Read the Conversation
Conversation highlights:
- AstraZeneca & Leadership Mission: Driven by impact, innovation, and a strong pipeline, she joined AZ to broaden her industry perspective and lead a market-leading organization with real capacity to shape healthcare.
- Strategic Value of Portugal: Portugal offers skilled talent, an international mindset, strong infrastructure, and a pro-innovation environment, making each euro invested highly competitive for AZ’s global operations.
- Portfolio Strength & Pipeline Growth: AZ Portugal is anchored in CVRM, respiratory, immunology, and a fast-expanding oncology portfolio, with major upcoming launches across multiple indications and long-term expansion into vaccines and weight management.
- Collaboration & Data as an Asset: Emphasizes deep partnerships with regulators and the ecosystem, value-based models, and heavy investment in clinical trials and real-world data (e.g., TRANSCEND) to improve access and system efficiency.
- People, Skills & Future Capabilities: Recruiting diverse, tech-literate talent; prioritizing AI and digital upskilling; and positioning a total of 750-person Lisbon organization (global hub and local business) as a bridge between science and the wider tech ecosystem.
EF: What attracted you to AstraZeneca, and what mission did you set for yourself in this role? What do you want to achieve?
NC: Once you get acquainted with a company, you start to reflect on your journey. I am very grateful because I had many opportunities, both at Bayer and later on. That is why I progressed so fast from sales to marketing, then to regional roles, and eventually to leading country organizations, which is always an honor. I also had global exposure in radiology, which was an early attempt to go beyond what I already knew. There was a real sense of curiosity, and I asked myself whether there was something else to explore.
The radiology opportunity spoke directly to that curiosity. It was a wonderful experience and made it clear how dependent pharma and med tech are on each other, especially in precision medicine. The role of imaging in staging, diagnosis, and even surgery is so important. It gave me a strong appreciation for that business and a huge appetite for what can be achieved in a company with market leadership and the ability to make an impact. In this industry, you are usually driven by patient impact. Once you see results for patients, you want to do more. You care about innovation, but you also want to see it materialize, to see patients living better lives and customers having an easier time serving patients.
When Portugal first came up as an option, I wondered whether it would offer enough scope for personal growth. I have been in a position before of leading a major pharmaceutical company in the country. However, after they outlined the hub model, the market leadership, and AstraZeneca’s scale in Portugal, I could see the potential. I started to think about how we could drive patient impact through negotiations, collaboration with associations, and broader engagement with society, and it struck me as a compelling opportunity.
Starting in an organization with a national scope is also a good way to enter a new company, as cultures can be significantly different. So, I decided to pick up the phone and explore. There was a strong self-drive to increase impact and to understand the industry beyond a single company. You cannot really speak for the entire industry if you have experienced only one part of it.
Finally, it was AstraZeneca itself. It is a very large organization with a strong performance culture. When you realize they want you for such a role, it is, of course, very humbling. There is also the pipeline, which is one of the strongest in the industry. That matters a lot because it brings investment and allows you to truly follow science.
EF: Could you tell us about the strategic importance of Portugal?
NC: First of all, it reflects how AstraZeneca is built and how fast the company is growing. We have been very clear about our global ambition to increase from 45 billion in 2024 to 80 billion by 2030. We also plan to launch 20 new medicines, which will then multiply into many more indications. That is massive growth, and we need to prepare ourselves for it.
AstraZeneca has built different hubs around the world, including in Europe with Spain, Poland, and Portugal. Investing in Portugal was a very strategic decision. I was not present at the time, but it makes a lot of sense when you think about diversification, especially of the workforce. These are global hubs with global functions, but they also rely heavily on local talent. More than 70 percent of people in the Lisbon hub are local talents.
Portugal offers strong education, an international environment, and very good English proficiency, so there is no real language barrier. There is also a solid base of experts and a supportive infrastructure, which makes it easy to live and work here, even if your Portuguese is not so good. All of this made Portugal an attractive choice.
Beyond that, there are clear benefits to investing in Portugal. What I really like about the Portuguese culture is that it is very outcome-driven. I see people, both within the company and in the authorities, who genuinely try to find solutions. Even during the financial crisis and the Troika period, Portugal was able to develop solutions by working closely with industry.
