Silvia Casellas, CEO of Anagram, a Spanish CRO, discusses the challenges of the consolidation process the company has gone in recent years, the reasons for the boom in Spain’s clinical trials ecosystem, and the importance of a close-knit client-to-service-provider relationship for CROs today.
The company has evolved a lot recently. As the CEO, could you give us a background story of Anagram?
My partners and I have worked in the field of clinical research for some 20 years. We all have different backgrounds and experiences in clinical research, working both at the local and international level, at a large and small scale. Some years ago, we founded 4 Clinical Trials, with the main objective of helping to improve clinical research based on our lessons learnt, from imaging to project management.
We started with core lab imaging doing clinical tests for patients in oncology within the autonomous community of Catalonia. Through organic growth, there was a sudden need for a centralized image reading point for national and international studies; therefore, we set up a centralized site and today our team of radiologists and nuclear medicine read and inform images on our premises, which has brought consistency in results, a must for clinical research.
Over time, this gave us the opportunity to merge with Anagram, a company with 20 years’ experience in the field of clinical research, mainly in the areas of cardiovascular, neurology and medical devices. Now, we are working with IEC, our official imaging core lab, and combining this with Anagram’s research in drugs and medical devices, we are the first Spanish company to offer global services including central imaging capabilities and CRO operations at a national and also international level.
What challenges have you had throughout this integration process?
For me the main priority was to get up to speed with my team. They have great energy and experience working in most therapeutic fields and I was able to help them with my past international experience and to challenge their processes so we could work together to make operations even more efficient. Integrating CRO activities with core imaging capabilities, has presented challenges too, some of which we have resolved by adjusting our structure and moving both teams to the same office to synchronize operations in a smoother way.
This is your first time as a CEO. How has that been for you?
Managing people is something I have a passion for, and my past experience included managing international teams across 20 to 30 countries, taking into account different backgrounds, languages and cultures. This is something I really enjoy, and the Anagram team is just fantastic!
The main challenge was being able to manage very different clients, from large international companies to smaller players, while still being a flexible partner that offers a high quality, cost-efficient service. This is not easy as the demands and needs of companies varies a lot, and many require different services. We need to tailor each study strategy to every client needs so we can provide first class services to each and every company, no matter their size or their budget.
Where does your competition come from?
We are competing with other small and medium sized CROs from Europe.
What has positioned Spain as a leading nation for clinical research?
Spain has worked for many years to ensure that good quality data can be generated, and the nation has many well recognized key opinion leaders in areas such as oncology, neurology, cardiology and many others. Furthermore, there is a lot of research being done in Spain compared to other nations, and it is reasonably quick to start the clinical research process. This is backed by the 2015 Royal Decree, which has made the process even faster with centralized operations for certain areas.
Furthermore, Spain is a great place for companies to conduct their clinical trials due to the fact it still remains a low-cost option that delivers world-class results, compared to places like the UK and Germany, which are costlier. In fact, at Anagram cost is one factor for us focusing on medical devices, where sponsors often can’t use big budgets for their studies and need a cost effective approach which we can offer in Spain.
What areas are you focused on?
Oncology is one, and Spain has some very important hospitals that we work with that are very strong in this field, such as Hospital Vall D’Hebron. We also have many other institutes and hospitals that do quite a lot of leading clinical research in oncology. Anagram has robust experience too in neurology (stroke) and cardiovascular and across our 20 years have really worked in most of the therapeutic fields
Overall, we are very diverse and work with pharmaceutical, medical device and diagnostic companies, private investigators and even public-funded trials. Having this inclusive approach is something implanted into the company’s mindset, and always allows us to grow and learn.
The merger with IEC was huge. What potential does this bring to your operations?
We are now working on our first global study (CRO + Imaging Core Lab), and we believe the merger will accelerate this international business as more clients now require these centralized imaging processes from the same company. It creates a fluid team that decrease the overall complexity of the trial, which in turn makes it simpler and more efficient for us and the client.
Many of our clients want this close-knit relationship as they are normally start-ups, spin-offs, biotechs or smaller companies. They need us to sit down with them and accompany them along their journey, and we ensure that we give them our full attention and resources. This develops our brand in the long run, and repeated business is crucial for a service provider like us.
Where are you clients coming from mostly?
Fifty percent are local, and 50 percent are international. We grow locally a lot through word-of-mouth, while the key opinion leaders we work with often suggest us on the international scene.
How do you see the CRO client-customer relationship evolving?
In our range of studies, we see more and more the need for the one stop shop. Companies want their operations to be simple and flexible; therefore, they prefer that one company does all the processes, rather than having a team of different CROs who they have to coordinate. We also enjoy this model working from start to finish, as we are able to keep constantly engaged and have full control.
How are you preparing for the rise of personalized medicine?
Some of the trials we manage are already addressing personalized medicine approaches. The important steps are ensuring we can gather all the data required, so we are constantly engaging with our data managers throughout the trial.
We also see a rise in artificial intelligence being part of clinical trials, and as you mentioned the rise of personalized trials in areas like oncology, which eventually will end up in proposing each patient exactly the customized treatment they need.
