Read the Conversation
EF: You have recently been appointed as VP of Emerging Markets in Latam. How have your roles and responsibilities changed after accepting this position and what is your mission in this new role?
ML: Today marks the end of my second week in this position, so it is still early for me to provide a comprehensive plan or detailed insights into the region. Fortunately, the region is brimming with opportunities. It is a matter of identifying and prioritizing which ones to pursue first. My initial observation of Latin America, specifically within Coloplast, highlights two more advanced markets: Argentina and Brazil. The rest of the region offers significant untapped potential for growth.
My goal is to accelerate growth across the region, including Brazil, and protect our market share in key countries like Brazil and Argentina. For the rest of the region, we aim to drive growth sustainably. In the coming months, we will map out market potential in other countries and create a plan to seize these opportunities. Our agenda is firmly focused on growth. Currently, we have a presence in Argentina, Brazil, Colombia, and Costa Rica, where we also have a manufacturing site. The rest of the region is managed through distributors. We will assess where else we can establish our footprint to expand our business further.
EF: What do you think is the key to success when you enter a new organization?
ML: I believe it is crucial to take the time to understand the business, the company culture, and the people. These three elements are fundamental for success: understanding the culture, connecting with the people, and grasping the market dynamics and intricacies. My personal style emphasizes close collaboration with my team and all employees. I frequently engage with different levels within the organization to gain deeper insights into the business. Listening is vital; those on the frontline often have the best understanding of the business. Staying connected with them provides a clear sense of how the business is evolving and what actions we need to take. In the first three months, focusing on the culture, the people, and the market dynamics will be my top priorities.
EF: Coloplast’s commercial model is based on four things: clinical preference, payer preference, consumer preference, and having superior products that are differentiated. What is your strategy for success in these four areas? What metrics do you use to keep track of growth in these distinct areas?
ML: Let's start with user preferences. We believe we have the best product on the market and aim to satisfy customers and users through exceptional nursing care. Our specialized nursing team provides strong, personalized support for users, particularly in managing their stomas and intimate needs. We have field care nurses and a dedicated call center, Central Ativa, staffed with 11 nurses who actively reach out to users to check on their well-being and offer clinical support.
Our key performance indicators (KPIs) include tracking user retention with our products, reduction in urinary infections through hydrophilic catheter use, and monitoring adverse events related to ostomy care. Our goal is to enhance the quality of life for our users through our superior product portfolio and our comprehensive support.
For payers, our portfolio, particularly our hydrophilic catheters, is designed to prevent urinary infections, thereby helping to control costs by reducing hospital admissions, ICU stays, and antibiotics use. In ostomy care, providing high-quality equipment and services helps to prevent skin problems, further managing healthcare costs. Our products and services positively impact the budgets of healthcare providers and payers by promoting cost-effective health outcomes that reduce secondary health complications. For healthcare providers (HCPs), we offer continuous training to keep them updated on new technologies and care methods. We track their engagement with our training programs, website platforms, and conferences. By employing brand lift methodology, we assess how well our products and services are recognized and valued by HCPs. This approach helps us measure and enhance our impact on healthcare professionals.
EF: What work do you do with the public sector and government; and how is Coloplast helping to move forward the reimbursement situation in Brazil and the rest of Latin America?
ML: Firstly, I want to talk about Brazil, as I am still familiarizing myself with the broader Latin American business landscape. Let's separate the discussion into the ostomy business and continence care business. In Brazil, the ostomy market is more advanced, and the public healthcare system provides coverage for users. However, the primary challenge is the low standard of care, specifically the amount of ostomy bags provided by the government. Ideally, users should receive around 30 bags per month, but they currently receive an average of 10 bags. This shortfall means users must clean and reuse their bags, which is far from ideal. The consequences it brings impact directly into their well-being, as the appropriate change routine of their ostomy bags helps to prevent leakage and peristomal skin problems.
In this scenario, ostomates may isolate themselves from society in general (family, friends, work) as they fear suffering embarrassing situations. To address this, we are collaborating with the Patient Association in Brazil and have established a market access structure within the company. Our team, including government affairs professionals, is actively working with the federal government to revise the current regulation (Law 400) to determine a minimum number of bags per user per month. This process is complex and time-consuming due to budget constraints and competition with healthcare priorities like HIV, oncology, diabetes, COVID-19, and dengue. Despite these challenges, we are committed to improving the standard of care by ensuring users receive an adequate supply of ostomy bags.
In the case of Continence Care business, particularly hydrophilic catheters, the challenge is to establish access to better technology. Currently in Brazil, 92% of users who need to perform intermittent catheterization receive catheters made with PVC from the government. These rigid catheters can injure the urinary tract and cause infections, posing significant health risks, especially since many users do not feel pain due to their health conditions, making them unaware of potential damage. Our hydrophilic catheters, which were approved and recommended by CONITEC in 2019, offer a cutting-edge solution that reduces infections and is more convenient for users. We are now working with the Ministry of Health to develop the PCDT (Clinical Protocol and Therapeutic Guidelines) and to finalize budget discussions among federal, state, and municipal governments. We are in the advanced stages of this process, aiming to ensure that users across Brazil have access to our best-in-class product.
Clinically, our nurses and sales force are actively educating urologists, rehabilitation centers, and users about the benefits of our hydrophilic catheters and the consequences of inadequate catheterization. We are fully engaged and by addressing these challenges through comprehensive strategies, we aim to improve the quality of care and access to superior products for users in Brazil.
EF: How would you rate the level of awareness when it comes to these therapeutic areas in the past couple of years since you entered the company? Do you have any awareness campaigns in LATAM that you can tell us about?
