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EF: If health had its own COP26 and you were a speaker, what would be your message to world leaders?

AR: Diseases occur primarily due to the lack of sanitation and drinkable water. Water and energy are vital; energy desalinate the water needed for consumption, transports clean water, etc. Even in countries with established healthcare systems, diagnosis is the biggest gap after sanitation and water. We don't have enough trained physicians to cover the multiple symptoms a patient can display, and in many cases, we cannot find the patients. Some patients never get diagnosed or treated, but what is happening today could change the situation dramatically. With a combination of wearables and artificial intelligence, technology can detect and diagnose a larger volume of people. Once we get better at diagnosing, more patients will need treatment and solutions. Non-communicable diseases, chronic and degenerative conditions defy the logic and knowledge that healthcare systems were built on. A patient must feel sick to go to a physician to get diagnosed and prescribed a medicine that solves the problem. The problem with chronic conditions is that only 50% of what needs to be done to control that patient properly is in the physician's hands, and the other 50% is in the patient's hands. Health literacy is a huge topic, and there will be a considerable need to train populations to care for their health. We will have to educate the new generation of children to be responsible for their health. We will all have to become more knowledgeable on dyslipidemia, cholesterol, triglycerides, and blood pressure. The platforms should make the knowledge easier to come by, as their growth has been exponential, and technology has made them readily available. Over the next ten years, thanks to the many satellite internet provider projects, everybody will have access and be connected, so there is a way to educate and train people to live healthier lives, and I believe this will be a game-changer. In a nutshell, my message is to diagnose more and train people to take care of their health.

EF: 2020 has been the year of prevention & diagnosis, and 2021 the year of vaccines. If you had to tag 2022, how do you envision next year?

AR: For 2022 our objective is to "reconnect patients back to care". Specifically, patients with chronic conditions are at the moment castaways, and they are disconnected from the care they need. Hospitals are full of patients with chronic conditions, either because they are decompensated or in a critical condition, as they have postponed tracking their chronic disease for so long.  

EF: What will be the role of the patient in accelerating access and treatment in that reconnection to care?

AR: Crisis and pandemics have a good side; they teach us priorities. We have seen a dramatic change in adopting innovation within the Mexican healthcare system. The authorities are moving; COFEPRIS is on steroids trying to take advantage of everything that exists, putting together a very aggressive initiative to amplify the use of reliance to take advantage of what has been already studied and approved by other reference agencies around the world. The administration was very ambitious in changing the model and purchasing medicine, and there was a cost to that learning. Crisis makes us stop wasting time mainly because there is no time to be wasted... The role of the patient is much more active, having an awareness of the problems and acting on them. The next phase will be exciting; with the mega information sharing around the world, patients will have more health literacy and be knowledgeable; they will take the helm of their health, and the pressure will be on them. The pharmaceutical companies are now in the process of showing the value of the healthcare system to the government. If the work is combined with COFEPRIS, we could have a renascence period for the healthcare industry and systems as a whole. AbbVie was created in 2013 –with 130 years of heritage from Abbott- and the reason we started a new and different company was to create a 21st-century company with 21st-century values, views, and solutions, i.e., innovation. We assembled a diverse team with the brightest minds to tackle the biggest challenges and co-create. We call our teams ninjas, people trained to challenge the status quo and find solutions for complex problems. They go to our stakeholders and work with them to co-create easier, cheaper, faster, more effective, and more efficient solutions. We are building a more robust pipeline in immunology, hemato-oncology, neurology, ophthalmology and aesthetics. AbbVie approaches illnesses differently; we are not driven by sales or our market share but by the changes and improvements we can create in the therapeutic areas; our fundamental objective is to raise the standard of care. When we enter a new therapeutic area, we look to change and improve it. We disrupt to improve, not minor enhancements but huge ones. Our biggest gap isn't in the therapies themselves but in finding the patients; for example, in rheumatoid arthritis, only 3% of our patients are using novel therapies, so the issue is not a better biological frame but giving access to the 97% remaining patients to them.  

EF: AbbVie was awarded the Best Place to Work, quite an achievement considering the employees' mental health during the pandemic. What was key to being chosen for the award?

AR: Four ingredients have always worked for us in the past and are connected to universal values: i) people need to feel recognized ii) people like to connect with other interesting and successful people, it creates a sense of community, iii) they want to do meaningful work, work that makes an impact that can be easily seen, and iv) to be considered and treated fairly. The primary three aspects of creating transparency and a communication culture are a sense of community, a meaningful job, and being treated fairly. This is how we work, and I am not surprised about the award because the working environment is excellent, collaborative, and magic happens. The sense of community is tangible, as is employee gratitude for the transparency we worked with during the pandemic. We were one of the first companies to pull in everybody from the field and one of the last to send them back in. AbbVie always puts its people first, and the commitment level and engagement of the employees are remarkable. I have a group of warriors working for me. The leadership team also represents these same values.  

EF: What are you most excited about in the product portfolio and pipeline?

AR: In the short term, I am very excited about what is coming in immunology. We will revolutionize –again- the way we treat those malignancies. Mid-term neurology, the company is actively working on compounds for treating Alzheimer's and Parkinson's diseases. By 2030, we will know how to treat most cancers; I am not saying we will eliminate them as a cause of death, but they will be managed. By the end of the decade, Alzheimer's and Parkinson's and their effect on aging populations will be our next significant objective.


EF: You mentioned disrupting therapeutic areas, so what will be the role of pharmaco-economics when introducing new drugs in Mexico?

AR: Mexico is very advanced in this area; Mexico has had a very established process to demonstrate cost-effectiveness or cost savings for some time. I lead the access commission at AMIIF, and we are talking to the Consejo de Salubridad General ( CSG)  on how to integrate Quality of Life Indicators in the pharmaco-economic evaluation. So far, evaluations in Mexico are very straightforward, but we have to include Quality of Life Indicators into the pharmaco-economic evaluation. If a patient has cancer, it is not just about extending the patient's life; it is about giving wellbeing to that patient during the treatment and it must be part of the equation. This administration has incorporated the word wellbeing into the equation, and the innovation industry is discussing options with the authorities.

EF: You are part of the sector's leadership, driving the industry forward and into the future. Where do you think you are headed?

AR: I believe we have learned not as an industry or as a country, but as individual human beings the fundamental and primary role healthcare plays in all our lives, the world over. Covid and the pandemic have put healthcare in the center. Our job as industry executives is to step up to the challenge, drive innovation, technology, and knowledge that will ultimately render healthcare benefits to the largest amount of people possible. In 2030, I will look back at this year and realize that in 2021  healthcare took center stage.  

December 2021