Richard Wikner, country manager of Lundbeck Sweden, explains the affiliate’s strategic significance to the research-based company and its role in raising awareness about mental illnesses in the region, in addition to the company’s mission of striving to help patients return to their normal lives following depression.
Lundbeck is one of the Nordic champions, with a history of more than 100 years in the region. Could you comment on the company’s footprint here in Sweden?
When it comes to depression and schizophrenia, Lundbeck is number one in doctors’ minds. We have been here for so long that our customers appreciate our dedication to psychiatry and the fact that we are owned by a foundation, since it allows us to operate beyond focusing on revenue every quarter and dive deeper into the patients’ needs. Lundbeck, as a company, looks to the long term. We have a relatively small presence in the country, but one that constantly performs at the top; Sweden has a historical significance for the company.
How would you describe the importance of the Swedish affiliate for the headquarters in Copenhagen?
I believe Sweden is very important because it is a very complex and advanced market. If you look back in time, you find that Sweden was a key market when Lundbeck transitioned from being a small company in Denmark to a big player globally in the central nervous system (CNS) area. Nowadays, we continue to be an advanced market that challenges the company in terms of market access. Another reason is that the country is at the forefront of digitalization, which provides us with unique opportunities to try new things and look at what the future might look like.
According to the EU agency Eurofound, 41 percent of Swedish youths are “at-risk of depression”. Based on WHO guidelines, this is the highest number in Europe. What is the role of Lundbeck in raising awareness of the risks of depression?
Brain diseases have a big burden on society. It is not just the patients, but also the families that are involved. Taking schizophrenia as an example, it is just a terrible disease that has an impact on every aspect surrounding the patient’s life. Our role is to relieve that burden as much as we can.
We work with the Swedish healthcare authorities to raise awareness, especially when it comes to treating the patients, so they can return to their normal lives. When we talk about depression, we see that it works on different scales, so it is hard for patients to get back on track with their lives. That is why Lundbeck works with patient organizations, so the doctors understand that just prescribing antidepressants is not enough. It is a lengthy process that requires continuous interaction with the patient; it is not enough to just prescribe. The plan for the near future is for Lundbeck to get involved beyond just the healthcare system and get the message out. Everybody should listen more to the patients and we are committed to contributing as much as possible in this endeavour. It is no easy task, but it is one that we take seriously.
You mentioned the benefits of being owned by a foundation. To what extent is this an advantage for the company in Sweden?
Lundbeck is in a special situation because it is a publicly-traded company, but around 70 percent of the shares are owned by the foundation. It is a great advantage because this allows stakeholders and the general public to understand that Lundbeck is not just about the money. We are able to say with perfect clarity that most of the money goes to the foundation, which then is reinvested back into society through different channels, i.e R&D or patient projects. You can see our commitment all around the world.
Looking at Sweden, what has been the performance of the company’s portfolio in the country?
Lundbeck is performing quite well in the Swedish market; we have an annual growth of 25 percent. The Swedish market moves slow, so the first months of performance do not accurately predict the end performance of the products. That means that it sometimes takes time for products to take off. Of course, we will not continue growing at that 25 percent rate forever, but we will not flatten out. We have the complete portfolio here, with Brintellix and Abilify Maintena leading the way.
Something that makes me optimistic about the future is the fact that the authorities in Sweden are changing the guidelines in a manner that benefits Lundbeck; for example, Abilify is one of the first treatments to be prescribed. Researchers have seen the performance of our products and the healthcare providers have taken notice, too.
Many of your peers have talked about Sweden as a testbed for new product launches. Having many years of sales experience, to what extent would you say this applies to Lundbeck?
If you look at Sweden as a whole, outside the pharma business, it is clear that the digital opportunities and data-rich systems translate into advantages in other industries. Companies choose the country because the population tends to embrace new things. When it comes to pharmaceuticals, they are a bit more hesitant because of the cumbersome market-access process; but the country still remains a top destination for new treatments, especially if a company is working with a revolutionary therapy.
The situation for the treatment of diseases affecting the brain is a more complex because the regions that pay for pharmaceuticals in Sweden try to save money on diseases like depression, not allowing the population to get the new medication they should have; but it is true that the system tries to invest money in other areas with a higher degree of innovation.
Depression is an area that they are not willing to pay a lot because the advancements are relatively slow. It takes time to develop new treatments, so we have incremental innovation. On the other hand, they are willing to pay for psychosis and schizophrenia treatments because in many cases the prices are low, yet the impact is significant.
One particular aspect of the Swedish ecosystem is the great amount of data available, which provides real-world evidence. How does Lundbeck take advantage of the country’s data?
The situation is complicated, we have been trying to use the data from the Quality Registries, but the e-health authorities decided that the industry could not use them anymore. Still, I expect that to change. The different players are concerned about this situation and there is an ongoing conversation with the authorities to change this and make sure the data can be used. At the end of the day, the data is beneficiary to everybody, especially the patients.
Would you like Lundbeck to be more involved in the market, in terms of collaborations and partnerships?
Yes, I would like to work more collaboration with healthcare providers and doctors. If you look at depression, what happens is that doctors see patients and do not ask as many questions as they could. It is especially relevant when for the follow-up process and we could speed up this process and get more data if they allowed patients to fill questionnaires. That is not happening at the moment, we tried to work on it a couple of years ago, but the region’s IT departments pushed back. Lundbeck was looking to get even better information directly from patients; information that was going to benefit everyone involved in their recovery process. We want to work more closely with patients so the whole system can get better outcomes.
The most important thing is to make sure that the patients get better, that they are able to get their lives back. The systems need to work better with the patients because the treatment for CNS diseases is a long process.
After being at Lundbeck for over 16 years, you finally had the opportunity to become Country Manager in 2015. What motivated you to stay all this time?
Lundbeck has a great family atmosphere where everyone takes care of each other. It does not mean that we do not have targets, but we work as a team to achieve those outcomes. Also, the decentralization allows us to adapt to the market with a high degree of autonomy.
What can the audience expect from the Swedish affiliate over the next five years?
The long-term plan for the affiliate is already in place. We recently bought a company with a biological migraine compound that will hopefully be launched in Europe in the next two years, and the United States in one year. The product will allow us to continue growing. Talking about the system, it helps that there is a willingness to pay in Sweden, so I foresee that we will get reimbursement. It is a great acquisition that fits well with our portfolio.
We also have a promising Parkinson’s medication in the pipeline. The journey will not be easy, but the affiliate has the right team to succeed. Of course it helps that Lundbeck works in an area with high unmet medical needs, and we bring a positive change to society.
