Amgen’s Mohammed Nasser casts his eye on some of the key trends affecting healthcare and the life sciences in the Middle East and Africa, including a significant maturity in uptake of digital and telehealth tools, better synchronisation of electronic medical records, and how artificial intelligence can be used to better understand the economic impact of diseases. Nasser also outlines his key priorities as vice chair for PhRMA MEA’s executive committee, the relevance of the UAE to Amgen as an innovation-friendly early launch market, and the qualities he looks for in new talent joining the company.
Since we last met around nine months ago, what have been some of the key healthcare trends taking place in the Middle East & Africa (MEA) region?
Some of the trends we have seen in the last couple of years continue and are shaping up further, especially in the fields of digitalisation and telehealth. After COVID the interest in these areas grew, and now they are maturing. For instance, patients are adopting these technologies and are interacting at a higher level and frequency with their providers via telehealth services and digital patient support programs (PSPs).
Furthermore, in terms of electronic medical records (EMR) there is improvement in syncing laboratory data and prescriptions. Many private hospitals in the region have started combining patient services (like home care, post-discharge care etc) with more data integration which is better for patients and can be leveraged to enhance the effectiveness of research.
The new buzzword and booming trend is artificial intelligence (AI) and how it can be applied to healthcare and used to accelerate patient data integration and disease management decision-making. One of the key applications of AI is leveraging it to better understand the total economic burden of a disease throughout the patient journey and how we can improve outcomes and maximize the impact of healthcare investment.
Do you believe that AI has the potential to allow less-developed nations to leapfrog some of their more developed counterparts in terms of healthcare provision?
Yes, absolutely! Almost every country in the MEA region jumps to mind.
Technology has always been a key enabler of rapid development for countries in this part of the world. Years ago, landline phones were hardly nine or ten lines per 100 households and communication was a challenge. With the introduction of mobile networks, which now have a penetration level between 90-200 percent, the ecosystem and use of technology have changed dramatically leading to a booming spread of knowledge. I believe AI in general and in healthcare, in particular, will lead to a similar revolution in knowledge and accelerate engagement by allowing us to step into terrains that were not explored before.
Could you outline the scope of your new position within PhRMA’s MEA organisation?
I now serve as vice chair for PhRMA MEA’s executive committee. The chair, Patrick van der Loo, is also a new appointee, and both of us have been part of the executive committee for some time now. The industry has a live and defined agenda as well as a set of challenges and opportunities such as IP and access to innovation that drive our priorities.
Our focus is to build a strategy for the next three to five years and look at how we can shape the future and narrative of healthcare and pharmaceuticals.
We are also looking at developing solutions to better enable and empower affiliates to create effective working relationships with local healthcare bodies while leveraging common opportunities and solutions across MEA as well as prioritising engagements with key stakeholders to frame healthcare as an investment and a key driver for economic growth and prosperity which will ensure better patient access to innovative medicines.
Many companies in the region have had some high-profile challenges, and some big players have even left certain geographies. What are the challenges, and benefits, of being a big pharmaceutical player in the region?
Many countries across MEA are enhancing their healthcare systems and regulations and are doing so with great ambition. On the other hand, there are numerous unmet needs that cannot be single-handedly solved and require strong partnerships with different stakeholders including local players via the appropriate business model. This will create novel approaches to access to innovation, organizational structures, use of technology and higher focus on certain areas while collaborating on others. These partnerships will yield solutions to these unmet needs through smart resource allocation and an agile approach.
Amgen had a slower 2022 than many expected at a global level. How have you been able to perform as a company in the region?
2021 and 2022 were highly successful years for us despite the known pandemic challenges. IQVIA analysis confirms that Amgen was among the fastest-growing in the MEA region. Additionally, IQVIA’s 2023 analysis is showing a very good trend with a significant increase in volume. In fact, we never envisioned we would reach this many patients and launch these many products, so we are quite excited. Overall, the past three years have been fruitful.
For growth, we must always balance looking at volume and value, especially given the price pressure environment. There is a significant opportunity to reach more patients across different segments in MEA by partnering with payers and healthcare providers in the long term view to create diverse solutions which suit particular segment needs and help healthcare bodies cover more patients, this sometimes results in a growth in volume that is faster than the growth in value.
The UAE is not the biggest pharmaceutical market in the region. What is the importance of this nation for Amgen’s operations?
The UAE is a priority for us at Amgen because the value of a market is not solely defined by its size, there are other factors at play.
