Mirela Iordan country manager of Pfizer Romania reveals some of her milestones, including integrating new acquisitions and setting up the first financial centre in Europe for Pfizer. She shares her insights on how the affiliate is working to maximise patients’ access to the latest innovations through patient assistance programs, early access programs, and the Pfizer Care program. She highlights Pfizer’s efforts to improve the patient journey by investing from the moment of registration to the point of sale in pharmacies.
What are some of your milestones and achievements while leading this affiliate for the last four years?
I am a medical doctor by background and my aim throughout my career has always been to serve the Romanian patients. In 1997, I switched over to the pharma side and have been working for the last 21 years for Pfizer.
I joined as an HR director, and alongside human resources tasks, I oversaw the integration of various acquisitions for Pfizer in Romania and the region. The first of them was Park Davis, which added Lipitor (Sortis) to our portfolio. Thereafter, Pharmacia and Wyeth have been added as well as the manufacturing site of Ferrosan in Cluj in 2011. As the investments of Pfizer grew, so did the scope of my role, and I was trusted with the oversight of USD five million for expansion projects. Hospira’s manufacturing site in Austria was also integrated under the Pfizer umbrella. Additionally, I was given a regional position and was overseeing the Czech Republic and Slovakia from an HR perspective.
Amongst my achievements, was setting up the first financial centre for Europe in Prague and managing the hiring process of the talents required. This was a challenge to find the right people with the necessary linguistic skills. After this experience, I had the opportunity to be elected as GM of Romania effective December 2016, after the competitive process.
Since 2017, I have been elected on the board of directors of the American Chamber of Commerce (AmCham) while leading the healthcare committee. Additionally, I have joined the Local American Working Group (LAWG) as an executive secretary, and the Romanian Association of Manufacturers of Medicines (ARPIM).
How do you navigate the difficult environment and ensure that patients get access to the latest innovations from Pfizer?
Pfizer works closely with the patient associations as patients’ wellbeing is at the top of everything we do; trying to champion their voices and raise their concerns for earlier access in the reimbursement process. There are certain legal mechanisms to facilitate access to innovations, either through donations, co-payments, or early access programs. These try to shorten the period until the medicine is available for the patients.
Oncology is Pfizer’s area of major investment in which it has a first-class breakthrough therapy with an accelerated approval process in the US. In Romania, the approval process is on average 43 months after it has been approved by the European Medical Association (EMA), and patients suffering from late-stage breast cancer do not have the luxury of waiting for this long. In such circumstances, when no bridging process can be found, Pfizer donates the medicines to hospitals that request it. Half of Pfizer’s investments are done through donations, as a means to bring innovations to the patients.
Another very important medicine belongs to a new class of anticoagulation agents, widely prescribed worldwide to prevent life threatening complication of atrial fibrillation This medicine is in the affiliate’s portfolio and has not been reimbursed for the last seven years. At this stage, patients must pay for it out of pocket and Pfizer covers 40 percent of the treatment cost for a patient for five years through a co-payment system. This represents millions of investments to assure that the patient can receive treatments with this product.
Rare Disease is another core area of our presence in Romania, serving patients afflicted by some of the most devastating diseases. We work closely with the medical community, patient associations, and payers to make our innovative breakthrough medicines accessible and available early so that lives are changed for better. We aim to offer solutions in the field of disease awareness programs, continuous medical education, and access to genetic diagnostic testing. Pfizer is also committed to the education of healthcare stakeholders to incite several pressure points, in the hopes of creating more action from the authorities. On February 29th Pfizer celebrates Rare Disease Day to create more awareness. There are over 7,000 such diseases, so it is critical to identify the patients and have a proper screening process in place.
How can Pfizer be a partner to key stakeholders to facilitate access to medicines in Romania?
