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HEALTHCARE
HEALTHCARE
LIFE
SCIENCES
LIFE SCIENCES
REVIEW
REVIEW
PHARMACEUTICALS:
SHAKING UP THE SYSTEM
PHARMACEUTICALS:
PAGE
21
PHARMACEUTICALS:
CHILE
FROM
SHAKING UP THE
SYSTEM
SHAKING UPA THE
SYSTEM
MANAGER’S
PAGE 21
PAGE 21
PERSPECTIVE
PAGE 12
&
CARVING OUT A MEDICAL
DEVICE MARKET
CARVING OUT A MEDICAL
PAGE
56
CARVING
OUT 21
A MEDICAL
PFIZER’S DEVICE
USD
MILLION
MARKET
DEVICE
MARKET
INVESTMENT IN CHILEAN
PAGE 56
PAGE 56
BIOMEDICINE
PAGE 16
CONVERGENCE IN ACTION:
CASE STUDY: SILANES
FOCUS ON DIABETES
CONVERGENCE IN ACTION:
PAGE
70
CONVERGENCE
IN PAGE
ACTION:
INTERVIEW
JOÃO
UNIVERSIDAD
DE 82
LOS
CASE
STUDY:WITH
SILANES
FOCUS ON DIABETES
CASE
STUDY:
SILANES
FOCUS
ON
DIABETES
SIMÕES OF GRÜNENTHAL
ANDES’
FIRST
SCIENTIFIC
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70
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CHILE
SPIN-OFF
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PAGE 32
MEXICO
2013
MEXICO 2013
COFEPRIS
Revamped
COFEPRIS Revamped
PHARMA’S CHANGING LANDSCAPE
Mikel Arriola, the man who changed an institution and an industry PAGE 18
CHILE
published in association with
Mikel Arriola, the man who changed an institution and an industry PAGE 18
Mikel Arriola, the man who changed an institution and an industry PAGE 18
HELIA MOLINA, CHILE’S MINISTER OF HEALTH, ON THE COUNTRY’S NEW DRUGS LAW PAGE 8
published in association with
published in association with
2013
2013
2013
August 2014
Brought to you by
2
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As Minister of Health, I am proud to introduce this special report dedicated to the pharmaceutical
and healthcare industry. We consider this communication platform as a great opportunity to display
the capabilities of pharmaceutical companies and healthcare in Chile.
2014 represents an exciting time for healthcare in Chile with the implementation of a new medicine
law; ensuring the creation of a system that makes access to medications easier and more
transparent for patients and moreover assures a sufficient supply all over Chile. The new
government of Chile has made a commitment to improving the health of the population and the
Ministry of Health will be active to reduce chronic diseases.
Chile has one of the most important developed markets in the region. With an excellent base for
human resources, strong infrastructure, immense production capacity renowned for high quality and
affordable costs, Chile continues to provide the best healthcare to Chileans while at the same time
ensuring an efficient regulatory environment for pharmaceutical companies
With this special report on the industry, I invite all members of the pharmaceutical and healthcare
community to take a look at the exciting activities that Chile has to offer.
Warm regards,
Dra. Helia Molina Milman
Minister of Health Chile
CHILE AUGUST 2014
4
Acknowledgements
Focus Reports would like to thank
Jean Jacques Duhart, president of CIF;
Elmer Torres Cortes, president of ASILFA;
Ricardo Fábrega, director of the Public Health
Institute, and Eduardo Bitran, executive vice
president of CORFO for their cooperation and
support in this project
and
Helia Molina, Minister of Health, for taking the time
to meet with us and provide her support for this
endeavor
CHILE AUGUST 2014
5
“Sharing Expertise”, more than just two words.
«Sharing Expertise» is a promise from B. Braun to customers and colleagues to
share medical knowledge and expertise for the benefit of health, to use this
knowledge and build on it effectively and consistently, in dialogue with partners.
