Read the Conversation
Meeting highlights:
- Healthcare Digitalization: Italy is shifting from a hospital-focused model to a digital, retail-centered healthcare system, emphasizing telemedicine and patient journey digitalization.
- Italy’s Pharma Role: As a top producer of active ingredients, Italy is crucial for Europe’s pharma supply chain but needs to accelerate drug launch processes to enhance competitiveness.
- Global Adaptation: IQVIA and Italy’s healthcare must stay agile to adapt to global shifts, especially in personalized medicine and biotech.
- Public-Private Collaboration: There is a need for stronger collaboration between public and private sectors to use data effectively and drive innovation.
- Sustainability and Workforce: Italy faces healthcare sustainability challenges due to an aging population and staff shortages, highlighting the need for digital solutions and better resource management.
EF: What mission did you set for yourself when you were appointed, and what mission do you want to achieve in this role?
AL: After almost 15 years with IQVIA, a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries, I was excited to take on the general manager role on January 2023 and bring IQVIA Italy to its next level, elevating our role as a partner to healthcare transformation for our customers.
In the last few years, a number of challenging dynamics called for this change: the uncertainty in the macroeconomics, the complexity of the digital and data transformation sustained by the Recovery & Resilience Programs EU, the emergence of promising treatment paradigms conflicting with the tight financial sustainability of care and R&D. My mission was to embrace this context and change accordingly our way of serving life science clients and the healthcare system as a whole.
In this context, I set a few strategic priorities for us to stabilize our core data business while growing in the services for Life Science and Healthcare: client centricity and innovation, operational excellence, and people engagement. Let me focus on client-centricity and innovation.
More than ever, our clients need to make informed decisions to optimize their investments, whether it is in field operations, go-to-market model and marketing investment of affiliates or portfolio strategy, M&A, and geographical expansion for the Italian champions looking to a broader global role.
This is where I have focused my team's efforts. We have shifted our go-to-market strategy and organization to start with our client's strategic agenda rather than leading with our products or services. Our goal is to offer end-to-end solutions, not just data, but actionable connected evidence and services that support their decision-making and execution.
Fostering structured collaboration and focus on the clients, IQVIA can truly operate with a unique proposition serving the industry by leveraging vertical competencies across data, organizational design and portfolio strategy, analytics, primary market research, technology, real-world evidence, implementation science, and clinical research, to mention only some of our pillars. Our ability to integrate all these assets, partner with clients, and address their business challenges and opportunities is the key theme of today’s company setup and continuous tension to innovation and quality since my appointment.
In fact, while data is still the most renowned single component of our offering, we achieve our best by delivering evidence and recommendations that encompass our deep knowledge of the ecosystem and its trends.
Under this new model, we are also evolving our more traditional data assets through re-platforming programs, for example, enriching sell-in and sell-out data across channels, incorporating new KPIs and insights via our panels across physicians, consumers, and payors, and finally incorporating Healthcare-grade AI™ as a key enabler of insights and effective engagement models.
This very same approach has been applied also to our public health business. Our aim is to help the digitalization of our healthcare system achieve its transformation. This will help us to better face major challenges such as the aging of our population, the global competition in clinical investments, the innovation of treatments and care models, accelerating the adoption of personalized therapies as well as the transition to retail and home care settings.
In this space, IQVIA has successfully participated in national calls for proposals on the digitalization of healthcare, from telemedicine to data interoperability and patient journeys, where we are providing our contribution to larger consortia, leveraging the depth of our knowledge in the field of
complex regulatory issues, such as the delicate issue of patient data processing, interoperability standards between IT systems and OMOP standards for clinical data, the creation of registries, and public health programs.
Finally, as part of our positioning and ambitions in the ecosystem, I am also being very active in reinforcing our collaborations with institutions and associations under the common aim of sustaining the strengths of our country and being better prepared to retain and reinforce our competitiveness, in the light of the global dynamics we do measure us against to as industry as well as Health Care system.
EF: Why is Italy such a strategic market for IQVIA, and why is IQVIA so important for the Italian sector?
IQVIA Italy is one of the most critical contributors within the EMEA region, where we do belong, not only by the number of employees (more than 1.500) but also because of the diversification of our offering, the size of our panels across channels(Pharmacies, On-Line, and Hospitals, Physicians, and Payors), the ability to drive innovation generating evidence, for commercial and medical applications, as well as technology platforms for the life science and the healthcare system.
