Germany remains one of Europe's most important pharmaceutical markets, combining scientific excellence, strong clinical research capabilities, and early access to innovation. Yet as breakthrough therapies become more sophisticated and global competition for investment intensifies, maintaining that position will require more than scientific strength alone. Urs Voegeli, Managing Director of Johnson & Johnson Innovative Medicine Germany, discusses the opportunities and challenges shaping the future of healthcare innovation in Germany, from oncology and clinical research to patient access, policy reform, and the leadership mindset needed to navigate an increasingly complex environment.
How have your experiences across different markets shaped your leadership approach?
I have been very fortunate to work across different geographies and healthcare systems over the course of my career. The common thread throughout that journey has been the opportunity to work with outstanding colleagues and partners, whether physicians, patient organisations, or payers, and that continues to be one of the most rewarding aspects of this industry. I have also had the privilege of leading organisations of increasing size and complexity at a time when innovation in our industry has accelerated dramatically. One of the most important lessons I have learned is the value of leading with clarity of purpose. When you are clear on your mission and the impact you want to create, it becomes much easier to align teams, navigate complexity, and remain resilient in a rapidly changing environment.
My time in Australia was particularly formative in that regard. I experienced first-hand the consequences of a healthcare system that applies a very rigorous cost-effectiveness approach to innovation, where patients may gain access to new therapies only after many years, or sometimes not at all. I met physicians who could see the latest scientific advances at international congresses but had little expectation that those innovations would ever reach their patients. Those experiences strengthened my conviction that innovation only fulfils its promise when it reaches patients and gave me a very clear sense of purpose. As I now see some of these trends emerging in Europe, I understand exactly why this remains such an important issue and why it is worth fighting for.
What makes Germany such an important market for Johnson & Johnson Innovative Medicine, and what have been your key priorities since returning to lead the affiliate?
Germany remains a critical market for us, not only because it is Europe’s largest pharmaceutical market and provides early access to innovation, but also because of the strength of its physicians, research centres, and clinical ecosystem. Our headquarters in Neuss is located close to our Belgian campus in Beerse, where much of J&J’s pharmaceutical heritage and research activity is rooted, reinforcing Germany’s importance within our broader European footprint. It continues to be a key market for innovation, clinical research, and patient access, and I hope it remains so for many years to come.
At the same time, the environment has evolved since I last worked here. One of the most notable changes has been the gradual erosion of certainty around rapid market access and value-based pricing, making it increasingly important to engage constructively with stakeholders and help preserve conditions that support innovation and patient access. The other major focus has been bringing a rapidly advancing pipeline to patients. When I returned, we were launching our first CAR-T therapy in Germany for multiple myeloma, which was exciting not only because of its potential impact for patients, but also because it requires a much closer partnership with specialised treatment centres across the entire treatment pathway. Since then, we have launched a number of important medicines in areas of high unmet need, including in inflammatory bowel disease, myasthenia gravis, lung cancer, and multiple myeloma. It has been a very dynamic period, one that constantly reminds me of the tension between what science can now deliver and the increasing restrictions and uncertainty surrounding patient access. A central part of my role is helping to bridge that gap and ensure innovation reaches the patients who stand to benefit from it.
Where do you see the most promising opportunities emerging across Johnson & Johnson Innovative Medicine’s innovation portfolio?
We are in a phase of unprecedented innovation, driven by a deeper understanding of disease biology and by technologies such as artificial intelligence, which are accelerating the identification of new targets and the development of new therapies. As a result, the pace of innovation continues to increase, creating tremendous opportunities for patients while also presenting a challenge for physicians, who must integrate an ever-growing level of complexity into daily clinical practice.
