Malin Parkler, country manager of Pfizer Sweden, breaks down the extensive footprint of Pfizer in Sweden across the value chain, lays down the advantages of Sweden as a research and manufacturing hub, and shares the exciting local collaborations and partnerships the company is developing to support healthcare and patients.
The production of high-tech biologics is one of Sweden’s strengths
Pfizer is currently celebrating 65 years in Sweden. Could you begin by introducing the company’s footprint in the country?
Pfizer’s footprint and history in Sweden is both extensive and interesting partly thanks to the heritage from Pharmacia, a company founded in Stockholm in 1911 that Pfizer acquired in the early 2000s. We have medicines in our portfolio that were invented and developed here, and some are still manufactured at our local manufacturing site in Strängnäs, such as growth hormone and low-molecular-weight heparin. As often as I can, I proudly share our footprint, usually covering three areas, but lately I have been adding a fourth.
Firstly, we provide Swedish healthcare and patients with more than 140 products, medicines and vaccines covering a wide set of conditions and diseases. So if you have not yourself been helped from a Pfizer product, you likely know someone who has. Our products span across the entire lifespan, from childhood to old age, and many therapeutic areas, from simple painkillers all the way to life-saving oncology medicines. We take great pride in the way we support healthcare and how we contribute to changing patients’ lives. We do this by ensuring our medicine are used in the right way to get the most value for patients, supporting healthcare and patients with relevant information, education and tools.
Secondly, we have a large production site in Strängnäs manufacturing five active substances included in growth hormones, growth hormone inhibiting hormones (GHIH), anti-clotting agents, rheumatoid arthritis and vaccines which are exported worldwide. Originally built more than 70 years ago, this site stands as a hallmark of Sweden’s manufacturing excellence and has been expanded since Pfizer acquired it. In 2009, we inaugurated a new $214.8 million advanced biotechnology facility. A key focus of the 6,000 sqm plant is the growth of the bacteria E. coli and yeast for the production of recombinant proteins. We have lately expanded with vaccine production and are running contract manufacturing for SOBI. We are now investing SEK 350 million (USD 37 million) in this production site in order to double capacity. I think that the production of high-tech biologics is one of Sweden’s strengths. We are really proud of the Strängnäs site as it helps maintain and grow Sweden’s skills and know-how in the manufacturing of advanced pharmaceuticals.
Thirdly, Pfizer has a substantial research footprint in Sweden. While it is often said that the number of industry-sponsored clinical trials has diminished in Sweden over recent years, Pfizer on the other hand still value Sweden as a high-quality country for clinical trials and many of our ongoing clinical development projects are conducted here with Swedish health care engaged. We are especially proud that Sweden is the only country outside the US conducting Pfizer studies on the next generation of pneumococcal vaccine, acknowledging Sweden as a vaccine-friendly country. Swedish clinics are participating in one-fourth of Pfizer’s global clinical trial program. There is a clear interest from Swedish Health care and politics to be active in industry-sponsored clinical trials, however, healthcare is under huge pressure to produce care and would benefit if they were given more room for clinical research. In addition to clinical trials, we also collaborate on early research with local universities such as the Karolinska Institute and Lund University, as well as with local companies.
One of the local companies is AMRA, a medical imaging company that analytically transforms MR images into precise body composition measurements. These highly accurate measurements aid metabolic research and drug development in the challenging areas of obesity and its co-morbidities. AMRA wants to replace BMI with a new, more useful body composition score, a topic the company is currently discussing with EU medical authorities. On this point, Sweden is recognized internationally for its expertise in medical imaging. The Pfizer group has since long collaborated with Karolinska University Hospital, as one of few places in the world for PET scan analysis. Another example of a strategic research collaboration is with BioInvent, a biotech company developing novel and first-in-class immuno-oncology therapies. Pfizer recognizes the innovative strength of the Swedish startup scene and is on the look-out for potential partnership opportunities. For instance, Pfizer’s global team searching for strategic collaborations always attends the Nordic Life Science Days to meet with promising companies. Mikael Dolsten, Pfizer’s Global President of Worldwide Research, Development and Medical, was one of the keynote speakers a couple of years ago.