B.Braun Medical S.p.A. - Av. Puerta Sur 03351 | San Bernardo, Santiago de Chile | Fono: 56-2-24407100 | Fax: 56-2-26234334
CHILE AUGUST 2014
6
CONTENTS
Chile: Pharma’s Changing Landscape 8
Level playing field 9
The R&D Incentive 10
Tecnofarma: an outstanding example 11
Chile from a manager’s perspective 12
Changing Landscapes 12
Deutsche Pharma: partner of choice 13
Multi Latina 14
A particular market 14
The Overview effect 15
Pfizer’s USD 21 million investment in Chilean biomedicine 16
Agility and flexibility the key to successful product launches 18
Building a network for natural products 20
Bringing Medtronic to Chile 22
Grünenthal on how to blend the cultures of two family companies 24
Leading Chile’s biotech wave 26
Chile’s geography proves challenging for logistics companies 28
German hospital at the forefront of private medicine in Chile 30
Universidad de los Andes’ first scientific spin-off
32
This report was prepared by Pharmaboardroom.com
Publisher: Ines Nandin
Project Director: Martijn Jimmink
Project Coordinator: Gabriela Cordova
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liabilities for errors and omissions. Opinions expressed in this report are not necessarily those of the authors.
CHILE AUGUST 2014
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CHILE:
Pharma’s Changing
Landscape
“2014
represents an exciting time for healthcare
in Chile with the implementation of a
new national drug law; ensuring the creation of a system
that makes access to medications easier and more transparent for patients and, moreover, assures a sufficient supply
all over Chile,” explains Helia Molina, a doctor specializing
in pediatrics and nephrology and Chile’s Minister of Health
since March 2014. The ‘Ley de Farmacos,’ or Drugs Law,
was passed by Chile’s former government in January 2014;
its implementation now rests with the new administration.
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“The new government of Chile has
The Chamber of the Pharmaceutical
made a commitment to improving the
Industry in Chile (CIF), which reprehealth of the population,” Molina exsents the international innovators, will
plains, “and the Ministry of Health will
carefully monitor the implementation of
expand the list of chronic diseases inthe new healthcare law, which requires
cluded in the Regime of Explicit Health
prescriptions to mention the name of the
Guarantees (AUGE) plan, which enchemical compound. While this is seen
sures government-funded coverage for
as positive for the customer, who will
patients regardless of age, class, and From left: Helia Molina, Minister of Health; now have access to cheaper alternative
Ricardo Fabrega, director of the Public
ability to pay.”
products and also their personal brand
Health Institute
This should contribute to boost a
preference, for, innovators there is still
market that is already expected to grow
a major concern about bioequivalence.
8.2 percent between 2012 and 2017 according IMS Health.
In Chile, as in other Latin American countries, similIn 2012, the Chilean pharmaceutical market was worth a ares have high market penetration: generic drugs that do
total of USD 2 billion, according to the latest available data not have proven bioequivalence. “If the law would allow
from IMS.
physicians to prescribe any generic drug including nonThe new government plans to introduce further legisla- bioequivalents, all efforts made by previous governments
tion to improve healthcare in Chile. In her paper entitled would be for nothing,” says Jean Jacques Duhart, execu‘50 Commitments for the First 100 Days of Government,’ tive vice president of CIF. “A large portion of products on
President-elect Michelle Bachelet builds the basis of her the Chilean market cannot demonstrate quality, safety and
plan for better health services for the nation, committing efficacy through bioequivalence studies. Similares are neito invest significantly in the construction of new hospitals, ther generics nor originals and have not demonstrated their
increase the number of specialists to combat long waiting quality, efficacy and safety as recommended by the World
lists in the public sector and provide patients with better Trade Organization.”
access to free drugs.
He also warns: “This is not merely a concern in terms
As it currently stands, Chile’s universal healthcare plan of health and risk for patients but it also introduces an imcovers 80 percent of the population. The remaining 20 per- portant market distortion—different actors are competing
cent are entitled to pick their coverage from a number of with different standards.”
private insurance companies known as ISAPRES. 80 percent of people in Chile should have access to free drugs un- LeveL pLaying fieLd
der FONASA, the public health insurance system; however,
the reality is that there are often shortages at hospitals, and Chile is aiming to achieve complete bioequivalence of geas a result people turn to private pharmacies to fill their nerics by the end of 2014. Chile’s Public Health Institute
prescriptions out-of-pocket. As a result, despite FONASA, is leading the bioequivalence testing, aimed at regulating
out-of-pocket expenditures in Chile are some of the high- differences between generic and bioequivalent drugs. The
est in the OECD: A total 4.6 percent of the average Chil- recently appointed director of the Public Health Institute,
ean family’s budget is spent on healthcare, compared to the Ricardo Fabrega, echoes the need for drastic change and
OECD average of 2.86 percent.
