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EF: Could you provide more information about the current priorities for Bayer Pharmaceuticals in Latin America and share your strategic plans for the region? 

AJ: Back in 2020, we embarked on revitalizing our portfolio in Brazil and Latin America, transitioning from a focus on oral contraceptives to a more diversified company. Despite challenges, we have successfully launched new products and expanded our presence in oncology and specialty care. Our operations have grown consistently, and we plan to achieve double-digit growth in 2023. We have also improved reimbursement and expanded our market reach through private insurance and inclusion in national healthcare programs. Bayer has a strong presence in oncology, with five products, including darolutamide, a potential global blockbuster for prostate cancer. Moreover, women's health, particularly our intrauterine devices, remains a significant part of our portfolio, with impressive growth in Brazil. 

In the field of ophthalmology, our product aflibercept has gained a significant market share, particularly in treating retina diseases. We achieved inclusion in federal reimbursement through the SUS program, leading to strong growth. Additionally, we launched a compelling cardiovascular product that protects the kidneys of patients with diabetes, addressing a critical complication of the disease. Furthermore, we are close to obtaining reimbursement for a modern hemophilia product under SUS. 

Despite the challenges, most of these products were launched or achieved improved reimbursement during the pandemic, driving double-digit growth across these franchises. Despite the challenging patent loss of rivaroxaban, one of the company's main products, to generics, the company is in a favorable position, poised for double-digit growth in the coming years. We are looking ahead with confidence. 

EF: What is your access strategy for Latin America and Brazil? How do you leverage global and local partnerships to improve product access in the region?  

AJ: With 130 years, Bayer is one of the earliest pharmaceutical companies in Brazil, with a history dating back to its establishment. Regarding medical education and partnerships, Bayer adopts a highly decentralized approach. We have professionals situated across the country, eliminating the need for third-party involvement. Whether in the central, northern, southern, or any other region of Brazil, our Bayer associates are present, including sales representatives, medical experts, and access personnel. We aim to establish close relationships with customers and assist them in decision-making processes. 

In Brazil, the healthcare system involves the national SUS program and state-level coverage, with thousands of municipalities responsible for healthcare expenditures. To navigate this complex landscape, we engage in operations such as educational campaigns to prevent unwanted pregnancies and work closely with municipalities and state secretaries to raise awareness. We collaborate on pricing strategies and clinical trials, not limited to renowned institutions, but also partnering with academic centers across different states in the country. 

Recognizing the country’s vastness and regional variations in GDP growth, we ensure our approach is mindful of these factors. Our decentralized model extends to medical education, clinical research, and patient-focused initiatives. Bayer's commitment spans all our therapeutic areas, covering the entire country through various aspects of our business.  

In addition to our existing collaborations, we actively forge new alliances. For example, an intriguing partnership with Fiocruz, a renowned institution based in Rio de Janeiro, to facilitate the distribution of Chagas treatment product to the federal government. We are currently in the initial phase of collaboration, aiming for a full-fledged PDP (Productive Development Partnership) with the potential for future tech transfer. 

Moreover, we are discussing partnerships in close coordination with the government in areas such as hemophilia. These collaborations with public institutions are approached with care, considering the mutual benefits for Bayer and the patients we aim to serve. 

EF: How does Brazil strategically position itself to capitalize on the shift towards precision medicine and innovative treatments in the changing landscape of healthcare operations in Latin America? 

AJ: Bayer recognized the evolving landscape of medical science and positioned itself as a relevant player in cell and gene therapy and precision medicine. We have developed groundbreaking treatments to target specific gene fusions in multiple cancer types. Our larotrectinib precision therapy has shown remarkable efficacy, particularly in pediatric cancers, offering new hope for patients. Furthermore, Bayer has made strategic acquisitions, including Blue Rock and Ask Bio, which have provided them with a broad platform in cell and gene therapy. 

Brazil holds significant importance for Bayer, as the country has played a key role in the early adoption of our innovative products. Notably, Brazil was among the first countries to launch larotrectinib and darolutamide for prostate cancer.  

