AstraZeneca (AZ)’s country president for Singapore, Vinod Narayanan, outlines the challenges of taking the reins at an affiliate against the backdrop of a pandemic and how the Anglo-Swedish company’s quest for a COVID-19 vaccine has opened up new partnership opportunities in the region. Narayanan also touches on Singapore’s open ecosystem for innovation, the rapid speed of approvals for innovative therapies there, and key trends across the Asian oncology landscape.
[Growing] awareness and recognition of the burden of cancer is accelerating the push for innovative medicines and diagnostics. With the availability of newer diagnostic platforms, there is a trend towards targeted cancer medicines that offer better outcomes for patients
Can you introduce the responsibilities of your role as country president for Singapore and the career trajectory that has brought you to this point?
As Country President for AZ Singapore, I lead an organization that is patient-centric and brings healthcare innovation to Singaporeans every day through our medicines. My responsibility is to lead an enterprise that: (1) thrives on scientific and commercial excellence, (2) invests in partnerships with our healthcare partners and providers, (3) delivers a profitable and sustainable business built on AZ values and a people-centric culture.
I started my professional career over 20 years ago in Philadelphia at the height of the dot com boom. I am a Chemical engineer by training and consider myself an Asian returnee, having grown up in India before moving to the United States in the mid-90s to pursue a master’s degree and subsequently an MBA from Stern School of Business at New York University. I worked in the US for nearly 15 years, first in management consulting with Ernst and Young before moving into the pharmaceutical industry with Aventis based in New Jersey, and then with Roche/Genentech in San Francisco. I had the good fortune to work in different business units early in my career and held various commercial responsibilities with both companies. I was always drawn to roles where I could be closer to patients, customers and the business. Gradually, I made the transition from being an enabling function expert to a P&L owner; leading commercial teams across multiple disease areas.
Having spent almost 12 years in the pharma industry at that point, one of my aspirations was to gain global experience. I moved from the US to Singapore in 2013 with Roche to set up the commercial excellence capabilities for the organization. The US is a more mature market and is highly specialized, but Asia presented exciting growth and business development opportunities. I was able to ride that wave, first in Singapore and later in Thailand and Malaysia. Through these experiences, I developed expertise in oncology commercialization leading teams through successful launches of many breakthrough biologics and immunotherapy medicines.
In 2019, after spending three years in Malaysia, I returned to Singapore with AZ as commercial director for the Asia markets. This leadership role provided me with a platform to get acquainted with a broader portfolio beyond oncology, and an opportunity to work across a broad geography all the way from India to South Korea. I was working alongside diverse and multicultural teams to drive regional strategy and commercial execution. Last year, I took on my current role as country head for AZ Singapore while continuing to serve as the oncology sponsor for the Asian markets.
The mile-markers of my career journey are embedded with memorable transitions across companies and countries and the ride has been quite exciting. Through these experiences, I worked alongside so many great people and teams who enriched my learning and development as a leader and continue to inspire me every day.
Having taken your first country manager position during the COVID-19 pandemic, how did you go about setting up priorities for the organization?
Working against the backdrop of the pandemic has come with plenty of starts and stops. Over these 15 months, I have had to build my leadership team as well as expand the organization to support our business growth. Carrying out this transformation in a virtual setting has been a tremendous experience.
During the pandemic, one of our main priorities was to maintain business continuity, ensuring our products reached patients and healthcare professionals without disruption. On that front, our supply chains proved to be extremely resilient and we have had no stockouts across our portfolio. I must give kudos to our operations and supply chain associates who have made this a reality despite challenging circumstances.
Our second priority was re-imagining ways to reach healthcare professionals and to continue engaging them despite the severe access restrictions that the pandemic brought about. We have embraced digital and virtual ways of working in a big way and I am amazed at the agility shown by our customer-facing teams to make this possible.
Thirdly and most importantly, we invested in our people (AZians) to make sure we stayed together, supporting each other to maintain our overall wellness through many Great Place to Work initiatives. Beyond providing monetary support through digital care packs and working from home (WFH) benefits, we prioritized activities around mental wellness such as meeting-free days & exercise programs to ensure our team stayed positive and healthy. The engagement and response to these home-grown ideas have been outstanding.
In terms of overall business performance, AZ is ranked as one of the fastest-growing Pharma MNCs in Singapore. We are over 100 people strong, including teams representing the Asia Area and International business. We promote a strong inclusion and diversity (I&D) culture via our I&D champions to foster a speak-up culture, to empower inclusive leadership while sustaining a diverse leadership and talent pipeline.
Can you tell us about the products that AZ has already commercialized in Singapore? What are the therapeutic areas driving growth?
AZ has a broad and strong presence across multiple therapeutic areas. Oncology, cardiovascular, renal, metabolism as well as respiratory and immunology serve as the main areas of focus. Vaccines is the latest addition to this impressive portfolio, ranked one of the best in the industry.
While our growth story runs across all our product lines, our oncology portfolio has seen some remarkable product approvals in the last few years with Tagrisso and Lynparza leading the way and establishing new standards of care in lung cancer and ovarian cancer respectively.
Although AZ is now strongly connected to vaccines in the public imagination, it has not traditionally been a vaccines company. From a country manager perspective, what has that meant in terms of communication and managing expectations?
Embracing the COVID-19 vaccine clearly reflects the courage of the organization and a significant contribution towards changing the course of the pandemic globally. Being able to develop a life-saving vaccine in a short amount of time in partnership with Oxford University has been a huge inspiration for everyone in the company. As we speak, the AZ vaccine is present in more than 170 countries and over one billion doses have been shipped within a year.