stresses that: “laboratories that produce generics will have
There is positive news on some fronts however: after to understand that they must comply with bioequivalence
years of infamously tense relations between MNCs and studies; otherwise we will take them out of the market.”
the government, both parties finally seem to have found
The request for bioequivalence could be a game changer.
a platform for dialogue. “As an industry, we have an ac- Companies producing similares could be forced out of the
tive dialogue with the ministry regarding the expansion market, or to drastically change their practices. Accordof access to innovative medicines, but the discussion is ing to Carlos Cicogna, managing director of MSD Chile,
still young and we still have a lot to do,” explains Erich it could also drive investments from MNCs in the country:
Viertel, country manager at Janssen Chile. “Finding the currently, MNCs are responsible for more than half of the
best path to lead Chile toward economic development has bioequivalent generics on the market. “The environment is
been an ongoing task of Chilean governments and lead- getting more attractive for innovators such as MSD: with
ers over the last century. And if the country is able to the new regulations we will see an equal playing field; fair
sustain its current momentum, at the end of this decade conditions are being implemented. And as a result there is
it will probably become the first fully developed country an increasing interest from the industry to increase investin Latin America.”
ment in the country.”
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Cicogna, who has been in Chile
since 2009, has already witnessed drasThe R&d incenTive
tic change in the market: “There have
been two major developments in the
With the goal of making Chile a hub
past five years: the implementation of
for innovation, the Chilean Ministry
the new drug law and the shift in landof Economy and CORFO, the Chilscape: the top players on the Chilean
ean Economic Development Agency,
pharmaceutical market used to be local
announced last year that four multiplayers, but today the key players are From left: Jean Jacques Duhart, executive
national companies would invest in
vice president, CIF; Erich Viertel, country
multinationals.”
new research and development centers.
manager, Janssen
Another proposal currently being
From the pharmaceutical sector, Pfizer
discussed in parliament is the complete
will invest in a precision medical cenoverhaul of ANAMED, the national regulatory agency for
ter studying new genome-based diagnostic technologies for
medicines in order to bring it in line with other regulacancer. The aim is to enhance Pfizer’s precision medicine
tory bodies around the world. Elmer Torres Cortes, general
approach to help understand the underlying biology of dismanager of ASILFA (the association representing generics
ease and identify patients likely to benefit from new drugs.
companies in Chile) explains, ANAMED is currently part
For the project, Pfizer partnered with the government to
of Chile’s Public Health Institute, but should be separated
develop technology and research: CORFO has contributed
in order for it to stand as an independent regulator of mediUSD 7 million out of a total investment of USD 21 million.
cines. The current plan being discussed for ANAMED is
“Our expectation is that with the initial support of the govfor it to reach level four of the Pan American Health Orgaernment, this will be the first of a series of programs that
nization (PAHO) assessment table, at which point it can be
Pfizer will develop in Chile,” explains CORFO’s executive
designated a reference authority for medicines. “ANAMED
vice president Eduardo Bitran. “With this subsidy, which
should be autonomous, independent and capable of moniwe consider seed money, we expect Pfizer to change its view
toring the local and international industry. We believe this
of the country and continue to develop applied research in
is fundamental for the pharmaceutical industry in Chile,”
Chile. As a country we are sending a signal with the aim
Cortes adds.
that other pharmaceutical companies will follow suit.”
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Chile lead the per capita rate of cliniThis strategy seems to be paying off:
cal trials in Latin America (0.34 per 10
“The feedback from the industry has
000 inhabitants, threefold of that of
been extremely positive and as a result
Brazil or Mexico).
we have received many inquiries about
Roche has a long history of conductthe center,” says Ricardo Avila, mediing Clinical trials in Chile. Currently
cal director at Pfizer Chile. “It seems
the company has 19 on-going trials in
that there is an increasing interest to
10 different disease stages and is eager
increase investment in the country.”
to conduct more in the future. AccordPfizer’s country manager in Chile, Car- From left: Carlos Cicogna, managing
ing to Ciro Caravaggio, general manlos Murillo, feels responsibility to turn director, MSD; Elmer Torres Cortes,
ager of Roche conducting clinical trials
this project into a success in the coming general manager, ASILFA
in Chile can be expensive, the process
years and believes that Pfizer has paved
can be slow, and requires significant approval hurdles.
the way for Chile to position itself as a biotech hub for
“Furthermore, many don’t see the value the trials can bring
Latin America. “I expect the ecosystem to start flourishto a hospital or a patient. For a major oncology hospital,
ing soon,” he asserts. “This country is for our company
an example of how we can work in partnership with the
government.”
