Ipsen's Stephane Brocker discusses a transformational period for the iconic French mid-cap in recent years, how this has played out in Italy, and emergent trends – such as hybrid digital/in-person physician interactions – that have emerged from the COVID-19 pandemic period. Brocker also touches on Italy’s relevance to the global Ipsen group as an early launch market and clinical trials hub, how Ipsen engages with patient groups in the country, and his priorities for 2022 and beyond.


After 13 years with Ipsen, what has kept you at the company for such a long time and made it such a good fit for your career development?

I started my career at Ipsen straight out of business school and, 11 years later, I was promoted to general manager of Italy, one of the top five European markets. That speaks to a strong culture of investing in people, helping them learn and grow, giving them opportunities to make an impact, and recognising it. Over the last decade we have also seen a change in management culture, putting evermore emphasis on knowledge, growth mindset, empowerment, cross-functional collaboration, and diversity. These are crucial skills in the complex ecosystem in which we work today. All in all, Ipsen has provided me with a nurturing environment, full of opportunities to work across different markets and functions.


Ipsen has undergone a transformation in this period and is now increasingly doubling down on specialty care under the leadership of David Loew. How have you felt these shifts at a country manager level?

Ipsen is a mid-sized pharmaceutical company, with 5700 employees globally and a reach of 115 countries, of which 35 are with a direct presence. We have been on a transformative journey for almost 20 years, shifting from the historical legacy in the primary care business to a focus on Specialty Care.

The arrival of David Loew in 2020 has accelerated and provided focus to this long-term vision for the group. As part of our new growth strategy Focus. Together. For Patients and Society, our ambition is to lead in the development of transformative medicines for patients living with highly specific and underserved diseases in oncology, rare disease and neuroscience.

We have also become more precise and informed in our decision-making, leveraging data-driven insights, whether in R&D, business development and dealmaking, or my own area of expertise commercial operations. Today, we rely less on gut instinct than we did a decade ago and more on data and insights. This enables us to roll out more impactful and focused projects and initiatives that better serve patients.

I feel confident that we are as a company well equipped to achieve the goals that our CEO David Loew, our Head of International Mari Scheiffele, and our leaders in the executive team have established for us.


Just how important is Italy for Ipsen and what mandate were you given upon taking this role?

Italy has an important role for the company as an early-launch market for our innovations; a role that is supported by a large population and strong clinical expertise. Additionally, despite being a mature market there is still plenty of room for growth here. My mandate in Italy is closely tied to Ipsen’s global strategy of maximising the value of our medicines. All our leading assets achieved number one or two positions in Italy that demonstrates the power of our strategy and the benefit of a focused portfolio.

Our data-driven philosophy plays into this value maximisation strategy. However, we look beyond gaining market shares. We are working hard to ensure that the whole healthcare ecosystem works to serve patients. As a pharma organisation, we have a responsibility to help shape the system, putting the patient truly at the centre.


Ipsen achieved total global sales of EUR 2.869 billion in 2021, a 12.3 percent increase on results from the pandemic-affected 2020 total, with David Loew putting this partly down to “improving levels of commercial execution reflecting in excellent performances from every major brand.” How did the Italian affiliate perform last year and how has your commercial execution strategy evolved in the country?

Our strong growth in 2021 is testament to the power of our strategy that enabled us to maximise our brands, strengthen the pipeline, drive efficiencies, and focus on culture. Italy is a key contributor to these strong results, and I am very proud of what the team has achieved last year.

Overall, we have become more data-driven, more agile and more focused in the execution of our strategy, which is transforming our commercial model.
All of us have been impacted by COVID, and after ten to 15 years of hypothesising we have now seen the future in terms of the impact of digital and how our stakeholders receive it. We now know how physicians react to these new tools, the ones they appreciate, and those they do not.

It will be crucial to continue emphasising meaningful innovation; tools and services that truly bring value to all stakeholders.

Additionally, cross-functional collaboration has become more important than ever with a greater variety of stakeholders and needs. This is key in a complex and heavily regulated environment. Breaking down the silos between medical affairs, commercial, and market access departments to collaboratively solve problems as a single team is a true competitive advantage for Ipsen and is allowing us to really focus on the quality of execution. Naturally, these efforts are not always perfect, but this is the direction in which we are moving.


How willing were Italian stakeholders to embrace these digital tools during the pandemic period?

There is no one size fits all answer. There will always be physicians who prefer the digital channels and relish doing away with the hassle of travelling to congresses in person etc. However, our surveys have shown that many physicians still prefer in-person interactions. In Italy, this preference remains much stronger than in some other markets, such as those in Northern Europe. As we emerge from the pandemic, our focus in Italy is increasingly on using digital tools to complement our traditional in-person interactions, offering a broader digital portfolio of on-demand services and omnichannel experience.

It is not a question of choosing one way or the other, but of working towards an integrated approach in which online and offline complement each other.


What are the key characteristics of the Italian healthcare system and where are the inefficiencies today?

Healthcare in Italy is highly regionalised, with a lot of different decision makers spread throughout the system. However, in the past few years we have seen an attempt to codify and streamline patient journey management, ensuring a smoother process between diagnostics, treatment, and follow-up. This is still ongoing.

What is clear is that the decentralisation of our healthcare system means that some regions and hospitals go faster than others in creating and implementing these kinds of processes, which adds a layer of complexity. Companies must therefore equip themselves to be able to track and monitor these processes as much as possible.

We are fortunate to be bringing forward very innovative products. While there are administrative issues of regional access following national reimbursement and registration, these have never been true roadblocks for Ipsen because we have managed to communicate the innovative value of our products.

