Read the Conversation

EF: What accomplishments are you most proud of since being appointed managing director in 2018?

FPM: It has been quite an experience in terms of integration and organization. Janssen South Africa has been immersed in an amazing transformational journey. We have been building capabilities and preparing the organization for the future innovative products that will be brought to the market. We have been investing resources in different therapeutic areas such as immunology, oncology and mental health which has all been part of our transformation. 

EF: You mentioned patients’ voices and new organizational expansion in South Africa. How has the patient voice focus changed things internally? How are you integrating it into your decisions at a top level?

FPM: As an innovative pharmaceutical company, we believe patients should be at the heart of our business model. We need to integrate the patient’s voice with our strategic plans, from R&D design to market access. This responsibility falls on each individual within the organization, regardless of their function. The capacity to listen to and understand the patients’ needs is embedded in our Credo at Johnson & Johnson. We are currently offering significant patient support programs, but we can always improve to better understand their needs and to adapt our proposals, structures and offerings accordingly. 

First, we must understand what the patient’s journey is and realize our treatments play only a relatively small part in that journey. It is more complex than having access to a given treatment; there’s the complexity of diagnostics, of symptomatology, the referral pattern. As a company, we must understand the full process even better and the best way to do that is to listen to the patient. Patients’ voices are increasing. They are more informed. They understand what they need and want. Therefore, providing accurate and balanced information is critical. The patient’s voice should be an important element as well for the decision makers as they have much to say to the payers, to the funders, and to the pharmaceutical companies. 

EF: How does this tie into the overall corporate effort to shift from being profit focused to value and patient focused? 

FPM: Patient centricity is not a new concept for us. It is in our Credo and has been there from the very beginning. It’s about having it as a top priority. Building together  a value-based healthcare system, by understanding the needs of the country is a different concept.  In order to  incorporate  the benefits of innovation, there needs to be a balanced dialogue with relevant stakeholders on what value means, and that involves more than cost or pricing. We should be looking at the complete patient’s journey, at the impact on mortality and morbidity, at how side effects and costs associated can be reduced, and how innovation can for instance eliminate the need for a second-line treatment. Treatments can no longer be evaluated looking exclusively at the cost of a given  medication. The whole patient’s journey must be considered and discussed carefully with our critical stakeholders. 

EF: What are your main priorities today and over the next couple years?

FPM: I have a number of priorities. First  one is to complete the internal transformation, ensuring that we build the right capabilities and that we generate high quality employment. Externally, our priority is innovation. To accelerate innovation in the country and ensure that South Africans will have access to new and innovative treatments. Affordability plays a part in access but availability is even more important because the first step is to make the products available in South Africa. We have to consolidate the regulatory process and clear the backlog which has caused significant delays in access to products in this country, an even more complex situation than affordability itself. The first A in Access is for Availability, and then, Affordability. I must say SAHPRA is doing a great job. in the process of building capabilities and reducing the backlog, but over the next two years, we need to see the products coming to South Africa. 

EF: SEP is a challenge for many alternative reimbursement models. Do you see any new models that Janssen could help shape? 

FPM: Finding new models to increase affordability is a pending matter in the South African  environment. All around the world, there are significant examples of flexible and innovative contracts through managed entry agreements, e.g. performance based or financially based models. I strongly believe that we need to start by listening to what the needs are. For example, in certain areas, disease prevalence will be a problem, especially for the budget impact. In other areas, you may be dealing with the cost of treatment induction or a long maintenance. Future treatments will also have complications in funding. For example, with cell therapy that only needs to be administered with one shot, how will you consider the down-stream benefits of such a treatment? There are many different situations, so there should be flexibility for different reimbursement models to be considered. 

The starting point is always through sitting with all the relevant stakeholders, particularly with the Department of Health, and talking about that flexibility. Nowadays flexibility is quite limited. There is no room to even discuss what alternative models – which exist in many other parts of the world- could be used. I do consider it critical for the future Sometimes the dialogue seems to be centered around rebates, discounts, or acquisition cost which I think is an over simplistic approach. There’s a real importance to innovative contracts that can adapt to a country’s needs, which may vary in different therapeutic areas. Janssen has always considered equity as the guiding principle behind our decisions. Overall, there are many innovative models to pursue that can create a more equitable and accessible system.

EF: Janssen is a global leader in innovation. Could you tell us about your progress in fighting Tuberculosis? 

FPM:  Innovation is clearly part of our DNA. We are principally an innovative company with focus in immunology, oncology, mental health . TB is as well a particularly important area in South Africa, as we all know what the burden of the disease is. The last years we have been doing an amazing work from R&D such as developing Sirturo which has been extremely effective against multi-drug resistant TB. But Our TB venture is also a good example in understanding the burden of disease of the country and increasing access for the patients. Most importantly, the TB space has been an example of partnering with the Department of Health which has helped us to look at the patient’s journey, end-to-end. It’s not just about having Sirturo; Our success has been a result of working with the authorities and defining the patient population that will benefit the most from the treatment.. That success has lied with tackling other issues by building capabilities, propping up a system capable of treating MDR-TB patients, and training healthcare professionals accordingly. We look at the potential complications of MDR TB treatment and start a program to deal with that. The end-to-end patient journey has been a critical success for Sirturo and for MDR-TB treatments, with more than 12.000 patients treated in the country in the last year. 

EF: How does Africa fit into Janssen’s global strategy?

FPM: For Janssen and J&J, it is vital for us to partner with the different departments of health in the continent. It is part of our credo and strategy, and we believe it is possible to meet the needs of innovation in Africa. We are seeing a revolution in terms of building capabilities for many healthcare systems,  so there is a huge opportunity for these systems to embrace innovation  by looking for the most innovative treatments. Janssen will always want to be part of those opportunities in partnering with the healthcare systems.

EF: Where do you think the most exciting advancements will be happening over the next 5 to 10 years in Africa, in general, and South Africa, in particular? 

FPM: As I have already mentioned, TB is an area where there have been and will continue to be incredible advancements. I am also very optimistic about the development of an HIV vaccine, so this area should advance as well. Last but not least, oncology has major potential for innovation with the development of cell therapy and personalized medicine. From a human resources perspective, for pharmaceutical  innovators, there is a huge opportunity in the continent for building skills, generating high quality employment, expand localization, and creating strong partnerships with the governments. In terms of economic growth, pharmaceuticals will represent a very attractive segment for Africa. South Africa urgently needs sustainable economic growth and, with unemployment being a major problem, these companies create high quality jobs and investment in the continent. Janssen and other such companies offer economic growth contributing to the country and the continent.

EF: The pharma sector manages their triple bottom line (People, Profit, and Planet) very well. What advice would you give to others leaders in managing a triple bottom line?

FPM: J&J success lies in having a strong long-term plan. To look for initiatives that build capabilities and a long-term pipeline. By building capabilities and developing local talent, the system sustains itself with the resources that are available. In the short term, it can be difficult to make the business profitable -and business needs to be profitable- but even more, it needs to be sustainable in the future. Building capabilities is an essential part of that. We have an extraordinary portfolio and an amazing pipeline, but we must not only focus on the products but on people’s talent and capabilities as well. That’s our real strength at Janssen. 

February 2020
South Africa