This is very much consistent with the country’s positioning for the life science sector across its value chain. In fact, Italy is the first country in Europe for the size of its manufacturing, with 52Bln, and second also for the number of new drugs approved for access to patients, only after Germany.
The industry employs >70.000 professionals, out of which 54% are in R&D; it accounts for 2% of Italy’s GDP and generates exports for approx. 49Bln and sustains 3,6Bln of investments in clinical research and production.
By size, Italy is the third largest market by drug consumption market, after Germany and France, recording higher growth rates (+9%) in the most recent quarters (versus +8% and +6% respectively).
Italian industrial champions are playing an increasingly important role in driving global innovation, investing in areas of unmet clinical needs, such as oncology, CNS, and rare diseases, and expanding their commercial footprint globally.
As IQVIA, we do our best to serve their growth ambitions, helping them with internationalization programs, scouting new assets, entry strategy, and portfolio and marketing mix initiatives, defining the best organizational footprint as well as setting and executing the best evidence generation and client-centric strategy supporting their medical strategy.
IQVIA also plays a key role in advising for M&A and collaborations between large pharma and biotech companies. We understand the challenges of the journey, and our expertise enables us to help both parties navigate through it. Our value lies in assisting with decision-making and trade-offs that come with drug development — whether it is deciding on indications, targeting the right population, or building the best study models. Additionally, IQVIA offers end-to-end support through due diligence and decision-making processes, leveraging our global consulting and data capabilities.
Despite this extraordinary positive context, challenges remain, and that’s where again IQVA can best play as a partner to move our ecosystem forward, playing its strengths and maintaining its competitive advantage in the global battlefield. In fact, as a global vertical organization serving the pharma industry and healthcare systems, we have a privileged observatory point of view around key pressure points and growth levers. In addition, we have the evidence required to measure gaps and set priorities.
This is, for example, the case of the adoption of the secondary data treatment and HTA regulation, the implications of the more recent AI Regulation and EU Data Space initiative, or the new EU Pharma Regulation, with its implications directing and retaining investments in the EU. Across all these themes, IQVIA has run dedicated meetings and initiatives to bring all the stakeholders to a common understanding of what is at stake and what other Ecosystems have been doing not to miss opportunities.
Italy must remain competitive in the global healthcare ecosystem. Collaboration among the pharma industry, general managers, and associations is key to ensuring Italy fosters its competitive edge.
EF: How do you evaluate the sustainability of the healthcare system from your perspective, and what is IQVIA doing to ensure we're building more resilient, future-proof systems?
Italy must find an effective and sustainable response to the health needs of our population. The challenge is anything but trivial. Data from the IQVIA Health Observatory shows how the progressive aging of the Italian population is accompanied by a significant increase in chronic pathologies and cardiometabolic, respiratory, osteoarticular, and oncological comorbidities. There are over 7 million people over 75 in Italy today (11% of the total population), 42% live with three or more chronic diseases, and it is estimated that in 2050 there will be over 5 million over 65 who are not self-sufficient.
Dedicated socio-health planning, which includes models for taking charge of chronic conditions in elderly patients in non-hospital settings, including our homes and communities, telemedicine, and the synchronization of new local health centers and professions are essential ingredients of the recipe that will give health and sustainability answers, for staff and costs involved.
As IQVIA, we stay at the very center of these conversations and are directly involved in the design and implementation of the IT infrastructure that our healthcare system will need to deploy.
Looking then to the research ecosystem, the most vital initiatives Italy should focus on are the advancement of the legal framework regarding secondary data treatment and the acceleration of the initiatives to simplify the startup of clinical studies, fully adopting the EU regulation and improving the alignment of key roles and competencies at sites and ethical committees to the evolving complexity of protocols for innovative treatments.
Then, at the crossroads of research and the future of our care models, we should invest more in personalized medicine and the optimal functioning of Molecular Tumour Boards, considering a more systematic adoption of genomic programs. An area where IQVIA is active in bringing our capabilities already utilized abroad, from lab capabilities to advanced technology managing data treatment and interconnection from DNA sequencing down to historical claims and treatment protocols for personalized medicine.
Finally, the digitalization of sites, enabling patient-centered solutions for better care, higher quality of care, and faster identification of possible candidates for clinical studies, is a must, and our enterprise and product solutions, already adopted by primary research sites throughout Europe as well as US and Middle East & Africa, are a very solid example of what is possible.