That does not mean everything is simple. Reimbursement conditions, for example, are not always easy to understand. We have clawbacks, we have product sales caps, and similar measures. That has not necessarily made it very attractive to launch products, or it has delayed them quite a lot, especially during negotiations; this can take up to two years in comparison to launches in Germany. But this has changed. Just as Portugal managed the financial crisis, there is now a clear acknowledgement that, as we move out of the crisis, these measures also need to change. They have revised them quite significantly and also quite creatively. We are still working through the details. We only signed the new reimbursement conditions, the protocol, as we call it here, in March. It will be very interesting to see, toward the end of this year and into next year, how this plays out.
The clawback can be reduced, depending on how we as an industry grow, and we can also deduct our investments in Portugal. Of course, there are thresholds, and that makes the whole exercise mathematically complex and quite long. But this is exactly what makes Portugal interesting as a place to invest. From a profit and loss perspective, it is really interesting to leverage this framework and to attract more investment.
From an AstraZeneca point of view, there is also the opportunity to expand the scope of investment. Today, the focus is on global business services such as HR, procurement, project management, and finance. But we could move further into areas like clinical trials and potentially even manufacturing. That would be very positive and would also support a broader European vision, with more production and intellectual property located in Europe, reducing dependency on other continents.
When I talk to my ecosystem, what I find intriguing, especially being still quite new in the role and back in Portugal, is that when I speak with the mayor of Lisbon or with the government, there is a real curiosity and a clear intention not to be seen as cheap labor. It is, of course, attractive from a cost point of view as well, and I am not going to hide that. But what really stands out is that they want impulses and innovation. The conversation is genuinely about innovation and about what you actually bring to the country.
We are also sponsoring the Health Hub here in Portugal, which is a project from the Unicorn Factory and very close to the heart of the mayor, Carlos Moedas. The idea is to create those impulses across other local industries and to foster a real win-win situation. I find that quite striking. The tangibility of what I hear and how they want to incentivize innovation here is very strong.
EF: How is your pipeline evolving, and which upcoming areas of interest will really make a difference?
NC: AstraZeneca has a great heritage in Cardiovascular-renal management and respiratory medicines. This area is referred to as the Biopharma Business Unit. Here in Portugal, this is our number one selling area, covering diabetes, heart failure, and chronic kidney disease. For SGLT2 inhibitors, it is the best-selling product in the country, and that is also why we are number one in the market overall. This cardiovascular and renal footprint remains very important, with hypertension as well.
In respiratory, covering COPD and severe asthma, we are doing a lot, not only in terms of new products but also across different indications. There is strong innovation happening in that space, tackling disease with different modes of action. Oncology represents the other big part of the pipeline, almost the other half. We also have rare diseases, which are evolving, but that sits with Alexion here in Portugal. That said, we are looking at potential synergies.
Oncology is massive. We are really leading a revolution to transform cancer care. We have multiple brands with a wide range of indications, something I have never seen in my career. As someone new to the business, it is impressive to understand how much we can cover across different treatment pathways. It also comes with a responsibility to help physicians keep up, because treatment schemes are changing very fast. Not only are companies evolving, but guidelines are evolving as well, and there are many new options to consider.
Oncology will be a major area going forward, across different types such as lung, breast, ovarian, blood, gastrointestinal, prostate, and bladder cancers, to name a few. It will be very exciting to see how this evolves. As I mentioned, we plan to launch around 20 new medicines by 2030, and there is more beyond that. That is the high-level story. Behind it, there are many molecules with abbreviations that I am still getting acquainted with, but the scale is quite significant. We also have vaccines, which will enter a new era, although this is more toward 2030 and beyond.
EF: What is your approach to collaboration in Portugal, and how are you working together?
NC: On collaboration and partnerships, I like to describe it as moving from science to society. At AstraZeneca, we always say we follow the science. But as a market leader, we also have a responsibility to go further and help create an environment where patients actually get access to solutions. This is not something we can or should do alone.
Collaboration applies across many scenarios. I mentioned discussions on pricing and reimbursement with the authorities. It is about a real willingness to be part of the solution, not just to present what is coming, but also to recognize the burden on the other side, especially financial frameworks and budgets. We fully understand that budgets are always tight, and the question is how we ensure that the patients who need treatment the most actually get access.
We invest heavily in data generation, and it is important for us to connect different stakeholders and even authorities. The footprint we can generate in Portugal, both economically and for society, is significant.
We also need to start measuring the broader impact of investing in innovation. If you invest in therapy and grant access to it, this can enable patients to work longer, be there for their families, care for their children, and remain active participants in the economy and society. This is an important aspect we need to ensure.
Studies show that the pharmaceutical industry ranks among the most productive, with an input–output ratio of 2.1x. This is something we also try to highlight in collaboration with the Ministry of Economy, so they see that investment is not just financial, it benefits everyone.
