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Conversation highlights:
- João’s experience working alongside consultants as a general physician in both Spain and Poland inspired him to pursue the management side of healthcare as a way to effect change.
- João’s description of current state of health in Brazil in one word: “Access,” encompassing the complex task of maintaining a high-quality patient experience while ensuring increased access to treatment João’s description of the future of health in Brazil in one word: “Navigation,” considering the need to proactively identify how to support patients and drive them efficiently into coordinated health services in order to maximize the health system sustainability.
- João’s predictions for the future of Brazilian Healthcare: More partnerships between industry and payers; a transition from organic to inorganic partnerships and increased verticalization; increased partnerships between non-leading providers and payers.
- EY-Parthenon helps companies navigate this complexity, merging deep sector knowledge with a focused mind on execution and realizing strategy.
- João’s source of pride at EY-Parthenon: Their ability to develop specialized expertise in a wide variety of areas while simultaneously uniting to tackle broad issues for the benefit of patients and stakeholders.
EF: Can you describe your role at EY Parthenon and how your previous experiences have prepared you for this role?
JS: I began as a physician, having studied at the University of Barcelona. During my studies, I practiced medicine in several hospitals in Barcelona. I also spent a year in Poland, working with colleagues across Europe in various hospitals, and later went to Brazil to work in an ER and infectious diseases department at a public health hospital, which was an incredibly valuable experience. To become attractive to consultancy companies, I then went to the U.S. and completed an MBA at Hult IBS to enhance my business skills. Afterwards, I worked in California for a private company funded by the CDC, helping them refresh their strategic planning as an external consultant. This marked my shift from clinical practice to management.
I met some people from EY's Latin America office around 2017. They were interested in investing in the healthcare and life sciences sector and saw a lot of challenges and opportunities in the field. They thought it made sense to hire a physician to help build this area, which led to my joining EY.
Regarding my role at EY, we have a structure organized by functions and sectors. In the healthcare and life sciences sector, we have various functions. One of them is strategy and transactions, which falls under the EY Parthenon sub-brand. At EY Parthenon, we work with pharma companies, payers, and providers to help them develop strategies, navigate market pressures, and grow their business. We also have other functions like supply and operations, technology, and advanced analytics, as well as audit and risk.
In my role as Vice President at EY Parthenon, I am mainly focused on corporate growth strategy. Over my years in consultancy, I have spent about 50% of my time in Brazil, 20-25% in other parts of Latin America (working with colleagues from Argentina, Chile, Colombia, and Mexico), and 25% in the U.S., where I was based in New York for a couple of years working on U.S. healthcare projects.
EF: Did you enjoy your time in Poland? How is Poland different compared to Brazil?
JS: I worked in Poland as a physician and in Brazil mainly in management, so I have a different perspective on both markets. Both Poland and Brazil are high-growth markets in healthcare, actively developing new services to engage physicians and patients in innovative ways. They are both focused on improving patient experiences and retaining healthcare professionals. However, I feel that the private healthcare sector in Brazil is more mature and developed compared to Poland. This might be due to Brazil's larger size or the competitiveness of its market. Brazil seems to have more advanced transactions, acquisitions, and market consolidation in the private healthcare sector, which is what I noticed in my experience.
EF: If you had to describe the Brazilian healthcare ecosystem in a few words, what would they be?
JS: For Brazil, the key concepts that come to mind are access, experience, and navigation. Compared to many other markets, particularly in Europe and the US, Brazil's private healthcare sector offers much more direct access to healthcare services. In Europe, the public system is heavily relied upon, with a structured and regulated process where you need to see a general physician before being referred to a specialist.
In Brazil, however, you can go straight to a specialist, physician, or emergency room without extra charges. This almost unrestricted access is crucial for its benefits as well as challenges. Alongside access, there is a strong focus on innovating the patient experience. The population expects high-quality engagement and ease of navigation through the healthcare system. This includes access to hospitals with top-notch physical infrastructure, well-known physicians, and the latest technology. The challenge lies in providing this high level of access and world-class clinical and non-clinical experiences while maintaining economic sustainability.
EF: What is the strategic importance of Brazil to EY Parthenon, and why will you continue to invest resources in this market?
JS: Brazil is a very mature health and life sciences market in the region. The complexity of the environment requires highly specialized consultants to support clients. The conversations are challenging and have become even more difficult now. Brazil has a large market with a population of 220 million and a private health market of 50 million. It is also a high-growth market. For these reasons, it is crucial to keep investing in healthcare in Brazil. The complexity is increasing from regulatory, payer, provider, and pharma standpoints, and this increasing complexity demands the support of consultants who can bring global experience and are able to focus on practical local solutions. The trend indicates that the demand for consultancy in this market will continue to grow. There is a lot to learn from Brazil's market that can be applied to other regions and vice versa.
EF: What services are your clients demanding the most, and what measurable impact are you making on healthcare in Brazil?
JS: I will break down the answer by type of client, as we work with various clients like payers, pharma companies, and hospitals.