Over the past decade, as clinical research activities have
been growing steadily within Latin America, Chile has
With the introduction of the meaworked hard to become a regional leader for conducting
sures to enforce bioequivalence,
clinical trials. Due to its qualified human capital base and
companies must adapt quickly if
favourable government environment, the country has comthey want to continue to compete
petitive advantages for developing such a cluster. Currently,
in the market. Tecnofarma, a Uruguayan company that has been in
the Chilean market since 1983,
is moving rapidly on this front,
and is bullish about its future
prospects in the country, having Antonio Avila,
general manager,
recently secured new Santiago Tecnofarma
office space as part of the company’s continued growth plans.
Antonio Avila, general manager of the company, arrived in 2011, after working experience in Venezuela
and Dominican Republic, with a fresh outlook on the
business. Avila adapted the business model to the
current needs of the market. The company increased
its business units and launched new products to the
market while focusing on its core products. With a
broad product portfolio, Avila is currently focusing on
products for oncological and non-oncological therapies. “Tecnofarma launches about 4-5 products per
year,” Avila says. “This is challenging for a pharmaceutical company and only succeeds with a wellplanned business model.”
The company has a positive attitude towards bioequivalence and Avila is confident that the company
will meet the deadlines for bioequivalence standards
for its products in Chile: “The government created
three product lists detailing the dates by which the
products should have proven bioequivalence and
therapeutic efficacy. We are already advancing on
each list and I am positive we will reach the objecwww.tecnofarma.cl
tives,” Avila explains.
Tecnofarma: an outstanding example
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Chile from a manager’s perspective
Ciro Caravaggio took the helm of the Chilean operations of
Roche a little less than three years ago after an experience
in Roche’s headquarters in Basel, and a career with the same
company in his home country, Canada. Caravaggio describes
how different Chile and the Chilean environment were from
what he expected.
First and foremost I found healthcare was more politicized and Ciro Caravaggio,
in the media than I was used to.
general manager,
In particular as I arrived we were in the midst of launching Roche
Herceptin, a revolutionary product for the treatment of breast
cancer. Herceptin was not reimbursed in the public setting at the time and several
actors where pushing to get the drug approved. Immediately it became clear to
me that there was no formal evaluation process in place. Naturally each country is
different in terms of market access and its reimbursement system but what was
different in Chile is that the industry is not officially part of the reimbursement or
access process.
Cécile Bassereau, managing director B. Braun Chile, took
over the reins of the Chilean operation in 2012. She describes
the challenges and achievements she faced as the head of
local operations.
I took the helm of a German company, in Chile while being
French. In such a multicultural environment I am trying to transmit that we have to be flexible and tolerant without prejudice.
Chile has been developing extremely fast, with a five percent GDP growth rate in the past decade. Nevertheless public
Cécile Bassereau,
hospitals in Chile do not have access to some state-of-the-art
managing director,
technology and sometimes the cost of a medical device looks
B. Braun
like a barrier. But it is important to look at long-term benefits.
That being said, it is a challenge and our responsibility to influence decision makers
to make them adopt a long-term cost benefit approach to treatments with the help
of state of the art technology.
João Simões has been with Grünenthal since 2004. Prior to
his appointment as head of integration at Grünenthal Chile,
he served as CFO for Latin America and country manager, in
his home country, Portugal. Simões elaborates on the fundamental differences between a country like Chile and Southern
European markets.
I see similar trends in terms of healthcare. In Southern European markets, healthcare is substantially funded by the government. In Chile we see a similar trend as the newly elected
João Simões, head
government is moving forward with the improvement of the of integration,
country’s healthcare system; increasing coverage for Chileans. Grünenthal Chile
Public healthcare in Chile is improving its quality, but the
coverage on medicines is still below the expectation of its
people. Chileans want access to medicines for which they do not have enough
resources. Universal healthcare is a global trend, which we also see in Chile.