What excites me most is our ambition in oncology. By 2030, we aim to become the leading oncology company in terms of patient impact, and we believe we are on a very promising path towards that goal. For us, the opportunity spans multiple solid tumor types. We have recently entered lung cancer and expect to expand into colorectal and head and neck cancers in the coming years. We are also seeing exciting progress in bladder cancer and in hard-to-treat hematologic malignancies such as acute myeloid leukaemia, while prostate cancer and multiple myeloma remain core pillars of our portfolio. Multiple myeloma remains one of the cornerstones of our portfolio. For me, the real opportunity lies in translating that innovation into clinical practice, ensuring patients can access these therapies quickly and broadly, helping physicians navigate their increasing complexity, and ultimately enabling patients to derive the greatest possible benefit from these advances.
How can the industry ensure that increasingly sophisticated innovations translate into meaningful patient outcomes?
I think what many people underestimate is how much of the work happens years before a product is launched.
In Germany, we need to anticipate very early how clinical trials should be designed to fit the health technology assessment process. At the same time, we need to anticipate how the standard of care will evolve by the time a medicine reaches the market and which endpoints and patient-reported outcomes will ultimately matter.
Over the years, we have increasingly aligned our development programmes accordingly. Ultimately, it comes down to one thing: bringing innovation to patients faster, and that is what determines access after approval.
Equally important is education. In oncology, many patients are treated in office-based practices rather than large hospital centres, which means physicians are being asked to manage an unprecedented level of complexity, from targeted therapies to companion diagnostics. Helping healthcare professionals understand how to integrate these innovations into daily practice is therefore a critical part of ensuring patients derive the full benefit from them.
That is also why I believe the future of oncology will depend on strong partnerships across the entire healthcare ecosystem. One initiative that I find particularly encouraging is Vision Zero, which brings together academia, researchers, healthcare providers, patient organisations, policymakers, and industry around the shared ambition of reducing avoidable cancer deaths as close to zero as possible. What makes it so valuable is the recognition that no single stakeholder can solve these challenges alone. We see ourselves as an active partner in that dialogue, helping to identify where the remaining barriers are and which stakeholders are best placed to address them. As the next wave of oncology innovation reaches patients, that kind of collaboration will be essential if we want to ensure scientific progress translates into better outcomes in clinical practice.
Why is preserving an innovation-friendly environment becoming such an important issue for Germany’s pharmaceutical sector?
Our industry is characterised by long innovation cycles and significant investment. Developing a new medicine can take up to 15 years and cost several billion USD. This makes two things essential: a predictable policy environment and a healthcare system that consistently rewards innovation based on the value it delivers to patients.
For many years, Germany providedexactly that. The AMNOG framework, which governs the benefit assessment of new prescription medicines, created a high degree of predictability because it is firmly rooted in the principle of evidence-based patient benefit. If a medicine demonstrated superior clinical value, this was taken into account in the subsequent price negotiations with the statutory health insurance association (GKV-SV). This made Germany one of the most attractive markets for pharmaceutical innovation.The first signs of change emerged in 2022 with the GKV Financial Stabilisation Act, including the AMNOG guardrails and combination discount, which introduced new exceptions into the system and created a degree of uncertainty. At the same time, it was an important signal that the federal government recognised the pharmaceutical industry as a strategic driver of innovation, research, manufacturing, and economic growth, helping to strengthen confidence in Germany as an investment location.
That sent a strong signal to the industry and contributed to renewed confidence in Germany as a destination for investment. Seen in that context, the draft legislation proposed this spring came as a significant surprise. Measures such as a dynamic manufacturer rebate linked to overall pharmaceutical spending, mandatory price-volume agreements, and the proposed tendering of patent-protected medicines run counter to the principles that have historically made Germany attractive for innovation. They significantly reduce predictability for research-based companies and risk undermining a system designed to reward clinical value.
