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EF: What are Pfizer's key agenda items and priorities in the Brazilian healthcare market for the upcoming year?
MD: Before I share some of our priorities, I would like to recognize the importance of prioritizing health and encouraging the Brazilian population to get vaccinated, maintain health, and seek diagnosis and treatment. A healthy population is the backbone of economic growth and sustainable development. Our priority at Pfizer is to deliver breakthroughs that change people’s lives. To achieve that, we need to ensure that medicines and vaccines reach those who need them. We must work together with governments, policymakers, and health professionals to address the barriers that limit or prevent access.
Inclusion and equity in healthcare are essential. Brazil has made great progress towards improving healthcare for the entire population in recent years, but there is room for more improvement. There is a need to evolve the process of evaluating health technologies for incorporation into the public system, ensuring the population has faster access to cutting-edge solutions. We value the government’s important role in providing medicines to the people and recognize the challenge of balancing the inclusion of new treatments, especially innovative ones, with the system’s sustainability. We have established this topic as a priority and are promoting engagements around it, aiming to be part of the discussion and contribute ideas. We want to support this process to offer people the opportunity to age well and live longer, always with a high quality of life.
Boosting innovation is also key. There are significant legislations in Congress related to clinical trials, for example, that could improve Brazil's participation in the R&D ecosystem, attract more investment to the country, and improve patient access and physicians’ knowledge of key innovative therapies.
EF: Pfizer has been at the forefront of RNA-vaccine development. How is this innovation accelerating access to advanced healthcare solutions in Brazil, and what plans are in place to further promote its adoption?
MD: Pfizer and BioNTech signed a worldwide collaboration agreement in 2018 to work on the development of vaccines using mRNA technology. Initially, the idea was to look for ways to develop a flu vaccine, considering the opportunity the technology could offer to produce immunizers more quickly for the strains in circulation - and in large quantities.
With the pandemic, however, efforts were channeled into fighting COVID-19: using mRNA technology, we developed, tested, and approved, in partnership with BioNTech, an effective vaccine to fight the new coronavirus in the record time of 248 days, playing a key role in tackling the biggest health crisis in modern history.
Thus, since the COVID-19 pandemic, Pfizer has emerged as a leader in mRNA-based vaccines. With decades of experience, we have developed arguably the most efficient capabilities in the world for clinical development and vaccine manufacturing. Immunizers based on this technology require only the genetic sequences of viruses, allowing for faster and more flexible manufacturing, which can lead to better strain matching and potentially improve vaccine efficacy.
We believe that this technology has the potential to have a transformative impact on global health, which is why we have developed a robust mRNA strategy. The partnership with BioNTech for the development of immunizers using mRNA technology includes, in addition to the candidate flu vaccine, other clinical programs: a combined vaccine against COVID-19 and influenza, as well as a vaccine to prevent herpes zoster.
In addition to vaccines, mRNA is a versatile technology with potential applications in several other medical areas, such as infectious diseases, cancer, rare diseases, and autoimmune diseases. We, therefore, plan to continue investing in mRNA technology in different therapeutic areas.
We believe this is just the beginning of an exciting and important journey of scientific innovation. And we look forward to continuing to advance this technology for the benefit of patients.
EF: What is Pfizer's approach to achieving digital health and optimizing its organizational structure for enhanced efficiency and patient care in Brazil?
MD: Since 2019, we have undergone a profound cultural transformation at Pfizer so that the way we interact with our audiences reflects the increasingly digitalized and continuously connected world in which we live. Our purpose of innovating in everything we do, anticipating the needs of tomorrow, has driven our preparation for the changes we saw in society years ago.
The urgency we have experienced during the health crisis caused by the pandemic has forced us to think differently and challenge our processes in several areas. We adopted a "lightning speed" mentality to develop, for example, essential vaccines and an antiviral to combat COVID-19.
As part of our cultural transformation, the “lightning speed” mentality has permeated our teams, boosting research and development areas and fostering more agile business structures, i.e., faster and even better. The pandemic has reinforced our certainty that we can and must do things differently than usual.
For example, the development process for Paxlovid, Pfizer's antiviral for COVID-19, used artificial intelligence and virtual screening to speed up the selection of one of the drug's components. Machine learning, a variety of artificial intelligence in which programming models evolve as they process data, was used to predict the properties of oral medicines. These models helped to select virtual compounds to prioritize the most effective ones.
We are also using digital tools to support patient journeys. In the midst of a glut of information and fake news, it is hard to know what you can and cannot trust, especially what appears on the internet, and even more so when it comes to health. That's why we launched the 'Cuidamos Juntos' portal, where people can find lots of credible information about health and well-being curated by Pfizer. It holds content ranging from prevention, mental health care, oncology, skin diseases, and even rare diseases. It is a channel that centralizes reliable content and innovative solutions for patients at any point in their journey and who, by accessing the portal, can find the help they so desperately need.
EF: What three necessary pillars are required to build a more sustainable healthcare infrastructure in Brazil?
