Read the Conversation
EF: You have worked for several big pharmaceutical companies in the past. What attracted you to join Angelini?
OI: I have had an amazing career. Novartis was a great business school, and Novo Nordisk was my leadership school. After more than 20 years in big pharma, I came to a point in my life and career where I said, "You know what? I've learned so much. Where can I build?" I wanted to build something. I decided to leave Novo Nordisk in 2019 and set my eyes on Spain. My husband and I looked at smaller companies in Spain where we could create, build, and give back all that I had learned for the past 20 years.
I was attracted to Angelini because, on the one hand, they had a legacy as a 100-year-old company with a well-established reputation. On the other hand, they strongly believed in evolution. Even though they are a family-owned traditional company, they also know that in order to grow and be competitive in the future, you have to evolve. This transformation mindset or ambition attracted me. I think transformation has been a theme throughout my career, so Angelini fits perfectly into my plans.
I did not expect this new path in my career to happen during COVID-19, but the pandemic helped people to stop and reassess. When I came in and talked about transformation and change, people had an open mind and were ready to embrace it. COVID-19 created an environment where everybody was in unfamiliar territory. Some of the concepts that I brought in were embraced with little or no resistance.
It was a pleasure to come into a new company where the people were willing and ready to embrace change. We created a strong leadership team during the pandemic years. We have managed to change the mindset of the people and our way of working through the implementation of an agile way of working. We have shown that we can be leaders within the company as an affiliate and in the industry. I have also learned so much and grown as well.
EF: What are your current priorities on the agenda, and what can we expect from Angelini Pharma in 2024?
OI: Angelini Spain has been growing every year. The major milestone we are chasing is surpassing the 100 million euro mark. We are currently in a position where we might achieve and surpass this goal. This is the company's economic goal and has become a personal goal for all our employees. We have laid the groundwork for how we are going to achieve this goal. One of the key elements of our transformation has been to become a company with more focus and purpose. That is part of what we have been working on as a leadership team over the past four years. Our focus and purpose are to improve people's quality of life.
We have a broad portfolio and want to focus on a couple of areas. Our first focus is on brain health and, more specifically, epilepsy. We just launched an important therapy for drug-resistant epilepsy. This is an area in which I think that we can make real changes in people's lives because, up until now, regardless of the number of drugs you put them on, a percentage of epilepsy patients were not getting better. Our drug has been approved, and we have been seeing real change in people's lives. We have seen people be able to go back to work and become more independent and confident. Up to 20 percent of the people with drug-resistant epilepsy achieved seizure freedom, and that is something that was almost unheard of in this patient group.
Over the past year, we have heard testimonials from doctors and patients that are truly motivating. We also work in the areas of schizophrenia and depression. That’s another area of focus for us in brain health. Forty percent of our business is in consumer health, which also plays into brain health because we have products in our portfolio, such as vitamins and melatonin for sleep. Those are vital to good brain health and have positively contributed to our society.
We also have business in infectious diseases, ophthalmology, and pain management. These legacy areas are important contributors to the business and our goal. Brain health goes beyond the products that we sell; it is also about how we support society and work with the government. At a global level, we have partnered with House Ambrosetti, which is an Italian think tank. We have worked with politicians, thought leaders and patient groups to determine how best we can advance mental and brain health management.
For example, this past April, we had a meeting in parliament where we brought together thought leaders, patient associations, and politicians to have a debate on how to advance the care for people with mental health and epilepsy. We had a brain health theme in terms of policy, investment, and how we can partner with the government to support people. We also discussed the investment that the government needs to put into treatment, awareness, and prevention. Those are the three areas of focus that we have across all of the disease areas that we treat, both in prescription medicines and consumer health.
I have been in the industry for more than a few years, and I have seen so many product launches. On one hand, I can count the number of products that really make a difference, and our epilepsy therapy is one of them.
At our factory, we manufacture one of our throat lozenges. We produce more than three million units a year. We always have this questioning feeling of whether we are doing enough. Are we really contributing to Angelini and Spain as a whole? We are now partnering and working with our global colleagues to evolve the capabilities of the factory, consequently changing the plant name to Angelini Plant Barcelona and working on converting it into a packaging plant so that we can expand our capacity and the contribution that we can make as a country to Angelini Pharma.
EF: As the leader of Angelini Spain, how would you describe the importance of the Spanish market to Angelini as a global company?
OI: Spain is very important to Angelini Pharma. After Italy, it ranks second in Angelini's locations. We currently have about 200 employees in Spain. Our turnover in 2021 was about 80 million dollars. Reaching that $100 million milestone in a few years is important. Angelini Pharma as a whole reached the one billion dollar milestone last year. Being a major contributor to that is a point of pride and ambition for us, and that is why we are so focused on growth and success.
