Country manager at Lundbeck Portugal, Sara Barros, came to the Danish company after a number of management positions at larger pharma companies and took on the leadership of its local affiliate about three years ago. She comments on the shift in societal attitudes towards mental health, discusses Portugal's psychiatric care framework and the EUR 88 million from the European Recovery & Resiliance plan earmarked to strengthen it. She also shares her excitement about the upcoming launch in the country of Lundbeck's anti-monoclonal antibody migraine treatment.


This is your first country manager role. How challenging has the transition been?

The journey has been remarkable, and I have already spent three years in my current position. Transitioning into the country manager role amid the COVID-19 pandemic posed distinct challenges. With the first 100 days coinciding with lockdowns, my focus shifted towards building strong relationships within the team. The limitations on conventional promotional activities prompted creativity in finding alternative ways to sustain business operations. Embracing an open dialogue, I prioritised gathering feedback from the team, fostering a culture of shared insights.

Leadership, I have learned, is a continuous process of assessment and re-evaluation. The ability to glean insights, whether positive or negative, from the experiences of those around you enriches decision-making capabilities. In essence, leadership is an ongoing journey of learning and adaptation.

Another significant takeaway from this experience is the imperative for leaders to make immediate decisions, especially tough ones. Navigating through these challenges, I have come to understand the critical need for leaders to be comfortable with risk assessment and capable of inspiring action in others.

Despite the constraints, we succeeded in finding alternative approaches to engage with healthcare professionals, ensuring the continuity of our business and, more importantly, addressing the needs of patients.


After almost five years at Lundbeck, first as national sales manager and now as country manager, what stands out for you most about the company?

Mid-sized European firms like Lundbeck often have a unique culture, which is quite different from the larger American corporations I had previously worked for. The agility in decision-making really stands out and is a notable departure from the complexity of larger corporations with over 50,000 employees. The size of our company, at 15,000 employees, contributes to this agility. One of the most insightful aspects of this transition has been the direct access to top management. Within a year and a half, I had the opportunity to meet our CEO, which is something I had not experienced in my previous roles. This direct access has allowed me to better understand and contribute to the company’s strategic decisions.


Given the increased focus on mental health in various countries, especially during the COVID-19 pandemic, has Lundbeck been actively involved in initiatives around the topic? How do you perceive the shift in societal attitudes towards psychiatric pathologies, and what role does Lundbeck play in raising awareness and combating stigma?

The COVID-19 pandemic has undeniably brought mental health into sharper focus across countries. We have observed an unprecedented level of discussion around mental health in the media, with an open dialogue becoming more prevalent. Societal attitudes towards psychiatric conditions, including schizophrenia, depression, and bipolar disorders, have evolved positively. There is a growing awareness of these pathologies, leading to increased dialogue and understanding.

Lundbeck acknowledges the importance of destigmatising mental health issues, recognising the challenge in convincing individuals to seek professional help. Social media has played a pivotal role in this shift, allowing for campaigns like our “Depression Without Stigma” initiative. The aim is to combat misconceptions, raise awareness, and promote literacy in mental health.

Stigma not only surrounds the diseases themselves, but also extends to the perception of pharmacological treatments. We recognise the need to address these misconceptions, as people may hesitate to accept medication for mental health conditions compared to physical ailments. This reluctance often stems from the perception that mental conditions are related to the soul or psyche rather than the physiological dysfunction of the brain.

Lundbeck sees this as a shared responsibility among various stakeholders, including pharmaceutical companies. Our mission is to actively engage in educating the public about mental health, breaking down barriers to treatment, and supporting the adequate care of patients. Overcoming societal stigma against seeking psychiatric help and challenging preconceived notions about mental health treatment is crucial. The ultimate goal is to ensure that mental and brain diseases receive the same level of understanding, acceptance, and treatment as physical ailments.


How important are patient associations in this push for awareness?

In terms of patient communities in Portugal, they are well-developed, and we acknowledge their efforts. Partnerships between pharmaceutical companies and patient organisations are essential to collectively address challenges and improve healthcare services. Patient input is invaluable for us to adapt our strategies and activities to better serve their needs. Lundbeck is committed to being patient-centric and contributing to the overall well-being of the communities we serve.


How would you evaluate the ratio of psychiatric doctors to the total population in Portugal? How do psychologists fit into the mental health care framework, and what challenges does Portugal face in this regard? Has the government recognised the need for increased investment in mental health?

In Portugal, the challenge in mental health care is not necessarily a shortage of psychiatric doctors in terms of numbers but rather a distribution issue. Some regions, particularly rural areas, face challenges with insufficient adult psychiatrists. Additionally, there is a notable shortage of child and adolescent psychiatrists in certain regions, highlighting the need for a more balanced distribution.

The primary care approach often starts with psychologists, who play a complementary role to pharmacological treatments. However, Portugal faces a shortage of psychologists, making it challenging to provide comprehensive mental health care.

The Portuguese government, acknowledging the urgency to invest in mental health, has initiated the National Mental Health Programme. This programme, integrated into the national coordination of mental health policies, includes a comprehensive plan to reform mental health services. As part of the Recovery and Resilience Plan, an investment of EUR 88 million is earmarked to strengthen mental health services within the National Health System.

