Read the Conversation

EF: Could you tell us a bit about your background?

TP: I was initially working for Hexal Pharmaceuticals where I launched the Pierre Fabre dental range, which is now one of Pierre Fabre’s brands. After that, I worked in the immuno-suppressive division until I eventually moved to Merck where I was involved in launching their oncology division for about 5 to 6 years before being headhunted to go to Teva Pharmaceuticals to launch their neurology division. At the time, they were launching treatment for multiple sclerosis into the country for the first time. While I was at Teva,  I was mentored by Ian Ross Marsh, a very dynamic gentleman who gave me vision on large, strategic projects and helped me to understand the local implementation of a global portfolio offering. When I was helping to grow Teva’s international side, I was involved in pipeline management and regulatory affairs, which provided a critical personal growth phase for me. Later, I joined Pierre Fabre as Key Accounts Manager and subsequently promoted into Business Unit Manager of Oncology, where the previous general manager helped to groom me for the role. 

EF: After working in large pharmaceutical companies, why did you choose Pierre Fabre, a small, niched company by comparison?

TP: I prefer smaller companies. It’s easier not to get boxed into a position. It’s more entrepreneurial and more comfortable to get exposure to so much more. In a large, corporate company, one person does one job, and it can be very segmented. There’s a large Silo Effect where the different departments may not talk to one another.

Pierre Fabre is one of the few multinational pharmaceutical companies that is run by a foundation. The Pierre Fabre Foundation owns 86 % of the company, with the remaining 14% owned by the employees. The work we’re doing is not just going into the investors back pockets but goes into the investment of something bigger, and this fits very nicely into what I stand for. PF is small and very niched, but it is very dynamic. The company started with a pharmacist that had a passion for nature; the majority of our products come from natural sources, even our oncology drugs. PF has sustainable farms where we source the leaves. The full back-end of our manufacturing process has quality built into it from beginning to end. PF is present on a range of activities from ethical medicines to dermo-cosmetic care and general public health.

EF: What would you say is Pierre Fabre’s role in South Africa?

TP: Pierre Fabre South Africa is a medical subsidiary of which I am the General Manager. I work very closely with Paulo Dos Santos who is the Country Manager for the dermo-cosmetics side of the business. We are focused on two main areas of business namely medical and dermo-cosmetics in South Africa we are currently predominantly more on the medical side of the business, but we are also developing the dermo-cosmetic side of the business in South Africa specifically with the launch of Avéne into the market in 2015 Internationally, Pierre Fabre’s dermo-cosmetic is a very big focus, but interestingly enough, Africa is the one continent where the medical side of the business actually contributes  more of the revenue in comparison. Within the AFMET region where Africa falls, 60% of the business comes from the medical side of the business which is the reverse in other regions internationally. Dermo-cosmetics are absolutely amazing in terms of the benefits for the patients. The ethos of taking care of the human being as a whole, with the patient centric approach to healthcare, is embodied in terms of where we are. We are in oncology but we also want to support the patient with regards to the side effects that may rise from chemotherapy. Our marketing approach is cross dimensional in South Africa. It is not just a matter of providing an oncology side and a dermo-cosmetics side. We are treating the patient from the beginning to the end. We have everything from a teething gel to an anti-aging cream to oncology medication. We treat patients through all phases of their lives.

EF: When you were appointed as GM two years ago, what was the mission you set for yourself? 

TP: For me, it is what we define as a journey of confluence. Confluence is when two rivers come together and ultimately become one. For Pierre Fabre, this was the merging of the dermo-cosmetic business with the medical business to become one Pierre Fabre. People development is also a critical part of the confluence. We use an employee engagement survey for feedback to understand their feelings and their personal journeys. In doing so, we want to be establishing Pierre Fabre oncology as a critical player in the market with our pipeline of new molecules.

EF: Could you tell us a bit about the pipeline and what you are most excited about? 

TP: Pierre Fabre International has an agreement with a company called Array Pharma for the treatment of melanoma. South Africa was recently incorporated into a global agreement with a company called Puma for a drug that targets HER2+ breast cancer which fits very nicely within our oncology-focused portfolio. 

Regarding dermo-cosmetics, the consumers’ back pocket is minimal. We are strategic about launching our products in the right phases. We are also having a very medicalized focus with a dedicated medical representative team that directly calls dermatologists, podiatrists, and paediatricians, specifically branding the product. PF believes that even if it is a skincare product, it still boasts the same robustness of any pharmaceutical product. There have been clinical trials for all the products like trials on breast cancer patients with radiation dermatitis and the application of the Avene range of products. 