We are in about 5 million Spanish homes right now, between our prescription medicines and our consumer health products. Our presence and growth are strong. I think that we have been able to demonstrate that we can be leaders. We launched Agile methodology, and we are the only country division that has gone through that. Our other country divisions are now looking into it. We are also leaders in cultural transformation in our way of working. How can you focus on impact versus activity, and how do you establish that drumbeat where every week you are checking in and seeing how you are doing towards the goal and being able to adjust if the market changes? This was key during the pandemic. Our Agile process is called PLAY: Prioritize, Lead, Align, and You Learn. The concept of continuous learning and adjusting according to what the market needs is really important. We have demonstrated a great deal of leadership within the organization.
EF: To what extent do you promote local innovation in Spain?
OI: On the consumer health side, we are the only country outside of Italy that has its own headcount for business development. We are constantly looking for opportunities to bring innovation to patients. If we happen upon an opportunity for the prescription medicine side, we pass it along to the global office. We are very fortunate to have a headcount that works specifically on business development.
I think our strength also lies in the fact that although we do not do primary research in Spain, we do run clinical trials. This is important for the future, and the countries will have experience with the products that are launched. For example, even before the commercial launch, many local expert physicians already had experience with the treatment because of the preclinical program and the phase three programs. Having that kind of experience and expertise in the country also elevates the reputation of the company in the country. We have also been able to export some of our key opinion leaders to help other countries launch and to bring the experience that we have here in helping patients access this medication to other countries as well.
In terms of R&D, I was surprised to discover that Spain has a really high level of scientific knowledge and talent. The quality of the clinical trials and scientific work done here is really high. I think that is one of the things that makes Spain attractive from an R&D standpoint. We have the talent, professionals, and infrastructure. Our CROs are very strong. The hospitals and investigation centers are well organized, and this helps us make an important contribution to R&D globally.
In 2023, the Ministry of Science and Innovation had the largest R&D budget in the history of our country. The ministry's budget reached about four billion euros this year, reflecting a four percent growth compared to previous years. This also reflects a doubling in direct investment in science and innovation since 2020. That is a 98 percent increase in three years. That shows the importance that the government is placing in this area. In my history at Angelini and Novo Nordisk, our interactions with the Ministry of Health have always been about: What is your company contributing to R&D here in Spain, and whether it's primary research or clinical trial research? Do you have a plant? When I joined Angelini, I was very excited to discover that we had a manufacturing plant.
The investment in our industry was 1.3 billion euros. This puts us second in terms of industrial sector investment after motor vehicles. About 20 percent of all industrial R&D carried out in Spain is conducted by the pharmaceutical industry. Spain, as a leader in clinical trials, has authorized more than 900 trials, according to the Spanish Registry of Clinical Studies. About 86 percent of this is from this industry. These are a couple of stats that show that Spain is a big player in the future of healthcare.
EF: How are you using digital tools to enhance your operations in this post-pandemic tech revolution era? Secondly, nowadays, executives have to balance the physical world with the digital world at the same time. How are you using tools, and how do you balance those two worlds?
OI: That is a question that every single company is dealing with: how do you balance? The digitalization brought on by the pandemic has helped shift mindsets in the country. It has shown that people can work well, and they almost work more. At Angelini, we have had to put limits on the number of hours people work from home to prevent them from overworking. I think digitalization has made people more efficient in terms of the flexibility that they have now. The work has to get done; where you do it is secondary, although we do have some guidelines.
We have been able to use technologies to solve business challenges in a different, more effective way, for example, for insight-gathering. Barcelona is a known health technology hub, and we have been able to tap into its networks. TechBarcelona or Barcelona Health Hub are partners that we work with and that gather thousands of start-ups. We have been able to tap into AI and NLP technologies to answer questions that we have. For example, instead of going out and spending a lot of time gathering information with field teams, we analyze the aggregated market and competitive intelligence information in a more efficient way.
There are now programs that allow you to go out on the Internet and look at what is going on in the market. Industry representatives can have real conversations with doctors based on the conversations happening in the industry. For example, if a big topic of conversation is how to improve quality of life and improve compliance and adherence to medications, from a marketing standpoint, we can adjust our messaging to be able to be experts in that area. I think when you have this as a resource internally, it makes you more efficient. Instead of representatives having to spend so much time investigating, we can have these insights already so that they can actually go and be effective in what their actual job is.
In terms of technologies, we just had a congress on Friday with general neurologists where we were able to use virtual reality to simulate an experience of what somebody who has epilepsy goes through. This is very powerful, especially in an area where, up until recently, doctors were not really interested in epilepsy because you can help some patients, but most of them have no hope because the existing drugs are not highly efficient. We can now appeal to doctors on an emotional level because they can put themselves in the shoes of the patients. This is very powerful in terms of breaking therapeutic inertia or therapeutic nihilism. This is a situation where people say, "You know what? The patient is good enough." Doctors now have tools at their disposal to say that is no longer an acceptable answer because now there are solutions for patients. Let's put ourselves in the shoes of the patient.