Looking then to the life science segment, faster and more efficient drug launches should be the priority. Currently, on the positive side, the number of launches is second only to Germany in Europe; the time required for a drug in Italy to reach patients is almost four times that in Germany. The readiness of our regulatory bodies and data owners to comply with the HTA regulation is a major part of this challenge.
Also, the current payback system, while necessary to control drugs’ budget, hinders Italy's prioritization in innovation addressing unmet clinical needs or investments to achieve optimal patient access. Addressing sustainability and innovation balance with new mechanisms will help to maintain the country’s leadership role in the global healthcare landscape.
A better alignment and stable partnership between the public and private sectors are necessary, and I remain optimistic that conversations are progressing across the ecosystem.
EF: How do you assess the receptiveness of digitalization in Italy, at IQVIA, and in the ecosystem?
AL: At IQVIA, we have a long tradition of “smart working.” As a service company, we have always been quite flexible, even before COVID-19, allowing hybrid models. This has been fully formalized in our internal governance, and our working model has been fully digitalized.
My goal now is rather to continuously adapt the new normal to the “talent war” and the “values of the new generations” to strike the best balance between hybrid work and maintaining the sense of community and engagement necessary for driving innovation and loyalty within large leading organizations such as IQVIA. To harness the best energy from our teams, we need people who not only stay with us for years but also deeply understand our purpose and embrace the company goals as their own professional challenge.
In this regard, I have sponsored several initiatives, such as fit-for-purpose development programs, talent communities, management forums, and employee interest groups connected to our IQVIA regional and global programs. This is a unique opportunity not only to create a sustainable and ethical future but, above all, to collaborate in cross-functional teams, expand your network, and generate exchanges beyond the daily boundaries.
When people bring their uniqueness and diverse experiences to work, they enable us to achieve extraordinary things.
Also, I have created a new space in our cafeteria for hosting hybrid sessions, inviting clients and experts who share our mission to move Healthcare forward and/or can help us reflect on how to best address the challenges and opportunities in our day-to-day journey as professionals, managers, and citizen.
All this effort has also been translated into several important certifications, the best testimony of our commitment to inclusion and diversity, parenting, environmental sustainability, compliance, and legality. With the high number of colleagues attending these sessions and adhering to engagement platforms, I believe we are moving in the right direction.
Our hospital, regional, and Local Health Authorities have a lot of legacies that need to evolve in a synchronized manner to interoperability and state-of-the-art functionalities. Differently from other national systems, Italian sites rely on point-to-point vertical solutions rather than enterprise solutions, which complicates the transition to a data-driven model, much needed for clinical research, planning and control of resources, and optimal care management.
Preparing for the European Health Data Space and implementing effective data governance and controls is a massive undertaking. While we have taken some initial steps, our data governance challenges extend beyond the systems and point to our National Data Privacy regulation and its specifics beyond the GDPR compliance.
Unfortunately, this means we are falling behind. The need to evolve our legislation is even more urgent, considering the need to exploit AI to strike the best balance between sustainability and the right to access quality and timely treatments.
The research competition is indeed global, with countries like Spain being very effective in adopting a favorable regulatory framework and Central and Eastern Europe leveraging enterprise solutions and interoperability in their systems. To remain competitive, we need to accept these as the game's fundamental rules. On top of that, it is crucial to attract the best researchers and innovative ideas. While we have access to great researchers and a strong patient base, the digitalization level in place is not sufficient.
Yet, the sense of urgency and the collective consciousness of these gaps is improving across the industry and the research ecosystem, reaching our political leaders. I feel fortunate to be part of a company such as IQVIA, which is actively investing in this area and can have a positive role in moving this transformation forward.
EF: With the growing focus on personalized and next-generation therapies, which demand a unique set of skills, how does IQVIA ensure that it continually adapts and evolves to meet the changing needs of the sector?
Over 18,000 patients from 70 countries have participated in 210 cell and gene therapy trials since 2012. These advances in cell and gene therapy represent innovative treatments, particularly where traditional methods fall short, but require navigating new risks and definitively call for a much more complex patient access governance in the healthcare systems.
At IQVIA, we have a unique perspective and capabilities across the landscape of Cell and Gene Therapy (CAGT) and other innovative treatments. Working extensively with biotech and large pharma clients, we draw upon our broad experiences to craft tailored solutions to help sponsors optimize and accelerate their clinical development. In addition, we also work with healthcare systems setting up their population-wide genomic sequencing programs, preparing to deliver life-changing treatments to patients sooner.