Although I see both worlds coming closer the Portuguese and Chilean market dynamics are still quite different today. Healthcare in Portugal is mostly funded by the
government, while Chile still has a high patient out-of-pocket expenditure on health.
clinical research is an integral part
of care and not an afterthought;
it is critical! So many patients are
at the end of their treatment and
want new hope.”
Historically the clinical trial
environment has been seen as a
matter for international companies but the CIF is working hard
to turn around this situation. “We
are working on involving more local partners in clinical trials and
research and development. It is
our ambition to establish Chile
as a leader for clinical trials and
research in medicines”, CIF executive vice president, Jean Jaques
Duhart said.
changing Landscapes
Pharma M&As are back with a
vengeance. Latin America, which
is predicted to grow two to three
times faster than developing markets in the years to come, has
been a prime target. Chile has not
been spared in this recent activity,
with several acquisitions in recent
months.
The dealmaking in Chile
started in December 2013 when
Grünenthal Group, an international research-based pharmaceutical company headquartered
in Aachen, Germany, completed
the acquisition of Andrómaco
Laboratories for an undisclosed
sum. Andrómaco is a leading
Chilean pharmaceutical company
with over 70 years in the market
that specializes in prescription
drugs, but also has a wide range
of high technology products, generics and OTC. Grünenthal accepted the public tender offer
with respect to the acquisition of
all issued and outstanding shares
of Andrómaco.
João Simões, head of integration at Grünenthal Chile, explains
that the acquisition has been a
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major step in the company’s growth
Prescription Drug Sales in Units
strategy and has almost doubled its revTop 5 Ranking 2011
enues up to USD 450 million in Latin
(Mkt Share)
America. In the words of Grünenthal
1
Laboratorio Chile
6.2%
Group’s CEO, Eric-Paul Pâques: “With
2
Laboratorio Saval
5.2%
Empresas Andrómaco, we acquire the
Andromaco
3
4.7%
best regional company to complement
4
Recalcine
4.3%
our own business and our therapeutic
Laboratorio Bago
5
3.8%
areas in the Andean countries and Cen- From left: Carlos Murillo, country manager,
Top 5 Ranking 2014
tral America.” In Chile, it propelled Pfizer; Eduardo Bitran, executive vice
(Mkt Share)
president, CORFO
Grünenthal into the market’s top four
1
Laboratorio Chile
5.8%
companies.
2
Grunenthal Group
4.9%
The latest move
In May 2014, Alliance Boots, a British pharmacy-led
3
Saval Corp
3.8%
in a series of multihealth and beauty group, signed an agreement to acquire
4
Abbott Corp*
3.8%
billion dollar deals
Farmacias Ahumada (FASA) Group. FASA is a publically5
Bayer
2.7%
came in May with *Recalcine and Abbott consolidated
listed pharmaceutical specialist in Latin America comprisyear, with the ac- IMS Data April 2014
ing of two retailers: Farmacias Benavides, based in Mexico
quisition of CFR Pharmaceuticals by Abbott Laboratories.
and Farmacias Ahumada, based in Chile. Together the reThe largest maker of heart stents and adult nutritional bevertailers operate over 1,400 stores, with combined revenues
ages joined the wave of mergers and acquisitions with a USD
of around USD 1.4 billion: the third largest retail phar2.9 billion agreement to acquire Chile’s biggest drugmaker.
macy chain in Mexico with around 1,000 stores, and one
Santiago-based CFR sells a range of products for women’s
of the three largest retail pharmacy chains in Chile with
health, heart and respiratory diseases in 15 markets across
around 400 stores.
Deutsche Pharma: partner of choice
Deutsche Pharma stands out as
one of the more interesting cases
of a local success story. The company was established in 1992
and expanded internationally
to Ecuador in 1995. Two years
later, when the Chilean branch
got acquired by Sanofi, Luis Aguilera, Deutsche Pharma’s general
manager, continued leading the Luis Aguilera,
general manager,
company in Ecuador. In 2008 Ro- Deutsche Pharma
emmers acquired the Ecuadorian
based company and Aguilera decided to re-establish Deutsche Pharma in Chile. Today
the company commercializes its own brands and acts
as distributor, supplying the local market with a variety
of products for paediatrics and dermatology. Focusing
on high value products, Aguilera has found partnering
to be an indispensible part of the company’s strategy.
“There are segments of the market that have unmet
needs and that is why we are constantly looking for
partnerships that will add value to our portfolio,” he
said. The company recently partnered with a New Zealand based company for the distribution of the very
first bioequivalent isotretinoin, a medication primarily
used to treat cystic acne.
