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EF: What opportunities or challenges do you see for 2024?
DF: It is crucial to remember that the growth that Poland is experiencing at the moment is occurring on a very particular foundation. First of all, we experienced high costs caused by the pandemic and subsequent post-COVID-19 infections. This led to an increase in the cost of pharmaceuticals. The second significant effect was the war in Ukraine. Over 1.7 million individuals applied for a Polish national registration number, and it is estimated that around one million individuals are permanently resident in Poland right now. This figure was stagnant in 2023 and saw no growth. The system's customer base started to dwindle immediately thereafter. Keeping that in mind, we need to consider the volume reduction, and all of this occurred at the same time when we were experiencing double-digit inflation across the board.
In our most recent estimate, the pharmaceutical market is expected to increase by eight percent to 11 percent in terms of value in 2024. The volume growth will be modest, in the single digits. This is what we anticipate for the upcoming year. The market can be surprising at times. For example, for Q4 2023, we had predicted less growth than what occurred, and there was a specific explanation for this. There was a significant infection season last year, which was post-COVID-linked. It was reported that people were more susceptible to infection due to a lack of interaction during the peak of the COVID-19 pandemic. We therefore anticipated that Q4 2023 would not experience the same circumstances, but surprisingly, that was not the case, and we saw infections peak in that period. Fortunately, we remained within the range that we provided as our estimate for 2023. Our next estimate will be made early this year in Q1, and we will publish our new prognosis for 2024.
Regarding the current transition, this year's election resulted in a less than seamless handover of power. We are going through a politically tumultuous period in Poland despite the political parties being quite similar to each other We will continue to monitor the situation and see how it will impact the healthcare sector as a whole. There are some positive aspects, such as the fact that the Vice Minister of Health, who oversaw drug policy in the previous administration, will remain in the current administration. He is a highly respected professional, and I think it is excellent that he was retained in his position.
There are huge changes in other areas, and that will impact the whole ecosystem and possibly our plans for the coming year. The situation is still evolving, and we are still in the early stages. However, the new government stated that healthcare will be a priority, and they intend to spend more in this area despite the current high needs of the system. We await to see which direction they will go.
EF: Could you elaborate on IQVIA’s footprint in Poland?
DF: Our organizational structure in Poland is diverse across six entities, collectively employing 1300 staff and several hundred contractors. Within this, 700 individuals are in clinical trial-related roles, and 600 are in non-clinical positions, with 260 in the regional business unit (RBU) reporting to me. Our global business units, housing numerous engineers, cater to both Polish and global markets, optimizing company efficiency.
Poland excels in clinical trials, commanding a substantial 10 percent share globally, ranking third in patient recruitment after the US and Japan. We hold the seventh position worldwide in the number of trials conducted, reflecting a strong foundation in the clinical sector, where we anticipate further growth.
While Poland exhibits promise in clinical trials, we acknowledge a decline in such trials across Europe, contrasting with stable or growing trends in the US. This shift raises concerns about reduced access to innovative treatments in Europe. To address this, IQVIA is proactively working to ensure Europe remains competitive. Our recent collaboration with Pratia in Poland establishes a top-tier clinical trial organization, reinforcing our commitment to advancing clinical research and maintaining competitiveness in the evolving global landscape. forward to expanding that cooperation and, as a result, expanding access to innovative treatments for Polish patients.
It’s important to note that we partner with virtually all pharmaceutical companies present in Poland to various extend with our data, consulting or technology offerings. Recently we have expanded our cooperation with Payers, Providers and Government (PPG) entities.
As an example I can refer to a project that we did a year ago for the Ministry of Development and Technology, assessing a list of API (Active Pharmaceutical Ingredient) crucial to ensuring the health and safety of Poles. The report highlighted challenges in the EU's pharmaceutical supply chain, prompting recommendations for Poland to play a more significant role in ensuring a stable supply of essential elements. Proposed incentives for businesses could stimulate the production of API in Poland or neighboring nations.
We are looking forward to bringing our mission to accelerate innovation for a healthier world by working with all private and public entities in Poland. EF: How do you strike a balance between bringing in new ideas and making new therapies accessible while making sure they are affordable for the whole market?
DF: From an EU perspective, we need to be more competitive. We need to be efficient in doing the clinical trials. If we are at the same level of efficiency as low-income countries, innovation and clinical trials will shift away from the markets. We need to be more efficient than other regions. In terms of accessibility, a large portion of innovative drugs are becoming more accessible because they are becoming generic. That also impacts our clients and can have an adverse effect because of the lack of funding for new discoveries. The industry is concerned about how it will be able to fund future discoveries due to what is happening on the market from a macroeconomic perspective. The increasing interest rates will radically change the market in terms of the availability of funding for biotech companies. Those companies will need to adapt to the new circumstances in that aspect.
EF: How do you see the long-term potential of Poland becoming an innovation hub when it comes to IT services in the healthcare industry?