MD: First, it is necessary to consider that Brazil has one of the largest public health systems in the world, with 206 million people in the country's more than 5,000 cities covered by the Unified Health System. Managing such a large and capillary network is certainly quite complex.
In this context, collaborating in the search for solutions that favor the sustainability of Brazil's immense health ecosystem is also one of Pfizer Brazil’s priorities. To progress on this issue, we sought a partnership with IQVIA experts to develop a white paper on the subject and offer concrete proposals.
From this perspective, the first pillar for the sustainability of health systems in Brazil is the need to broaden the population's access to innovative therapies. This is directly related to the process of assessing and incorporating health technologies into the public system. For this to happen, it is essential to advance, for example, the applicability of the concept of avoided costs, especially given the high burden of disease in some medical areas, such as oncology and rare diseases.
Another important pillar has to do with reviewing health financing models. In the scenario of an accelerated aging population, it is essential to create and define practical standards for innovative agreements, such as differentiated contracts and risk-sharing arrangements. Investing in health is also key to guaranteeing a more prosperous society.
Finally, as a third pillar, it is important to highlight the need to solve the obstacles that make it difficult to dispense medicine even after it has been incorporated. It is therefore necessary to work towards speeding up the implementation of actions to make technology available, reducing the time until first access. Acting to reduce the time for preparing or reviewing Clinical Protocols and Therapeutic Guidelines, as well as strengthening integration between the units responsible for recommendations, decisions, and agreements within the public health system, for example, are part of this challenge.
EF: What is your perspective on the current status of female leadership within Brazil’s pharma sector, and how do you believe it should evolve? Additionally, what initiatives or changes would best support female professionals in the industry?
MD: The health industry has traditionally been a male sector, and the devaluation of women in science is a subject we've been discussing for a long time. But over the last two decades, this has been changing. Last year, for example, an unprecedented achievement in Brazil altered the composition of the Brazilian Academy of Sciences. For the first time, the institution elected more women scientists than men to the full academic board.
We are experiencing a moment of transformation in our segment, but I also know there is still much more to conquer. It is a fact that women are increasingly occupying more prominent positions in organizations, but we still have only a few pharmaceutical companies led by women in Brazil. A recent movement formed by such female leaders, called LeaderShe, was broadly launched in Brazil, aiming to inspire and motivate other women to grow in their careers, positively impacting their journeys and contributing to greater gender equality in the sector. Leaders from different companies work together to mentor and support other leaders, creating an environment where women feel valued and empowered.
At Pfizer, we have been working to support women in their career pathways. As a result of these efforts, if in 2008 female participation in the company's executive leadership was 23%, today the situation is quite different. In 2023, we reached 57% of Pfizer Brazil's leadership positions occupied by women.
Many strategic areas of the company, such as the Medical area and the Innovation, Human Resources, Compliance, Legal and Corporate Affairs, as well as different Business Units (Vaccines and I&I and Hospital, for example), are led by women of different profiles, age groups and backgrounds at Pfizer Brazil.
How have we managed to make so much progress in such a short space of time? This response certainly has to do with several factors. One example involved a strong internal policy encouraging women to apply for all available positions. It is important to talk about this because the data shows that women tend to apply for positions of greater responsibility only when they feel fully capable, which is quite different for men.
So, as a company and as a society, we have the challenge of strengthening our capacity to encourage these women so that they take more risks, seek new positions, and have the courage to go further. We need to give these women a voice, value their ideas, and always reinforce how capable they are.
On another front, we need to consider the benefits policy as an important pillar to support the professional development of women in a corporation. At Pfizer, to encourage the retention and growth of our women, we have implemented work policies that favor the harmonization of professional and personal life, such as extended maternity and paternity leave. There are several other programs, such as the possibility of flexible working hours and the adoption of the hybrid work model, even before the pandemic, among many others.
But just as important as the benefits policy is to keep the gender diversity agenda a priority in everything we do: in every discussion about talent and career analysis, we need to think about the gender issue and question whether we are bringing any unconscious bias into this process.
Finally, I would like to talk about the importance of a support network, whether in your personal or professional life. Having people by our side who support, inspire, and motivate us makes all the difference. LeaderShe, as I mentioned before, is also about that.
EF: Would you like to add a final message?
MD: Last December, Pfizer completed 70 years of history in Brazil, with an impressive legacy of contribution to the population’s health. We have a portfolio of almost 150 medicines and vaccines launched in the country, which help millions of Brazilians with their different health challenges: patients with rare degenerative diseases, people facing different types of cancer or a serious infection, patients with autoimmune disorders or families who want to vaccinate their children against highly lethal diseases such as meningitis and pneumonia.
In 2022, for example, 1 in 2 Brazilians used a Pfizer medicine or vaccine: that's more than 120 million people who have had their lives impacted by us in some way, a fact that we regard with great honor, respect, and responsibility. So, with first-rate science and our innovative spirit, we are proud to support Brazil in tackling diseases that have a major impact on the population and the health system. We are doing all this to respond to the growing needs of a population that, fortunately, is getting older and living longer.