The use of these new treatments holds great potential for bridging the gaps left by traditional treatments. These innovative clinical development programs require a suite of complex laboratory assessments to satisfy regulatory submissions and support Proof of Mechanism, Pharmacodynamic, Safety, and Efficacy investigations. IQVIA’s global laboratory network and industry-leading subject matter experts are ideally positioned to shape, validate, and deliver those biomarker assessments.
The challenge is the readiness of the Italian system, from the activation of Molecular Tumour Boards across the country to the limited initiatives so far undertaken to have population-based genomic programs, such as the One Million Genome program run in the UK, where we partner with the NHS.
Not that we do not have guideline documents, but rather the opposite. We lack a concrete systematic commitment to an implementation program nationwide on personalized medicine and genomic sequencing.
Missing it could become detrimental for our research sites as global competition attracting clinical studies, especially from Asia and the US, intensifies. The negative implications extend to our local industrial champions, local biotech, and start-ups that have great potential in their manufacturing capabilities and pool of talents in R&D and operations.
At IQVIA, we are part of this movement, striving to ensure our leading organizations stay strong, continue their R&D, and remain competitive on the global stage.
EF: IF you were to create a challenge for the sector, what would it be?
This is a tricky question since several actions are required to successfully achieve our mission and goals as a sector. The most critical is the ability to achieve a “Data and Tech” driven transition of our healthcare systems. The reason is that this is the most cost-effective enabler of several other challenges, such as more sustainable R&D or better adoption of personalized medicine up to the optimization of the care pathways for chronic care patients, from oncology to diabetes.
For Italy, this means making decisions around our data governance model for primary and secondary use, moving a few steps forward from the current state, which is far from friendly for both R&D and commercial purposes, accelerating the actual adoption of new EMR systems and interoperable standards across systems.
EF: As we approach the end of 2024, what do you think this year will be remembered for in Italy? Additionally, what achievements or milestones would you like to celebrate as you complete your second year as general manager?
AL: This is a tough question, but I hope that 2024 will be remembered as a year of consciousness—a significant starting point for future initiatives. This year should highlight the value of our pharmaceutical industry in contributing to the country, particularly in terms of talent, GDP, exports, and innovation.
We have seen stronger collaborations between the national associations and the government, creating a more unified ecosystem than I have observed in the past. My hope is that we can finally celebrate a comprehensive understanding of the importance of investing in healthcare, similar to the historical focus on the mechanical and automotive industries in Italy. It is time to recognize that the chemical, biotech, and pharmaceutical industries hold immense growth potential and are the strategic platforms for the good of future generations.
For me, 2024 has been another exceptional year, as we have achieved our objectives, outperforming the market in selected areas of our portfolio and demonstrating the strong value we bring to our clients. In a landscape with increasing alternatives, our company is reaffirming its position as a trustworthy partner that delivers high-quality connected evidence and knowledge on a local and global scale.
Could you elaborate on your current ESG strategy?
At IQVIA, we believe that diversity and inclusion, as well as respect for policies and the environment, are factors that strengthen our mission to accelerate innovation.
Our commitment to ESG is divided into three pillars:
• Social: with our experience, we want to improve the lives of patients and make progress for the well-being of people around the world.
• Environment, which sees us committed to minimizing our business impact on the environment.
• Governance, which helps and supports us in guiding our strategy related to climate and well-being.
We have made this commitment concrete by creating a structured path that sees the involvement of multiple groups across the company on different topics. These are groups made up of volunteers, with the aim of working together actively and in a coordinated way to build our initiatives.
This is a unique opportunity not only to create a sustainable and ethical future but, above all, to collaborate in cross-functional teams, expand your network, and generate exchanges beyond the daily boundaries.
When people bring their uniqueness and diverse experiences to work, they enable us to achieve extraordinary things.
I would also like to mention some important milestones achieved this year by IQVIA, such as the Gender Equality Certification. IQVIA Italia was among the first companies in the country to obtain this certification, and this year, it obtained a score of 98%.
Another important certification is the SA 8000, a reference model known throughout the world whose aim is to guarantee optimal working conditions and an environment in which people are protected and valued.
We have also established important collaborations with Valore D and Banco Farmaceutico, and we have involved a psychologist and professor of work and organizations in a series of webinars to learn about strategies for assessing and best managing stress in the workplace.
