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EF: Regarding the pandemic, what were the lessons learned from both a management and leadership perspective?
MB: It is much easier to reflect on the past in hindsight. There were difficult moments because COVID-19 is something we knew nothing about, we had to continuously transform on a daily basis, over a long period of time. Digitalization was very important for us because we faced the scenario of social isolation, this meant that many sectors were racing to adapt their business model to what we now call the “new normal”. We realized that many tasks could be performed remotely, with the same or even better quality.
We lost the opportunity to work face-to-face with our customers and patients, which became a real challenge. We first had to identify the practices that could only be carried out in person, and then work out how we could perform these activities safely. This was important for us because we always put a strong focus on our associates. The second challenge was maintaining the feeling of proximity among co-workers, being unable to be physically present was hard, and it had a significant impact on our management and leadership roles.
Perhaps I can summarize this into three categories; the main role of Sandoz Brazil during the pandemic was first and foremost to support society. We worked together with different stakeholders to provide access to treatment and avoid a drug shortage. We worked with companies like Novartis to provide many donations, such as food and facemasks, which really supported people during these difficult times.
Our second role was the commitment to our associates, crucially because we moved our office into their homes, and nobody was prepared for that. We began spending many hours in online meetings every day, which was very exhausting. The sales representatives and the care managers usually spent their days working in the field, and that changed completely. Due to the impact of working online, we worked with psychologists and psychiatrists to develop an emotional support plan, we feel it is of paramount importance to support the emotional and psychological needs of our associates.
We also created some programs to extend launch dates and pause projects to increase well-being, we empathized with them and created a weekly space between leaders and the associates to discuss the situation surrounding the pandemic, and they were able to talk freely about their emotions and feelings, which created real clarity between divisions.
Finally, we had a commitment to the patient. We not only provided donations, as previously mentioned, but we also made sure to continue with all our programs despite the situation. We have a variety of ongoing support initiatives, such as one providing growth hormones, a summer program, and support for parents to name a few.
We support popular pharmacies, and we continue working closely with our partners such as Bio-Manguinhos. We signed three different PDPs during the pandemic. In terms of access, it was critical for us not only to maintain all our programs but also to accelerate the process of signing new PDPs. We have the products here in Brazil, have the registration from ANVISA, and we have the opportunity to sign new contracts. We now have three new contracts in place. This is the role of Sandoz, and during this period, these were our three main focuses.
EF: If 2020 was the year of diagnostics, 2021 the year of vaccines when we look back, what will 2022 be the year of?
MB: 2022 will be the year of rebalancing the healthcare system. This is of great importance because over these past years the industry has had an overload, the type of which we have never seen before. We need to promote access, if each patient with a chronic disease has access to quality treatment and is up to date with follow-up care, it will provide great relief to the healthcare system. Following the rise of remote healthcare delivery during the pandemic, we now know it is not necessary for these patients to occupy a hospital bed for their follow-up treatment. This means we can reallocate these funds to other pending demands of the health sector, one of which is promoting access. Another one, as previously mentioned, is the advancement of the local technology park to include biological products. Brazil has the potential to expand the industrial park and adapt to biotechnology, in future years we need to be in the position where we have the capability to produce biosimilar products locally. Due to their reduced costs, biosimilar products have the opportunity to broaden access.
Another crucial element to rebalancing the healthcare system is digitalization and telemedicine, since the pandemic, technology has become a great ally of the whole world. In the future, we must continue to work with this in the health industry. We learned during the pandemic that it is possible to operate rooms and exams remotely, perhaps not 100% of patients in all the therapeutic areas, but the pandemic broke down the digital barrier in this sector, which gives us the opportunity to continue this and evolve further. We have recently discussed how we can leverage this to make life easier for patients, physicians, and pharmacists. Today, it is increasingly common to make a large investment in healthcare, and we are seeing a lot of start-ups attempting to disrupt this space.
My 30 years of experience is just in cell pharmaceutical products in different go-to-market models, but my role has changed now, I've learned many ways to positively impact the health system. One example of this is PDPs in Brazil, but we also have new start-ups and new ways in which data is managed. Now you can search on an app, and you have all the information you need readily available, it almost provides the diagnosis and treatment. We must be careful with this information, but the future looks very different for the pharmaceutical industry.
EF: What does access mean to you?
For me it is very important, access is like our flag. Now more than ever, the Brazilian health system needs to increase access to solve problems, especially at a time when trust with both the government and civil society organizations has been broken. While companies and their leaders have gained relevance, we need to promote that access. This year I had the opportunity to renew my position as Vice President at PróGenéricos, where I can represent Sandoz, I am very proud of this because this year we can drive change.
