Read the Conversation

EF: 2020 was the year of diagnosis and prevention, 2021 the year of vaccines; what do you think 2022 will be remembered for?

GC: I hope the pharmaceutical industry will be remembered for its contribution to humanity in a crucial moment when it was most needed. In the past, the pharmaceutical industry has been extremely undervalued from a public opinion perspective. The majority of people are not concerned about spending money on non-priority items, however, tend to complain if they spend the same amount on health care, including medicines. There are a lot of thoughts, comments, and complaints that are not considerate and understanding of the industry.  
I co-relate Covid to HIV. Today a patient will not die from HIV because of the investment and research that has gone into developing innovations to help patients. I want people to remember 2022 as the year in which the pharmaceutical industry came to the forefront to resolve the Covid issue and deliver on it. It was the first time the world recognized the importance of our sector. Everyone woke up with a decision based on a healthcare issue, from presidents to oil and gas companies or automotive industries. Bristol Myers Squibb was one of the companies that led this movement. We were not involved with the vaccine, but we engaged in gathering and delivering resources, which was necessary and part of why we are here today. The way Covid vaccines came about will be the new frontier for the rest of the R&D industry.  

EF: What are the two key lessons you have learned from this process?

GC: I have learned a lot of amazing lessons in the last two years. In January 2019, we made the largest acquisition in the pharma industry when we acquired Celgene. We were in the process of integration in November 2019, we created a new company when the acquisition was confirmed. Between November 2019 and February 2020, we were designing this new company. We had a large spillover of jobs, processes, and other technicalities. In March 2020, we announced the new company. People did not know each other or the organization's work culture. And, on March 13, we were all at the home office.  
Like everyone else, we thought we would be working and integrating for at least a month or two, and everything would get back to normal. It took two years. Before the pandemic, I would meet at most 15 employees per meeting to hear what was on their minds. At these meetings, employees could ask me personal, strategic, business, or any other questions they had. It was a listening session of sorts.  

Immediately after lockdown, I called a meeting to keep people informed of where we were going. We had 200 people in that online meeting, which was a wake-up call. I have a saying which goes, 'If I don't take care of my family, how can I expect to care for a company or anything else?' People were eager to talk and ask questions during that first call after lockdown. I felt awed by the overwhelming response I got during that call. I realized that people needed a sense of belonging because they were busy adjusting themselves.  

The meeting was the first sign that mental health would be a primary focus we should pay attention to. The idea was to be a steward of myself and my family, and a steward for the well-being of our employees. We had a global leadership conference with over 400 Bristol Myers Squibb leaders, and the lead speaker was the author of Emotional Agility, Susan David. She gave us an overview of the book and, everything she discussed, we experienced in the last two years. Susan taught us to be careful of what is behind an “I'm okay”. When someone says, “I'm okay”, we should dig deep and fast to determine what is behind that response.
The meeting was thus named “What's in your heart and your mind” with sensitivity. The sessions went from weekly to bi-weekly, and now they are held once a month. For two years, we learned to celebrate life. We knew that we were all facing the same storm as humanity, but we were not in the same boat. Many companies announced the closure of physical offices and moving into virtual offices, which was a bold move because humans are social. Office space is an asset. We need to give ourselves time to learn in the process.

We are identifying two groups of people that emerged during the pandemic. One group feels more productive when they work from home. The second group of people is those unwilling to return to the office because of previous treatment. I have shared my experience with other companies and sectors on how a tentative policy of a hybrid work model is the worst-case scenario. At BMS, we have a clear policy on workplace conduct. We came up with the concept of collaboration days, so every Monday, Tuesday, and Thursday is a collaboration day. It means that if an employee chooses to go to work on any of those days, they can interact with others and boost their morale. The policy is a starting point and will keep changing in the future.  

It is important to have humility regarding the knowledge we do not have. Transformational leaders are emotionally agile and emotionally intelligent, which makes them winners. I am very proud that our level of engagement with our employees is one of the best among global companies. People go through many life changes, so leaders need to be more understanding. I became a more inclusive leader without realizing it. I now do not take someone's “okay” at face value.  
I am happy that we are slowly returning to the office and adjusting to office life again. This year, we are learning the importance of returning to the past for guidance and integration. We are learning to listen to our employees and let them speak out their thoughts.  

EF: How was the performance of BMS Brazil's portfolio, and how will we get patients back to care?

GC: We are a specialized company. Our areas of expertise are Oncology, Hematology, and Immunology. There are two new products in Cardiology coming at the end of the year. Our main concern is the numbers for the future, though we do not have performance issues to date. In 2021, we forecasted 50,000 patients that were not being diagnosed. That curve shows all the patients who should potentially receive treatment but might not be receiving it.  Our mission and vision are to help patients through science. We have been working on patient advocacy with associations and physicians. We are looking for ways to get patients back to their treatments at the public and private sector levels. Today we have multi-channels for our collaboration with customers. BMS Brazil is trying to be more flexible by understanding the customers' preferences.  

