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EF: What have been the lessons learned from this last very atypical year?
CA: IQVIA has a real and direct perspective on what is happening in the Colombian health sector. Patients, health institutions, and pharma companies have been impacted in different ways. Last year was a challenging one, and the Colombian health system responded very well to the Covid challenge in the relevant areas.
In the retail segment, the pharmaceutical market continued to grow regardless of the situation, March 2020 was a record month in terms of retail sales for the pharma industry. We have never recorded such high sales in a single month, and even though that number has not been sustainable, we are going back to high sales numbers again. After March 2020 there was a decline because those sales were related to ‘stocking up drugs’ in the last days before lockdown anticipating the pandemic, which favored the pharma sales.
During the pandemic, there was a big transition to virtual formats and online sales. Bigger pharmacy chains were better prepared because they were used to this process, whereas independent pharmacies relied on in-person visits and had to catch up. After the strict lockdown got flexible, independent stores saw a recovery in sales.
IQVIA tracks this information and we produce weekly and monthly indicators, particularly for the retail sector. During the pandemic we introduced a weekly newsletter with information related to Covid. We plan to continue this running after the pandemic and it is a way of sharing our perspective with different stakeholders. We share information with different stakeholders in the healthcare system, for example with ACEMI, the Colombian Association for HMOs that for example track the proportion of drugs that were delivered to homes as opposed to being claimed at the distribution points which is now back to a pre-pandemic situation. Colombia has a very different market when it comes to pharma to the rest of the Latin American countries as we have the lowest out-of-pocket percentage in terms of drug spending in retail and therefore we have the largest institutional market proportion of the region. If we compare Colombia and Mexico, Colombia’s institutional market is comparatively much larger even if it has suffered in terms of growth. Although we are still relying on public figures to be released, we know it has been growing in double digits for the last 8 years and, although not at the same rate, 2020 had a positive growth. Most of the value associated with the institutional segment is related to high-cost treatments, oncology, or rare disease treatments. While treatments for oncological patients have carried on through the pandemic, the identification and diagnosis of new patients have halted drastically from March through to the 3rd quarter.
EF: Could you elaborate on the differences between the Colombian and Latin American markets?
CA: The Colombian market is very well positioned and very attractive for investment. It is not the largest market, although large enough to have a lot of potential with reasonably good macro-economics in comparison to other countries in the region. Our market size is an advantage because it is not too large and provides an agile environment. The real world evidence on regulation, access, or innovation for the accelerated use of high-cost treatments -usually carrying better health outcomes- are much easier to manage in a country with the size and the configuration of Colombia. Colombia´s pharma market has managed to continue growing during the pandemic healthily, its growth was balanced between volume, innovation, and price. This is good news for the patient, for pharma companies, and even for the institutional sector. Colombia is well-positioned for growth being attractive but not too complex.
EF: What have been the biggest therapeutic areas driving growth?
CA: In Colombia, patients are willing to go to institutional coverage to get the needed medication for chronic diseases such as diabetes, hypertension, or cardiovascular disorders. This is very different to what happens in Mexico, where people go through a slower process. Colombians have more incentives to engage with the treatments which translate into a good outcome for market growth. Another important and decisive therapeutic area is oncology, given the way the Colombia system works there are many fewer barriers for innovation than in Mexico as authorizations can be accessed by the population. In Colombia, market authorization is more rapid than other markets and has mechanisms where physicians, institutions, or patient associations can access the high-cost drugs. It is harder for the institutional segment of the market to control the spending so innovation has continued to penetrate the Colombian market right up to 2020 which was not the case elsewhere.
EF: Could you elaborate on IQVIA Colombia´s footprint and its relevance to IQVIA LATAM?
CA: I am very happy to say that IQVIA Colombia has established itself as the number 3 country in the region which was to be expected given its size, Mexico has almost three times the Colombian population and that has an impact on the size of the pharmaceutical market. In recent years Colombia has solidified its position and closed the gap with Mexico growing faster in terms of percentage our base is lower so it is easier for our percentages to be higher. Additionally, we have been focusing on expanding our portfolio of solutions offering innovation to the market -typically driven by Brazil. There are examples where we have been the first country in the region to bring innovation in terms of tech solutions thus closing the gap with the bigger countries in the region in terms of portfolio.
EF: What are the services most requested and has this changed after Covid?
CA: After our merger with Quintiles the business changed significantly. One of our largest business earnings comes from the CRO branch, and we saw a significant increase during the pandemic. We were involved in several studies for vaccines and related products all over the world and LATAM and Colombia were no exception. We ran studies on vaccines that are now being reviewed, we had an impact on how the industry responded to Covid and we are proud of our effort to bring access faster to the population.
The demand for our services has changed over time; companies rely on the information and insights we provide to make decisions. During the pandemic, there was a shift on the promotional sales forces business model promoting drugs for the pharma industry. It is a unique model in that we deliver a full service; we have the technology to track the activity, and data assets to assess the impact of the promotion in terms of prescription and actual sales. IQVIA is a company that can connect the dots and the demands have shifted to these kinds of solutions. We were quick to provide access to recruited physicians while complying with the Colombian legal requirements and helping in the shift to virtual work. In the past, we relied almost exclusively on data subscriptions solutions with a set of standard solutions that could be subscribed to for tracking what is happening in the market. The value-added services has grown a lot and we have developed very valuable expertise focused on health –it is our only focus- and we understand everything surrounding the subject offering comprehensive solutions to our clients. The company started up in Colombia to track the retail segment and now we have a consumer health unit, an institutional market unit, we are entering the animal health segment, developing a dermo-cosmetic branch, and going into medical devices. Yes, we have changed a lot over the last 2 or 3 years.
EF: When you look back on this part of your career, what would you like your 2020/2021 tenure to be remembered for?
CA: The team has been the backbone of our success. I have tried to bring everything together, connect all the dots between the different businesses under my supervision in Colombia. It is not only about how my teams engage but about the way we shape our solutions to make sense across the board, how we rethink the services we offer to leverage technology to better support our analytics which I believe has made us a more effective and successful business in recent years. At IQVIA we take nothing for granted and constantly look for new ways to help.