The name of PróGenéricos is just pro-generics but we added the biosimilar word into our name, this is very important for me because at Sandoz Brazil we understand that it has a crucial role in the sustainability of the health system, it goes beyond the provision of safe, effective, and quality medicine. It is essential to support the Brazilian Government in its need to improve the quality of life for the Brazilian population. For Sandoz, investment in public policies is an important mechanism to meet the population's needs which goes beyond access to medicine, such as PDPs, increase in national production, and technological capacity because the heart of the PDP is the technical transfer of the product to the public laboratory. The Brazilian people can develop their technological capabilities and production capacity to make more complex products. Another important point is to increase access to information on the proper disposal of antibiotics to prevent the persistence of antimicrobial resistance.
EF: We have heard AMR be referred to as ‘the new pandemic’, could you elaborate on this and explain the role of Sandoz in AMR?
We call it the new pandemic. Sandoz has a strong position in the global fight against antimicrobial resistance, we are the number one producer of different anti-infective products. This is a serious global health problem, and by 2050 may be responsible for more deaths than Oncology diseases. We have a real focus on producing antibiotics as well as anti-infectives. One year ago, we bought two different anti-infectives from GSK, because we wanted to strengthen our portfolio in anti-infectives. We have completed the transfer from GSK to Sandoz through ANVISA, we now own this product, and we are very proud of it.
This area is one that requires a large investment of research and development because currently, we have no new anti-infectives, neither Sandoz nor the pharmaceutical industry as a whole. We are working to provide more training on this subject to different healthcare providers across the industry, as it is vital that the right treatment is delivered to the right patient at the right time, if not, we will have a big problem in the future.
EF: In terms of the operations and projects that you are currently working on, what is the importance of Brazil to Sandoz?
MB: Sandoz Brazil represents around 44% of the total sales in Latin America. We also have all the go-to-market models, different countries in LATAM decide to operate within certain areas, such as medical detailing, specialities, or biosimilars, whereas here in Brazil we do everything. We have a strong position regarding pure generics in pharmacies, the Sandoz brand equity is very high throughout the entire pharmacy system. We produced around 100 million boxes during 2021 despite the Covid pandemic, our production facilities in Brazil operated 24/7 every day during 2021.
In addition to this, we have speciality products for the private market, such as biosimilars and Oncology products, but we also have them in the public sector and the PDP business. We are a unique company in Brazil. We signed three PDPs, one example of these is a product that we deliver with our partners Bionovis and Bio-Manguinhos. We promote cardiologists, CNS, psychiatrists, the neurologist, and finally, we have the new team, the hospital line for the new anti-infectives. As you can see Sandoz is very dynamic, and we act as a good school for learning as we have all the go-to-market models at the same time.
EF: What is the scope for your PDPs and what are your expectations for them?
MB: PDPs started 10 years ago in Brazil, but Novartis initially decided not to participate. However, four or five years ago, when I started to work for LATAM and I heard about PDPs, I realized it was a huge opportunity for the patient, the government, and Sandoz. We sought a product development partnership and we started with rituximab, which was our first product. We have now support from global and they push us to continue to develop this Product Development Partnership.
Originally, we had the product and the marketing authorization, with that, we went public to the consortium to ask if Sandoz had the opportunity to participate in this PDP. Now, we are working in the opposite way. We are discussing new products with our partners for the new pipeline from Sandoz that is coming next year, and we are working to put together a molecule between the partnership and the public and send it away together, with this we have had amazing results over the past three months.
We have the opportunity to close two more PDPs in the near future, which is fantastic not only for the Brazilian government but also for the Brazilian people. Also, it's important to mention that Biosimilars in Brazil only represent 5% of the total Biologics Market, which is around US$ 2,6 billion. We have an opportunity to increase this and really improve the quality of life in Brazil in the coming years, we are working hard to achieve this.
We can define the PDP model as a best practice, and we are sharing our findings with different countries, Sandoz is truly an international organization, we cover Japan, China, Australia, Africa, and Latin America altogether and just as we do within a country, we share data with the rest of our colleagues regarding the PDP like a project because it's very good for the government, for the patient and from a technological point of view.
EF: In 10 years, when you look back on this part of your career, what would you like to be remembered for? What decisions are you making now that will have an impact in 10 years?
MB: I am very happy to help people in general. I hope I can be remembered as someone who made a move toward the future and also helped others to do the same. Finally, here in Brazil, the most important thing is the relevance of our culture. I'm working day by day to improve that, set example, and leave a legacy.
We have an internal survey where more than 90% of the people answer, we are 500 people and the level of engagement between the organization and culture last week was 91%. This is key because topics such as strategy, and product pipeline are very important, but the culture must remain relevant.