First is speed to market, meaning how quickly a product is registered. Then there is the speed at which the drug will reach the first patient. The UAE has significantly accelerated the registration of innovative products and is developing solutions to accelerate the time to reach the first patient across different healthcare bodies.
Second is the span of healthcare coverage. Every resident in the UAE is covered. We partner with government payers and private insurance companies to realize the opportunity of accelerating access to innovative medicines at the same speed of registration.
The third is the predictability of the market. The UAE healthcare ecosystem has a stable outlook, which reduces business ambiguity and allows us to plan well ahead.
Looking at Amgen’s upcoming pipeline, do you envision the UAE being an early launch market for the company?
The simple answer is yes. The overall healthcare environment in the UAE encourages innovation and the launch of new products. The challenge facing patients and pharma companies is how quickly medicines actually reach patients. The industry has to work with various healthcare bodies to introduce a product to every formulary which takes quite some time while patients cannot wait.
Much of the medicine pricing debates in Europe and the US have been driven by the concept of ‘value-based’ assessments. Is this a realistic goal in the region?
Yes, and the R&D-based pharma industry is very supportive of value-based assessment, and with AI even more so. Historically, data has been spread out, with patient records being in one area, lab records in another, and so on. AI would bring it all together, which would in turn speed up decision-making processes and allow for faster health technology assessments (HTA). Integrating and analysing all this information together for example would allow us to see the exceptional impact of medicines. It is known that 90 percent of healthcare expenditure is directed towards non-medicine interventions like administration and hospitalization, while medicine constitutes only 10 percent of that budget and despite that, unfortunately, the payor’s first action is opting for medicine budget cuts. AI-activated assessment could more objectively show the impact of that 10 percent on the overall disease economics and the associated potential savings, which could be a real game changer on how to construct overall healthcare budgets.
Is Amgen’s increasing global focus on rare diseases being reflected in its regional portfolio today?
At Amgen, our aim is to transform how patients, physicians and caregivers fight serious illnesses, some of which still being undruggable, and where we can create the deepest impact in key areas like cardiovascular disease (CVD), osteoporosis, oncology/ haematology and nephrology.
For example, CVD in the MEA region continues to be an area of utmost priority since it is the leading cause of death¹ and the same time the good news is it is preventable. Locally, myocardial infarctions (i.e., heart attacks) occur 10 years younger than the global average². Elevated low-density lipoprotein cholesterol (LDL-C), known as “bad” cholesterol, is recognized as a major, modifiable risk factor for cardiovascular disease ³ and when managed, can help prevent heart attacks and strokes. Familial Hypercholesterolemia prevalence is 1:112⁴ which is double the global average of 1:250. We must act now and with a high sense of urgency to tackle elevated LDL-C levels.
Another modifiable disease is osteoporosis. In MEA, the diagnosis rate is significantly lower than the global average and mortality rates are 2 to 3 folds higher than western populations⁵. That’s an area where we can also bend the curve.
Having been in management for a long time, what qualities do you look for in potential new employees today?
We learned a lot from the pandemic and emerging technology and today I see three key hiring success factors. Firstly, agility. This is being able to adapt to different challenges and concepts and change directions at high speed as well as having the ability to unlearn. Secondly, diversity. This is not just from a social perspective, but it is also about the skill to accept new thoughts and ideas. Finally, the ability to execute in a team, since a team achieves better results than the sum of each individual achievement towards a common goal.
Looking ahead, where do we see Amgen in the region in the future?
Amgen’s mission is to serve patients and in MEA we focus on reaching significantly more patients. The region has 1.2 billion people and pharmaceutical companies currently barely reach half of them. We must work further towards equitable health and access for all. A key enabler to achieving this is partnerships with both the public and private sectors and adapting our business model accordingly. We continuously work on developing solutions with healthcare providers and payers to expand coverage in our focus TAs like here in the UAE. In other markets where we are not directly present, we develop partnerships with local companies to serve that mission.
References
- World Heart Federation.
- Yusuf S. et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004; 364:937–52.
- Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-952.
- AL Habib K, et al. Familial Hypercholesterolemia in the Arabian Gulf Region: Clinical results of the Gulf FH Registry. PLoS One 2021; 16(6).
- Baddoura R. et al. Osteoporotic fractures, DXA, and fracture risk assessment: meeting future challenges in the Eastern Mediterranean Region. J Clin Densitom, 2011. 14(4): p. 384-94