The imperative is to be in the front-line and have the courage to provide evidence to policy- and decision-makers. This starts with drawing attention to the areas where Romania is falling behind compared to other countries in Europe or Central Eastern Europe. We try to educate them about the value of innovation and how this saves lives and reduces the burden of disease on the healthcare system and healthcare professionals. We also talk about the economic value of our medicines. We then offer solutions that draw on best practices in other EU Member States and are tailored to Romanian reality, such as innovative contracting agreements and pay for performance agreements with the payer or filling in the gaps in optimal care and treatment by mobilizing our resources.
We, among other peer innovative companies, are a prime source of continuous medical education, helping Romanian doctors to deliver care and treatment according to the latest scientific data and information. We help them to keep abreast of the latest scientific knowledge which translates to better outcomes for their patients. Clinical trials are another way of facilitating Romanian contribution to the global quest for research and development of better medicines and vaccines.
We work closely with patient associations, understanding their needs and perspectives on the hardships they are facing in their pursuit of a normal life. We often support their initiatives such as disease awareness, medical services towards their members to secure an optimal patient journey, or sharing best practices from other countries.
Last but not least, we promote Romania as a prime place for investments, thus benefiting the local economy, ultimately increasing in time the country’s capacity to provide better care for its needy patients. We are proud that Romania has been selected by Pfizer to host two regional hubs which serve a third of the world in supply logistics services and rare diseases.
How much of the global portfolio is currently present in Romania?
Globally, Pfizer has 600 molecules in their portfolio, including well-established medicines which lost patent protection and innovative medicines. In Romania we commercialize almost all of our innovative medicines and more will come as we clear regulatory approvals, including advanced biologic therapies for oncology, rare diseases, inflammation and immunology, and internal medicine. Hospital products such as biosimilars and sterile injectable products represent an important part of our portfolio. Our well-established medicines portfolio is serving more than one million patients in Romania. More recently, we have been building up our vaccine portfolio, addressing significant preventable communicable diseases such as pneumococcal and meningococcal vaccines.
Are you planning to bring any innovations to the market this year?
Seven products are planned to be launched this year. For the last two years, Pfizer has launched new products globally yearly, which is a testament to the continuous investment of the organisation in R&D.
The dossiers are awaiting pending evaluation and approval from the local agency. One of the major products that we hope to launch this year, is one of its kind and is an antibiotic for fragile patients hospitalized in the intensive care unit. This is a lifesaving drug, as patients have only a few hours to take it once they reach a critical stage. Even if it concerns only a few patients, this high impact drug should be a priority.
There is an oncology drug, an inflammation biologic, two major indications for psoriasis and ulcerative colitis, as well as a new formulation for haemophilia that are awaiting approval.
Recently, we have registered a novel medicine for cardiomyopathy, a disease with a very poor prognosis. We made the medicine available to the first patient in Romania through the Pfizer Care Program before it was officially endorsed. Through this program, patients are directly supervised by clinical trial researchers, and carefully monitored by the investigators.
Where do you want to take Pfizer Romania in the future?
I want to maintain Pfizer’s reputation for outstanding governance while ensuring that the good practices are shared from one department to another within the organisation: especially clinical trials. Furthermore, the aim would be to continue to push for an accelerated reimbursement process by providing more real-world evidence. This is crucial for products in the field of haemophilia, anti-infection, vaccines, cardiology and oncology. Additionally, ensuring a high level of quality of delivery and appropriate supply of medicines at the point of sales is a priority.
Through the associations, I want to continue to advocate for alternative sources of funding as the budget cannot remain at the same level without any adjustments. Gene therapy is one of the dreams that we would like to bring to the country. Personalized medicine needs the support of the government and requires extensive education on the subject, which partnerships with genetic testing labs can fulfil.
What is your motivation to keep working after 20 years?
When I see patients and their families who put their faith in Pfizer—hoping that we can support them through our financial resources and care—this gives me the motivation to keep fighting for them and continue to bring them the newest innovation.
This gives me the energy to go the extra mile, to be involved with different organisations, events, find new solutions, and propose different models such as risk-sharing ones.
I was nominated for the “Women Who Changed Romania” award, and I was grateful to have my efforts recognized. This meant that I was doing the right things.
