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EF: What is the extent of Eurolab’s current footprint? 

LD: As an oncology group, we started 12 years ago with just EuroLab, a pharmaceutical company. Our focus was creating access for more patients in South Africa to oncology drugs, which are sometimes unaffordable. We started with the pharmaceutical company and launched a wide basket of generic products. 

Eurolab's philosophy has always been, and still is, to be the least expensive generic molecule in the market. We have maintained that for 12 years. Doctors can prescribe Eurolab products knowing that the patient will not have too much of a copay, and if they do, it will be the least expensive product.  

We have subsequently started another pharmaceutical company called Biomab. Biomab specializes more in originator products. We currently market several Roche portfolio products. In addition to that, we offer some of our proprietary products in the anti-emetic market, which is particularly significant in oncology. One example is a product from a Swiss company that we market. It provides extended anti-nausea and anti-emetic relief for five to seven days, longer than most chemotherapy treatments and anti-emetics typically offer, usually covering only 24 to 48 hours. This product comes in capsule form, offering patients a solid five-day relief period. We are continuously seeking innovative products like this.  

Another notable addition to our portfolio under Biomab is a drug primarily intended for pain relief. Unlike traditional morphine formulations, this one comes in oral drops, making it suitable for paediatrics, although we have not registered it specifically for paediatric indications in Europe. Its primary application lies in palliative care, particularly for end-of-life patients who may have difficulty swallowing or drinking. The oral drops offer immediate pain relief when administered under the tongue, which can be crucial for cancer patients experiencing difficulty finding a vein for injections.  

We have established numerous companies centred around Eurolab, including the only aseptic compounding unit dedicated to mixing chemotherapy drugs with cytotoxic agents. Operating within a sterile GMP facility, we aim to reduce the cost of expensive drugs by offering patient-specific compounding based on weight. This approach enables patients to purchase smaller quantities of the drug at a lower price, thereby reducing premiums and copays.  

Additionally, our compounding unit handles radioactive nuclear compounds, further enhancing our oncology services in the Southern Hemisphere. Furthermore, we hold a 50% stake in a laboratory specializing in next-generation sequencing and liquid biopsies. By offering these services locally, we aim to alleviate the need for patients to seek testing overseas, which often incurs significantly higher costs.  

Overall, our expansion efforts have been extensive. We have a network of 12 esteemed companies that enrich our extensive healthcare solutions. A keen sense of urgency drives our approach to testing, which is vital for the seamless introduction of new products without any setbacks. Our primary objective is to execute testing with precision and speed, enabling us to swiftly transition products to the market, ensuring timely delivery and efficiency. 

EF: How can we keep Healthcare the focus during this election year?  

LD: We have extended an offer to the government to handle the chemotherapy mixing for all clinics and hospitals nationwide through our aseptic compounding unit. This service is intended for public patients, and we are awaiting a response from the government on our proposal, as we believe we are uniquely positioned to provide this service effectively.  

Additionally, we have a distribution service in place, the country's largest courier pharmacy for oncology, allowing us to distribute the mixed chemotherapy to local clinics. Only five public hospitals currently administer oncology chemotherapy, leading to significant patient travel burdens. We actively advocate for our proposal and explore all avenues to make it a reality despite the political climate dominated by election-related discussions.  

We hope to get some answers from the government regarding the services we can offer. We will keep the momentum going. There are enough tragic stories of patients failing to access chemotreatment, and we are not willing to give up on this. If we can get that medication to patients and save them 60,000 rands a year on one box of tablets of their chemotherapy for prostate cancer, this is what we are going to try and do. We intend to create access channels for patients to be treated for cancer.  

EF: What is your perspective on expanding the opportunities you are fostering in South Africa to other African nations? Do you have any internationalization plans that you are currently working on? 

LD: We currently have products registered and boast a robust regulatory department with extensive experience in product registration across various African countries, including expertise in biosimilars. Our in-house regulatory team is skilled and experienced in navigating these processes. We have a diverse portfolio of registered products in countries like Namibia, Botswana, and Tanzania, with ongoing efforts to expand into others such as Zimbabwe and Mauritius.  

Collaboration with local partners and pharmacists in these regions is key to ensuring smooth market entry and delivery of high-quality products. We are streamlining our operations by centralizing efforts through designated representatives who oversee our product range across multiple countries. This consolidation aims to optimize efficiency and ensure consistency in our approach. We are optimistic about the prospects of expanding our footprint in Africa, as addressing healthcare access and disparities extends beyond South Africa alone. We should be launching a nice basket of products by year-end. 

