Pierre Behnam, general manager of Pierre Fabre in Morocco, breaks down the strong and long-standing footprint of the group in the country in the medical and dermo-cosmetic fields. On the medical side, he talks about the amazing progress Morocco has made in the prevention and treatment of cancer, and his ambition to bring Pierre Fabre’s innovative targeted therapies and adjuvant therapies to Moroccan patients. In dermo-cosmetics, he shares his strategy to become more patient and consumer-oriented in the digital era without compromising the group’s medical identity.
Could you start by introducing the footprint of Pierre Fabre in Morocco?
Pierre Fabre has been active in Morocco for more than 45 years and the affiliate was opened in 2000. In fact, Morocco was one of the first foreign countries where the group started operating as Mr Pierre Fabre himself had a personal connection to the country. Today, we employ about a hundred associates, mainly medical reps, sales reps, and beauty advisors, with about 15 percent of the total made up of administrative and support staff.
Our activities are well-balanced between our pharmaceutical and dermo-cosmetic divisions, with each representing about half of our turnover. In order to manufacture and distribute our products, we partner with local players: 60 percent of our pharmaceutical drugs are manufactured locally.
When we met with Eric Ducournau, he explained how the company changed its global slogan from “from Health to Beauty” to “Taking Care, Living Better” to better reflect Pierre Fabre’s focus on patients’ health and well-being alike. In line with this new vision, the two business divisions of the Group are becoming increasingly intertwined. How have you driven this new strategic vision at the local level?
The Moroccan affiliate is in fact already in line with the new global organization as the two divisions have been integrated under one roof and one General Manager and structured around four business units: Medical Care Mature Line of products, Medical Care Oncology, Personal Care and Dermo-Cosmetics,
We are also aligned with global in terms of strategy as our focus is on strengthening our medical expertise and building our presence in oncology. In Morocco, we have been helping cancer patients for the last ten years with our chemotherapy medication Navelbine in both injectable and oral form. Navelbine is a unique product which offers many benefits for people suffering from metastatic breast cancer or non-small cell lung cancer. In addition to its clinical efficacy and safety profile, it offers convenience to patients who can continue to take the treatment at home.
Pierre Fabre is now looking to introduce the next generation of cancer therapies. To this end, we have partnered with two innovative US biotechnology companies, Array BioPharma – acquired by Pfizer in 2019 – and Puma Biotechnology, to develop new targeted oncology therapies. These efforts have already paid off as the combination treatment developed with Array BioPharma received approval from the FDA and EMA for BRAF-mutant metastatic melanoma in 2018, and the application for colorectal cancer is underway. Moreover, the targeted therapy developed with Puma Biotechnology received approval for the adjuvant treatment of HER-positive breast cancer in Europe and the US. We hope to bring these new therapies to Moroccan patients in the coming years. The first step is to register the products and receive marketing authorization, a process which takes at least 18 months.
In the medical field, we are present in other therapeutic areas besides oncology such as gynecology and urology where we have a strong position in Morocco thanks to our well-established and proven products.
In dermatology, we bring both prescription products and dermo-cosmetics. The latter are recommended by dermatologists as their benefits are supported by strong scientific evidence through clinical studies performed under the same conditions as pharma studies. The results are presented in peer-reviewed international publications such as the British Journal of Dermatology and conferences such as the World Congress of Dermatology.
Our prescription and dermo-cosmetic lines complement each other as skin care brands like Avène or Ducray offer solutions to treatment side effects. For instance, dermatologists recommend our moisturizing creams to help with dry skin, a common side effect of acne treatment. Oncology treatment also leads to side effects on the skin which need to be addressed to improve the quality of life of patients. Pierre Fabre is actually the only pharma company commercializing both oncology treatments and skin care products.
As the cosmetic and pharma fields are becoming increasingly linked, the border between the patient and the consumer is getting blurrier. Moreover, patients and consumers are changing, becoming more involved in their care, for instance by gathering information on the web and in social media. We need to be at the forefront of these dynamic market trends.
