s skin is burning from morning to evening and they are not able to sleep comfortably, emollients that can calm the burning will drastically improve their quality of life and give them the courage to go on with their treatment. This is just one example of how we live out Pierre Fabre’s mission of ‘taking care, living better’ with the patient at the centre of everything that we do.
Has it been a steep learning curve for you to get more involved in the medical side of the business?
It has. I am a pharmacist by training, which is surely one reason why I was given the opportunity to move to the medical part. Most Pierre Fabre country managers come from the medical care department but given this background as well as my experience with dermatology drugs, I was handed the responsibility of taking on this new challenge. There has been a lot to learn – often remotely – all about the biological aspect of our treatments.
What are the different characteristics of the Belgium, Netherlands and Luxembourg markets in terms of market access and reimbursement?
First of all, I need to underline that although Benelux is often seen as a uniform cluster, this is not at all the case. The oncology market in the Netherlands, for instance, is more mature, given that the country has the second-highest incidence for melanoma in the world after Australia.
The market access process in the Netherlands is much quicker than in Belgium. At its fastest, the process can be completed in a month in the Netherlands after a positive CIEBOM advice, whereas it can often take over a year in Belgium. However, this does not mean that the process is easier in the Netherlands. Indeed, the CIEBOM, an association of key opinion leaders, gives advice on oncology treatments and its medical added value. If they do not judge a treatment as having medical added value, it will not be reimbursed. This is something specific to the Netherlands.
In Belgium, there is a longer procedure where the regulatory authorities conduct a thorough scientific and economic evaluation of every drug. Luxembourg follows the Belgian procedures and once Belgian reimbursement is granted things move quickly.
These things need to be managed within a thoroughly prepared launch plan but keeping some flexibility in the marketing and MSL approach is necessary.
How would you characterise the importance of the Benelux cluster to Pierre Fabre in Europe?
We are the leading country in the Northern and Western Europe zone and are delivering an EBIT level in the high range of the company’s overall performance. Without sounding pretentious, we must be proud as a team of this achievement and of being a solid contributor to the overall results of the group.
What have been the contributing factors to the recent success of Pierre Fabre Benelux?
We have consistently proved our agility to quickly adapt to new situations by utilising a cross-functional omni-channel approach and investing heavily in digital tools.
The strong brand awareness for our dermo-cosmetic brands has also contributed to our consumers being able to securely obtain our products via e-retailers despite more limited access to pharmacies during the lockdown period.
This will be developed even further in the second half of 2020 with precision marketing approaches – approaching the right consumer with the right message at the right time and place.
What kinds of digital tools has Pierre Fabre invested in to navigate the COVID-19 crisis?
In oncology, we have had to develop our digital offering rapidly. When face-to-face contact was stopped completely in the hospitals, we had to be agile to quickly adapt our ways of working and maintain contact. Additionally, we moved to organise virtual classes with our MSLs to speak about important medical content and created a LinkedIn page which oncologists could access via QR codes to resolve any questions they had.
A similar strategy was rolled out in the dermo-cosmetic branch to maintain contact with dermatologists and pharmacists that are not with MSLs but rather with medical reps and sales reps.
In the last few weeks, we have reintroduced offline face-to-face contacts, but moving forward, having a mix of different touchpoints, both online and offline, will help us progress.
Mouloud Boukhachab, your predecessor, explained to us how under his watch the Benelux affiliate shifted from OTC to ethical and innovative oncology products. How well-represented is Pierre Fabre’s broad global portfolio in Benelux and what are your focus areas moving forward?
Mouloud did a thorough job of cleaning up and rationalising our portfolio in pharma care and medical care, helping ensure greater profitability. However, this does not mean that oncology is our sole focus, as we also have other important OTC products. Today, the oncology and medical care department represents 44 percent of our total portfolio, and dermo-cosmetics along with personal care (oral care) represents 56 percent.
The difference is that the rapid growth of Pierre Fabre Benelux comes primarily from our innovative oncology products. In April 2019 we launched BRAKTOVI and MEKTOVI in the Netherlands, where we have already gained a 37 percent market share.
We still have good profitability in dermo-cosmetics and have managed to maintain the results we had in 2019 despite the COVID situation. This was thanks to the fact that we paid a lot of attention to e-retailers and ensuring that our products were still available. Even when the pharmacists were still accessible, were forced to take sanitary measures that made it complicated for consumers to easily find our products.
What is the working culture and team dynamic you want to put in place?
In any corporate culture it is extremely important to surround oneself with experts in their field but also to empower them to make decisions themselves. Domain experts need to feel responsible for their projects.
Open communication has always been very important for me, but during this transformation, I have had to pay attention to what was clear and what was still foggy for our team. These things needed to be discussed before they are implemented; a good understanding of goals is important, as is having the team working for the same purpose. We must set clear, realistic, and multi-disciplinary shared KPIs in order to promote teamwork and team spirit. Without these factors in place, a transformation plan cannot be implemented successfully.
Synergy between the different business units is growing rapidly and is very encouraging. Within this holistic approach, the patient and consumer should be at the centre; that is what motivates us. Encouraging recent results, despite COVID-19, demonstrate that everyone is working towards that purpose.
What are your goals in the short- and medium-term for Pierre Fabre Benelux?
We want to continue with the rationalisation of the portfolio and develop our offering to have the patient and consumer even more at the centre of our activities. We also want to strengthen our offering in oncology and are now working on other indications with the launch of BRAKTOVI for metastatic colorectal cancer and NERLYNX for early breast cancer. I am already working with the oncology team on the market access approach for Benelux for these treatments
Taking a higher perspective, a key objective for our teams in Benelux is to contribute to the EBIT level that is needed to maintain the independence of the Pierre Fabre Group. The company uniquely belongs to a not-for-profit, government-recognized foundation created by Mr Pierre Fabre and was his sole legatee when he passed away seven years ago. The Pierre Fabre Foundation is very active in Sub-Saharan Africa where it partners with local players to train and support health care professionals. For example, it has developed a partnership with Peace Nobel-prize winner Dr Denis Mukwege in the Democratic Republic of Congo and in the Central African Republic to support women hit by sexual crimes in war zones.
What will you take from the COVID-19 crisis that can be useful for the future?
This situation has caused a worldwide crisis but by showing the necessary agility we have learned a lot. Our ways of working went through a drastic change and taught us to respond quickly and accurately to the situation. We also found that virtual online contact with HCPs did not weaken the medical and scientific value of the contact, so in the future companies will develop platforms with both online and offline touchpoints. This represents a time saver, not only for the HCPs but also for the industry and will ultimately benefit the patients. At the end of the day, that is why we do our job.