These are the areas where we aim to collaborate and be innovative, not just with discounts, but also through value-based pricing models: if it works, you pay; if it does not, you do not. You cannot do this for every preventive medicine, but there are treatments where results can be seen quickly, sometimes prolonging lives by several years. That impact is amazing, and we are investing in it.
Data is key in all of this. We started a huge project this year, called Transcend, connecting with local health units through the application of real-world evidence and value-based healthcare. We have a leading role in real-world evidence. Over the last five years, we have generated more than 255 publications and invested around 27 million euros in medical data collection.
We are number one in clinical trials in Portugal, so it would be a pity to leave all that data sitting in a data lake where no one is using it. To make it valuable, you also need a commercial mindset. You have to understand what is actually interesting for the authorities and what questions they have.
It is not just about medical questions, which are our core focus, but also about what matters to payers, the Health Ministry, and the Ministry of Economy. Projects like Transcend allow us to leverage our data lake to answer these questions, and, if needed, invest in generating additional data.
Collaboration is critical, both medically and operationally. Strategically, we need to engage in constructive dialogue with the authorities and secure their involvement. We operate transparently and in full compliance, recognizing that the more engaged the authorities are, the more objective and relevant the data becomes as a basis for decision-making. I am personally committed to shaping this framework to maximize its potential.
EF: What kind of people are you looking for at AstraZeneca?
NC: I have just been to Switzerland with my bosses and peers in Southern Western Europe, and we have been asking ourselves exactly the same question: what do we need? We call it strategic workforce planning. It is about understanding the capabilities required for the new portfolio. For example, as we evolve into different therapeutic areas, they require different knowledge and skills.
Building on what you just mentioned, we are putting a lot of effort into increasing AI and digital literacy. That is part of my role, and of course, it is a focus for the entire leadership team. There is always a question of how much to push this versus letting it grow more organically. I often take a more organic approach. I use myself as a reference point: what do I need to do to encourage myself, and how can I influence this mindset across the business?
When it comes to AI, it is clear that my imagination is limited because I have not been formally educated in it. That is why educating ourselves is so important. I cannot see what I do not know. At the moment, I see a lot of automation and ways to reduce workload, which is useful, but not very inspiring or acknowledging the full potential yet.
It will not directly drive innovation, but it can free up time for innovation for the customer and the patient, which is a great outcome. We are now exploring how to build that mindset.
Another key point is leveraging collective intelligence. Drawing on my medtech experience, I am reaching out to people with the expertise we need, because knowledge is not confined to our internal network. This links back to partnerships. We need to expand and learn from others. That could mean engaging with large technological companies, or smaller ones, depending on the need, and sharing our business challenges and the types of solutions we are seeking. But we avoid diving too deeply into solutions too early, as that can narrow our perspective, and if you do not know everything, you risk limiting yourself.
We also need to change how we communicate to collaborate effectively across our ecosystem. Diversity plays a central role here, and studies show that diverse teams achieve better outcomes. However, the challenges of diversity, especially in communication, are often overlooked. It takes more time, and misunderstandings can arise if people are not educated.
There are many things I am doing with the team to encourage this kind of diversity, such as how we talk, how we avoid offending people from different cultures, and how we actively invite everyone to chime in, even in simple brainstorming sessions. That is something we have to drive intentionally.
When we engage with critical software teams, they often have big ideas, but first, we need to educate them about how our business works. Once they understand, they can contribute with their wide-ranging solutions, which is very exciting. So, even though I am a technology laggard, understanding the levers and partnering with the right people allows us to excel.
The hub is a wonderful opportunity. We will have around 500 people on top of the 250 in local businesses by the first quarter of 2026, and already, we are seeing the benefits of having them close. Next year, when we move into one building, we will have the chance to talk directly, share coffee, discuss, and get immediate feedback on whether they understand the problems. That will be a huge advantage.
We have given ourselves the mission to be the interface between science and the tech ecosystem. This is the role we have given ourselves as the marketing organization, the local business, and the hub: to deliver value, not just quick fixes in Portugal.
EF: What is your final message?
NC: My final message is that innovation comes with commitment. Innovation is not necessarily a lean investment, so we need to work with our partners to enable sustainable growth. That growth will allow us to do everything I just described. I believe this is still quite open at the European level, and it reflects a commitment that creates a win-win situation with our partners. We are willing to go all the way: we participate, co-fund the investment, but growth is essential.
