Read the Conversation
EF: How satisfied are you with Accord’s performances last year and what are you most excited about in 2024?
AH: Accord has demonstrated growth across various sectors, particularly in therapeutic areas where we have a strong presence. We have also seen new market entrants in platforms where we previously had no presence. In the African context, our established portfolios have experienced good growth. The success of new market introductions depends on the positioning of the product within its lifecycle.
In the generic space, products that are among the first generics to market tend to show higher growth profiles. This year, our performance was healthy and something to be proud of. The previous year was particularly notable as we introduced more first-to-market generics compared to this past year. We are following market trends, which show growth in the generic sector.
EF: Which therapeutic area drove the most growth this past year?
AH: The most growth this past year was driven by our primary care portfolio. With more entrants and players in the oncology market, it has become more saturated, causing growth to slow down. To achieve significant growth in this space, we need either a differentiating molecule or product or a broader variety of offerings. In most companies, growth peaks and troughs can depend on when product registrations come through. Accord Healthcare has a strong pipeline, ensuring pockets of substantial growth when these registrations are completed. Growth varies by year. For example, the previous year saw significant growth in critical care. While oncology remains consistently strong, there are different therapeutic areas that show higher growth rates.
EF: What are your perspectives on which areas will require more attention under the NHI framework?
AH: For developing parts of South Africa, it is important to recognize that the country has both developing world components and highly advanced sectors. Our portfolios, particularly in areas like primary care, cardiovascular, and CNS, align well with the anticipated needs of the NHI. These sectors are likely to demonstrate significant added value as the NHI is implemented. The NHI rollout will occur in stages, as envisioned by the government, and each stage will indicate where our involvement is most needed.
In specialized medicine, we anticipate playing a significant role in our portfolio and future pipeline, which includes biosimilars and immunotherapies. These areas are crucial and will likely be integral to the NHI framework. Currently, the private sector in South Africa drives much of the healthcare spending, and penetrating these markets will be of significant value to us. Our hospital products and critical care offerings are well-suited for integration into the NHI.
As things stand today, our portfolio is well-positioned to fit into the NHI scope. Adapting as the NHI unfolds will be crucial, and we are prepared to adjust our strategies accordingly over the next few years.
EF: With all the new technological developments, how do we keep the focus on pharma?
AH: It is somewhat sad to see the heavy focus on technology and science when there is still a significant need for basic healthcare. For me, the balance is off. While it is great to have ambitious plans for many South Africans, we need to slow down a bit and reassess our priorities. We need to ask ourselves: where are we as a nation, and what do we need first?
A vast portion of our population still lacks access to basic medicine. The government's primary goal should be to ensure that more medicine reaches more people quickly, efficiently, and effectively. Once we have established a solid foundation of basic healthcare, we can then look at how technology can enhance these efforts. For instance, technology and AI can play a crucial role in improving the distribution of medicines, diagnosing diseases, and identifying health trends. But first, we need to address the fundamental healthcare needs of our population.
We can achieve better healthcare for the population by spending our money wisely. While technology is undoubtedly essential, it is important to position it correctly.
EF: What initiatives can promote access in South Africa?
AH: This is a complex issue, and we need to address it by considering the distinct needs of South Africa's rural and urban settings. Our primary objective should be ensuring a consistent supply of medicine to the government, whether through a new procurement system or the current tender-based environment. This means guaranteeing the availability and regular delivery of medicines.
The next critical aspect is affordability. Our therapeutic products must be priced so that the government can procure them and provide them to patients. It is crucial to avoid applying first-world pricing in a third-world economic environment, as this mismatch can create significant challenges. Education is another cornerstone of our approach. We are committed to ongoing education efforts, whether through conferences or general public information. Our focus spans various areas, including Urology or rather Men's Health and CNS portfolios. We will continue these efforts, adapting and expanding as new opportunities arise. By prioritizing these fundamental aspects— consistent supply, affordability and education—we can make meaningful progress in improving healthcare access and outcomes in South Africa.
EF: What strategies are you introducing in South Africa to focus on patient-centricity?
AH: We have expanded our strategy by identifying key partners in our business. It is important to partner with the right avenues and access levels to ensure our medicines reach the patients who need them. As a company, you must be able to diversify to remain viable in any market, avoiding the arrogance of thinking you can succeed alone.
