Read the Conversation
EF: What mission were you given when appointed GM of Mundipharma Brazil in August 2020?
CG: Mundipharma started its global transformation in June 2020 when Marc Princen became CEO, improving country-to-country synergies, best practices, etc. The process happened to overlap with the pandemic. When I was appointed, my mission was to replicate the transformation process in Brazil and provide health consistently and responsibly while addressing the needs of our people and customers (doctors and patients). I had to move the Brazilian affiliate in the same direction, do the transformation and consolidate operations of the team in Brazil, paying attention to the top and bottom lines while offering health consistently.
EF: What were the lessons learned while managing through the pandemic?
CG: We had to adapt to working virtually, which was harder for some people than others, but we managed well. We are now coordinated, and our employees work with responsibility in a home office mode. We have moved from a big office to a smaller one, and we have a mobile office too. Currently, 50% of the personnel work from home and the other half from the office. Our "We Care" initiative creates an environment where people are respected and have a good work-life balance in a psychologically healthy environment. It is our way of taking people into account and staying close to them.
EF: 2020 was a year of diagnostics and prevention, and 2021 was a year of vaccines. What do you think 2022 will bring?
CG: We are returning to a normal situation with certain added side effects. During the pandemic, many people delayed their health checkups on their more serious ailments, as people were scared to go to hospitals. Some patients are now showing Covid side effects that have appeared in the mid to long term. Another pandemic effect is that people are more aware of health prevention, possibly because most of the patients with Covid complications have comorbidities, creating more health awareness.
EF: You have an oncology, pain, and ophthalmology portfolio. How does this portfolio translate to Brazil's needs?
CG: Our focus in Brazil is on pain treatment, putting the patient's unmet needs at the centre of the equation. We don't have an oncology area in Brazil, but we do pain treatment for cancer. We work with continuous patient-medical sessions and support the doctors to better treat the patients in pain (generally from cancer), with moderate to severe pain using both our and competitor's products to address the needs of the patients. Patients often receive treatments that do not match their pain level, and nobody can live a normal life when they are enduring pain. Pain medical education is the basis and foundation of our work. We treat the patient's pain responsibly with "delicate" drugs.
EF: Is pain management perceived as a therapeutic area in Brazil? (Is it even considered a disease?)
CG: There aren't a lot of pain specialists, but this is improving over time. The main concern of the oncologist is to treat the tumour or cancer in the patient's body, but we think there must be more empathy for the patient's suffering. A study from an NGO for patients with cancer, OncoDia, which works with over a million cancer patients, did a survey that shows that more than half of the patients suffer from pain and believe pain treatment should be part of the healing process. It also shows that many treatments were inappropriate for the cancer patient's pain level. Pain management must be addressed, and there must be more empathy for patients. There has to be more aware of how suffering blocks the possibility of the patient from doing many other activities. A balance must be found in the correct and responsible use of pain management, with the right doctor prescribing the right product and indication for the right patient.
EF: What is your personal definition of access?
CG: The word access is usually linked to the public health system but is a much broader concept. In Brazil, for instance, 75% of the population depends exclusively on the public health system, and 25% have a private healthcare plan. Only a quarter of the population has access to better hospitals and treatments. The rest have to resort to the public system, which doesn't compare to the European public system. Even though there is access to better institutions in the private system, the cost is excessively high. In terms of private healthcare costs, I think there is better access in Argentina than in Brazil, and we need to improve the system as a whole, not just the public system. Decrease the cost of the private system and improve the quality of the public health system.
EF: How much of your business is directed to public versus private?
CG: In pain management, less than 5% of our business is with the public sector, and it is a number we want to improve. There are very few options and alternatives available in the public system in the pain area, and they must be increased; other therapeutic areas have many more choices. In Brazil, to sell at a national level, we must be approved by CONITEC, a government entity that approves products to be available for use in the federal public system. They have some autonomy and can purchase directly even if the product is not listed at a national level.
EF: What skill set is needed for the future employee, and how do you attract talent to Mundipharma Brazil?
CG: To retain the talent within the company, we need to show we are going in the right direction, growing consistently in our health offering, and have a vision for the future. Last year we needed to fill some positions, and we prioritized our people internally to participate and get promoted and grow within the organization. We encourage our employees to voice opinions, recommend suggestions, participate with ideas, and when we put them into practice, we gain trust. As a result, our people promote the company, making us an attractive one. Before I came to Mundipharma Brazil, the company went through many ups and downs, and during the first part of our transformation, people left the company because they didn't believe it would work for them. It is better to have a lean structure, be agile, move forward at the right speed, grow carefully, and consolidate each step.
A key aspect for us in Mundipharma is to further increase our diversity and inclusion footprint, and Brazil is a country with a lot of potential on that front.
EF: What potential does Mundipharma see in Brazil?
CG: Based on the new launches we have planned, we see a lot of space for growth in Brazil. In pain management, there are great market opportunities related to the unmet needs of patients. Once the government starts giving patients access to pain management products and buys Mundipharma and our competitors' products, we will certainly improve our 5% sales to the public sector. More specialists must be trained in pain management as it is central to better life quality. Pain specialists are now discussing multi-modal treatments for severe pain. Different medicines can be used for the same patient suffering severe pain: anti-inflammatories, opiates, or other alternatives, all combined, as they substitute one for another.
On top of that, Brazil has been selected together with the US and Japan as a key market to launch a novel antifungal product. This is an area that has not had any innovation launched in the last 2 years. This represents a great opportunity for Brazil, and this is the result of the collaboration of Mundipharma and Cidara Therapeutics.
EF: How do you rate the physician's eagerness to learn and have more information on pain management?
CG: By putting the patient in the centre, we create empathy toward the patient from the doctors. We encourage doctors to participate in events, training courses, and key opinion sessions because this helps them empathize with those suffering pain. For example, oncologists focus on cancer rather than the patient's pain, and this is what we want to change. The Brazilian Society of Pain Specialists is dedicated to improving pain management for all specialists, for example, orthopedists that are not specialized in pain.
EF: Fast-forward five to ten years; how would you like your tenure as a leader to be remembered?
CG: Passion is a legacy. I want to be remembered for having worked hard to prioritize patients' unmet needs and allowing people to grow, learn and flourish. I would like people to remember me for their professional development and feel I was part of that. HCP (Healthcare Professional) is a term that includes doctors, nurses, and caregivers, but I consider myself to be an HCP. I don't sell medicines; medicines are sold due to my work with doctors and patients unmet needs, and I would like that to be my legacy. My role is to reassure people's genuine concerns, be transparent, and play in a diverse space. Leaders need to change their mindsets, or they will not retain people's trust. I work with sales representatives in the field and visit doctors. There are no barriers for people to access me. The role of leaders has changed a lot with the pandemic, and we have to listen, guide and give purpose to the team. The healthcare environment needs to work in an integrated way, not in silos, and collaborate even with competitors to discover unmet needs and improve patient access and the health system. All countries in the world, developed and underdeveloped, had problems coping with Covid. Now they must analyze and identify their mistakes and be proactive for the next pandemic in the future. The countries must be better prepared next time.
