Read the Conversation

EF: What are the lessons learned from this last very atypical year?

JP: I have been in the industry for 27 years, and the model has not significantly changed over time. Most pharmaceutical companies have had a traditional approach to clients and physicians, doing on-site congresses with speakers for hundreds of people. The biggest change I saw over this period, was the shift from printed materials to digital but otherwise, the format was always the same. In March 2020, we had to change our commercial model, and in record time -just six weeks- we started using new tools and training our people, particularly the sales force. Since June last year, we transformed our go to market model thanks to key aspects of our innovation-driven culture: our achievement orientation and agile mindset allowed us to adapt quickly and learn a new way of managing the operation 100% remotely, and to be able to materialize the opportunity that was present through this challenging times to build something that lasts over time that can improve the experience we give to physicians.

Everything that was accomplished and achieved responds to the strength of our purpose as a company of having the patient at the centre of everything we do. We obtained the consents of 70% of our physicians to start and keep a virtual relationship with them. We learned a lot in the process of creating an internal performance review but most importantly, we focused our efforts on medical pain relief, which we see as an imminent need considering most patients in Latin America are misdiagnosed. Last year alone, medical education made a big jump with the development of several online programs for pain management. With the new virtual era we are connecting 1000 physicians at the same time from all over the Andean region, and all the important subjects can easily be covered. This transformation is giving us an incredible opportunity to enhance medical education in pain. We are developing several programs with Universities inviting speakers from Peru and Ecuador to participate virtually. We share good practices among countries and create synergies for the benefit of the cluster. 

Despite the new virtual era, I believe we will return to face-to-face congresses at some point. Everybody’s having to transform and going to a new model at the same time, obviously is an opportunity even though we are not sure as yet what that model will be moving forward to a new normal situation as the process has just started. But one thing is clear. Digital has come to upgrade the go-to-market model.

EF: How do you think digital will change the way health is delivered specifically in pain management? 

JP: The impact of digital on pain management is important.  Virtual medical education is a considerable opportunity for physicians as there are no boundaries for digital meetings. Nowadays we are able to reach them and deliver incredible knowledge. More pain-trained physicians mean a better pain management approach for the patient in terms of diagnosis, treatment and relief which consequently translates into a better life quality and functionality.  

Virtual technologies can facilitate the consultation, and this is where digital will make a big difference. For example, patients located anywhere will have access to a pain specialist that is not in the same city through a hospital digital platform. This provides patients access to a good diagnostic not to mention the reduction of costs. I foresee in the future having virtual hospitals, offering most of their services online with the specialists working from their homes attending patients with centralized technology-empowered services, at a reduced cost.

EF: What is your personal definition of access? 

JP: Access for us can be divided into patient access, physician access and product access. It is not only about having the possibility to but also taking aspects such as time and location into consideration. 

Pain management is a broad area, it exists all over the world, and it covers all areas of health because, regardless of the ailment, pain is always present. At Grünenthal, we have identified these barriers within the Andean Cluster, and we work constantly and from a multidisciplinary perspective to improve the way pain is treated.  This includes the availability of innovative therapies, training for doctors, articulation of multistakeholder initiatives to improve the understanding and better knowledge of this disease. We believe that digital can be an effective solution as it is faster for patients.

We deal on the daily basis with several challenges to make it easier for millions of patients who suffer from chronic pain to receive comprehensive and timely treatment, which allows them to find relief. We have identified many access issues and work constantly from a multidisciplinary perspective that includes training, strategic alliances, availability of innovative therapies, among others, inside cluster countries. We believe digital can be an easy solution as it is faster for patients.  

EF: Could you elaborate on the key therapeutic areas of pain management in Colombia? 

JP: Pain management is a broad area, it exists all over the world and covers all health areas because regardless of the ailment pain is always present, pain exists across the whole health system and in all the different pathologies. However, if it lasts longer than three months and continues after the injury or illness that caused it in the first place, or if it is not attended to in a timely and adequate manner it becomes chronic and this has a tremendous impact on the quality of life of the people who suffer from it.

Chronic pain is a major source of suffering and disease by itself, according to the ICD-11(WHO’s International Classification of Diseases), nevertheless, the WHO states that pain it is a highly underestimated public health problem and there is a very important knowledge gap, since it is generally perceived as a symptom and not as a disease that has a very high impact, not only on people’s health (physical and mental) but also in their independence and productivity, because it is highly disabling. Therefore, the approach must include timely diagnosis, correct and comprehensive treatment with a personalized approach, and a follow-up to ensure the patient's recovery. 