While these plans demonstrate a commitment to addressing mental health challenges, there are concerns about the effective implementation of these initiatives. Clinicians and professionals on the ground have expressed apprehension about the practical applicability of the plans and the need for effective implementation strategies. The long-term economic impact, such as indirect costs related to mental health issues affecting the workforce and the country’s productivity, is also an area of concern that needs attention and further study.

Lundbeck, as a pharmaceutical company, is invested in supporting mental health awareness and treatment, and the company’s focus extends beyond pharmacological interventions to advocating for a comprehensive and effective mental health care system in Portugal.


Can you provide any insights into Lundbeck’s portfolio in Portugal and its focus on bringing innovative treatments to patients?

Our portfolio in Portugal is strategically aligned with our commitment to delivering innovative treatments, particularly in the areas of depression, migraine and schizophrenia. We strongly believe in the transformative power of these therapies, aiming to make a substantial difference in the lives of Portuguese patients and their families. Our unwavering dedication is centered on ensuring that life should not be interrupted by brain diseases. Currently, we are gearing up for the launch late next year of a more convenient treatment for schizophrenia – a long-acting injectable administered every two months, offering enhanced convenience for patients, doctors, and nurses.

The journey to bringing innovative treatments, such as our upcoming migraine therapies, has indeed been lengthy. The process involves rigorous clinical evaluations, economic assessments, and negotiations on cost limits. The negotiation phase, especially regarding the limits suggested by health authorities, poses challenges as product growth curves may extend beyond this thereshold. It requires ongoing discussions and potential renegotiations to ensure continued patient access to these transformative therapies.


Seeing as it will not be the first migraine product in the Portuguese market, how does Lundbeck’s new  therapy differ from existing treatments?

We are thrilled about the imminent launch of our groundbreaking migraine product in Portugal. This will mark another important market in the European rollout, following successful launches in key countries such as Switzerland, Germany, France, Spain, Denmark, and others. Our migraine treatment, an anti-monoclonal antibody, is specifically designed for preventing migraine in patients experiencing more than three days of migraine per month. It is a rapid and potent therapy, outclassing existing treatments in terms of strength.

What sets our migraine treatment apart is not only its potency but also its unique route of administration. In contrast to subcutaneous treatments from other companies our medicine is administered intravenously every three months. This method offers greater convenience and compliance for patients and boasts a faster onset of action.

Recognising the importance of keeping the medical community informed, we have implemented educational programs and fostered close collaboration with headache and neurology societies. These initiatives aim to fill the knowledge gap and highlight the distinct advantages of our new therapy.

The prevalence of migraine is a significant consideration. We understand the profound impact migraine can have on patients’ lives, not just during an episode but also due to the associated stigma. We are committed to raising awareness about the debilitating effects of migraine and how innovative treatments can make a substantial difference and build a paradigm shift.


From a Portuguese perspective, do you have any comments on the EU’s reform of the pharmaceuticals framework?

We view the proposed changes in European Medicines Regulation as a unique opportunity, particularly for smaller countries like Portugal. We believe that this reform could pave the way for more timely and equitable access to safe and effective medicines across Europe. The minimum period of regulatory protection of eight years, with the potential for extension, encourages companies to launch medicines in all member states and the local health authorities to create agile processes, ultimately benefiting patients.

The reduction of the administrative burden, a key goal of the proposed reform, is deemed crucial for expediting processes and significantly reducing authorisation times for medicines. This streamlined approach is vital for ensuring faster access to medications, enhancing their availability for patients across the EU. The emphasis on efficiency aligns with the overarching goal of the reform to guarantee timely and equitable access to safe and effective medicines throughout Europe. This perspective underscores the importance of administrative reforms in the pharmaceutical sector and signals the potential positive impact on patient care. Additionally, the mention of upcoming initiatives for 2024, such as the medical clinic and the launch of mid-range products, further highlights Lundbeck’s commitment to advancing healthcare solutions.


Looking ahead, what are the Portugal affiliate’s priorities for the next few years?

In the coming years, our primary focus will be maximising our existing brands, given that we are currently in a growth curve and have not reached the peak with these brands. Our efforts are concentrated on driving excellent performance with our depression treatment and our portfolio for schizophrenia. I am particularly excited about the successful launch of our powerful migraine treatment, marking a significant milestone for Lundbeck in Portugal. We have been eagerly preparing for this for a long time, and it is finally coming to fruition.

As for other priorities, we are committed to empowering our people and enhancing our organisational culture. Talent retention is a key axis for us, with a strong emphasis on our workforce. Additionally, we are advancing our customer engagement model, which involves the development of a new business model. Lundbeck is at the forefront of leading this change, and we are set to launch the 2.0 version of our platform, the Veeva Sales Force, next year. This platform interfaces with healthcare professionals (HCPs) and aligns with our broader digital transformation strategy to engage with HCPs effectively.

To conclude, our main focus is on delivering financial results while maintaining a patient-centric, inclusive, and compliant market approach. Patient Centricity is a crucial aspect of our plans, and we are actively engaging with patient associations, such as Migra, a dynamic local migraine patient association in Portugal. We are collaborating on various activities to improve patient access to consultations, addressing the bottleneck issue in the system. Lundbeck is deeply concerned about the challenges patients face in accessing care for migraine, and we are actively working with patient associations to understand their needs better. Our goal is to go beyond traditional pharma business models and provide value-added services aligned with patient needs.