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EF: What are the current priorities on your agenda, and what can we expect from MSD Spain in 2024?
AA: Our company has an important mission focused on patient-centricity, placing them at the center of our research and clinical development efforts. Currently, in Spain, we stand as the first-largest market in clinical research in the EU. This places us in a great position where we can provide comprehensive support for development, emphasizing patient involvement and pipeline assistance. Our broad portfolio is a vital aspect and a positive representation of the company's more than 130 years of existence. In addition to human health, we play a significant role in animal health, with a major production site in Salamanca dedicated to animal vaccine production. Our commitment extends to a holistic approach, addressing the environment, animal health, and human health and aligning everything to the one health philosophy.
In oncology, our primary focus is on immuno-oncology, which forms a crucial part of our broad pipeline. We take pride in having more than 21 indications approved in Europe by the European Medicines Agency (EMA) and 17 reimbursed in Spain. Despite the challenges we face in access, we continue to launch new initiatives. Collaborations with companies like AstraZeneca, Eisai, and Moderna and our dedication to cutting-edge AI technology underline our commitment to advancing healthcare.
Vaccines play a pivotal role in societal health, and our collaborative efforts, both public and private, reflect our commitment to this cause. We are focused on HPV, as well as on pneumococcal disease. Our comprehensive pipeline spans V116 for pneumococcal disease in children and vaccines for infections like dengue and previous work on Ebola. The RSV monoclonal antibody is another example of our commitment to infectious diseases. HIV remains a significant priority, aligning with our collaborations with major players in that field.
Another key area for us is pulmonary arterial hypertension, a significant rare disease. While our portfolio is broad, we've made important decisions in immunology and cardiovascular disease. Our focus is growth, driven by our dedication to improving the lives of our patients and society.
EF: As the ambassador of Spain, how do you attract resources from MSD headquarters?
AA: Globally speaking, we're committed to clinical research, investing 23% of our total revenues, around 13.5 billion, in this area. This reflects our nature and mission. The New Jersey office understands our determination and dedication, which is straightforward. Collaborating with Spanish stakeholders and being the Spanish Medicines Agency, the first agency to implement European legislation, we focus heavily on hospital-based clinical research with impressive results. Our strong team of physicians and clinicians, supported by diverse and younger talents, contributes to our success in this competitive field.
In 2023 alone, we had 169 open clinical research projects, showing a remarkable growth of over 16%. With 55 years of experience, our roots in clinical development are deeply embedded. The true purpose of our Spanish subsidiaries lies in clinical research, evidenced by the fact that 80% of open clinical studies in oncology happen in Spain. We’re proud of our journey and continue to excel in this very important area.
EF: Could you give us some examples of how you are partnering with different institutions in Spain to advance the industry and to shape policies moving forward?
AA: Our partnerships come in different forms. We collaborate with companies like AstraZeneca, Eisai, and Moderna on clinical research, engaging in different innovative mixes and future developments. Whether it's phase one, two, or three, we have the domain knowledge and are willing to collaborate in these spaces. Manufacturing-wise, we have strong partnerships, notably with ROVI, an excellent Spanish company. They handle the production and packaging of our HPV vaccine. It emphasizes the importance of collaborating with various stakeholders.
We also engage in development projects like our collaboration with Medina in basic clinical research. This partnership, supported by authorities in Andalucía, involves ongoing investment and a relevant approach. Whether it's clinical research, manufacturing, or commercialization, we view partnerships as a holistic way to collaborate effectively.
EF: Do you have any advice for executives on managing both communicable diseases and a non-communicable portfolio simultaneously?
AA: Running diverse businesses is exciting; each business brings a unique approach. For instance, achieving overall survival milestones in severe diseases like oncology is a big win. On the other side, HPV is about promoting prevention, which includes vaccination, which is a whole different strategy. We've got the strength, science, and creative teams to handle all these different businesses.
The key is to focus. You can't tackle everything; focus allows expertise to grow. It's about having the right people specialized in each area and fostering team collaboration. Connecting dots between different specialties, like oncology and cervical cancer expertise in HPV, is also highly important. Allocating resources differs for each business. Vaccines and public markets require different skill sets. It's about matching resources to the unique needs of each business. It is about tendering expertise for vaccines and strong medical knowledge for oncology launches. The capabilities and skills needed vary significantly.
CN: During the pandemic, our company made a significant effort to maintain ongoing clinical trials for severe diseases like cancer. This was a remarkable achievement during the challenging times. While we often discussed various steps during the pandemic, the dedication to continuing these crucial studies deserved more emphasis. It was a tremendous effort that shouldn't be overlooked.
EF: Having such a huge pipeline on a global scale, how does this translate in Spain? Is there some area of your pipeline that you are most excited about that would specifically impact the Spanish market?
AA: Becoming a leader in oncology is one of our goals, and we're happy with our progress. We're expanding in various indications and immuno-oncology while exploring new collaboration models like Daiichi Sankyo and Moderna's personalized approaches. Our exceptional oncologists and scientists, combined with our diverse portfolio and robust clinical research, are remarkable in Spain. On the vaccine front, our involvement goes beyond major initiatives. For example, our collaboration during the Ebola outbreak showcased our readiness to aid global crises. The focus on diseases like dengue, especially considering regional vulnerabilities, is significant. We're particularly excited about our developments in pulmonary rare disease treatments yielding outstanding results, which represent critical milestones, altering the trajectory of the disease. It is an amazing achievement.
EF: What is your personal definition of access?
AA: It is making sure every patient receives the right treatment; this is my core purpose. Together with Cristina Nadal (Policy Exec. Director) and our market access teams, we're devoted to this fight. Securing new immune-oncology indications is a big win and a major part of our daily work. It involves national and regional approvals and navigating protocols across numerous hospitals. We aim to ensure equitable access for all patients. Everyone deserves access to innovation.
EF As you near your fifth year in this role, what achievements do you reflect as your proudest, and how are you looking forward to the next five years?
AA: As a managing director in Austria, I had prior experience, but Spain's size and complexity are different. Eight months into this role, COVID-19 hit, which created an amazing challenge from a leadership perspective. It was my first taste of true responsibility, ensuring we never stopped, especially with our role in producing animal vaccines for MSD. Animal Health is critical for the food chain.
The pandemic changed our portfolio significantly, requiring adjustments in our go-to-market model. On a personal level, our subsidiary's most significant development was in adopting a flexible work approach. Embracing a hybrid model permanently, I'm proud of how we navigated this change. Additionally, being part of the Diversity, Equity, and Inclusion Council in Europe, I've noticed an even greater emphasis on acknowledging our differences. Our networks grew and supported us, contributing to improved inclusion and well-being despite our challenges.
EF: Do you have any final message you want to share with our readers?
AA: Putting patients at the center of the health system is key. Critical aspects are collaborating, nurturing talent, and working strategically and purposefully to prioritize effectively. These factors stand out as the most crucial factors to focus on.
