Read the Conversation
EF: How has your approach to leadership evolved after working in various countries during your career?
RS: Living and working across various countries such as the US, Mexico, Switzerland, and Brazil has given me a broader perspective on dealing with diverse cultures. Each culture has unique nuances that require adaptation, but ultimately, clear and transparent communication with the team is essential. Ensuring that every team member understands their role in the overall objective, and recognizes how their contributions are vital to the project's success, is absolutely necessary.
Of course, the regulatory environments differ significantly between countries like Mexico, Brazil, Switzerland, and the US. As a foreigner, I may not be an expert in local regulations, but I rely on local experts to provide insights and recommendations. By collaborating with these experts and understanding their perspectives, I can make informed decisions that align with my broader view and strategic goals.
EF: What is the strategic importance of Latin America to Ferring?
RS: LATAM is structured in three clusters for Ferring. The first cluster is called NOLA (North of Latin America), based in Mexico City, and is responsible for Mexico, Central America, and the Caribbean. The second cluster, SOLA (South of Latin America), is based in Buenos Aires and oversees Argentina, Chile (where we have subsidiaries and offices), and the rest of South America which is managed through distributors. The third cluster is Brazil, based in São Paulo.
Latin America is part of the ELAC region (Europe, Latin America, and Canada) and is a significant emerging market. Due to its proximity to the US and collaboration with the FDA, it is often easier to register and submit products in Latin American countries than in Europe. Given the market size of Brazil and Mexico, we plan to launch some pipeline products in these markets as part of the first wave after the US. The region's importance is underscored by its large population, with 220 million people in Brazil and 120 million in Mexico. Overall, Latin America has a population of around 660 million, compared to the European Union´s 450 million, making it a vital growth market. There are issues of access, however, and we need to address them both in the public and private sectors.
EF: Where is Ferring dedicating the most resources at the moment?
RS: We have a unique situation with innovation, as we operate one of Ferring's four research centers in Brazil, alongside centers in Russia, India, and China. Our center in Brazil is particularly notable as it is the only one of its kind established by a multinational company specifically for local innovation. This center was created in 2017 and currently has several promising projects underway. One of our projects, in partnership with Cellera, is already advancing to phase three. We are also developing projects in gastroenterology and reproductive medicine, with plans to launch these in Brazil within a few years and eventually expand to other Latin American and emerging markets.
Innovation in Brazil is a hot topic, especially now, as highlighted by recent news. A new law for Clinical Research in Humans (PL 6007/23) aims to simplify and reduce the ethical and regulatory approval time. It recently passed in Congress and is awaiting presidential approval, aiming to significantly boost Brazil's R&D capabilities. In 2023, Brazil ranked around 10th or 11th globally in terms of the pharma market size, but it is only 19th in R&D research. This represents a substantial opportunity for growth in innovation. At present, only 1.9% of global R&D is conducted in Brazil.
With the new law, the goal is to increase this to 4% over the next few years. Brazil's large and diverse population of 220 million people provides a rich environment for conducting R&D and clinical trials, which can facilitate product registration internationally. Innovation remains a top priority for us, and we have several clinical projects, four or five in total, progressing well. Hopefully, the first one will be in the Brazilian market in the next two years. We are very excited and proud of this progress. The innovation that we are creating in Brazil has been developed by ourselves, but for phase three, we partnered with Cellera for an anal fissure product we are developing jointly.
Regarding our pipeline, we have two products that, while not developed in Brazil, will soon be introduced to the Brazilian market. These include a product in gastroenterology and another in gene therapy. The gastroenterology product was acquired from a US company that Ferring purchased a few years ago, and it is based on microbiome technology. We are hopeful that both of these innovative products will be available to Brazilian patients in the near future.
EF: As a company known for reproductive health, what was the strategy behind enhancing your offerings in gastroenterology and gene therapy?
RS: From a global perspective, the company is divided into three core areas. The first area is reproductive medicine and maternal health, which accounts for 54% of our global sales. The second area is gastroenterology and microbiome, with a particular focus on diseases like IBD in certain regions. Ferring pioneered the foundational treatment for this disease 30 years ago, and this area now represents approximately 22% of our global sales. The third core area is urology and uro-oncology, where we have a longstanding presence in prostate cancer.