Additionally, Bayer recognizes the regulatory advancements made by ANVISA. Brazil's health regulatory agency has established a regulatory framework for cell and gene therapies, paving the way for the future introduction of these advanced treatments in the Brazilian market. As Bayer continues to advance their cell and gene therapies, Brazil will remain a priority market, ensuring that patients in the country have access to cutting-edge treatments. 

EF: How does Bayer strategically align its portfolio to meet the specific healthcare needs of different countries in the Latin American region? 

AJ: We have flagship brands focused on the main therapeutic areas that we introduce to most markets. However, we also recognize specific needs in different regions.  

In Mexico, we have identified a promising market for contraceptive implants and launched an affordable product compared to our main competitor. Our implant offers five years of protection against pregnancy, surpassing the three-year offering in the Mexican market. This has led to a positive collaboration with the Mexican government. They included our product in their listing and placed a significant order for this year. The government is substituting a substantial portion of its annual purchase with our product. 

In Brazil, we have identified a high demand for injectable contraceptives and are increasing production to supply the market. The company is attentive to these particular needs and takes proactive measures to address them - products like these present opportunities for us to assist governments with more affordable options. 

EF: What three key pillars should be present in a sustainable healthcare system, considering the lessons learned from the pandemic and the focus on meeting patient needs? 

AJ: The three crucial pillars are innovation, affordable prices, and innovative business practices.  

First and foremost, we focus on legitimate innovation. Simply offering a me-too product or a slightly improved version is not sufficient. The public healthcare system and even private markets no longer have room for premium-priced products. We strive to change the way diseases are treated and provide real value. 

The second pillar is ensuring affordable prices. Bayer recognizes the importance of affordability. It is essential to align the pricing of our products with the expectations of government agencies and payers. Our prices must be compatible with the drug’s clinical value and consider the macroeconomic factors of the market.  

The third pillar is innovation in the way we do business. Pharma companies should focus on selling a solution rather than just a product. This involves supporting physicians in diagnosing and treating patients by providing personalized guidance. Assisting a patient’s journey includes providing them with an understanding of their disease and support for exercise, diet, and overall disease management. 

To achieve this, we must embrace a holistic approach. We must leverage technology and connect payers, prescribers, and users within the ecosystem. Bayer is actively pursuing various innovative projects, such as BayerFlix (officially named Universo Médico), our 24/7 platform for medical education, which has received numerous awards and explores different funding models and partnerships with payers. We aim to be among the most innovative companies. 

EF: How does Bayer focus on innovation throughout the entire product lifecycle, including education, diagnostics, and improving the patient journey? 

AJ: In the case of the mentioned products, diagnosing gene fusion is not straightforward. We invested 70% of our resources in building a program to fund the necessary tests and established a network of labs to perform them.  

We realized it was not enough to emphasize the drug’s effectiveness alone. We needed to help physicians find patients with the specific fusion of genes required for the treatment to be effective. We developed the Digital Patient Journey project to track patients from diagnosis to treatment using technology. This project builds upon our previous initiative of Universo Médico, which has already engaged over 10,000 doctors in Brazil. 

Additionally, we have ventured into e-commerce, allowing customers to purchase our products through web platforms, apps, and mobile phones. Although the pharmaceutical industry is still in the early stages of leveraging technology, Bayer Brazil is committed to embracing these advancements seriously. 

EF: What are your aspirations and goals for the next decade, considering the significant progress and growth you achieved since we last met in 2020? 

AJ: By introducing innovative products and maintaining a strong growth trajectory, I foresee Bayer sustaining double-digit growth in Latin America for the next five years. We have upcoming launches in various therapeutic areas, including a phase three clinical research to a non-hormonal solution for menopause symptoms, and ongoing studies in prostate cancer, kidney protection, and heart failure. These and many other products in exciting stages of their life cycle are bringing further innovation and reinforcing our reputation as a highly innovative and reliable partner. 

While we may not be present in all therapeutic areas, such as pain and depression, our goal is to continue introducing new products and remain a valuable partner for healthcare professionals and patients. We aim to uphold our strong ethical standards and solid reputation, as reflected in the well-known slogan: "If it's Bayer, it's good.”  

July 2023