From my personal experience, having visited many hospitals in Italy, I do not necessarily subscribe to the general assumption that northern Italy is much more developed than the south of the country. There are several centres of excellence in southern Italy, even in places where you might not expect them, and there are impressive institutions and people across the entire country. However, the density of those structures are not necessarily the same between regions, leading to some patients travelling to other parts of the country to be treated at specific centres. Despite this, all in all, the Italian healthcare system does a pretty good job at providing viable treatment opportunities for all patients in an efficient and efficacious manner.


Italian physicians and KOLs have a strong global reputation; is Ipsen leveraging this clinical excellence to conduct clinical trials in Italy?

Ipsen is not only commercialising its products in Italy, but also working with physicians and with centres of excellence here to conduct several clinical trials. These trials represent a mix of projects, both those tailored to Italian needs and others that form part of European or even global trials. Moreover, these trials cover both Phase III and post-registration studies across Ipsen’s core therapeutic areas – oncology, rare disease, and neuroscience. The strategy is really to work with the right centres to conduct the best clinical trials possible.


Ipsen’s portfolio contains products like Cabometyx® that can potentially be used in combination with other companies’ therapies. What does this entail for country managers such as yourself?

Partnerships are part of Ipsen’s DNA and many of our products exist because of strong collaborations cooperation with other companies. We already have an extensive global network of commercialisation partners, but these combination therapies mean that new types of partnerships must be created. We are currently working through this process in Italy. We have submitted an HTA dossier for our oncology drug Cabometyx® in combination with nivolumab with the aim of launching it as a treatment option for patients living with renal cell carcinoma as a combination therapy later in 2022. There are also similar opportunities for other assets in our portfolio. The pace of innovation happening in this space is truly exciting for the Ipsen team, for physicians, and most importantly for the patients. who stand to have their lives positively impacted.


How well developed is the patient group ecosystem in Italy and how closely is Ipsen working with these groups?

There is a burgeoning ecosystem of patient groups that are becoming better integrated with the overall healthcare system and decision-making processes. Ipsen has been always working closely with various patient associations supporting, for example, projects with the aim of training patients’ associations on procedures, legal aspects and pathways in which they are called upon to contribute in order to improve the quality of life of patients. But not only that. Our role as a company is also to listen to patients’ needs and support them in giving them visibility and a voice to find solutions. Like I said earlier, it’s about understanding and delivering what really matters to patients across a variety of areas, including accessibility, service, effectiveness, quality of life and cost.

That’s what we did, for example, during the COVID pandemic by supporting a communication campaign to encourage patients with prostate cancer to assess with their HCP how they can manage prostate cancer and limit hospital visits to reduce the likelihood of COVID-19 exposure and healthcare system overload.

There are still improvements to be made in terms of organisation and amplifying the voice of patient associations, at several levels, but we are seeing good levels of progress.


One of the roles of a country manager is to lobby for greater investment to their country from headquarters. What is your pitch to continue attracting resources to Italy?

The Italian environment is getting better and the recently announced National Recovery and Resilience Plan should continue to bring in resources and momentum to the overall pharma market. There is a limit to the pitch due to the continuing issue of clawbacks within the pharmaceutical budget governance. This issue still needs to be addressed, which puts a ceiling on expectations for Italy.

Overall, Italy remains one of the top five countries in Europe with a very strong environment in terms of both manufacturing and clinical expertise. It is an important market to be present – and to be winning – in.


Italy is in line to receive a lot of funds from the EU; what are your hopes in terms of how this funding is spent on healthcare in Italy, beyond the government’s stated priority to improve hospital infrastructure?

There are several ongoing discussions on the best way to spend this enormous amount of money. The strategic direction of the National Recovery and Resilience Plan to try to bring medicine closer to the patients – avoiding a focus on big hospitals which COVID revealed to be a significant gap – is very promising. Additionally, I hope that the focus will not just be on building hospitals and recruiting physicians, which is of course important, but also allowing and incentivising companies to provide the right tools and medical education to physicians and nurses so they can tackle patient needs more efficiently, in terms of diagnosis, access to treatment and disease management.


Given that many interactions, both internally and externally, now occur virtually, what are your thoughts on what effective leadership looks like today?

Over the past two years, all of us have struggled with the question of how to connect with people through a screen, with various distractions like children in the house etc. However, whatever channel is used, we have chosen to engage with our team based on trust. Our engagement surveys show that Ipsen employees recognise the genuine spirit of trust and empowerment that exists here. Traditional leadership skills such as communication, taking the time to pause, managing the tempo of the organisation, and setting priorities are still relevant but, in an environment with fewer interaction opportunities, this spirit of trust and empowerment and creating a system of delegation is vital. Managers must accept a certain loss of control, which is actually a net positive on overall engagement and results as well as employee wellbeing


What priorities have you set for the Ipsen Italy team across 2022/2023 as we (hopefully) move away from the worst of the COVID-19 pandemic?

Globally, Ipsen will continue to implement its growth strategy across all four pillars, including building its high-value and sustainable pipeline. Last year alone we concluded seven external innovation agreements for a total of eight new assets.

At a national level, we will continue to focus on executing our strategy as precisely as possible, working closely with patient organisations, HCPs, regulators, payers and other relevant stakeholders to bring the full potential of our medicines to patients and drive best-in-class diseases management in the three therapy areas of focus – oncology, rare disease and neuroscience and our data-driven model will be key in achieving our goals.

While continuing to grow our market share, I want to drill down on improving efficiency to fuel investment that supports our growth in areas that are a priority for us. Underpinning this ambitious strategy will be a culture of collaboration and excellence embedded into our daily realities.