More broadly, these discussions have raised questions about Germany’s long-term direction. On the one hand, there is a clear ambition to position the country as a leading biopharmaceutical location; on the other, some of the proposed measures send a very different signal to companies making long-term investment decisions in a competitive global environment. Germany has all the ingredients required for success, including world-class science, a strong research infrastructure, a large market, and highly skilled healthcare professionals. The challenge now is to bring these strengths together through a coherent pharmaceutical strategy that is aligned across government and provides the certainty needed to attract investment, support innovation, and ultimately ensure that patients continue to benefit from the latest advances in medicine.
What will it take for Germany to strengthen its position as a leading destination for clinical research?
Germany remains one of the leading clinical research markets in Europe, although it has lost some ground in recent years, moving from second to third place in terms of the overall number of clinical trials. From an industry’s perspective, three factors matter above all: quality, scale, and speed. Germany continues to excel in the first two. The quality of the data is exceptionally high, the scientific expertise is world-class, and the country benefits from a large patient population and strong research infrastructure. This is particularly evident in Phase III studies, where Germany continues to perform very well because it combines high-quality research with the ability to recruit at scale. Where Germany is challenged is speed, and that has become a critical factor in today’s research environment, especially in early-stage clinical development.
The Medical Research Act (Medizinforschungsgesetz), which came into force in October 2024, is a positive step because it seeks to reduce bureaucracy, accelerate approval procedures, improve ethics committee processes, and facilitate access to research data. The direction is clearly the right one, particularly when it comes to strengthening Germany’s position in Phase I studies, where we have seen the country lose ground. The challenge is that much of the intended progress has yet to translate fully into daily practice. When we speak with clinical research centres and our own development teams, many of the same obstacles remain, from lengthy contracting procedures to the fragmentation created by different ethics committees and processes across the federal states. Compared with countries such as Spain, where more standardised approaches can significantly accelerate study start-up, Germany still has work to do. The good news is that the fundamentals remain very strong, and with continued focus on implementation and collaboration across stakeholders, there is every opportunity for Germany to regain momentum and reinforce its position as a leading destination for clinical research.
How is Johnson & Johnson Innovative Medicine adapting its approach to talent and leadership in an era of rapid change?
We are fortunate to continue being seen as a very attractive employer, and my experience in Germany has been that we can draw from an exceptional talent pool. People are certainly attracted by the strength of our pipeline and portfolio, but they are also looking for purpose. They want to work for an organisation that stands for something beyond a pay cheque and offers the opportunity to contribute to a meaningful mission while continuing to grow and develop their careers. I believe that is something we can offer.
We are also seeing a profound shift in the way we work. Artificial intelligence is transforming many aspects of our business, and the profiles we look for are evolving accordingly. Across all functions, curiosity, adaptability, and the willingness to embrace new ways of working are becoming more important than ever. I believe mindset is taking on greater significance than ever before. As our portfolio becomes more complex, market pressures increase, and uncertainty becomes a constant, people need to be comfortable navigating ambiguity and continuously learning. Experience and relationships remain important, but qualities such as curiosity, resilience, and a growth mindset are now critical to success. Yet healthcare remains a fundamentally human business, and we firmly believe that direct engagement with physicians and other stakeholders will continue to be essential.
What would you like to achieve in Germany over the next few years, and what legacy would you hope to leave behind?
First and foremost, I hope we will have improved the lives of even more patients by bringing our innovations to those who need them. We have an exciting pipeline, and over the next 24 months I look forward to seeing more of these medicines reach patients across the disease areas we have discussed. At the same time, I am realistic that uncertainty will remain part of the environment in which we operate. The question is not whether challenges will arise, but how we respond to them while staying focused on our mission. If there is one thing I would like to leave behind, it is a culture in which people embrace growth, curiosity, and resilience, and continue to thrive despite the complexity and uncertainty around them. Throughout this conversation, we have spoken about innovation, access, policy, and transformation, but ultimately it all comes back to people. If we can strengthen this mindset, stay true to our purpose and continue translating innovation into meaningful benefits for patients – while making it available to the right patients as early as possible – that, to me, would be success.