For pharma clients, we help them demonstrate the value of their products and services to physicians, patients, and provider institutions. This is increasingly important as pharma companies need to prove their value not just to individual physicians and patients, but also to institutions making decisions about which therapies to use. With rising healthcare costs, aging populations, and new innovations in therapeutics and diagnostics, healthcare is becoming more expensive. This necessitates managing growth to remain commercially viable and sustainable. Hospitals are developing more clinical protocols to standardize care and ensure they use therapies and devices that offer the greatest value for patients. We assist pharma companies in navigating these conversations with physicians, patients, provider institutions, and payers. Payers are increasingly asking why they should include a particular product and what value it brings to the healthcare ecosystem. With finite resources, they need to make decisions based on the expected value for the population.
COVID-19 was a turning point in how pharma companies interact with key stakeholders, especially physicians. The pandemic disrupted in-person interactions, pushing the industry to rethink engagement strategies and leverage digital tools. During the early stages of COVID-19, we worked extensively with Big Pharma in Latin America to help them understand these changes and adapt their strategies accordingly. This shift also highlighted the importance of engaging with new stakeholders like provider institutions and payer health insurance companies. It is increasingly crucial to reimagine experiences for all stakeholders, and to define new roles and functions for your field force,
Another important area we assist with is pricing strategy. When you have innovative products that can help many people, launching them requires a well-thought-out pricing strategy. This strategy should address the concerns of all stakeholders, including hospitals and health insurance companies. The more value your product delivers and can demonstrate, the higher the price it can command. This value is not just in the product itself but also in the additional services and partnerships it includes , such as patient education, physician training, and support in diagnosis and therapy. Ultimately, pricing needs to reflect these broader value conversations.
EF: Are there any services you believe are under-demanded that pharma companies should focus on more for a long-term strategy?
JS: The top priority areas are how to demonstrate the value of your products and services. This is a complex issue that requires a complex approach. You need to think about your pricing strategy and understand the changing landscape of buyers and providers. Providers are building specialized hospitals for fields like oncology and cardiology. As a pharma company, you need to figure out how to relate to these specialized institutions. They are developing more protocols, and you need to engage with them to be part of the conversation and contribute meaningfully.
Additionally, the relevance of rare diseases is increasing. While each rare disease affects a small number of people, collectively, they impact millions. Innovations in this area are typically high-cost, and you need to effectively price these products and discuss their value with payers. These complex and critical conversations revolve around demonstrating the value of your products in the pharmaceutical industry.
EF: Are there any critical issues in the healthcare sector that you believe are being overlooked, where EY Parthenon could offer valuable assistance?
JS: There is an aging population, increasing costs for equipment and therapeutics, and high expectations for full access and experience. All these trends drive up costs. Payers are increasingly worried about the rising health costs, sometimes growing at rates of 12%, 15%, or even 20% per year, depending on the segment. This rapid cost increase makes it challenging for companies to afford health benefits for their employees. We need to implement strategies to manage this growth while addressing access and innovation. It is a tough environment to navigate over the next 5-10 years. Pharma is a crucial part of this conversation because innovation, while necessary, significantly contributes to cost increases. We need to find effective ways to generate maximum value.
EF: What do you think the healthcare sector will look like in 10 years? What are the three biggest differences you expect to see?
JS: I think we will see a lot more partnerships between pharma companies, payers, and providers, not just for providing products but also comprehensive services. This collective approach is a good way to maximize value. While it is still in its early stages, the trend is growing and becoming more relevant.
When I look at provider networks, there is a noticeable trend of market consolidation, mainly through acquisitions in recent years. However, there has been a recent shift towards organic partnerships. We are seeing providers partner with health insurance companies to reduce variability, create protocols, integrate patient journeys, and avoid unnecessary spending. In return, insurers give providers direct access to their patient volume.
Some health insurers are even building hospitals with major hospital operators. I think this trend will continue, and in ten years, we will see even more of these partnerships. Larger providers will maintain their growth through their bargaining power, while smaller ones will increasingly develop these partnerships and create integrated care pathways.
EF: When celebrating your 10-year anniversary, what achievements would you be most proud of?
JS: I am and will continue to be proud of EY’s vast expertise in diverse areas within healthcare and life sciences. EY is a large consultancy with specialized knowledge in various complex subfields, from pharma to hospital operations and health insurance. I will be proud of how we maintained and developed this specialized expertise while addressing significant questions across the entire health ecosystem. For instance, we have helped insurance payers launch and manage new products, assisted hospitals with physician relationship management, and supported pharma companies in rethinking their field forces.
The key achievement I will be proud of is how we have supported the entire health system on crucial issues like sustainability, economic viability, commercial attractiveness, and growth. It is rare to have the capability to debate these questions at such a high level. Usually, such discussions are reserved for government or regulatory agencies, but we have been able to provoke our clients to think long-term and evolve, considering both short-term commercial success and long-term social impact.