The biggest takeaway for me, one that makes me extremely proud to be part of AZ, is the fact that the company decided to bring this vaccine to market at cost while helping to ensure equitable access. As a result, we have been able to provide vaccines to low and middle-income countries that would otherwise not have them.
While Singapore has successfully rolled out mRNA vaccines, we continue to be in touch with the Ministry of Health and infectious disease experts to share the evolving real-world evidence around the AZ vaccines and inform their thinking on vaccination approaches post-pandemic. In addition, AZ is also developing Long Acting Antibodies (LAABs) that have a role to play for the population segments unable to take COVID vaccines.
Singapore is a relatively small market, but what is its significance to AZ in the region and beyond?
I think Singapore offers significant advantages. First, it has an open ecosystem for innovation where we are able to bring new products to market and get them approved by the regulator much more quickly than in other parts of the region. Second, it provides access to world-renowned institutions and healthcare professionals with who we partner to advance these innovations in patient care. We work closely with healthcare professionals not only from a commercialization perspective but also in terms of investments in clinical trials and generating real-world evidence. We have invested over USD 30 million here over the last five years. Third, Singapore offers AZ the opportunity to tap into a highly skilled talent pool across many disciplines. Our Singapore talent not only does great work for the local market, but we also have great examples of people moving from Singapore to regional and global leadership roles as well.
How do you work with government stakeholders in Singapore beyond bringing drugs to market?
Our ambition to become a healthcare innovation partner of choice requires strategic partnerships in the Singapore ecosystem including with the government. We are aligned with initiatives such as Smart Nation journey and the Healthcare Industry Transformation Map’s ‘Three Beyonds’ strategy to partner and speed up the deployment of digital healthcare technologies, accelerate skill development, and advance Singapore’s position as a global hub for cutting-edge R&D initiatives. To this end, we launched our Global Innovation Hub in February 2020 with three leading healthcare organizations in Singapore.
In April 2021, AZ also joined the War against Diabetes in partnership with Diabetes Singapore through a multi-year partnership endorsed by MOH. We have launched a digital campaign called Beyond Sugar to enhance education and early screening efforts aimed at preventing and delaying complications arising from Diabetes and Chronic Kidney Disease.
Importantly, through these ongoing interactions, we seek to build the government’s confidence in working with industry through private-public partnerships, to foster an open and collaborative environment for healthcare innovation.
Looking at oncology in Asia, what are the main trends that the industry should keep in mind and where are the areas in which AZ can make a difference, considering a large number of innovations coming online and the presence of so many big competitors?
The incidence of cancer is increasing in Asia and sadly many cases are detected only in the later stages of the disease. For example, Stage IV (advanced) presentations of lung cancer is close to 70 percent or higher of the total leading to poorer clinical and quality of life outcomes for these patients.
One of our signature initiatives working with healthcare systems is to improve the screening and diagnosis of lung cancer patients. AZ is spearheading a global program called Lung Ambition Alliance to double the survival of lung cancer patients over the next five years. In that process, we want to make sure that hard to treat diseases like lung cancer move in the direction of higher survival and even towards a cure.
This multi-year program implemented across the Asian markets has three main objectives: one is investment in screening and diagnosis, the second is the use of innovative medicines in the right setting to help patients when it matters, and third is post-treatment, enhancing the quality of care for patients.
Beyond enhancing the quality of care for patients, we continue to make a difference to patients through our Cancer Can Give movement where cancer survivors come together to inspire other cancer patients through contributions to society, and are given a voice to advocate for progressive healthcare policies. This movement started in Singapore and has now launched in 27 other markets in the International region.
Asia is a very heterogeneous region with both very developed economies and healthcare systems as well as those currently in a much earlier stage of development. How then do you develop a region-wide oncology strategy?
Asia offers a variety of market archetypes ranging from government-funded systems on the one side to largely out of pocket systems on the other. There are distinct differences in the regulatory approval timelines that can be years apart across these markets. Additionally, the infrastructure and the capabilities of the health systems are at various points of evolution. As a result, our oncology strategy tends to be very customized to the realities of the respective markets.
The good news is the awareness and recognition of the burden of cancer is accelerating the push for innovative medicines and diagnostics. With the availability of newer diagnostic platforms, there is a trend towards targeted cancer medicines that offer better outcomes for patients.
Improving and sustaining patient access to innovative medicines is another central piece of the oncology strategy. Many markets around Asia have a dichotomy of payer systems, making it necessary to have approaches catered to these segments. While the public payor has cost containment and value considerations as priorities, the private market is keen to adopt the latest innovations and offer a wider range of treatment choices for patients. It is common to see patient assistance programs across these markets to help with affordability barriers and these programs are expanding to offer services beyond product assistance to include holistic services associated with cancer care.
Finally, what is your organization’s overall strategy over the next couple of years, through the pandemic and beyond?
Our calling has always been understanding what science can do, focusing on innovation to address unmet medical needs.
I believe that it is an exciting time to be in healthcare. Because of AZ’s leading role with COVID-19 vaccines, we have been able to appreciate the strength of partnerships and how quickly we were able to create strong networks with different stakeholders around the world.
When it comes to ambition, our strategy revolves around three pillars: innovation, expansion, and partnerships. The innovation side is, of course, our scientific advancements advancing standards of care and leading with patient-centricity. On expansion, we want to serve new patient segments & establish new channels of business in the Asian markets to serve more patients. We are not centred only around big cities but also expanding and investing in capabilities to serve patients in rural areas. The bigger goal is to leave no patient behind!
In terms of partnerships, we do not see ourselves just as a manufacturer of drugs but rather as an organization that can play a broader role in the patient journey, from awareness & screening to post-treatment care. Through our network of innovation hubs in Asia and around the world called A.Catalyst Network we are actively working towards realizing this ambition in a sustainable manner.