EF: What partnerships do you have now that you are proud of and support the agenda of improving access in South Africa? 

LD: We actively participate in various NGOs advocating for cancer awareness and support. I recently assumed the chairperson role for GBMSA (Generic and Biosimilar Medicines of South Africa) after serving as vice-chair for the past two years. Through GBMSA, we collaborate closely with other generic companies to advocate for our collective interests at governmental and NGO levels.  

Additionally, we are involved in new clinical trials in the haematology space, although details are currently confidential. Another significant initiative is our managed healthcare company, OHMC (Oncology Healthcare Management Consortium), recently registered with the Board of Health Care Funders in South Africa. OHMC comprises a nationwide network of oncologists and haematologists who negotiate with medical aids to develop cost-effective treatment protocols for oncology patients.  

Within OHMC, we have established the OHMC Foundation, facilitating patient assistance programs to ensure access to essential treatments. This comprehensive approach covers everything from drug provisions to treatment protocols, prioritizing affordability and patient choice. Through OHMC's network, physicians can access assistance from the foundation to mitigate high copays for critical medications. These initiatives demonstrate our commitment to holistic, accessible cancer care and represent exciting developments in our ongoing efforts. In addition to medical aids, we will look at other schemes to see whether we can offer these cost-effective solutions for our patients. 

EF: Do you have any initiatives or special commitments to promote education and patient awareness throughout the patient journey? 

LD: We have worked with the Mayo Clinic on several initiatives. We have been working with the Mayo Clinic on some of their CAR-T therapies, and as a spinoff from that, we have looked at some patient education literature. Mayo Clinic is good at providing what they call "news" navigators and all sorts of patient education information. I have visited the Mayo Clinic with oncologists and haematologists several times over the past couple of years and have been very impressed with the patient journey that the patient takes. We are looking at developing something very similar for our patients in the new oncologic-serve centres that we are putting up, 

We are establishing multidisciplinary centres with various medical professionals such as physiotherapists, haematologists, oncologists, general physicians, psychologists, wig specialists, and surgeons specializing in oncology procedures. These centres will also feature serene outdoor spaces for patients to relax during chemo treatments. We aim to enhance the patient journey and have already acquired properties and begun designing these centers. We plan to build six centres nationwide, focusing on providing comprehensive care with a multidisciplinary approach. This initiative will prioritize patient well-being and educate families and communities on how to support their loved ones through their journey. 

We have also offered education initiatives to the public sector. We extended an offer to train all nurses in clinics and hospitals nationwide, ensuring they receive proper education in managing and treating oncology patients effectively. Many of these nurses are trained in general nursing but lack specialized knowledge in oncology nursing, which requires a unique skill set centred around empathy and specialized care. Recognizing this gap, we actively participate in training initiatives and regularly distribute patient education materials such as leaflets and pamphlets in oncology centres. These materials cover a range of topics, from breast and prostate cancer to lung cancer, aimed at empowering patients with valuable information about their condition and treatment options. 

EF: What do you think the future of Generics and Biosimilars will look like, and what do we need to do to guarantee a secure environment in South Africa and the region? 

LD: I believe it is vital that we provide access. There is no question about that. Eurolab has never been afraid of competition, and we embrace all the other generic players in the market whether we compete with them in molecules or not. We embrace that they are on the market because the worst thing you want to do is go out of stock of an oncology medicine a patient is on, especially if they are on a cyclical or long-term treatment. Knowing that other players have similar molecules on the market is comforting because the patient will not be compromised.  

Having a diverse foundation for our generics and biosimilars sourced from various manufacturers worldwide is reassuring. We procure them from different countries like India, Greece, Iceland, the United States, China, Taiwan, and Argentina. We appreciate the diversity in the supply chain. Unlike the tender system in the UK, where supply is dominated by a few players, South Africa's market offers a refreshing array of options where we can get good quality meds from different suppliers worldwide and still compete on price and try to make access available to patients. 

I love that more and more biosimilars are coming into the market. We embrace those, and we are very excited to have those kinds of therapies available for our patients who now have choices with the biosimilars that they can add to their therapy. It is wonderful that targeted therapies and immunotherapies are all coming through in the generic space now, and we are excited about the way forward. 

July 2024
South Africa