We are also developing virtual reality for infectious diseases. For example, we have an IV antibiotic where children have to sit while it is being administered. We used technology to create a service for the kids. The technology will distract or entertain them while they get their IV treatment. This is a way to improve the quality of care. It is not just about the drug; it is about going beyond the drug.
Looking forward, we are setting our sights on digital therapeutics. When you are talking about health, the drug is only a part of it, but technology is becoming more able to improve outcomes, whether it's improving adherence, patient understanding, or motivation. There are so many things to do. We are partnering with Barcelona Health Hub, Tech Barcelona, and other companies to determine how we can impact the regulatory conversations about improving patient access to not only drugs but also digital therapeutics.
In this area, we are working with the Consortium for Digital Therapeutics (DTX), a strategic alliance where we have partnered with Bayer, Pfizer, Boehringer, Chiesi, Ferrer, and Almirall and also Vodafone or business schools such as IESE to boost the regulation of digital therapeutics to facilitate their access to the Spanish market so that we can improve access to patients for the improvement of their health and well-being.
Our head of digital medicine believes in a brighter future, and she is working with other heads of digital medicine to share ideas within competitive standards and behavioral rules. There are things in the industry that we can get in our heads together to advance how patients are treated and have a wider impact through collaboration. As a result of her initiative, there is officially a digital medicines group within the pharma industry to deal with topics having to do with digital health. This is the result of having people who are passionate about what they do.
I have always talked about the community that surrounds a patient, but the words that we are using now go even beyond that. We are talking about ecosystems. We have to go beyond just the medicine and the treatment—we have to go beyond thinking in terms of a company or the pharmaceutical industry. We have to look at the whole ecosystem that surrounds treatment, and that includes the pharmaceutical industry, the health tech industry, caregivers, healthcare providers, and the government. The government is a key player in all of this because, without access and investment on the part of the government, how do you move things forward? The concept of ecosystems is really important for the future. I think you will hear more about that.
EF: Looking back at the 50 years of Angelini in Spain, what achievements do you think the company is most proud of?
OI: I think Angelini is most proud of its history. Juanola has been around for more than 100 years. People know the brand before they know the company. Taking a brand like Juanola, which started out as a licorice lozenge, and evolving that to have a strong business in the area of consumer health that is anchored in that brand, I think, is a really strong achievement. That brand has a legacy, but it is also evolving with the needs of consumers.
I think the second achievement is the focus on brain health. We used to be a company that was focused on selling products through licensing and acquisition agreements. This transformation means we are now a company with a real focus on improving people's lives, with a particular focus on brain health. It is probably one of the things that marks the future for Angelini. Angelini's strategic decision to focus on brain health will mark the future, and I think that is an accomplishment that is not so easy to do in a really short time.
We have probably been talking about brain health for two to three years. It started here in Spain. That is another part that we are really proud of because we were initially focused on mental health. When we got the epilepsy product, it was no longer just about mental health; it was much more than that. It's much broader. Brain health made a lot of sense, and we took it back to its basics. We pitched our idea to the global office, and they adopted it.
The third achievement we are most proud of is the people and how we have been able to have a major transformation in the way we work. I am really impressed by how people just opened up their minds to say, "OK, let's do it." To be able to empower people, give them a voice, enable them to work bottom-up instead of in a hierarchical fashion, and work in cross-functional teams is a major achievement. The people like it and feel like they have a say in the future of the company. This is so powerful when you are talking about creating solutions to improve people's lives.
EF: Is there any final message you would like to give to our readers?
OI: The other area that we need to talk about is sustainability and what that means for Angelini in terms of our commitment to global health. When we are talking about sustainability, most people think about the environment. We are doing a lot of work within the environment and the climate, with a particular focus on the supply chain and packaging, to shrink our footprint.
Sustainability is also about access. There are so many barriers to access in Spain. Access to healthcare and innovation is challenging. This has gotten a lot of press and a lot of pressure. It is unacceptable that a country has to go more than 540 days from when EMA approves a product to when it is reimbursed.
I think corporate social responsibility is really important. I have always said we are not just a company in a country. We are part of the country; we are citizens of the country. Therefore, we have a responsibility to give back. For example, we have partnered with an NGO called Banco Farmacéutico, and they work to fight pharmaceutical poverty. In the beginning, it was more of a monetary contribution. Now, we have volunteer days where we go and partner with them. We also have service days with the organizations that this NGO serves. This brings so much more to Angelini, what it is like to work at Angelini, and what we are about. It is completely in line with our goal of improving the lives of people.