ML: I believe the level of awareness is increasing, and we are heavily investing in sharing more information with users, HCPs, and public stakeholders. We are dedicating substantial funds to PR activities, focusing on the clinical situations of ostomy patients and continence care users. Both ostomy and continence care are often overlooked issues.
When people see someone in a wheelchair, their first thought is about mobility. However, for many wheelchair users, their top priority is having access to comfortable sanitary products and high-quality catheters and technology. This need is often unknown by the general population, but wheelchair users are acutely aware and advocate for these necessities. Our current efforts aim to increase public awareness, as this helps pressure the government to approve better catheters, thereby improving the quality of life for these individuals.
Regarding ostomy care, while colorectal cancer and oncology receive significant attention, the aftermath, such as living with a stoma, is rarely discussed. Patients with stomas depend on ostomy bags and must manage their use and hygiene daily, making it a silent condition. The public focus is usually on cancer treatment, not on the long-term consequences for patients. Our challenge is to educate the population in general that post-surgery life for stoma patients involves managing an ostomy bag for many years, sometimes for the rest of their lives. This aspect of their life is often unknown, and these patients, who are typically from low-income backgrounds, do not have the means to advocate for their rights. Many of them fear losing even that minimal support and as a result, they are less likely to demand better care. We are taking on this advocacy role by working closely with patient associations to raise awareness and fight for better support.
Our comprehensive approach includes PR activities, training, government affairs, and more, aiming to enhance awareness and engagement and ensure these patients receive the care and products they need.
The DNA of our company is centered on taking care of the users of our products. Our mission is to make life easier for those with intimate healthcare needs, and this is reflected in our daily operations. Our primary concern is continuously exploring ways to improve the quality of life for our users. Unlike other pharmaceutical or medical device companies, which operate under different business models, our company maintains a unique closeness to our users. This closeness is embedded in our portfolio, our mission, and everything we do. Our focus is always on what more we can do to support and enhance our users’ lives.
EF: Is there any new information that you can share regarding upcoming acquisitions or initiatives in new therapeutic areas outside of the classic ones that you operate in?
ML: The company is currently launching new products within our existing business lines, introducing advanced technologies in the areas where we are already competitive. Also, Coloplast has a clear plan to leverage our last acquisition, a company called Kerecis, an innovative company in the biologics wound care segment.
Our voice and respiratory care business is experiencing significant growth, with substantial potential not just in Brazil but worldwide. The challenge here, as with our continence care and ostomy businesses, is establishing a higher standard of care. The issues we face in Brazil, such as access and standard of care, are consistent across Latin America. Over the past 15 months, I have been in touch with my peers across the region, and it is evident that these challenges are shared throughout Latin America. Therefore, we will continue to apply our current approach in Brazil to the rest of the region. We may need to intensify our efforts in certain countries depending on their specific levels of access and standard of care, but the overall challenge remains similar.
EF: Why do you think $1 invested in your industry segment is worth more in Brazil than anywhere else in the world?
ML: I believe our company offers a compelling value proposition. We provide cutting-edge technology designed to improve the quality of life of our users. Our unique business model enables us to stay very close to our users, something that is uncommon in other companies in the healthcare industry. We have an intimate understanding of not just the general needs of our users, but the specific needs and experiences of each individual user. This allows us to know how they are doing with our products and identify additional ways to support them.
Our closeness to the business and the marketplace sets us apart from other companies. The clinical and nursing support we provide is unparalleled, and no other company offers the same level of personal care and attention that we do. This, in my opinion, is our main differentiator.
EF: Is Brazil an ideal place to grow this type of business?
ML: Yes. I believe we have significant untapped potential to grow the business. There is a unique combination of a low standard of care and market access challenges to overcome. In continence care, for example, creating a standard of care with our superior hydrophilic catheter presents a tremendous opportunity, especially considering that 92% of the market currently uses PVC catheters.
Our market leadership and product quality position us well to capitalize on this opportunity. In the case of ostomy care, users currently receive only 10 bags per month. This demonstrates why Brazil is an excellent country to invest in, with ample opportunities for growth. The company's goal in Brazil is to double its size within the next few years, and we are well on track to achieve this. This ambitious target reflects our confidence in the growth potential and our commitment to making significant strides in improving the standard of care.
EF: What do you think it is about Danish companies that make them so forward-thinking and sustainable?
ML: This is my first experience working for a European company, and I am fortunate to be part of a Danish organization, which has been a pleasant surprise in terms of culture and business model. Culturally, Danish people prioritize trust and empowerment in their work approach. Given Denmark's small market size, innovation is crucial for differentiation on the global stage, which is evident in companies like Coloplast.
Sustainability holds significant importance within the Danish ethos, and I take pride in being part of this commitment. The working climate here is exceptionally positive; employees are genuinely happy and proud of the company's values and mission. To illustrate, we recently conducted an internal climate survey where Brazil achieved an unprecedented 9.5 out of 10 in employee satisfaction—a remarkable milestone in my career. This high level of satisfaction seems consistent across other Danish companies, reflecting their respectful treatment of employees.
EF: Do you have any final message for our readership?
ML: I believe Coloplast is poised to become a prominent company, not just in Brazil but throughout Latin America. While we already hold a significant portion of the market, our brand recognition in the healthcare segment is still developing, and constantly improving. We are committed to enhancing our visibility and reputation, driven by our strong value proposition and the impactful initiatives we are implementing to elevate healthcare standards for our users. Stay tuned—there's more to come from Coloplast.
