Santiago Ruiz, entering his fourth year leading B. Braun’s Portuguese affiliate in Lisbon, highlights the innovation present in Portugal, B. Braun’s Vision 2020 and emerging trends in the medtech world.
How has the affiliate evolved over the past three years under your management?
We faced two crucial challenges over the past three years at B. Braun: firstly, developing ambition in line with B. Braun’s Vision 2020, as one company covering all facets of hospitals procedures. We needed to realign our practices to become one, unified company that can offer a complete solution to hospitals.
Secondary to this was a challenge we faced in outpatients. B. Braun is widely recognized on products that address the hospital market. However, we have already a wide portfolio of developed products for people that suffer from chronic diseases. It is challenging to separate these two strategies – hospital and outpatient care. Since then we have incorporated a two-pronged approach to tackle this.
We want to be a complete partner to hospitals, as well as a partner to homecare and outpatient services. With this purpose, we have expanded our comprehensive portfolio with therapies that were not previously available, which are actually in Portugal since 2016. By creating a vision for hospitals, and a differentiated but coordinated concept for chronic diseases, while finalizing the complete portfolio, we can better serve patients in Portugal. Following the creation of this strategy, we are developing not only a commercial but also a complete new infrastructure to support it.
How successful were you in making available the entire portfolio in Portugal?
We are well on the way and have developed the ‘easy’ businesses so far. When we combine services and products, there are more hurdles to overcome, and this can take longer. We continue to develop the areas where the market has not taken into account our level of service, and therefore, we are in an in-depth process of rebuilding the offer in the fields where we were not present. Effectively, this makes one of the top priorities for 2018 -2020.
What are the primary growth drivers in Portugal?
In Portugal, the National Health Service aims to cover the aspects that are less developed, such as helping patients become aware of services and products that will help cope with chronic illnesses. One of our key strategies has to make sure that these products feature on the national health System reimbursement schema, to better serve patients. We have grown clearly in ambulatory thanks to our work with the government on this front.
We face different battles for different chronic patient illnesses, and one of the main important factors is the patient’s lifestyle, notably nutrition. Nutrition heavily influences the prognosis of the disease and is currently not covered by the National Health Service.
We try to show how effective the system could be in solving problems related to nutrition, ensuring a quick recovery and attain healthier patients. In essence, the longer a patient stays in the hospital, the more onerous the burden on the national health system, something we try to improve.
We have identified the KPIs and engaged stakeholders in the conversation; those who are in a position to discuss with the administration so that the National Health Service might become more effective day by day.
What is the scope of B. Braun’s operations in Portugal?
Braun is a medtech and pharma company—our sales are split half and half from each sector. However, we are a specialty pharmaceutical company in that we provide pharmaceuticals to hospitals and, as such, our products are treated as medical devices. We are active in medicinal administration innovation—how to use our medications in hospitals or ambulatory care. The way we care people, is as important as the care we provide.
Please note we are specialists in parenteral and enteral nutritional. We created personalized solutions to diets for people that need to be fed in unique ways. At first sight, it does not seem to be a very exciting business, but it ensures that people are kept in the best conditions so that they can undergo cardiac surgery for example. This can happen outside or inside the medical institution. Additionally, we are also involved in pain control, during and after surgery. Moreover, because we deal with paracetamol and other painkillers, we have created devices that ensure effective delivery to patients. With B. Braun you choose not only the best drug but also the best drug delivery system.
How well established is B. Braun in Portugal?
It is hard to find any procedure in a hospital where one single product from B. Braun is not present
It is hard to find any procedure in a hospital where one single product from B. Braun is not present. We are involved in 18 different therapies, and our company can provide 30% of what a hospital can buy. We are one of the biggest company in terms of our offering. The number of operations where B. Braun is present puts our company in the number one, we are at the same time present in a plastic industry and in the steel industry. We are a pharmaceutical company and a cosmetic one, we are an electro-medical company, offering electro-surgery, imaging systems as well as optics and software ones, and a few of industries more.
How is the company positioned in Portugal?
We have different positions on the market in various fields. We have one of the highest market shares for the region, and indeed, worldwide in clinical care inside B. Braun group. When we compare ourselves with other companies concerning our evolution, we grow faster in specific areas, where our share is low. We are capable of demonstrating in Portugal that we can reinvest for the needs within areas we should develop. As a multinational company we have one Central brain for finance; consequently, we allocate resources from a worldwide perspective dependent on countries individual developments, but Portugal continues to perform well.
How do you observe the market environment with regard to the procurement of medical devices?
Market access is highly regulated in Portugal, quite similar with the UK, and to succeed in introducing a new product, apart from all solid evidence we need to prove, a financial benefit for every single case is mandatory. The Regulatory Authorities, on their crusade to reduce expenses, imposes comparators with extremely low prices, which prevents the possibility of marketing all new products in Portugal at an acceptable price, reason why many Companies decide not to launch them. If this trend continues Portugal will be increasingly less competitive in terms of innovation.
SiNATS in an optimistic way, wished to contribute to maximize health gains and quality of life of citizens, ensure the sustainability of the NHS and the efficient use of public health resources. They have also proposed to monitor the use and the effectiveness of technologies, reducing waste and inefficiencies, promoting and rewarding the development of innovation, as well as promoting equitable access to technologies.
B. Braun is an active member of the Portuguese and International associations representing the devices and diagnostics industry, such as APORMED and MedTech Europe. Since 2016 B. Braun Medical integrates the MEAT Value base procurement, a Project promote by APORMED and MedTech and we are part of “MEAT Steering Committee” – working together with the industry and both associations to implement new procedures to achieve a better procurement outcome (innovation, quality, long term cost); the new criteria will put an end to the dictatorship of the lowest price and once again make quality the central issue.
What are your strategic priorities for the next five years?
We will continue to follow the 2020 strategy and operate a structure that is not only in contact with the users but those that understand how health is developed. We must work closely with administrators, nurses, doctors, and patients to ensure that simple processes involving needles, for example, do not harm people— continually seeking safe innovation.
Healthcare expenditure goes from acute care towards aging populations and chronic illnesses ones. We know where we need to develop and we understand this issue. We intend to put the patient at the center of the conversation, and the patient’s outcome is the ultimate goal, wherever he or she is being treated. In five years’ time, we will see an entirely new company operating in Portugal that totally focused on the same B. Braun vision: protecting and improving the health of patients.