Maria Fernanda Prado highlights some of the lessons drawn from her extensive experience in emerging markets which remain applicable in her current role as Janssen’s managing director for the Benelux region. Belgium, the home country of Dr Paul Janssen, continues to be a significant part of the company’s global operations, including as the location for its first cell therapy (CAR-T) manufacturing centre in Europe. Prado outlines how commercial operations dovetail with manufacturing and R&D activities, and how she tries to cultivate a talent and leadership pipeline on par with Janssen’s own robust product pipeline.
By investing so much in the Belgian ecosystem, we can be an important player on several fronts, leveraging the voice of the innovative industry
Given your experience in both developed and emerging markets, how does it feel to be in a country like Belgium, where the Gross Domestic Product (GDP) invested in health is double that of some of the other geographies you have experience in?
There are definitely meaningful differences. Belgium has a much broader system in terms of proportional coverage of patients, the overall timing of launching innovations and expertise in clinical trials. At the same time, it is also true that European governments in general are under budgetary pressure because of the macro environment here and the effects of inflation in our economies. So, while Belgium is not an emerging market, my experiences in regions with higher levels of uncertainty have prepared me for this role in Benelux and Europe in its current context. Working in emerging markets is about managing unpredictability and ensuring your innovative pipeline can reach patients despite these factors. This is a useful experience, given the pressure the European market faces today.
Janssen has a significant heritage in the Benelux region. Can you tell us how the opportunity to take on this role came about?
Benelux is indeed a great opportunity. Janssen has a strong footprint here, with a clear investment end-to-end, from discovery and development to commercialization of its innovative treatments. By investing so much in the Belgian ecosystem, we can be an important player on several fronts, leveraging the voice of the innovative industry. As a result, my role comes with more responsibility.
Thinking about that, in January we reorganized our Benelux structure, to allow us to be more country focused and have more dedicated resources on the ground in these important markets. Since then, we have worked with a dedicated management team in each country. With how the external environment and market access challenges are evolving in both Belgium and the Netherlands, we felt this was the best fit to better improve access to innovations for patients in the region.
What is on the agenda for this role and for the Benelux affiliate?
When I took on the role, the mission was to look at how we could keep improving our presence in Benelux and, with our innovative portfolio, make a difference for patients in this region.
As my assignment began at the end of 2021, and we were still coming out of the COVID-19 pandemic, the challenge was to resume our connections as we used to do before, but in a different challenging environment. Therefore, my initial priorities when I arrived in Belgium were to re-engage our people, understand the culture, and connect with stakeholders in this new context.
After 18 months in the role, and with the country set-up implemented, our priority now is to prepare the market for the upcoming launches, while maintaining our high standards for serving customers in all of the therapeutic areas in which we are present.
How well represented do you feel Janssen is with its portfolio across doctors, hospitals, and patients in Belgium?
For each of the therapeutic areas we cover in our portfolio, we are among the top players, with a noticeable presence. We are very well positioned in Belgium, from R&D to clinical trials, production, distribution, and commercialisation of our medicines. In that sense, all our recent innovations are available, with more treatments on the way to reach patients in Belgium.
What parts of Janssen’s Benelux portfolio do you feel are most significant?
As you know, Janssen has a strong heritage in neuroscience, as a legacy of Dr Paul Janssen. This is a field in which we have been present for decades, starting with areas such as schizophrenia, epilepsy and Alzheimer’s Disease, and more recently moving into the area of depression as well.
Another area where for years we have been contributing substantially to improved care and meaningful outcomes is haematology and oncology, particularly in the fields of multiple myeloma, lymphoma, and prostate cancer. Soon, we hope to launch more transformational medicines for certain types of blood cancers and solid tumours.
Another area where Janssen has a strong footprint is immunology, with an extensive portfolio in multiple indications, benefiting many patients also in Belgium.
Finally, we have a leading presence in Pulmonary Arterial Hypertension (PAH) with the acquisition of Actelion years ago, and the heritage and pipeline they added to the organization.
Are there specific therapeutic areas that face more challenges in terms of market access and pricing?
I would not call out a specific therapy area where it is more difficult to obtain reimbursement and allow patients to have access to innovative medicines. I would rather reflect on the lack of readiness of the system to evaluate upcoming innovations, especially when considering precision medicine and cell and gene therapy.
We are on the verge of the next innovation cycle, which will be to offer tailor-made treatments, addressing specific patient profiles, that consequently will demonstrate superior responses. It is becoming less ‘one size fits all.’ Therefore, the new paradigm of the industry will not be to produce at a large scale for all but customize the treatment to complex diseases, which is even more relevant for our ageing population.
To ensure that this new generation of medicines and treatments reaches patients in need, the reimbursement system will have to evolve at the same pace as science.
Belgium has been selected as the location for Janssen’s first cell therapy (CAR-T) manufacturing centre in Europe; can you tell us more about why the country was chosen?
I think that the choice of Belgium as the European CAR-T production centre is a positive testimony of the value of the country in terms of innovation capacity and quality of people. There is an appetite for the development of new technologies here, beyond the fact that geographically Belgium benefits from its central location.