Our latest innovation is a product for bladder cancer, which has already been launched in the US and is now expanding globally. Although reproductive medicine and maternal health dominate our global sales, gastroenterology, and uro-oncology, have also been integral to our business for many years. Our strategy is to balance and innovate within these critical areas, ensuring we leverage new technologies and treatment methods. Locally in Latin America and Brazil, our goal is to continue growing and expanding these key areas in line with our global objectives. For example, in gastroenterology, while we have historically focused on IBD, we are now exploring new innovations and treatments within this field. We are going to be launching a microbiome-based product for Clostridium difficile infection. The microbiome is a platform that could potentially be used for other disease areas in which Ferring operates as well.
We are taking advantage of the fact that we have been working in these areas for many years within these countries; we already have a salesforce that has great relationships with the KOLs, patient associations, and medical associations. We have already built a name there and now we are bringing new technologies to continue expanding the relationships that we have and bringing new benefits for the patients.
EF: What role does local clinical research play in Ferring?
RS: At Ferring, we engage in two types of clinical research. The first type is global clinical research, managed outside of Brazil and Latin America. Historically, Latin America has had limited participation in this type of research. This is primarily due to the lengthy process of registering clinical trials in Brazil. However, a new legislative initiative aims to reduce the registration time to as little as 90 days. If this law is approved, Brazil could become an attractive destination for global research projects. Currently, only 2% of clinical trials are conducted in Brazil, but the goal is to increase this to 4% in the short term. Although Ferring does not currently have global R&D projects based in Brazil, this new law would provide a strong incentive to push for more clinical trials to be conducted in the country.
The second type of clinical research involves projects initiated within our research lab in Brazil. These projects are specifically designed for the Brazilian market with the potential for expansion to other markets. We have several ongoing projects, including a partnership with Cellera in gastroenterology, as well as projects in maternal health.
Conducting clinical trials locally has several advantages. For example, having local data when submitting a product to regulatory bodies like ANVISA is highly beneficial. Additionally, local scientists working with the product before its launch can facilitate smoother integration into the market. Their familiarity with the product makes it easier to convince other doctors to adopt new technologies, as local experts can vouch for their efficacy based on firsthand experience with Brazilian patients. Increasing research capacity in Brazil would be a game changer, bringing resources, know-how, and investment to the country.
EF: What role do you think Latin America and Brazil could play in the future global production chain?
RS: As of today, we have several manufacturing facilities in Latin America. These include a packaging plant in Mexico, a manufacturing plant in Argentina, and an API manufacturing plant also located in Argentina. While we currently do not have a manufacturing plant in Brazil, establishing one within the next ten years is a possibility. Observing other multinationals with plants in Brazil, we recognize the potential benefits and would not rule out this option for the future. Additionally, we have an important R&D center in Brazil, which plays a crucial role in our operations. My expectation is to expand the size and capabilities of this research lab over the next few years, further strengthening our commitment to innovation and local development.
EF: Why is investing $1 in Brazil a safer investment compared to other countries or other regions?
RS: Brazil is a continental country with significant opportunities across various regions. The market is ripe for innovation, with many new advancements yet to arrive. Given its size and the government's support, there is substantial potential for good returns on investment. The recent government initiative to promote research sends a clear message that they are committed to fostering innovation. We are currently engaging in promising discussions with ANVISA to introduce new therapeutic areas, such as gene therapy and microbiome treatments, to the market.
Brazil's market size, combined with strong support from both public and private sectors, makes it an attractive place for investment. While other regions like Europe and Asia face complexities and challenges, Brazil stands out as a growth market with a positive outlook for the future. This makes it a prime location for new investments and business expansion. The country’s GDP and inflation levels are also quite stable, and this helps with planning for the future.
EF: Do you have a final message for our readers?
RS: Currently, Brazil presents numerous opportunities for our company, particularly in the fields of fertility and maternal health. Fertility access remains an important area for us to further develop in Brazil. Additionally, maternal health is of paramount importance. Recently, we introduced a product for postpartum hemorrhage aimed at reducing maternal mortality rates in Brazil. This initiative holds significant potential to positively impact Brazilian society. Globally, the maternal mortality rate averages around 70 deaths per 100,000 women. However, in Brazil, this number exceeds 100, returning to the ratio from 25 years ago. Such disparities highlight the pressing need for intervention within the Brazilian healthcare system. With our newly launched product and working in collaboration with private and public healthcare institutions, we aim to bridge this gap and contribute to reducing maternal mortality rates in Brazil, aligning our efforts with the World Health Organization (WHO), which in the context of the Sustainable Development Goals (SDG), countries have united behind the target to accelerate the decline of maternal mortality by 2030. It is quite exciting to have a product that has an impact on reducing maternal mortality because women are the center of the family. If a mom is missing, it will leave a lasting impact not only on that family but on society as a whole.
