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EF: Could you give us a brief intro of yourself and share what was your mission coming in a General Manager of Clinigen SA?
CB: I joined Equity Pharma in 2009, we were specialized in supplying unlicensed medicines to patients in this region which was a foreign concept to the South African market at the time. We had close relations with regulators to make sure our products would reach the market. We were growing double digits every year. At first I was heading up the Specialized division which was dealing with unlicensed medicines, and later on, I had the opportunity to oversee business development for the group.
First and foremost, my mission was to grow sales, to continue our double digit sales figure growth. Additionally, I want to expand Clinigen’s portfolio and license those products in new territories. We’re focusing on expanding our footprint in Africa, particularly in East Africa and Southern Africa. From a UK perspective where Clinigen is based, we are seen as Clinigen Africa. As you may know, the Equity Group merged with Link Healthcare to form the Link Group. At that time, Singapore was the head office for the group, and we had expanded to Japan, New Zealand, and Hong Kong. Clinigen Plc acquired the Link Group in October 2015. They were looking to get into the AAA region which is Africa, Australasia, and Asia which is the fastest expanding market outside of the EU and the US.
EF: Would you say that the strategic importance for the Equity acquisition was for Clinigen to penetrate into the AAA markets?
CB: Yes, that’s correct. Clinigen wanted to solidify their footprint in the AAA region. We have the opportunity to provide access to medicines in this region global overview and high quality control standards.
EF: Could you describe the contribution of each division to Clinigen SA?
CB: Clinigen SA is a holding company that consists of 5 operational entities. We have Equity pharma which is primarily focused on niche products. By dealing with European companies, we can distribute their products to the African market and provide access to unlicensed and specialized medications for niche areas.
There’s HomeMed which sets up and supplies devices, provides point of care testing and glucose monitoring. HomeMed is the 2nd biggest provider for glucose test strips in South Africa. This is a big focus to access that market.
Equity Medical Technologies is our advanced wound care company. They supply products like negative pressure pumps from the US and other wound care products for patients.
The Novagen company is a 50/50 joint venture with an Indian company. Novagen focuses on chronic diseases and HIV/ARV for the private sector.
To wrap things up, we have Equity Specialized Distribution which is our licensed wholesaler that distributes for the other 4 divisions. We have it set up adjunct to the building for two reasons. It’s close to the airport and, because we deal with a bunch of unlicensed drugs, or section 21 known in South Africa, we need quick access to medicine. We can provide personal vehicle delivery in case of emergency and other delivery services to provide access to patients. For the warehouse, we have stock holding for 3-6 months at least, so we don’t run the risk of being out of stock. When we’re dealing with exponential growth for different divisions, space is important.
EF: How do you allocate your resources regarding the public and private sector?
CB: It’s different for different divisions, but for equity pharma, we have a 50/50 split for public and private. The public sector is important for us. Even for unlicensed medicine, there is a need for certain products that may not be available. When there’s a local supply that’s out of stock, we work with the government to provide access for those lines for that short period of time.
EF: How do you ensure access to providers and the government for unlicensed medicine?
CB: We have a whole team set up for the unlicensed application process because we need to get the necessary approval from the regulators. We liaise with certain government sectors where they usually come to us to ask for a certain product. We can’t market unlicensed products, but we can speak about the service. The name has grown with the company and because of that, companies and hospitals will contact us for a certain product if it’s not available. If the product is available for us, we can refer them. If the product is not available, we can source the product internationally and provide access via the unlicensed route.
EF: Could you tell me more about your online platform that connects providers to the different products you offer?
CB: Globally, that’s one of the main reasons why Clinigen acquired the Link group. In the AAA, our focus was also on unlicensed supply. At that time, Clinigen had only acquired Idis, the most established global unlicensed supplier. Clinigen provided a global platform to provide access to a global supply which meant we had increased buying power and more certified venders. Once Clinigen acquired Link, we could tap into that supply.
Digitalization is important. Doctors can go to the website and search for products that might not be locally available. The South African arm is not currently set up where you can order a product by pressing a button. However, we currently deal with managed access. There are certain programs for a company that we run. If a patient requires medicine and that’s approved by the medical team, then we can supply that patient directly. The aim going forward is to be able to press a button and source that medication globally. We like to call ourselves the “iTunes of unlicensed meds.” The focus is to provide access with this platform so that they are able to tap into the global supply of medication.
EF: Clinigen deals with 22 of the top 25 pharmaceutical companies in the world. How do you position yourself to be a partner of choice?
CB: Globally, we have a team that works with companies specifically for niche drugs. If they can’t promote a drug yet, we can collect data for them. If a new drug gets through registration or clinical trials and it needs post trial supply, we can provide access to that medication without having the company seen as promoting that medicine. We collect real world data for them, e.g. results, patient numbers, etc. That’s what we call managed access.
Locally, we partner with businesses across the country. We try to be a friend to everyone, not a competitor. It is important for us to do business in an ethical way. If a product is discontinued, we would like to provide a solution or to take it over even if it’s for a smaller market. If a supplier is out of stock, we would partner and provide access to that medicine for the period that they’re out of stock.
