MSD’s managing director for Hong Kong and Macau, Vincent Tong, came to lead the affiliate during the COVID-19 pandemic. He outlines the challenges and opportunities of a challenging time, discusses the leading position of the company’s cancer treatment Keytruda and his efforts as board member of the Hong Kong Association of the Pharmaceutical Industry (HKAPI), advocating for a favourable ecosystem to, among other goals, attract pharmaceutical companies to invest in clinical research in Hong Kong.
We see the great potential of Hong Kong as a gateway to mainland China for the international markets and vice versa and we should leverage this position more, especially with respect to clinical trials
You have been in your current role for about two years now. What have your priorities been during this initial period?
I arrived in January, 2021, during the pandemic, so it was a rather challenging time. However, we have a saying in Chinese ‘opportunities arise from crisis’, so that time may have been challenging, but we were still able to make a lot of progress and transform opportunities into actions.
Firstly, it is important to highlight that those were difficult times, and even up until February last year we had many elderly patients lining up in the emergency rooms of hospitals. We were in fact the first company to bring oral treatment to Hong Kong for COVID-19 and the government was openly very grateful for the work MSD did, and my team demonstrated exceptional engagement with the relevant external and internal stakeholders during that time to make things happen in a relatively short turnaround time.
At that time doctors were having difficulties treating oncology patients and there were not enough doctors as they were involved in COVID-19-related operations. Normally patients get our immuno-oncology infusion treatment every three weeks, but based on new data we were able to accelerate just in time a new dosage registration for every 6 weeks, and this helped alleviate the overloaded healthcare system. The prospect of fewer trips is always a win for patients and families.
Thirdly, we placed a strong focus on patient access to innovative medicines and vaccines during that period and within this third point we brought forward several projects.
There is a misconception that everyone in Hong Kong is wealthy, but in Hong Kong there is a Community Care Fund (CCF) set up by the government and various charities to assist underprivileged patients who cannot afford innovative medicines. Through this programme, we made our immune-oncology medicines more accessible so that they could reach more ‘safety net’ patients for more types of cancers. In addition, to help another group of patients who are not eligible for CCF and need to pay out-of-pocket at public hospitals, we initiated our own MSD patient assistance program in partnership with a reputable cancer charity group – Hong Kong Anti-Cancer Society. Once a doctor decides that a patient requires the therapy and after the assessment carried out by HKACS, the eligible patient then enters the program with financial assistance.
Equally, we were not only working to treat cancer but prevent it through our innovative HPV vaccine. During COVID-19, people could not leave their homes and so the population was confined by the borders of Hong Kong. Therefore, we took this opportunity to generate massive disease awareness of HPV among women and men and drive urgency to make informed choices for preventing HPV-related cancers. We did a consumer activation campaign with huge success by using local celebrity artists who can resonate well with the general public.
How does Hong Kong evaluate a vaccine’s efficacy and safety to decide if it will become part of the territory’s vaccination regime?
There is a Scientific Committee on Vaccine Preventable Diseases that sits under the Centre for Health Protection, Department of Health and is composed of a group of experts. Typically once they make a recommendation to the government, and after the relevant government approval process, the vaccine will then be mandated as part of a free-of-charge mass immunization programme. The HPV vaccine has been recommended for all women under 18 in November 2022, so we hope this should be in place soon.
You mentioned the responsiveness of the affiliate to the pandemic. What are your priorities now that the crisis has passed?
People are an important priority. Our team is made up of more than 100 people and our goal is to allow them to grow and move within the company to different roles and functions. This gives them opportunities for development and helps to build the strong culture MSD is known for.
When coming back to your home country after many years abroad as I have, you always come back with a mission, and for me, it was to help grow the next generation of Hong Kong talents who can either go abroad or stay here and be the new industry leaders and shapers. We want to show the excellence of Hong Kong’s healthcare to the world and we already have some employees who are doing this.
MSD assets like Keytruda for diverse types of cancers are making an incredible impact on patients. How has Hong Kong received it and what is the status of new indications and possible combinations with other oncology therapies?
In Hong Kong, MSD’s immuno-oncology drug is not only the I/O class market leader in terms of patient usage, but physicians also appreciate it and the value it can bring to patients. It is not just a single product but has multiple indications that can treat many types of tumours. We are busy working with the regulatory authorities and the Hospital Authority to demonstrate this value and file for new indications continuously.
Some of these new indications have received FDA and EMA approvals, and we are looking to see how we can bundle approvals for more new indications, rather than submit them one by one. Thankfully, by working closely with the Department of Health to drive efficiency, last year we had 8 indications approved at once which was record-breaking.
The priorities are to continue enlarging further indication approvals because expanded indications approval can allow more patients to benefit from our affordability solution mentioned beforehand. Therefore, we are identifying the patient journey and the willingness of doctors to offer the therapy. We have a strong oncology pipeline, so we are excited for the years to come.
MSD’s immuno-oncology medicine has started to also become the backbone of many cancer therapies in conjunction with other medicines for cancer patients and we are working with our strategic alliance partners e.g. Eisai to provide them here. Furthermore, MSD is developing its own pipeline of innovative cancer medications that can be used as combination therapies.
Are pay-for-performance or value-based contracts a common practice for Hong Kong’s payer, the Hospital Authority (HA)?
