Read the Conversation
EF: How is Sindusfarma leveraging current opportunities to promote growth in Brazil's pharmaceutical sector and contribute to a sustainable healthcare system?
NM: In the pharmaceutical industry, two pillars are fundamental: one is predictability, and the second is legal certainty. In the middle of this, we must place state health policies. A great concern in Latin America is that health policies change according to who is elected, which negatively impacts the Public Health sector. We cannot have a healthcare system that changes with every Health Minister. Therefore, we are now building a constructive dialogue with the new government that goes beyond the interests of the private pharmaceutical industry.
In Brazil, we have several exceptional and globally recognized state programs that we are determined to uphold. Firstly, the Unified Health System (SUS) is a comprehensive healthcare system that serves over 150 million Brazilians.
Furthermore, the country managed to maintain a very effective AIDS program, despite the government changes, and has a very important national immunization program that proved itself during the pandemic reaching the farthest corners of the country.
As anti-vaccine groups have grown stronger in Brazil, we see diseases returning and must set a strategy with the new government to build back the negativism related to vaccines.
Another extremely important program is the Popular Pharmacy program (Farmácia Popular), which offers free medication to the population. The program was first created in 2003 and will now be relaunched with an extension for Women's Health.
It is also crucial to mention our regulatory agency Anvisa which effectively operated through the pandemic. Thanks to its independence from the government, but its commitment to the state, its operations saved thousands of lives. All these examples show the importance of healthcare as a state policy.
We need to understand healthcare not as an expense but as a future investment in people's quality of life.
EF: What is your assessment of the current scenario regarding Brazil's production of active pharmaceutical ingredients (APIs), considering the Ministry of Health plans to create a new value chain to increase local production?
NM: Today, Brazil produces only 5% of its demand for active pharmaceutical ingredients (APIs). We should first aspire to create the conditions to increase our production in the long term because the pharmaceutical industry is unlikely to achieve this goal in a short period.
The Brazilian pharmaceutical market represents only 2,7% of the global drug market. To be economically viable, we would need to create a consumer market worldwide that absorbs at least 30% of our production of APIs. This would require policies that consider America as a whole. Knowing North America already responds to 40% of global consumption of APIs, together with Central and South America, we would start to have a very large consumer market for these ingredients.
One big problem with APIs is that they are produced in tons and consumed in milligrams. Therefore, we need to choose products with the potential to supply the entire Latin America. Today, world production of antibiotics is concentrated in China. Since there is no technology transfer, and it is not an expensive and difficult product, Latin America could adventure antibiotic manufacturing.
Many drugs are also becoming less economically viable. We could use the power of the State, of public laboratories here in Brazil, to produce these products and distribute them to Latin America in general. It would be a source of income for our country and a way of maintaining a series of treatments still extremely solicited on the market.
EF: In light of current scientific developments, what is your perspective on the future of personalized medicine?
NM: Knowing that the costs of personalized treatment are extremely high, they present a big barrier for lower-income countries. Stopping chemical pharmaceutical production to pursue only molecular, cellular, or biological treatments could cause serious problems for the public health system.
To protect the sustainability of the pharmaceutical industry, it is necessary to share the risk of this more expensive technology effectively. Companies need to look for ways to secure clinical research demonstrating that their product will save lives and deliver on the promise to receive reimbursement.
We have to remember that healthcare, and especially the pharmaceutical industry, relies on credibility.
Moreover, a healthy society is the pillar of a productive country. We need to build a sustainable system and rethink how we will pay for extremely expensive care.
EF: How is Sindusfarma promoting innovation in Brazil’s pharmaceutical sector, and what strategies can the country employ to establish itself as a leading innovator?
NM: The first field to address is clinical research. Brazil has world-class researchers and extremely well-prepared centers for clinical research. We have patients willing to participate, yet still, too much bureaucracy to move this area forward.
Interestingly, during the pandemic, regulators approved clinical research programs in our country in less than 30 days. We should take this as a learning and use this experience to streamline Brazil’s approval process for clinical trials to stay competitive in comparison with other countries.
In Brazil, approval for a clinical trial requires two instances, our regulator Anvisa and an ethics commission. This way, approval times can extend up to a year, which is unviable for the industry.
Clinical research means innovation and could bring Brazil almost R$ 2 billion annually (US$ 400 million). We could resolve an important part of our negative trade balance with research trials if regulation became more agile.
The second area where Brazil needs to invest quickly is incremental innovation. As the country is still unprepared for radical innovation, it must create a positive environment for research step by step. To do so, we need to build better IP and data protection laws that match US and European standards and ensure the further development of the pharmaceutical industry in this country.
Another aspect to consider is the modernization of our pricing rules. These rules were created when our country’s production of generic drugs was still insignificant. Today, the production of generics already represents almost 40% of our internal consumption. To further develop and improve our industry’s performance, productivity, and profitability, we must rearrange the pricing. Otherwise, it will be difficult to invest in research lucratively.
When discussing profitability, the pharmaceutical industry is often portrayed negatively. However, it is crucial to comprehend that developing new medicines and treatments involves substantial costs and high-risk investments. Investing in such endeavors needs the potential for a significant return. Otherwise, investments and the adjoint innovation would be nonexistent.
We have to remember that investing in the pharmaceutical industry means investing in health. Taking the constant increase in life expectancy, for example, we can see the crucial role of the pharmaceutical industry in the development of humanity.
EF: What are your expectations for the industry over the next ten years, and what strategies can be implemented to establish a sustainable system for comprehensive healthcare?
NM: Our industry is a science industry; without science, we will not prosper. Therefore, we are very committed to training people in every instance of our value chain, knowing that education is fundamental for the development of our industry.
Moreover, Sindusfarma is trying to internationalize its scope. Countries cannot close themselves to pharmaceutical technology, so we are extending our international networks, seeking new collaborations, and bringing innovation and new companies to Brazil.
As part of our strategic planning, we are strongly focused on expanding access. Our discussions with the government turn around many related issues. We need price transparency and modernizing our procurement system. Additionally, we have to resolve complex judicialization processes and streamline product integration procedures. Last but not least, there is the need to improve digital healthcare. Electronic medical records will give the state better control over the public system, optimizing treatments and expenses. The government has created a Digital Healthcare Secretariat, a promising step in the right direction. As Sindusfarma, we strongly support this project.
EF: Do you have any final message to commemorate the 90th anniversary of Sindusfarma?
NM: 90 years is a number that shows commitment. Improving education and maintaining a critical and transparent relationship with the government has brought us this far. We operate under the one certainty that everything we do is to improve healthcare in the country. In this sense, Sindusfarmas holds a clear position by not defending the origins of capital.
We defend the interests of our associates and understand their problems, which helps us foresee new challenges and solutions to minimize the risks.
For us, every company in Brazil is a Brazilian company, and we believe it is important to use the capital available to generate more knowledge, health, and wealth for the country.