How would you assess the quality and access to cancer care in Morocco?
In the last 15 years, Morocco has made tremendous progress in the prevention, diagnosis and treatment of cancer thanks to the visionary initiatives of His Majesty the King Mohamed VI and health authorities. The Foundation Lalla Salma against Cancer, which was created in 2005, was instrumental in making the fight against cancer a public health priority in Morocco, improving patient’s care and promoting prevention. The Foundation launched an ambitious building campaign, set up the first national cancer registry and put in place early detection projects, among other initiatives.
Although the country started from scratch, Morocco now has a strong network of specialized medical centers for diagnosis and treatment and doctors are well trained. However, access to the latest therapeutic innovations remains the key challenge. Chemotherapy has made cancer treatment easily available and affordable to Moroccan patients. However, it has limitations in terms of efficacy and side effects. New immunotherapies or targeted therapies show great promise in extending survival and possibly curing patients. But as they are targeted at small patient populations with a specific genetic profile, they are more expensive. In Morocco, the reimbursement of those therapies is not well set yet. The Ministry of Health, the Department of Drug and Pharmacy (Direction du Médicament et de la Pharmacie, DMP) and the National Agency of Medical Insurance (Agence National de l’Assurance Maladie, ANAM) are working on putting in place access programs for those innovative but expensive treatments. Hopefully, once we complete registration of our new products, a system will already be place.
What is the status of Morocco as a clinical research destination?
In order to conduct clinical studies in a country, sponsors need a robust legal framework laying down the rules on Good Clinical Practice to ensure the rights, safety, and wellbeing of clinical trial participants as well as the credibility of clinical trial data. Morocco is lacking such a framework and, as a result, there are very few clinical studies performed here. Nevertheless, a law is under preparation, which I hope will be approved in the coming months. The country has the right infrastructure and capabilities to attract clinical trials. Developing clinical research offers a huge opportunity for patients, hospitals, and healthcare professionals. Patients would be able to access the latest therapeutic innovations, doctors and nurses would be trained on using these therapies, and hospitals would receive investments in material and equipment. Many developing countries have positioned themselves as clinical research hubs. The Ukraine for instance, which is comparable to Morocco in terms economic development and population size, started from scratch and today attracts investments of 500 million euros per year in the field. When the right ecosystem is in place in Morocco, I will be the first to advocate for headquarters to invest in clinical research in the country.
In dermo-cosmetics and personal care, Pierre Fabre has recently made significant investments to catch up in the digital space. In Morocco, how important is digital in terms of marketing and sales, and how have you developed your capabilities?
In Morocco, e-pharmacy platforms are not developed yet, and only represent about 2 percent of total consumer healthcare sales according to our estimates. However, 50 percent of patients/consumers consult the internet to compare the benefits of different products before entering a brick-and-mortar pharmacy and making a purchase. As a result, having a strong online presence is critical to success.
Locally, we have developed our social media presence early on and, as a result, we are among the first countries in terms of number of fans on the major platforms. The first phase of our digital development was sand consumer and refer them to a dermatologist when their skin conditions will require it.
Beyond sales and marketing, digital presents opportunities to accompany patients along their treatment journey, especially for difficult-to-treat conditions such as severe acne. We will soon launch an app in Morocco to give patients with severe acne being treated with isotretinoin advice on how to follow the treatment and the possibility to report side effects.
Looking forward, what are your top priorities to continue improving the standing of Pierre Fabre in Morocco?
On the medical side, I want to strengthen our contribution to national health efforts, improve access of Moroccan patients to innovative therapies, and position Pierre Fabre as a trusted partner for health care professional in our key therapeutic areas.
In dermo-cosmetics and personal care, we want to be the partner of choice to dermatologists, pharmacies and consumers alike. We need to become more consumer oriented by leveraging digital tools while at the same time continuing to focus on medicalization. This is a complex exercise for which we have the right to succeed!