As previously mentioned, I have recently begun to add a fourth dimension when talking about our footprint in Sweden. Pfizer is now leveraging Sweden’s burgeoning digital health startup ecosystem. Globally, Pfizer has a network of Healthcare Hubs in cities with a dynamic startup scene in the area of healthcare, such as New York, Berlin, London and Tel Aviv. Stockholm is one of them. The goal is to identify, interact and support the startups that can provide solutions to our patient’s most challenging problems, solutions that can help us produce the best possible outcomes with our medicines, including better diagnostics, monitoring, treatment follow-up and patient support tools. We know that startups are developing the technology which will shape the healthcare of the future, and we are excited to be part of this revolution.
We hope that collaborating with startups will complement our medicines with cutting edge technology throughout the whole patient journey, and help us drive the best possible patient outcomes.
One interesting initiative we are involved in is the Dream Catcher, a collaboration with the Young Rheumatics (Unga Reumatiker) patient organization, Department of Pediatric Rheumatology at Karolinska University Hospital, Centrum for Rheumatology, Pfizer and the communications agency Gullers Grupp. The initiative aims to develop the Dream Catcher app, an innovative digital tool for young people with rheumatic disease and has received support from Vinnova, Sweden’s innovation agency. It is a great illustration of the good climate for co-creation that Sweden holds. As healthcare is becoming increasingly technical and has a tradition of focusing on the disease, we sometimes forget that patients are human beings with desires and aspirations. The purpose of the app Dream Catcher is to inspire children, young people and young adults with rheumatic disease to achieve their dreams and not be limited by their disease.
Pfizer is one of the largest pharmaceutical companies in Sweden in terms of sales and is still growing rapidly. What is driving your performance?
Back in 2010, Pfizer was in a difficult situation with many products losing exclusivity and a weak pipeline. In the past nine years, Pfizer has made a fantastic journey, prioritizing strategic research areas and forming research partnerships to rebuild its pipeline. The measures the company has taken to deliver a stronger, sustainable pipeline are starting to show an indication that we are on the right track and I believe Pfizer has the strongest pipelines in over a decade and positioned for future growth. Since 2011, we have had 38 approvals, an average of between four to five approvals per year, two to three new medical entities a year, and at least one breakthrough medication, which has fueled our growth globally and in Sweden. It clearly shows that we are serious about our purpose, to deliver “Breakthroughs that change patients’ lives.”
In Sweden, our recent performance has been driven by a broad set of medicines and vaccines helping patients to a healthier life. We have important products in all our focus areas – internal medicines, oncology, vaccines, rare diseases, inflammation & immunology and hospital. One real breakthrough for patients is Eliquis, an anticoagulant developed in collaboration with BMS used to treat and prevent blood clots and to prevent stroke in people with atrial fibrillation. As for the area with the biggest number of new medicines, oncology, we have at least one new medicine reaching patients every year. The largest among the newest cancer medicines is for patients with metastatic breast cancer.
In the area of vaccines, Pfizer has a vaccine protecting against TBE. Sweden is a country where the tick-borne disease TBE is highly prevalent and people are increasingly making sure they are vaccinated against this disease. Prevnar 13 pneumococcal vaccine is one of Pfizer’s largest products globally and is, of course, an important treatment in Sweden as well, even though not as big as it is globally. Vaccines are one of the greatest public health advancements of all time, resulting in the control, elimination, or near elimination of numerous infectious diseases that were once pervasive and often fatal. It plays an important role for Global Health and Pfizer have focused research on vaccines against major infectious diseases as well as previously unexplored areas. We are also taking major steps to address the serious global health threat associated with AMR and have a commitment to research to find new anti-infectives & antibiotics.
An area of true life-changing potential is gene therapy. By targeting the underlying cause of a genetic disease at the cellular level, we hope to restore normal function in affected tissues or cells, which could potentially enable a patient to manage his or her disease without the need for ongoing treatments. If we are successful, imagine the possibilities.
Going forward, Pfizer has the ambition to launch 15 new products between 2018 and 2022. Our current R&D pipeline has the potential to lead to between 21 and 30 approvals, and about 13 breakthrough therapies. This is truly exciting for us at Pfizer and hopefully as well for health care and patients.
When we spoke with Anders Ekblom, vice chairman of LEO Pharma and former CEO of AstraZeneca Sweden, he regretted the fact that the adoption of new therapies can take a long time in Sweden because of the regionalized healthcare system. How can Sweden accelerate the adoption of new therapies?
I think we can accelerate the adoption of new therapies by starting discussions early on with national and regional authorities. When it comes to advanced medicines such as gene and cell therapies, in particular, it is crucial to engage in early discussion on value as well as potential infrastructure and organizational changes needed to implement these technologies. At the moment, it is not certain whether European patients will be able to access gene and cell therapies in every country. Instead, specialist centres may be located in a handful of European cities. Countries wishing to become early adopters of gene and cell therapies must first adapt their healthcare system.