DF: Poland boasts a rich pool of skilled IT professionals, particularly in the gaming industry, making it a favorable destination for expanding IT and shared services. Despite market disruptions caused by the Ukraine conflict and COVID-19, Poland remains resilient. Tensions between the US and China, primarily on political and economic fronts, are being closely monitored by both companies and the government.
The growing reliance on IT is evident, with companies exploring near-shoring strategies. Germany's high costs for IT specialists and the UK's limited capacity to train more data scientists make Poland, along with China and India, attractive options within the same regional and economic block. This strategic positioning positions Poland as a compelling choice for companies seeking efficient and cost-effective solutions.
EF: What initiatives may be implemented to foster greater collaboration, and are there any that could improve patient outcomes?
DF: A fund was announced for 18 sites in Poland to create regional centers for digital medicine. The buildings at each of those sites were designed to facilitate clinical trials and broader use of secondary data (including NGS) for research, and now they want to expand. Funding for each of those sites was approximately thirty million Polish zlotys. They want to invest in a variety of fields, and the first tenders are anticipated in 2024. They wish to make investments in technology, people, tools, and solutions. I think IQVIA can help with that, and we are keeping a careful eye on those standards to help us select the ones where we think we can be most helpful. The value will be realized by IQVIA, the regional centers for digital medicine, and the patients.
There is also a pan-European project funded by the European Research and Development Fund (ERDF) called "i3 DigiONE." We want to create a federative network of oncology sites across Europe to enhance patient outcomes based on data in one, shared OMOP model. There are two in Poland, one in Lithuania, Estonia and Czechia, and some in Germany and other countries. IQVIA in Poland has been working on the Polish aspect of the project, and a Polish person is leading the implementation of that project. This has brought great pride to the company.
EF: How do you attract talent and retain talent on one side, and how are you managing to balance all the different business units to keep them successful?
DF: In a major corporation, the management system is a matrix. Some of the business units are managed globally, and some units are managed locally by myself. We receive great support from HR. IQVIA leverages its global reach to explain to people what we are doing and that we are not perfect. People are seeing that what we are doing directly translates to their lives and health, and how that can impact a broader picture. They can see how our work can impact their loved ones in the short or long term. People value those types of employers. This is particularly important for the Gen Z population.
We are trying to show our qualities from the recruitment stage right up to our employees. This bolsters our ability to attract and retain the talent that we have. I joined IQVIA almost three years ago, and I did not expect to find a group of talented and committed people. The organization has committed employees that I have the privilege of leading right now. The industry that we are working in gives us that sense of accomplishment, and people want to go that extra mile.
EF: How do you see the trends of AI and digital tools in the pharmaceutical sector in 2024?
DF: IQVIA's extensive use of AI and machine learning spans many years, with operational solutions dating back to 2013. In 2023, these technologies were deployed across more than 70 facets of our business, showcasing our commitment to innovation. Our recent introduction of IQVIA Connected Intelligence™ is just one example of ongoing AI projects, positioning us favorably for the future given our established presence in the digital landscape.
Collaborating with Microsoft on our multilingual model and cloud computing solution enhances our capabilities. Contrary to common misconceptions associating AI solely with language models like chatGPT, our applications extend into the pharmaceutical sector. For instance, we've developed a system enabling physicians to swiftly analyze thousands of medications based on specific keywords, a process streamlined by AI within seconds in a controlled environment.
AI is a key ally in enhancing data analytics services efficiency. Our products empower businesses with predictive analytics capabilities, and we envision a future tool that proactively reaches out to patients in high-risk categories before symptoms emerge, reducing overall healthcare costs while advancing patient care. Our partnership with Apple focuses on harmonizing diverse data streams, combining information from wearables like Apple watches with clinical data to yield impactful analytics results. This synergy enables us to create a unified data pool for comprehensive insights.
EF: If you had to create a roadmap for a sustainable healthcare system in Poland for the next 10 years, what would your three base pillars be?
DF: Achieving sustainable healthcare in Poland requires strategic enhancements. Firstly, bolstering funding is paramount, as current allocations, particularly in preventative initiatives, are notably low, with only three percent designated by the National Health Fund. Emphasizing efficacy in resource utilization is crucial, shifting focus towards preventative measures over curative interventions.
Efficiency in the healthcare system stands as my second pillar. Streamlining processes is imperative, addressing instances where individuals seek medical attention for minor issues that could be managed differently. Although strides have been made in healthcare affordability, with free medicines for specific age groups, continued evaluation of the financial impact on both patients and the healthcare ecosystem is essential.
Innovation poses a concern, especially in the prolonged duration from approval to market availability for cutting-edge treatments, a timeframe exceeding European Union averages. Public authorities must address this lag to ensure timely access to innovative therapies. While the initiation of regional centers for digital medicine is a positive step, a comprehensive approach to data and analytics integration is crucial. Harmonizing various data sources will facilitate progress, and collaboration with experts experienced in systems like the NHS can expedite Poland's journey toward a more advanced healthcare infrastructure. IQVIA is poised to contribute significantly to navigating and accelerating this transformative process.