EF: It seems that a fundamental business strategy for Clinigen is to foster dialogue and collaboration.
CB: With the whole supply chain, there are often unforeseeable consequences. You might have a factory burning down or difficulties with the regulation. Anything can happen. Globally, a certain company may want to divest in the region. In those situations, we’d like to provide an interim solution. For our own brands, we want to bring our products to a market that needs it. Even if it’s a smaller molecule, we want to get it in through registration available as a licensed product to those who need it.
EF: Could you give some advice concerning South African regulation for other executives?
CB: It’s the same regulatory environment for everyone. However, we still like to liaise with the regulators and make sure we are aligned. It can be difficult, but, in the end, it is important to follow the process to get these products registered. There’s still a lot of work that needs to be done from a regulatory perspective. South Africa lacks an orphan drug program, and we have advised them on that multiple times. Overall, going forward, they are setting themselves up for progress. We’re quite optimistic about the future.
EF: You mentioned that your three priorities when appointed were double digit growth, portfolio expansion, and expansion into Africa. What’s the roadmap looking like for your 3 objectives?
CB: We managed to achieve most of the targets in the first few years. It’s imperative that we stick with the strategy and diversify outside of South Africa. BMS approached us for their portfolio and we ensured that their products are distributed and available in the Southern and Eastern African markets. The BMS portfolio focuses on 20 markets where we are not necessarily focusing on expenditure on smaller markets.
Regarding expansion in Africa, we have a couple of products in registration. There’s always something unexpected that can happen. It’s also expensive to do business in Africa which was surprising initially. Our key focus areas are on East Africa and Southern Africa districts. We’ve received registration through ZAZIBONA where we have partnered with distributors that can market and sell these products.
In East Africa, our priority is to establish our own footprint either through acquisition or setting up our own presence there. At the group level, it’s a strong, strategic objective and it should happen in the near future. We are also assisting some companies with our own supply of unlicensed products. We’ve frequently spoken with regulators to understand the intricacies of East African registration. For example if a product is registered in Kenya, they have a registration process similar to ZAZIBONA where we can receive registration over multiple territories. Expansion into East Africa, and particularly Kenya, is a key focus. Even though we don’t have generics, we have some key niche products that have a need in that market.
EF: I read that you have an educational background in Pharmacy. You’ve also been through plenty of mergers and acquisitions. How much of a pharmacist or businessman do you see yourself?
CB: I am a pharmacist by trade with a Masters degree in drug design. I’m fortunate because it ties into what the company tries to do. For us, the patient is always at the center. We have to make business decisions but the patient is still at the center of mind. We’re different than the run of the mill executive making corporate decisions. We really try to go behind it: why are we doing this? What are we trying to achieve? That’s very important for us.
EF: How difficult is it to integrate company culture due to all your acquisitions?
CB: We’ve been quite lucky in that sense. The people we acquire really do share our vision, and it’s very important to have that shared vision and to communicate it. We get together every Friday afternoon where everyone shares the stories of the week, from the managers to people from the warehouse. It’s important to understand what’s going on in everybody’s world. Our company culture is very important. We’re nothing without the people; a lot of them have grown with the company. In this environment, the only constant is change. Therefore, it’s important to adapt and to communicate what is required. It is important to empower and trust them, so we can share our objectives and trust in them to achieve them.
EF: Do you ever feel a pull back towards drug design or pharmacist?
CB: I certainly have an interest in drug design, but I think getting into drug design might frustrate me. It’s an intense process. During my studies, I understood the process for development and analysis. However, in that process, it’s not necessarily the case that everything goes according to plan. I don’t see myself developing drugs. I have a great appreciation for people that do so in R&D, and it’s important to understand what they do and why they are doing it. For me though, seeing the overview is the ideal position. Most drugs don’t go to market because they get lost in the R&D process. Once a drug reaches market authorization, it’s a big achievement. Going into the future, it’s going to be more and more important with personalized medication, gene therapy, etc.
EF: How is personalized medicine going to impact Clinigen?
CB: For us as a business, 5 of our acquired products are already strategically positioned as part of personalized therapies. Locally, we have set up certain devices to test for gene therapy, etc. We are going to expand into two levels: providing devices to figure out therapies required and providing the therapy and treatment available. In South Africa, we are in a unique situation with the NHI implementation. There will be changes in requirements and the NHI and those requirements won’t necessarily match. As a company, we are gearing ourselves up for both of those changes. Our focus will always be on niche products and their availability, but it’s also important to be geared up for NHI, to focus on what they require.
EF: Final Message:
CB: From a company perspective, we are ideally positioned to provide access for meds that are not in focus. Our vision for South Africa is to be a leading partner of supply for quality medicines and devices. Globally, our mission is to provide the right drug to the right patient at the right time. We really embrace our time here. With every change, there is also opportunity. Opportunity to develop the market and the country and to increase access. Looking at the pharma sector, there’s a lot of change and opportunity. It’s vital to transform to the changing requirements of the public, providers, and regulators. We strive to continually improve our systems and access schemes while ensuring we are still the partner of choice. Don’t get left behind on what was required a few years ago.