Sweden clearly has the ambition to become a frontrunner in these advanced therapy medicinal products (ATMPs). For instance, Pfizer is involved in the Centre for Advanced Medical Products, a collaborative initiative to accelerate the development and implementation of new ATMPs in healthcare, ensuring they reach patients. I am personally part of the board, together with academia, small biotech companies and other multinational companies such as AstraZeneca. Together, we work on solving issues regarding pricing models, manufacturing and healthcare implementation.
Ten years ago, Sweden introduced a National Cancer Strategy for the Future with a strong focus on quality and equity in treatment and six regional cancer centres were opened. Last autumn, the new government announced national investments in cancer care and the allocation of funds for a new cancer strategy. What is Pfizer expecting from this new strategy?
National investments in cancer care have improved patient outcomes and reduced waiting times. Today, Sweden is the country with the highest 5-year relative survival rates for all cancers in the EU by a strong margin. What we would like to see is an improvement on early diagnosis along with a centralized implementation of advanced biomarker diagnosis technology, which we see is crucial for precision medicine.
Pfizer has a strategic global network of 200 certified trial clinics called INSPIRE clinics, and three of them are in Sweden. What makes Sweden an attractive environment to perform clinical trials?
Generally speaking, Sweden is an incredible place for research and innovation thanks to its collaborative, inclusive, open and transparent environment. When it comes to real world data or real-world evidence studies, one of the strengths of Sweden comes from its personal identification system which makes it easier to keep track of patients. Moreover, Sweden has well-known national quality registries that companies such as Pfizer find highly valuable in order to understand the medical and patients’ needs for new products, as well as to follow up on treatment outcomes when a new medicine is being used by patients. Our global organization work with Swedish suppliers to analyze the real-world data and turn this into real-world evidence. For instance, in the case of our best-performing product Eliquis, we have been working with healthcare to look at real-world data in order to identify sub-populations and understand the value Eliquis has provided in the reduction of strokes.
With its facility in Strängnäs, Pfizer is one of the very few MNCs that still has a substantial manufacturing footprint in Sweden. What are the advantages of Sweden as a manufacturing location?
When it comes to manufacturing, Sweden has many advantages. First of all, contrary to stereotypes, the country has an attractive regulatory and fiscal environment with few unnecessary bureaucratic hurdles and a competitive tax regime. Taxes on property and energy are fairly low, and the corporate tax is close to the EU average. Second, the level of automation in our production process is high and we benefit from the closeness with many prominent Swedish automation companies such as ABB. In addition, Sweden boasts a highly skilled workforce in the fields of engineering, AI, automation and digitalization. Finally, Sweden is a stable country in every sense of the word: economically, politically and environmentally. In other words, events that might disturb production, such as strikes or environmental catastrophes, are rare.
Swedish companies are at the forefront in integrating a sustainable approach to business in their strategies and daily management. In this regard, what are some of the best practices the local affiliate has implemented from which the group can learn?
Pfizer is a fantastic company which values cultural diversity and leadership. We are a purpose-driven organization with strong values. Globally, the company is dedicated to enhancing diversity, not only gender and ethnicity but also different perspectives and backgrounds. Pfizer is keen on making sure that everybody’s voice gets heard and is valued.
In the Swedish affiliate, we put a special emphasis on people’s wellness from a body, mind and soul perspective. For instance, a few years ago, we trained all of our employees to mindfulness techniques during a six-month period. It is my strong belief that if people are not healthy, not only physically but also mentally, they cannot perform at their best. If people feel the company cares about their points of view and their holistic health, likely that is a place you want to work at.
You have been CEO of Pfizer Sweden for the past five years. What would you like to accomplish during your next five years?
I hope that we will have more dynamic partnerships. I would love to see an “explore hub” where Pfizer works in partnership with academia, healthcare, patients and technology companies in order to design solutions that increase the value of our medicines. I also hope we will work more closely when it comes to clinical trials, and that Sweden will be the first country to offer new ways to conduct clinical trials through digital technologies. Finally, I would like for us to take a big leap when it comes to the way we work. We have moved from traditional sales and marketing to more design thinking, collaboration and partnerships the last decade and we should continue in this direction. I think it is the way forward in order to get the best output for healthcare and patients and to make breakthroughs that change patients’ lives.