Currently, we work with experienced partners and are exploring additional partnerships to enhance our product distribution. Affordability for South African patients is a critical focus. We must understand both the needs and financial constraints of our patients to provide solutions that are both accessible and affordable. This patient-centric approach helps us balance global considerations with local realities.
Additionally, we are expanding our efforts to include neighbouring regions such as Lesotho, Swaziland, Botswana, Zimbabwe, Namibia, and others. By addressing the broader needs within Sub-Saharan Africa, we ensure that our healthcare solutions reach a wider audience. Understanding that patient needs vary by region, we tailor our approach to meet these diverse requirements.
EF: Is South Africa seeing the value of generic medicines and how can we increase this?
AH: I do believe we have crossed that bridge, although some individuals remain reluctant, likely due to the unknown. Historically, Accord Healthcare has demonstrated significant value, especially in oncology. We were the first organization in the country to introduce a wide product range of oncology-generic products, utilizing various channels to get them to patients with strategic partnerships. Accord Healthcare has been well-known to oncologists and patients for many years, but this recognition did not come overnight. It required a commitment to product quality and a sustainable supply chain.
In some therapeutic areas, there is still some reluctance, particularly with more serious conditions like organ transplants, where people are hesitant to deviate from the originator due to the high stakes. If the body rejects an organ due to treatment, regardless of what clinical trials indicate, you lose credibility. This hesitancy is understandable from both sides but is not as prevalent in the South African population. The devaluation of the RAND means that patients are more inclined to opt for the most affordable and best product available. My perspective on this has evolved over the years, and I believe many of my fellow South Africans have similarly changed their views.
EF: What are the key pillars for building a sustainable healthcare system for South Africa?
AH: There are always factors within our control and those outside it. Focusing on what we can control as leaders in the pharmaceutical and healthcare industries, it is crucial to identify the needs of the country and determine what our organization can offer that is not currently available or that can be improved. When you can offer something beneficial to patients or the healthcare industry, you must ensure sustainability in your manufacturing and supply chain, not just in quality but in continuity. We need to avoid disruptions in therapeutic areas where consistency is critical. It is essential to keep patients on a stable therapeutic regimen without frequent switches, which can cause concern and hesitancy. As leaders, we must design our profiles, portfolios, and infrastructure to deliver high-quality medicine consistently. Whether you choose a fixed or adaptable profile, it is vital to stick to it and ensure it works seamlessly. Having a backup solution is key. Effective planning and having the right people in your organization to ensure consistency despite normal yearly variability are essential.
Another significant aspect for South Africa is the need for more local manufacturing capacity. While some companies do manufacture locally, the scale and cost cannot compare to big players in India or China. Local manufacturing costs are higher, making continuous supply challenging. Externally, we need to work with our partners—hospital groups, government, etc.—to ensure that we can consistently supply quality products at an affordable price. It is essential to tailor our approach to the South African context to avoid the pitfalls of trying to impose an unviable model.
Adaptability is key to sustainability and survival in the ever-changing landscape of the pharmaceutical industry. We must be ready to adjust our strategies and models as needed to remain viable and keep our company thriving. I am confident that we are well-positioned to do so. In developing countries, corruption often poses a significant challenge. It is unfortunate because the end-user, typically the patient, suffers the consequences. We have witnessed this in South Africa on numerous occasions. Hopefully, the significant changes we are currently experiencing will lead to positive developments in this regard.
EF: Do you have a final message for our readers?
AH: Accord Healthcare operates within a vertically integrated model. This setup provides us with a vast scale and diversity in our portfolio, enabling us to introduce new innovations that can be game-changers in the healthcare industry. This flexibility allows us to adapt quickly to changing circumstances and pivot when necessary. If something is not working, we have the freedom to move on and focus our efforts elsewhere, ensuring we add value where it is needed most. Our accessibility to both generic and specialized medicines positions us as one of the more attractive companies in the industry. We are committed to supporting South Africa's healthcare needs and will continue to adjust our approach to align with the evolving healthcare landscape.
We have made significant strides in our product offerings, including several line extensions. However, the most exciting developments are yet to come, particularly within the subsequent 5 years. While the specifics remain confidential, we anticipate a wave of innovations that will make us highly appealing to potential employees.