EF: What is Pierre Fabre South Africa’s strategic importance to Pierre Fabre global, in terms of expanding their footprint?

TP: The strategic importance for South Africa is to grow the subsidiary as a whole on both medical and dermo-cosmetics. Medical is a big focus on the current status of medical care and the supplying of medical care to patients. We provide treatments in oral and IV forms, the oral form gives patients a better quality of life and has the same efficacy as the IV drip equivalent. Oncology is our focus area, but we are currently also building a strong dermo-cosmetics side to support our patients. It is important to recognize regional differences in Africa. African countries consider South Africa as very much being the trendsetter of what is available, especially if you are looking at the English-speaking parts of Africa. Strategically with regards to English-speaking Africa, especially in the south from the equator downwards and also West Africa, South Africa is going to have a powerful role to play in that market.

EF: What is your personal definition of access?

TP: Access means providing healthcare to people who previously did not have access to certain kinds of medication. It also implies the improvement of the tender process with regards to supplying medication. The running of the tenders is incredibly vital for providing medicines to patients. We do work in the government sector, but we are not currently on the government tender. We have to motivate it through a quotation process and get authorization from their department. The new tender process is opening up again for this year, and they are looking at a tender for the national level as opposed to having separate tenders for different provinces. Having one tendering process pertaining to the whole country is much better than the fragmented, regional process. 

Other countries have different issues. European markets have a very complicated price listing process, whereas we have SEP with one listed price that gets publicly published. The listing price and selling price are identical, whereas, in Europe and Australia, it is not. In my opinion, the SEP provides an excellent base for private healthcare as it allows for transparency and structure. 

For access, private insurance companies also need to come to the party. They increase their premiums on an annual basis, based on inflation, but they don’t increase the benefits. Many health scheme benefits, for an oncology patient, haven’t changed in the last five (5) years. SEP has changed. The cost of an MRI has changed as has the PET scan. Where does the increase of contributions go? Although there has been an increase in diabetes and cardiovascular disease, there has been an increase in all areas. With the rising cost of medication, specifically in oncology which is becoming very targeted and immuno-therapy driven, many patients end up having to have medical aid plus a gap cover and even other additions to sustain themselves once they get diagnosed. The insurance companies should do their part in terms of increasing not just their contributions but their benefits as well.

EF: What kind of partners do you usually look for when trying to expand your footprint? 

TP: PF has always believed in innovations. In terms of partnerships, whether with dermo-cosmetics or pharmaceuticals, they have been with smaller startup companies rather than the more prominent biotech companies. For example, two young guys in dermo-cosmetic labs started out doing a small business, so Pierre Fabre brought them in. Pierre Fabre usually looks at small biotech businesses, but these partnerships are mostly done internationally. In South Africa, we don’t look for direct partnerships as such. 

EF: PF seems to choose managers that are very entrepreneurial and hands on. How does that manifest in the rest of the company?  

TP:  People development is central to me. Pierre Fabre started in South Africa in 2013. In this business, sales reps don’t stick around for very long. A year or two years later and they move on to somewhere else. Last year, we gave two long service awards for five years, and, this year, another three long service awards for another five years. For them to have stayed for so long, there must be something within Pierre Fabre that made them stick around.  The values we talk and work in are definitely values that speak to people’s core. 

EF: How do you pitch South Africa to your headquarters?

TP:  It is a very different model. Our primary focus is private due to our portfolio focus. However, access will continue to be our real challenge. We position ourselves in SA as the hub for Southern Africa, and we manage the English speaking Africa from said hub. We are present in Namibia and Botswana and recently have been going into Lesotho and Mozambique. 

EF: We see a new generation of managers that are shaping the healthcare map of this region. What advice would you give to them? 

TP:  In this industry, we need to stand together and have a shared voice. Having a fragmented voice in the market will not accomplish anything. By standing together with a unified voice, the effect on the NHI and the government will be more impactful than the tiny battles that each company would be engaged in otherwise. I would recommend that these managers become part of associations like IPASA or SAMED; there are plenty of associations that drive robust critical cases. We all need to speak in a similar tone and language. 

EF: What would you like that one unified voice to say? 

TP:  We need to work together collaboratively with a strategy for NHI. We must have a clear strategy with regards to timing and implementation. NHI will most likely impact the providers and the hospital side of things first, where pharmaceuticals won’t be affected quite as fast. We will have to wait and see what the future holds. However, NHI alone will not solve South Africa’s healthcare problems. That can only be achieved through collaboration between NHI and other health services.

February 2020
South Africa