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EF: This year, executives must deal with complex multi-faced economic and political scenarios; companies are restructuring and reassessing their footprints. Do you see 2023 as a challenge or an opportunity?
MM: Companies are taking 2023 cautiously, preparing for a slight deceleration in the market trends. Covid boosted pharma performance and the sector in Latin America in two ways:
- Accelerated consumption in certain categories, the awareness of individual health conditions, especially for people with chronic conditions, adherence to treatment, and vitamins and similar products have boosted the pharma industry.
- During the pandemic, pharma spent less, the sales teams were not in the field, in-person conferences were not done, which are expensive, and expenses relating to marketing activities went digital, much cheaper than in-person activities. There was a boost in performance and fewer costs, similar to the tech industry that went completely remote, achieving much exciting growth.
Currently, we are moving out of the pandemic with a global inflation scenario, which is a double-edged sword for pharma. Usually, pharma would increase prices according to inflation, possibly incurring less product demand. Consumers have slightly changed their perspective on healthcare, for example, using their money for other activities, including leisure, travel, etc. Health is no longer the huge concern it was during the Covid-19 years. Due to the deceleration and inflation, companies are cautious about their structure and addressing the challenges and opportunities in 2023. Companies are cautiously cutting their budgets and not spending at the same rate.
EF: We know IQVIA supports businesses to make data-driven decisions. How do you assess the role of IQVIA in navigating organizations through these transitional periods?
MM: We are in an extremely privileged situation; we are a one-of-a-kind company in this industry. Traditionally we had data, consulting, and insights; then, we had the technology and added clinical activity (R&D and Clinical trials). Currently, IQVIA employs more than a hundred thousand people globally. We have domain expertise, positioning us in an ideal place to help and serve the industry with our unique capabilities. Our role is to help the industry navigate the transformational times with data, insights, and technology which we call connected intelligence, so that companies optimize their processes and impact in this environment.
EF: From your privileged position, how do you assess the level of access in Mexico compared to other countries you manage in your region?
MM: Access in Mexico is difficult; the data tells us that more than 60% of the market is a retail, out-of-pocket expenditure, meaning access is underdeveloped in Mexico. Recently, we did a study with the Latin American Association of Companies. Using the same methodology, we compared time to access in countries worldwide, from registration to receiving definitive treatment. Especially when high-specialty medication goes through the government system, Mexico is not among the top countries. Regarding access time, we are way below; there are many difficulties in registration and COFEPRIS delays. Once registered, on average, it can take up to three years to get access or even more, depending on the products. In Colombia, the system is completely different; they have easy access and highly controlled prices; in Brazil, there is a more balanced market between private insurance, the public sector, and the private out-of-pocket market. Mexico has an “oversized” retail market relative to the government spending on medication, and there is a small slice of private insurance. The big game changer for Mexico is addressing access to private insurance and the public sector.
EF: As a leading supplier of data, statistics, and data-driven insights, what role does IQVIA play in measuring and quantifying innovation in the industry?
MM: We play a very significant role; our real-world evidence or real insight division takes care of that. We have many professionals with validated methodologies that help healthcare systems understand the benefit of innovation, and we can measure it. Mexican regulations are clear on the pathway to achieving access, demonstrating through hard data that the product is cost-effective and a pharma-economic positive drug for the system, which is an excellent standpoint, and I applaud them for that. But the problem is the disconnect in the process, in gaining theoretical access and the institutions' day-to-day operations. The healthcare system is not working as a fully integrated system because each institution is looking at its single budget for medication and needs help seeing the overall benefits. The institutions are short-sighted on available budgets and what they acquire in a year. The approach is siloed; there needs to be more clarity between the access grant and what is executed at each institution level.
EF: We have heard a lot about the fragmented nature of the healthcare sector in Mexico and that the rate of innovation is faster than the rate of the regulations. Does Mexico have the potential to become an innovation hub in Latin America, or is the regulatory framework counterproductive to innovation?
MM: There still isn't a clear regulation for digital health in Mexico, and it is important to have it. We are a great country, but we need to adjust our perspective on the industry. The government should see the sector as an ally to help generate opportunities and better care. It doesn't matter if it is a big multinational or a small local company; overall, the dialog with the government and the legislators still has a long way to improve. There should be better collaboration between both sides to serve the Mexican population for the country's benefit. Due to a number of changes in the government, the industry has to deal with officials who are new to their positions, usually lacking the necessary knowledge in specific areas, which generates delays and inefficiencies. There is much opportunity regarding regulations and collaboration with the government.
EF: From your position and looking at the health sector, which kind of technology will be the most disruptive? Which technology will have a real impact on the Mexican population?
MM: The technology with the most impact is the technology that helps integrate our fragmented system and provides collaboration and the use of data. We don't have a single unifying technology in the private sector. The duplication and waste of effort happen due to the healthcare system fragmentation. Electronic health records would help several dimensions of the government. It would help the patient have an easier time navigating through the system, and we could save resources. AI is important and has a role in the healthcare sector, but we should take a step back and put effort into basic technology that would integrate the system.
EF: If you had to create your own startup company tomorrow in the Mexican healthcare sector, what would it be and why? The hypothetical question is to understand where the opportunities lie in Mexico.
MM: I would invest in digital health to help patients access better information and screening processes and speed up their time going through the system. During the pandemic, there was much pressure on digital, and there is a role digital can play, especially for the first contact in primary care services, to speed up diagnosis and shorten the time to treatment. New startups -small companies- have been created in Mexico, in the private sector, where many physicians are willing to subscribe to a digital practice to reach more patients.
EF: From your position in IQVIA, with all the trends and knowledge, what would be your three base pillars if you had to create a road map for the healthcare industry in Mexico?
MM: Innovation is important to the industry; it is what we do in the labs and bring them to patients for better health outcomes. Historically, innovation has been the transformative agent in healthcare. Access to innovation is an important pillar; without it, the impact is not immediately obvious, but we will have a big problem after a decade or two. My second pillar would be technology to integrate the system and make better decisions. It brings insights that can guide decisions. To be successful, the government must participate and understand the impact of what they are implementing. Finally, Mexico should think about health coverage since we still have a low percentage of health spending related to the GDP, and the private sector must also work to increase coverage. Compared to other countries in Latam, Mexico has one of the lowest private insurance coverage and healthcare spending. Some countries in Latam spend almost twice what we spend on healthcare in relation to the GDP. It should be part of the agenda for the industry, society, and the government. These are three points we should think about moving forwards.
EF: Is there any final message you would like to share?
MM: 2023 is a year of caution for the industry; Mexico must find a way to collaborate with government entities on topics such as access to innovation and information integration for better decision-making.