As a worldwide research powerhouse, Sweden is benefiting from the presence of multinational clinical research organizations like PPD. Martina Stenerdal, general manager for PPD in Scandinavia, discusses the company’s 25-year presence in the Nordic region and the unparalleled advantages of conducting clinical studies in Sweden.


Martina, you have been leading PPD’s operations in Scandinavia since 2015. Can you talk about your main achievements and journey during this past 4 years?

We have grown because we have developed strong outsourcing partnerships. Over the last several years, the type of trials has changed and has moved more toward rare diseases, vaccines, oncology and paediatrics. That is where we see research and development going in Sweden and Scandinavia.


We see that, prior to joining PPD, you accumulated a decade of experience working inside the hospital setting and another decade within the industry with Nycomed (now part of Takeda) and AstraZeneca. How has that experience helped you lead the PPD affiliate here?

That experience in big pharma, along with my long tenure in hospitals, has been very beneficial. It has helped me understand the environment and conditions, but, most of all, it has allowed me to learn how to collaborate with people and form winning teams. When I moved from a hospital setting to the pharmaceutical industry, it took some time before I was able to realize the benefits of what I had done, since my job as a midwife was very rewarding. It has been a great experience working first with a small marketing company, Nycomed, where we worked closely with regulatory affairs. That is where I learned how the whole chain works and the importance of working alongside doctors and users. Then, when I joined AstraZeneca, which is such a large organization, the opportunity presented itself to learn the full development process, from preclinical to marketing. Both were great experiences that allowed me to observe the challenges of developing new drugs, which obviously is more complex than it may seem.


PPD is one of the largest CROs in the world. Can you explain the company’s presence and footprint in Sweden?

Next year, PPD will be celebrating 25 years of presence in Scandinavia. We also have an office in Denmark, but the whole region is managed through the Swedish office. We consider the four countries as one region, but Norway, Sweden and Finland make up Scandinavia. We have office-based and home-based employees who work closely together, many of whom have been with PPD for over a decade. Some of them started as project assistants and have worked their way up to management roles. We have a highly experienced team and a good network.


Do you offer the complete portfolio of services in the region?

We get all of our assignments globally. We do mostly clinical monitoring and regulatory affairs, while Evidera is expanding and building a Nordic hub in Sweden. We can perform all of the other global services offered by PPD.


How has PPD helped develop all of 2018’s top 10 biologics and how did the company’s Scandinavian operations contribute to this achievement?

Most of that was performed at a global level. However, Sweden has many startups and biotechnology companies, which offers a great window of opportunity for PPD to contribute to the regional industry’s R&D efforts. When I joined PPD in 2012, much of the company’s focus was on big pharma. In the time since, that approach has changed dramatically thanks to a shift in the local landscape. PPD has developed the expertise, skills and tools necessary to provide comprehensive services to local biotech and mid-size companies.

We continue to change our mindset to better understand the particular needs of smaller companies that maybe less experienced with clinical trials. Most of them have one or two molecules that are the focus of their attention. Their future might depend on them, so they are keen to being involved in the process, which is very different from working with a big pharmaceutical company that is used to outsourcing trials.


Cell and gene therapies are expected to grow at a rate of 1,000% in the next five years. How has PPD been working with these novel therapies in the country?

PPD is supporting a wide variety of new projects in Scandinavia, selecting sites that are capable of providing patients and resources. Gene therapies will be part of the future of health care and PPD is ready to be part of that development.


How does PPD continue to differentiate itself from your competitors in the country and the region?

In the Nordics, we have an outstanding track record in following up. We are always looking to work with the local market companies’ representatives, and we have regular meetings with many of them to discuss how PPD can support them. Companies here also are very happy to help us in return. We have the same goal: to attract more studies to our countries because our clients, especially larger companies, are also competing to bring trials to the affiliate’s country. We have a common goal: building good relationships.


Research! Sweden’s annual 2018 report shows that the number of initiated drug evaluations in Sweden has reduced in half, from 218 in 2004, to 109 in 2016. In your experience, why do you believe are the reasons behind that decline?

One possibility is that other countries are faster to recruit patients because they have a more diverse population and Nordic patients do not meet the required criteria. In a sense, we are victims of our own success.


What efforts should the industry and public sector take to become a leader in clinical trials again?

We are members of ASCRO, the Swedish association for CROs, and LIF, the Swedish Association of the Pharmaceutical Industry. Because of that, we are able to work across the industry to look at new ways to enhance the country’s position. We are working hard to bring more clinical studies here, while making it easier to work with patient organizations and hospitals. We have seen that the staff in hospitals have a high workload, which prevents them from dedicating time to research. We have to establish a holistic approach to prioritize research across the health care system.


One of Sweden’s unique assets in the eyes of the life sciences industry is the great Quality Registries. How does PPD leverage them to produce better outcomes for its partners?

We are doing it mostly through Evidera. They are performing registry studies and hybrid studies. PPD is supporting them in that development. The data available in the region is a mine for any pharmaceutical or medical device company.


What can the audience expect from PPD over the next 5 years?

We would like to expand even further so we can utilize the company’s global expertise, coupled with its unmatched tools and knowledge. We also would like to work more with virtual clinical trials because Sweden is a highly innovative and IT-mature country. Telemedicine is big in the country because everyone has a smartphone and the country invested early in digitalization. That gives us an advantage over the rest of the world.