Read the Conversation

EF: The past few years have been a time of transition. 2018 was the acquisition of Quintiles, 2019 saw the transition of a new presidency. What advice would you give to other GMs on managing in a time of transition?

MM: To understand the complexity for both internal affairs and market dynamics. Once understood, it’s beneficial to simplify these complexities in terms of actionable goals. It’s less important to be precise and more important to know the big picture.

EF: What are IQVIA’s key growth drivers for the new decade?

MM: We have transitioned from a predominantly data-driven company to a more general technology and insights company. IQVIA positions itself as the human data science company which entails collection of data for both sales and patient effects, AI-driven prediction, and access to clinical data around the world. Technology is what unifies this new company that is IQVIA.

EF: What new technologies is IQVIA looking into, and your clients most interested in?

MM: There’s a substantial amount of interest with regards to human data gathering. The digital devices and platforms we have improve the process of clinical trials, Phase IV trials, and gather real world evidence. We have technologies that we can deploy at the patient level and receive the data. I believe this is where the future lies.

EF: Could you provide some facts and figures about the market and how it has changed since 2019?

MM: 2019 was a very interesting year in Mexico. We had strong growth in the private market, about 8.7% growth in value. The first semester of the year was much stronger than the second semester. Although we have plenty of requisitions from the public side, there were some communicative and executive inefficiencies. While the government’s metric indicated growth in terms of value, this did not seem to match the public sentiment. This operational inefficiency has remained, e.g. uncertainty, delayed contracts. On top of this, the GDP has been declining with deceleration in the first semester and negative values in the second. For 2020, we predict the private market will grow 8.5% in value. For the public side, there have been delays, particularly in the month of January. These delays may be temporary, but they have effects downstream.

EF: How are companies adjusting to the current market dynamics?

MM: Some of the companies have reacted by changing their capabilities, especially regarding tender processing and delivery. Some have increased their business units and internalized the distributor role. The government has pushed for tenders to be awarded to one, singular company. Previously, there were multiple players that could participate. Because of the single tender awards, some of these companies are uncertain if they can deliver the requested volumes. 

EF: Two years ago, the growth in the private market seemed to be driven by out-of-pocket expenditure and pharmacy chains. What is driving the 8% growth today?

MM: If we look at type of products, there are generics, branded generics, and original brands, both patented and un-patented. For 2019, generics were driving the growth followed by branded generics and finally original brands. When you look at original brands, the patented products were driving growth and the non-patented products were suffering in volume and had to compensate in value. 

EF: What is the strategic importance of Mexico in the Latin America context?

MM: Mexico is a very important market where there are sectors and industries that act as an example for the rest of the region. There is a very strong local market with a variety of local companies expanding into LatAm. These companies can easily produce high quality medication. In the past, registering medication was fairly easy compared to Brazil. However, one of the trends in the past 5 years is the increased difficulty to gain access to medication in the government system. One of the hurdles is the requirement to get approval from a multitude of different institutions. You might have to price differently for different institutions and deal with different volumes. Along with the regulatory in-cohesion, there’s also a budget problem which has manifested into the lack of execution for tender awards. However, with these problems, it’s still easier to get access here than in Argentina or Brazil.

EF: What systemic change would you advocate in order to increase accessibility?

MM: In LatAm, we have the highest out of pocket spending in healthcare. Relatedly, we also have one of the lowest rates of private insurance, around 6 to 7 percent. The universal insurance plan in Mexico, Seguro de Gastos Médicos Mayores, is only for major issues. The equivalent in Brazil covers issues from the flu to surgery whereas in Mexico it’s more towards just surgeries. Public spending in healthcare currently is a rather low percentage of the GDP. I would like to see a larger portion of the GDP invested into public health. 

EF: How much of your clients are local companies vs MNCs and how do their service requests vary?

MM: There is a mix of multinational and local companies. Evermore, they are requesting data integration and insights instead of a simple data set. For IQVIA LatAm, Mexico has the largest data accessibility at the rep level. For consultations, some companies are requesting resource optimization which analyzes sales rep deployment, company structure, and sources of revenue. If I work for oncology with a specific sales force, are my reps calling the right physicians and hospitals with the right access model? There have been more requests dealing with patient support programs. Since the public system is often found lacking, there are many more companies making sure the patients are initiated correctly, educated sufficiently, and looked after. The drivers are the fact that treatments are more complex, the treatments are higher value, and the patients are spread across the private system.

EF: What are some new innovations IQVIA is pursuing that ties in with patient centricity?

MM: We have a new CRM system that we call Orchestrated Customer Engagement. Expanding beyond tracking reps, the system allows you to track pharmacovigilance, compliance, event management, patient data, to list a few. With regards to pharmacovigilance, there is feature to use AI in reading and reporting potential side effects. This represents our move from being reactive to being predictive. 

EF: How easy is it for companies to integrate technology?

MM: We pride ourselves in that our technology is very intuitive. We have three criteria that all our products must meet. They must integrate  different platforms, be naturally intuitive, and bring solutions that have value.

EF: Could you share with us your experience at Harvard Business School?

MM: I try to look at myself as a business and apply business concepts to myself. One of these notions is centered around creating and capturing value. When companies create value, how can they capture the value for themselves? For my career, there are many ways value has been created: leadership, team, and market solutions. I had KPIs for my 10 year career plan from 2006 - 2016. My decisions, going to Philips, moving to a different region, being a GM, were all part of that 10 year plan. For careers, there are two concepts that are very important: potential and experience. Imagine if you have two suitcases, one of them is potential and the other experience. At the end of your life, your potential is consumed regardless of whether you use it or not. The question is how can you leverage your experience to rejuvenate your potential?

EF: What advice would you give other GMs in impacting the future of health?

MM: The decisions you make today will impact the future. Basing your decisions on short term factors will not be the most productive decision making method. These decisions will have a cultural impact, an infrastructure impact, and an educational impact. These factors are not easily changed. It’s necessary to see what one can do to impact the short term, but in the background, it’s essential to know the direction to head for an effect 10 years down the line. The countries that have the most successful systems have a long term vision and commitment. There’s a detachment between the decision and the effect. The decision needs to be made now with the right KPIs and the effect will naturally come later.

March 2020