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EF: 2020 was the year of diagnostics and 2021 was the year of vaccines; in your opinion, what will 2022 be the year of?

PE: I believe that 2022 will be a combination of both diagnostics and vaccines. One of the key things we are learning as a society is finding how to control a pandemic through the right diagnostics. That should help us bridge toward what we want to try and achieve which is a better healthcare system and better management of high-cost diseases. For 2022, I believe vaccines will still play a relevant role. We expect treatments of other diseases will return to normality, different stakeholders suffered a lot due to the need to adapt, and trying not to abandon the patients in need, perhaps specifically to oncology where we know a late diagnostic can make a big impact on the patient.  

During the pandemic, we had to adapt treatments and diagnoses, and in Brazil, there was a big advancement in telemedicine which was the main tool used to maintain the connection between patients and caregivers. There will be a need for the industry and healthcare as a whole to make an effort to restore the diagnosis and treatment to non-covid, the numbers speak for themselves, at the end of 2020 we had 50% fewer cancer diagnosed cases and this is accumulative. What we need to ensure is that patients get their treatment and feel safe and confident.

EF: How has the pandemic impacted the relationship with the physicians?

PE: At Roche, we are trying to change the role of the industry. We are not going to be betting on the traditional field force to make education but develop the two-way dialogue tools where physicians can reach out to us when they need support on a need such as educational or on a clinical trial level. We want to evolve our current CRM system, which is already very strong, so that the physician will feel confident in reaching out in different ways, such as a digital portal, a chatbot or through personal interaction, and they will get what they need when they need it. We are wanting to change the way we interact with the ecosystem as a whole. Because of the pandemic, physicians that were a little resistant to virtual tools suddenly had to rely on them and are now open to them because of the efficiency they provide.  

EF: What are the biggest lessons learnt and what two modules would you choose for a Master in Pandemic Administration?  

PE: The first lesson that comes to mind is how to keep employees engaged and focused internally. Adapting is not so easy, and we need to pay special attention, some people were able to adapt easily but equally people that did not adapt well, and it took a long time for them to find a balance. There needs to be much more preparation from us, as people needed to adapt to new circumstances, it is important to try and understand what they are going through and showcase empathy and give them the time to adapt. For me, this has been one of the biggest lessons learnt throughout the 24 months of the pandemic.

EF: Could you elaborate on the portfolio performance of this year and what do you see it going through?

PE: From a diagnostic perspective, our colleagues from Roche Diagnostics had a lot to adapt to with the growing demands but it also gave us the opportunity to leverage on that; this was the first time where we were depending more on what was done in diagnostics. A very interesting dynamic that happened at Roche was that for the first time, almost all interactions with customers, both private and public, were together, Pharma and Diagnostics teams, which in the past was more based on demand. In the context of the pharmaceutical numbers, 2021 was a good year, we were expecting it to be harder but we won over our main customer which was the government. Previously, gaining virtual dialogue was hard, but when the need was high around diagnostics and treatment, they reached out to us. Alongside keeping business going with the government, we knew of the entrance of biosimilars which would hit a few of our main products hard, but we countered this with the launch of new drugs in the areas of haemophilia, SMA (Spinal Muscular Atrophy) and lung and breast cancer. As well, the launch of the new drugs in 2021 was much faster than in the past. The early approvals of these drugs helped us and pushed us to be faster commercially which also translated into earlier sales and created growth in 2021.

EF: How do you see the market in Brazil for personalised medicine?

PE: This is where we need to focus most of our efforts this year. We have some advancements but still further down the line, what we are discussing is how can we as an industry showcase that this personalised healthcare medicine will bring over time a better way of planning the costs and sometimes savings depending on the disease area. We have been investing in all of the genomics that we have been bringing to the country, one area we have been focusing on is lung cancer which has many opportunities showing up. The current genomics tests at around 2 to 3,000 a year, mainly for cancer, but our ambition is to get to 25,000 or 50,000 genomics a year. The right genomic test with the right patient means that the patient does not need to go through the different lines of treatment, it pushes the patient to go to the right treatment. It is a better outcome for the patient and there are a lot of savings involved. We have created a consortium between 5 competitors that work in lung cancer to fund the genomic tests to prove to the payers that the outcomes of the patients be more efficient and cost-effective.  

EF: How would you describe access?  

PE: Access has a different meaning in every country. In Brazil, it starts with clinical trials, and we have seen how much this has made a difference, especially when we were 18 to 24 months later than most other countries in getting approvals. To the patients that needed care, the clinical trials were a way of providing that. We have been leveraging on this and this is why we keep increasing our levels of investment. Clinical trials themselves start with making sure you have the right centres which are also areas of investment. Access is also about the discussions between different parties in the early stages of diseases or products about coming to a common ground and making it a real case for patients, it demands a lot of flexibility.  

EF: Do you think the pandemic has changed the mindset of the system on healthcare?

PE: It has given a sense of urgency. Topics before the pandemic could be addressed in 2 weeks. Now, that can be done in 24 hours. It is too early to say if it will have an impact over time regarding faster imbursement, but the mindset and type of dialogue are different.

EF: Fast forward by 8 years, looking back at this period of your career what would you like it to be remembered for?  

PE: A transition from a system where things have a certain pace to a system where we prioritise things and the urgent things are dealt with within days, not weeks or months. I would look back and say that this began during the pandemic. If we collaborate more and if we are ready to be more transparent then the discussions and the solutions will come much faster and benefit more patients in Brazil.

March 2022