The differentiating factor between Bristol Myers and the rest of the industry is our culture of an on-brand team. We do not operate separately or individually, we work together. As we communicate with customers, our message should be one. We made a major shift in our access organization during the end of the pandemic. We saw an opportunity to ramp up the strategic account management being the central point of contact with our customers. A cohesive message is fundamental to the company. It is a major business shift that we want to invest in increasingly to be concise with our customers.  

The new products we have in our pipeline are very rich and are from our Celgene and MyoKardia acquisition and our development. When I joined BMS in 2012, I was privileged to launch the first Immunology on the market. We became a recipient of a Nobel prize. With the new launch coming, we will be the only company with products with three checkpoints for Oncology. One of our important customers specializes in Melanoma. At the beginning of his career, he would consult with patients to extend their life expectancy. After so many years in the industry, he now consults with patients to create a strategy for a cure. That is how science is making a difference in people's lives.  

EF: Is there a product you are specifically excited about in your pipeline?

GC: There are so many products that I am excited about. We recently announced a new product coming in the US, which is a combination of two former products. This will be the first time we have two products combined in one drug, positioning BMS as the only company that offers three Immune-oncologic drugs with differentiated and synergistic modes of action. When looking at the evolution of using Immunology, we also look for resistance at certain checkpoints.  

We also have a product in our pipeline that has been life-changing for patients who need blood transfusions due to two Hematologic diseases: Myelodysplastic Syndrome and Beta-thalassemia. Another product that was a result of the MyoKardia acquisition, falls under Obstructive Cardiomyopathy. There is no drug to treat Obstructive Cardiomyopathy, which is how this product got developed by design. Many patients became casualties of these conditions without a diagnosis. It is very exciting for us as we prepare for the launch of the products.

One exciting thing about the Brazilian branch is how it was behind in terms of the portfolio, but not anymore. The Brazilian Regulatory Agency is part of Project Orbis, an FDA initiative for concurrent submission and review of Oncology products with other international health authorities This has allowed us to launch products right after the US. Our portfolio and organization here in Brazil are a copy of the cooperation in the US or the Euro-Asian market.  We rely on people and not strategies. We have the right people to ensure that strategies are brought to life. The best strategy without the right people to implement them is useless. Our employees engage in a culture based on our values, so we can rely on each other to help patients.  

EF: What does access mean to you?  

GC: Access is not complicated in definition; it is complex in implementation. Looking at a patient's journey, the principal goal for this sector is to ensure the patient gets treatment. From diagnosis to treatment plans and all that comes with the treatment process. The final goal is to complete the entire process as swiftly as possible. I can describe Brazil in these simple words: Brazil is a country of contrast. We have 150 million people without private healthcare depending a 100% on the government, and we have 50 million people with private healthcare.  

Brazil's private healthcare sector has rules I have never seen anywhere else. If you launch a product and the product ends up being a biological product like an infusion, you are automatically reimbursed. However, you are not refunded if you have a similar oral or personal use product with the same benefits. We have to go to stakeholders and ask about the differences in the industry rules. These are the hurdles we need to work on within the frame of the private healthcare system here in Brazil.
We do not have a culture of reimbursement for drugs. Within BMS, the healthcare plan for our employees sponsors 10% of any medicines available for prescription. The Brazilian constitution of 1988 has the best strategy in the world from a healthcare perspective. I have worked in the U.S, Canada, and Venezuela, I have had joint ventures with a company in Japan, and I can confidently say there is no better constituent statement than Brazil's. The constitution states that it will give everything to everybody at any time. Unfortunately, no one can implement the constitution because no one has the funds. Any Brazilian who gets a prescription and the government fails to supply the prescribed drug can go to a lawyer and get a judicial mandate. The judicial decree creates an unbearable extra cost to the public sector. It is extremely difficult to budget with 150 million dependents that bring judicial mandates at any given moment.  

Unless we dare to look at our constitution and make it more implementable and realistic, we will always be going back and forth. We need to have the best people that understand how the private system works. We need people planning ahead of the game. There is a huge movement of consolidation taking place in Brazil right now. There is a lot of interest in funding and venture capital coming to Brazil. However, one thing that concerns me about the private sector is verticalization. Once you try to control the entire value chain, quality decreases, and people's expectations of private health insurance will no longer be the best-case scenario.  I wish there was a simple way to do access. This impacts me as the General Manager because I cannot be far away from the marketplace, I always have to be at the frontline. We do not have a lot of layers; however, I talk to key customers to understand what they are going through to work together better. We look into the same issues in the public sector as well. We had a product approved by CONITEC for Melanoma treatment in the public sector. The FDA approved the product. Unfortunately, funding has not been available for this venture due to the Covid crisis. My hope in 2022 is that the Health Minister will provide the best treatment for patients with Melanoma in the public sector, utilizing Immune-oncology. Patients from Brazil should have the best public or private sector access. We are stewards of health in the public and private sectors

EF: Is there any final message you would like to share?

GC: I am glad that you are doing this for Brazil. I think Brazil is a major player in the world’s economy, not only for the food supply but also for climate support. When looking at the matrix of our population, we are a diverse population. It is important to have diversity in clinical trials because we have microcosmos of different representations. BMS is leading in this market, and the best way to grow is to start with our employees. Many are going through different and difficult situations. If you do not begin by looking at yourself, it will be hard to have empathy for others.

April 2022