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EF: What was the strategic decision behind Pfizer’s restructuring, and what attracted you to Pfizer Spain?
CM: Our past experiences, business management, and the evolving global landscape influenced the restructuring decision. In Latin America, we consolidated our businesses under one management structure, learning from our journey. However, it differed in Europe. It was more like operating six separate entities. Reflecting on lessons we learned during the pandemic, we decided to change the European structure. We opted for a unified approach, consolidating businesses under one P&L management organized by country rather than by therapeutic areas. This change aimed for a comprehensive overview, focusing on country-wide potential growth. New roles were introduced to facilitate this, including the position of country president for major European markets. I embraced the opportunity to become the country president of Spain, bringing my experience from managing a large business in Latin America. Speaking Spanish was an asset, but my proficiency in managing a similar structure in Latin America played a more significant role. This move was both a professional and personal win for me. Having extensively worked in Latin America and the US, the prospect of contributing to a big European market was exciting. Plus, the chance for my family and me to experience living in Europe made it a fantastic opportunity. I happily took on this role almost a year ago.
EF: What are the current priorities on your agenda, and what can we expect from Pfizer in 2024?
CM: Looking at Pfizer's goals, from 2023 to 2025, the aim was to introduce 25 new therapies. This period is intense as we prepare and launch these products. It is a first for us to launch so many new therapies in such a short span, including gene therapies, which pave new paths in healthcare. It is an exciting yet challenging time.
Now, getting back to Spain, our priority aligns with this global ambition—to successfully launch these new products here. Vyndaqel, a significant product, was launched this year. We have also introduced NGENLA, a once-a-week growth hormone therapy, and we launched the RSV vaccine in December. Additionally, the anti-migraine product is on track for launch. Launching these products in Spain is vital. However, navigating Spain's healthcare system poses challenges, particularly regarding reimbursement for these new treatments. It is a process that requires great attention, so our focus remains on launching these products successfully and securing reimbursement in Spain.
EF: As the ambassador for Spain within the company, how would you describe the strategic significance of the Spanish market to Pfizer? What is your pitch to HQ to attract resources into Spain?
CM: Spain is one of our major markets globally, ranking among the top ten countries worldwide. This significant market size greatly impacts our sales, positioning us strongly in the business landscape. It is a key strength that propels us forward. Another key aspect is Spain's pivotal role in clinical trials. It's our second-largest global market for essential therapies in this domain. We invest substantially in clinical trials here, collaborating with 642 institutions on numerous medical research protocols. Spain's importance in this area is a competitive edge for Pfizer and the entire industry.
Additionally, Spain shines in technology adoption and innovative work models. Within our company, Spain is becoming a reference point for pioneering initiatives. We are a pilot country for the company's significant digital and technological projects, often leading the way globally. This sweet spot—substantial but not overwhelming like the US or China—allows us to implement and test innovative ideas effectively. Spain's contributions in these areas make us proud of our achievements.
EF: Could you talk to us about the technology pilot programs you are running? How do you distill what is useful to the patient and what is just tech-related noise?
CM: Answering that question is tough because we are still figuring it out. We are experimenting with various approaches but have not pinpointed the winning formula yet. Internally, there is a sense that something significant is brewing, but it is not crystal clear. I recently spoke with a leading figure in digital health, who emphasized that there is no turning back—it is an inevitable evolution, even if we cannot fully see it yet. Artificial intelligence is set to revolutionize things, and like many companies, Pfizer is actively exploring its potential. We have made progress but are still in trial and error, searching for what truly works.
Technology's impact at Pfizer differs across areas. Using big data and AI has been game-changing in developing new medicines that enhance the patient experience. We are still on a journey, striving to optimize these tools and eagerly anticipating what else we can achieve. A lot is happening, and we hope to be at the forefront of these advancements, but we are not at the stage where we can confidently say, “Yes, we have got this.”
EF: How do you quantify access to innovation in Spain, and what would be your definition of access?
CM: Having worked across Latin America, I have seen the spectrum of healthcare. Private clinics there offer top-notch care if you are one of the fortunate few with good jobs or income. The quality of doctors, access to technology, and treatments in places like Mexico, Chile, or Brazil can rival Spain or the US. However, this high-quality care only benefits a small percentage of the population—maybe 1% to 15%. Most of these countries have limited access and outdated healthcare systems. Contrasting this with Spain, where nearly everyone has access to good public healthcare, there is a significant difference. Private healthcare in Latin America excels in comfort and service quality. Yet, my recent experience in Spain showed the contrast—while I faced a three-month wait for a specialist, here, everyone has access, even if it might not be at the same level as in private clinics in Latin America. The key difference lies in accessibility: in emerging markets, high-quality care is limited by income, whereas in Spain, it is more universally accessible.
Access, to me, means getting what you need when you need it. It is not just about availability but also the timing. Spain's health system, once considered excellent, is facing challenges. Reimbursement for new technologies is getting more challenging, with an average wait of 629 days compared to the European standard of 180 days. This affects patient access, and only 58% of products get approval.
This situation is concerning, not just from a business standpoint at Pfizer but also personally, as I live here now. It is worrisome to see Spain, once known for its efficient system, facing delays and lower probabilities of approvals. The potential impact on my family's healthcare in the coming years is a real concern. The disparity in access within Spain is increasing, especially with the 17 autonomous regions, each having its own health process. It is a complex problem, and as a company, we aim to ensure that life-changing innovations reach patients despite these challenges.
EF: If you were to give a speech to your employees in 2024 as you celebrate Pfizer’s 175 years of shaping the future of medicine, what would you include in your speech?
CM: Over the last 18 years at Pfizer, I have seen our contributions to improving global health. We have been part of significant changes, such as statins reducing cardiovascular mortality. Our role in transforming health goes beyond inventing new medications; it is about reshaping our approach to health as a society. The world's complexity is evolving, demanding a shift in our business model and societal views on health. Innovations like gene therapy are on the horizon, prompting us to reconsider how we value long-term health outcomes. We are moving toward a future where preventing diseases takes precedence over treating them, and as a company, we strive to lead this change for a more sustainable healthcare future.