Our purpose is to change lives for the better, contributing to the improvement of this situation because we have the way and the elements to do it. We are working very hard at a world level on pain education, pain management, pain diagnostic and pain treatment because it is the chance to bring in trained physicians from the diagnostic world who in the majority of cases use our products and can offer a solution to the patients and the system. If the patient has access to the right physician at the right time, they will receive the correct diagnosis and medication. Our goal is to free people from suffering pain, which can be achieved if the patient receives the right diagnostic in the first approach.  

EF: What would be your advice in managing a chronic disease portfolio in a communicable disease scenario? 

JP:  ACED (Asociación Colombiana para el Estudio del Dolor) did a survey with amazing results, 20% of the patients with chronic pain never ask for pain diagnostic, showing they have normalized their pain. If you ask a big group of people in a conference room 59% of them will admit to suffering pain in some sort of way, and 26% will have been suffering pain for 3 months without looking for a solution so it is considered normal for a patient to suffer pain. It is also normal for some physicians to have patients suffering pain. In a factory maybe half the employees have chronic back pain from lifting boxes -generally ignored- and the cost on productivity is enormous, so the opportunity for us is huge as it is a problem which needs to be solved. Acute pain will become chronic pain if ignored and it does many times when people hope it will get better on its own. Chronic pain requires a personalized comprehensive treatment according to the needs of each patient. There are different drugs and therapeutic classes depending on the specific needs of the patient. There is a great opportunity to better understand the disease and to generate multidisciplinary work, jointly with the Ministry of Health for the benefit of patients who suffer from it. It is a pathology that requires comprehensive treatment.

EF: What is Grünenthal´s footprint in Colombia and what is its relative importance to the Group?

JP: Grünenthal is a global leader in pain management and related diseases, with a strong track record in Latin America of more than 50 years, it first arrived to Peru in 1968, then Ecuador and finally Colombia. Throughout these years, we have acquired companies with a small presence in Colombia and have consolidated an innovation-driven company with a solid portfolio of differentiated products in pain treatment and other therapeutic areas that add value to the physicians and patients. We focus all of our activities and efforts on moving towards our vision of a world free of pain. 

All our promoted and commercialized portfolio has availability in Europe and Colombia. It is part of our commitment to assure access to all technologies available worldwide. Recently, an extremely innovative product has been submitted to regulatory authorities and we are waiting for its approval which will benefit more patients in the mid and long term.

Furthermore, our capabilities and track record as a company position us as a partner of choice in Colombia and the region. 

EF: How active are physicians across the different therapeutic areas in understanding the pathology of pain and embracing innovations in pain management?

JP: Physicians’ attitude to learning is very positive. Once the physicians understand the importance of the diagnostic approach and the problem we are trying to solve, they are very interested in learning much more and they see Grünenthal as a tutor to highly benefit their patients. We carry out medical education initiatives such as academic updates, conferences, and experience platforms to expose real-life events around pain offering guidance for diagnosis and treatment, we also address the main doubts and drawbacks of proper prescription. We offer the adequate solution in lining up the patient with the correct diagnostic, the correct prescription, and the correct treatment. Grunenthal offers a solid educational platform called Change Pain, which the main objective is to understand the needs of patients with pain and develop solutions to improve pain diagnosis and treatment. It is free, unbranded and very welcome by physicians.

EF: What trends do you see on pain management in terms of innovation which will be easy to implement in terms of education and adherence to treatment thus ensuring effectiveness?

JP: In terms of access, the big moment of pain management lies in the acceptance of the remote communication tools by the physicians. The new technological virtual access provides us with the opportunity to work remotely with a physician; I believe some societies are already accelerating access in this respect. We need to focus on the balance between good diagnostics, good treatment and good management of the portfolio. We are the company with the better experience in pain management. In Colombia, the regulation and management of controlled substances are in constant development, we are working with the authorities and the pharmaceutical chamber to make the controls more rigorous. 

EF: What would you like your 2020 and 2021 tenure to be remembered for? 

JP: 2020 and 2021 have been very trying years that have allowed us to demonstrate, both outwardly and towards ourselves, that we are a truly innovative company, capable of adapting to circumstances and turning challenges into opportunities to accelerate our digital transformation, to generate value for patients, accompanying doctors and to move towards our vision of a world free of pain.

March 2021