How will this CAR-T manufacturing piece play into your country strategy, especially given that CAR-T is a therapy which benefits from proximity between the patient and the manufacturing?
Proximity is indeed important for this technology. Having the CAR-T campus in Belgium is an opportunity for us to gain experience, optimize process timelines and collaborate with the local ecosystem. More importantly, we will be able to gain traction to address the overall unmet need in the European market.
Jennifer Taubert, J&J’s EVP and worldwide chairman, Pharmaceuticals has set the ambitious goal of Janssen reaching USD 60bn in sales by 2025, an 8bn increase over the 2021 figure. Do you think this is possible in Europe?
Europe indeed plays an important role in our group strategy. This goal is based on a combination of existing medicines, line extensions, and new products to be launched. As the company has been diligent in ensuring we prioritize investments where we can make the most difference to patients, I do think we have an achievable ambition.
With our increasing presence and more innovations to come, especially in the fields of haematology, oncology and immunology, we have the foundation to sustain our growth, which obviously needs to go hand in hand with the evolution of the assessment of new technologies in our markets and the readiness of the systems.
When you work in emerging markets, one of the skills you develop is to extend the life of your existing portfolio, which people often lose sight of in developed markets. Is this a skill that is interoperable?
Actually, I see a substantial difference in terms of the dynamics between developed and emerging markets. The time to innovation in emerging markets is longer, given the different priorities in their healthcare systems. For developed markets, usually with a larger older population, the demand for innovation is higher and timelines tend to be shorter.
For me, it is all about how we, as a global company, leverage the two experiences to make the biggest difference to customers and patients. This means that emerging markets can benefit from the launch experience in mature regions, while the last ones can leverage the experience of life extension from emerging markets, ensuring a competitive presence in the two types of portfolios and markets.
How would you assess the current levels of market access in Belgium and what do you see as the key trends influencing them?
I think the entire sector is highly committed to ensuring that Belgian patients have timely access to its innovations. At the same time, I also see that we have a growing concern with hurdles and challenges we are facing in the system, now and in the future.
As I mentioned, science is evolving at a high speed, at the pace of hard-to-treat diseases. Meanwhile, the assessment of medicines is becoming outdated, not fully ready to properly value these innovations, thereby generating delays in reaching patients who are left with no other treatment options. This is true in many markets, including Belgium.
To evolve the systems, we need to have a collaborative approach between governments and the industry, co-creating solutions to ensure the sustainability of the system while paving a faster way to reach patients, making viable risk-sharing models and enabling data as an important source of information and decisions.
What is your response to the NIHDI’s new medicines roadmap?
While I think the intentions are good. I do believe the proposals would be better designed if NIHDI had involved more parties in the discussion to improve the current system.
Especially with the ambition of Belgium to be a biopharma valley that attracts continuous investment and innovation to the country, the roadmap should reflect a modern framework, better preparing the country for its future needs in healthcare.
I believe that there is a need to improve the evaluation of new compounds, ensuring earlier access to promising treatments, supported by data generation. I also see the value of conventions to encourage risk-sharing agreements, which may be disregarded in the proposed path. Personally, I am worried about the risk of discouraging the launch of innovative medicines in the country, contrary to what the government preaches.
So, I would expect an open and collaborative approach on this matter, as I see this is a prominent culture in Belgium, calling on different industry experts to craft the roadmap, and better understanding all the consequences that some decisions can trigger.
What would you like to personally achieve during your tenure in Benelux?
I am proud that we have taken the opportunity to redesign the organization to be closer to customers, stakeholders and patients, better interact with the ecosystem, to leverage all the potential that we have here.
We are still at the beginning of this journey, so now it is time to mature the changes we promoted, based on synergies we have as a cluster in Benelux, with more external focus thanks to our country set-up, that will allow us to better serve our patient needs. It was my mission to ensure that we were well-positioned for the future, and I think we are on the right track.
I am also proud that we composed new leadership teams, extremely talented and diverse, to drive the organization for new highs on our way forward.
Can you tell us more about how you consolidate a great team and make Janssen attractive to new talent?
One of our key priorities, beyond launching our amazing product pipeline is to form a great leadership pipeline. For that, we prioritize our people’s development and talent management.
We have the luxury to have very qualified, engaged, and passionate people, which makes our ambition of having the best team in the country easier. We have initiatives that allow short-term assignments, to boost the experience of our professionals, according to their development plan, combined with mentoring and coaching programs.
Another important agenda that generates high engagement and pride in our organization, is our focus on Diversity, Equity and Inclusion, with great participation and activities created in a bottom-up approach, to what is perceived as opportunities of improvement in our teams. The idea here is to promote a work environment where everyone feels they can be their authentic selves, with the sense that this is our Company, where we truly belong, with the common purpose to make a difference in the lives of so many patients we touch with our treatments every day.
Would you advise your teams to experience different emerging markets, given that this is perhaps the future of our industry?
Definitely! Johnson & Johnson is such a rich organization, with a global presence, with different sectors, that we encourage our talents to experiment with different environments and businesses, to gain diverse experiences and new perspectives. This is great for their development & careers, great for the company in forming future leaders, and great for our countries, to count on highly qualified professionals with a robust background in improving healthcare systems in diverse geographies.