Not a routine at the moment but discussions are ongoing with different points of view among stakeholders. While talking about this practice, I would like to bring out the importance of data in Hong Kong and its ever-increasing value. I would like to point out that the Hong Kong healthcare system has a well-oiled infrastructure with the potential to become a data-driven healthcare ecosystem. The HA is the largest healthcare service provider and has the majority of the electronic health record database related to Hong Kong patients, so if the data is more accessible in the future, it would make it easier to create performance metric assessments or assist in a pay-for-performance model. This could also benefit academic researchers, HA administrators and pharmaceutical companies to run more Real World Evidence (RWD) studies for the best patient outcome.
What does the future present itself for MSD in Hong Kong?
Oncology will continue to be a key driver for us. Our immuno-oncology product will maintain our leadership in I/O class medicine, but we will look to obtain access to more patients in need. Access is close to our hearts and brings out the real meaning of our work, and we can assist in this by accelerating regulatory approvals and facilitating affordability pathways to patients. We aim to bring in a more innovative oncology product pipeline either from MSD or in collaboration with other strategic partners.
Within vaccines, we have focused heavily on the HPV vaccine and the need to increase its range to all women, but we must not forget men. It has been shown that it not only prevents cervical cancers, but many other HPV-related diseases impacting men, e.g. Head & Neck Cancers. We have provided more relevant data to the scientific community with the intent to make it a gender-neutral vaccine.
Our hospital speciality products range will continue to grow and COVID-19 taught us a good lesson about the importance of antivirals and the ability to scale up with speed and have a solid supply chain.
MSD is also looking into cardiovascular diseases with quite robust pipelines in the next few years.
What is your view of digitalisation within the healthcare system in Hong Kong?
Digitisation is moving us in the right direction in Hong Kong, especially if you look at the recently established primary healthcare authority as it moves towards the prevention of diseases, rather than just treatments. If we are able to properly identify which patients are more prone to certain conditions through screening enabled by big data analysis, especially in areas like cancer and diabetes, we will save the healthcare system down the line. This will allow hospitals to focus on secondary and tertiary healthcare and primary healthcare will more focus on disease prevention which could be facilitated digitally. Furthermore, online App systems like ‘HA Go’ and ‘eHealth’ have already been put in place, which enabled electronic health record sharing between public and private sectors. The online virtual remote doctor consultations, followed by direct oral COVID drug home delivery, that took place during the pandemic also drove digital adoption more quickly.
As a member of the board of the Hong Kong Association of the Pharmaceutical Industry (HKAPI) one of the areas you are advocating for is the creation of a life sciences office within the Hong Kong government. What is the reasoning behind this?
It represents the possibility of ensuring that our industry participates in the economy and that our impact increases. We have undertaken many discussions about this and set up a number of task forces around this. The one I am sponsoring is called “Partnering for Medical Advancement” task force. It is a work group with representatives from multinational research-intensive biopharmaceutical companies. We are looking at how we can connect Hong Kong and make it a part of international biomedical health solutions.
One of the major discussions has been based around clinical trials and not just about investing money, but developing the ecosystem through regulations, the scientific community and making favourable policy changes that attract pharmaceutical companies to invest in clinical research in Hong Kong. Furthermore, we see the great potential of Hong Kong as a gateway to mainland China for the international markets and vice versa and we should leverage this position more, especially with respect to clinical trials.
The second area the task force is working on is obtaining quality data and using it responsibly. We have a population of more than 7 million, comparable to some European countries like Sweden or Denmark. Nordic Health Registry is famous in the world since it provides registry-based research in large populations with long time follow-ups from birth to death. If they are able to use their data to attract clinical trials, we probably can too. The Hospital Authority holds a sizable patient database in Hong Kong and it can offer great potential. If this data system can connect to the Greater Bay area in Southern China with ~86 million population in the future, it will be even more appealing for research.
Many RWD study results leveraging public electronic health record from the University of Hong Kong and the Chinese University of Hong Kong have been published and the result was amazing, especially during the COVID time to show the value and patient benefits of oral COVID drugs which had been published on various international medical journals. It was so good that many of the scientific experts involved in the study were invited to other countries to share what they learnt and created an impact above and beyond Hong Kong.
With the vision to develop Hong Kong as an international biomedical hub, we think a dedicated life sciences office/division in the Hong Kong government will help drive favourable policies and support the development of precision medicine and coordination among relevant parties. The office can also provide a concierge-style service in which pharmaceutical companies can talk with the government bodies so that both sides can align their goals and KPIs.
What kind of company culture are you looking to bring to MSD Hong Kong as you look ahead?
The culture here for MSD in Hong Kong and Macau is built around a three-letter acronym, ACE. ‘A’ stands for authenticity and this will allow people to live and work to their fullest. ‘C’ is for courage, and this is the ability to let people have different perspectives, this is what drives discussions and positive changes. And ‘E’ stands for experimentation, and is based on allowing people to try new experiences and grow inside the company. We don’t expect every experiment to be a 100 percent success, if people fail in a project, it is ok, as long as they learn and progress based on the lessons they have learned. If the whole industry, not just MSD, could put this diverse and inclusive culture in place to encourage more exchange and experimentation of new ideas, we would move forward to promote innovation and improve Hong Kong’s Healthcare together much faster.