Amgen’s Middle East and Africa General Manager Mohamed Nasser discusses the company’s approach to the region; the opportunities in the Saudi market, given its improved regulatory environment; and the disadvantages of its reference pricing system. In addition, Nasser explains Amgen’s approach to Saudization and the company’s place within Saudi Arabia’s Vision 2030.
What attracted you to Amgen as one of the last big independent biotech companies and what is your mandate?
It was interesting to join a company that is a little younger than me! As a pharmacist by education, I was very impressed by Amgen’s innovative products, high-quality manufacturing, excellent supply chain and great people. I didn’t hesitate for a second when I had the opportunity to join.
Amgen is only 40 years old and was born at a time when many companies were already active in the Middle East. Amgen began its Middle East operations just a few years ago through a distributor model and is now establishing a direct presence market by market. Therefore, my mandate is to look at the best possible ways to enhance the company’s footprint in the Middle East and Africa to reach more patients.
In general, the MEA region is not short of opportunities, the challenge is to prioritize the opportunities in which we can have the deepest and fastest impact. We are working to balance disease area needs, countries and segments with our resources.
Which markets are you overseeing and how have you been prioritizing them within Amgen’s overarching regional strategy?
Amgen has a presence in 16 markets across the Middle East and Africa. We are operating in all six Gulf countries: Saudi Arabia, UAE, Kuwait, Bahrain, Oman, and Qatar. We are also in Algeria, Morocco, Libya, Tunisia, Iraq, Egypt, Jordan, Lebanon, and South Africa. In some cases, we have a direct presence and in others, we work with distributors, but patients in all those countries have access to our products.
Our approach has been simple: we look at ways in which we can have the deepest and fastest impact on the lives of patients. But we must also be judicial in choosing where we establish ourselves, given that some countries require 100 percent local ownership, others require a 50-50 model and so on.
To be successful, we always keep compliance in mind. This is not just in terms of ethics, which are non-negotiable, but also in terms of quality to ensure that products reach the patient in the optimum conditions. On a positive note, healthcare coverage expansion in the region over the past decade has provided companies like Amgen with an unmissable opportunity to reach more patients.
Can you outline the significance of Saudi Arabia within Amgen’s regional strategy, especially given the fact that it is the price reference market for many other countries in the region?
Saudi Arabia is the key country in the region because it represents about a third of the Middle East and North Africa (MENA) region’s economy. Additionally, Vision 2030, which has driven decision making in Saudi over the past few years has made healthcare and the life sciences a fundamental part of national strategy. The Vision has very specific KPIs in therapeutic areas like cardiovascular so companies like Amgen know well how they can contribute to the strategy.
The reference pricing system is common in many countries around the world, especially those of very similar healthcare structure, reimbursement systems, economic conditions, and costs of doing business. However, when reference pricing is used across dissimilar countries it might not be as rewarding for innovation. For instance, referencing private market price to reimbursement or tender prices in another country does not appear to be particularly relevant.
Overall, as with taxation and subsidy schemes, a country needs to have a system that serves its national objectives and rewards innovation. Some countries want to attract innovation and investment while others are totally focused on healthcare budgets or costs of hospitalization etc. Accordingly, a pricing system should follow.
Another example is that the industry works closely with public sector actors to help them meet their budget ends. However, cutting list prices in the private sector does not serve the patient nor reward innovation. Rather, it shifts revenue from the high-risk R&D based pharmaceutical industry to the insurance industry, which is more service-based. This could cause an imbalance in the industry’s innovation risk-reward calculations and delay access to innovation.
You mentioned that one of the things that attracted you to Amgen was its innovative portfolio and pipeline. What has been your experience of introducing new products to the Saudi market?
We are observing an acceleration of product approvals in Saudi Arabia in part due to the keen efforts of the Saudi FDA. They are accelerating registration and early access programs where patients can access medicine at the same time of submission to the US FDA and EMA. This system is coming together behind Vision 2030, speeding up patients’ access to innovation on a par with developed countries.
Almost all of Amgen’s portfolio is registered in the Saudi and one product is currently under review by the Saudi FDA. We have launched almost four products over the past three years. Well educated healthcare professionals are quite keen on adopting innovation for their patients.
While procurement is moving towards unified purchasing, products must go through an independent formulary assessment by each major hospital or health authority, such as the MOH and National Guard. This process requires hospitals, health authorities, and companies to devote more time and resources than they would in countries with unified national formularies
Clinical trials are growing in significance in Saudi Arabia as a good way to expose patients and clinicians to innovation, and an incredible number of resources have been dedicated to infrastructure building. How important are clinical trials for Amgen’s strategy in Saudi and to the country’s regional ambitions?
They are very important. We have several clinical trials running in Saudi, some of them initiated by local institutions and some as part of global trials. Improved regulations, good infrastructure, medical talent, and patients with unmet needs form an environment that looks set to attract even more trials. Additionally, several CROs are now present in Saudi Arabia, which gives Amgen more operational confidence to conduct world standard clinical trials.
Beyond clinical trials, I believe that logistics can be another interesting area for Saudi Arabia. The country’s location, between East and West, is enviable and it is already a big market.
Within Vision 2030, Saudization is set to be completed this year, meaning that all your sales rep should be Saudi nationals. Do you believe attracting talent can become a bottleneck for the life sciences industry’s growth since there are other industries that need to fill their quota?
I think the challenge is not Saudization, it is more about attracting young, qualified, and talented pharmacists to work for the pharmaceutical industry. The objectives look achievable, but we must be careful because pharmacists are not only needed by us, but they also have opportunities in the thousands of retail pharmacies and hospitals across the rapidly growing healthcare sector in Saudi.
Our industry is one of the most regulated and demanding, yet not the highest-paid and with almost 25,000 pharmacists needed in the healthcare market, it is not becoming any easier for the industry to attract young qualified pharmacists who prefer to work in other sectors.
I think it would be good to go back and look at industries like oil and gas and banking. These two industries have been extremely successful in Saudization and attracting talents; we can copy and improve what they have done.
What is the role of diversity and inclusion within that paradigm?
Diversity is part of Amgen’s DNA and we are continuously striving to be a leader on that front. Amgen has many initiatives in place on DI&B (Diversity, Inclusion and Belonging). Saudi was always a land of a diverse workforce and almost 25 percent of the population is expatriates, which naturally enables diversity. We have also been working on giving more opportunities to Saudi women, especially via the government’s fantastic female empowerment programs. Today, around 38 percent of our employees and management team are females and Amgen Saudi was recently recognized as a “Certified Great Place To Work”.
Is there a final message you would like to share with our global audience about Amgen in Saudi Arabia and the MEA region?
In MEA in general, the biggest opportunity is to help accelerate the diagnosis and treatment of patients, too many of whom fall through the gaps of healthcare coverage expansion. The question remains how companies should approach this opportunity; I suggest choosing areas where one can have the deepest and fastest impact.
Although the government and industry have made great progress in establishing open and continuous dialogue, it is equally important to keep that dialogue going with a focus on patients, accelerating their access to innovation and elevating compliance standards.
Amgen came here a few years ago and we are here to stay; We have an innovative and wide portfolio covering key therapeutic areas and there are many patients with unmet needs on this side of the world and accordingly, we are developing an even better commercial approach to enable us to reach more patients and serve them well.