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Multi Latina
Biosano, a 100 percent Chilean pharmaceutical manufacturer that specializes in injectables, is a good example
of the many corporations that start in
one Latin American country and spread
throughout the region. “A company active in the Chilean pharmaceutical market has to reinvent its business model
every three years because today we
are competing against some of the
largest multinationals,” says Maurizio
Reginato, Commercial Director at Biosano. Biosano’s strategy is therefore
to expand its services portfolio and
to increase its export markets. The
company currently exports to 13 Latin
American countries and Biosano is already present with a direct office in Colombia. Additionally the company is in
the process of opening offices in Peru
and Ecuador. “Given our expertise in
manufacturing products under inter-
Latin America. The deal will more than double its branded generic drug business in Latin America and establish the company among the top 10 pharmaceutical companies in the region.
a paRTicuLaR maRkeT
Although Chile is a relatively small market, with only 17
million inhabitants, its geography makes it a challenging
national standards, our current aim is
to build a regional network with which
we can expand our activities into the
fast growing Latin American market,”
explains Reginato. In order to expand
its product portfolio the company is
looking at biotechnological products.
“We are in the process of concluding
partnerships in order to launch biotechnological products into the market
place,” Reginato adds.
environment for logistics and distribution services. Chile
stretches over 4,300 km along the southwest coast of South
America, a distance roughly the same as that from San Francisco to New York. At the same time, its width never exceeds
240 km, making the country more than eighteen times longer than its widest point. It goes without saying that Chile’s
harsh geography, typified by the Andes mountain range, is
one of the major challenges for the distribution of drugs.
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“Since 2007 we have been work“Reaching the outlying regions for
ing with the Ministry of Health for
private laboratories is very complicated
the distribution of vaccines and one of
to achieve,” says Edgardo Díaz Navarreour first customers was CENABAST,”
te, director of CENABAST, the public
Sánchez adds.
purchasing entity and distributor for all
Unlike large international logistics
public hospitals and clinics, and Chile’s
companies such as DHL and UPS, both of
de facto largest purchaser. “We reach
which are present in Chile, Peri Logistics
the whole country, either through own
only works with pharmaceuticals or supdistribution system or that of a logistics
From left: Edgardo Díaz Navarrete,
director, CENABAST; Raúl Sánchez,
plements. One of Peri Logistics’ strengths
operator,” says Navarrete. “We have
general manager, Peri Logistics
is its cold chain expertise. Peri Logistics
managed to expand our reach by esrecently expanded its services to address
tablishing great partnerships with third
the need for specialized temperature-controlled ground transparties that allow us to conduct our services uninterrupted.”
portation services. The company’s facility accommodates seven
But this is not the only particularity of distribution in
cold storage rooms, which allow them to successfully conduct
Chile. “The Chilean market place is very particular,” exthe annual vaccination campaign.
plains Raúl Sánchez, general manager of Peri Logistics.
“For example, the pharmaceutical market is characterized
by the vertical integration and dominance of three major
pharmacy chains in the country, which control together 92
percent of the market. This is something you don’t see anywhere else in the world. And, international logistics providA company specialized in homeoers that decide to come to Chile must take such particularipathic treatments, Heel has had
ties into account.”
to develop an innovative market-
The Overview effect
ing strategy in order to compete
with Western medicine in its chosen markets. Much of Heel’s success in the Chilean market can Eduardo Loyola,
be attributed to Eduardo Loyola, general manager,
who has been at the helm of Heel
Heel’s Chilean affiliate for almost
a decade, and has, through his innovative view of
the market, helped homeopathic treatments be introduced alongside their better-established Western
counterparts. “Generally, the person taking family
decisions on medicine in Chile is the mother,” Lozoya explains. “As a result, we focused our marketing strategy on paediatrics, which is also one of the
largest if not the largest group of doctors in Chile.
From the doctors we learned that mothers were often
looking at a less aggressive cure for their children’s
illnesses. Doctors were not able to provide such an
alternative. This was a huge opportunity,” he continues. “We educated paediatricians about our products and consequently reached the doctors.”
“Since I was appointed, Heel Chile has grown at a
rate of over 20 percent per year. I believe that when I
joined Heel, only 30 doctors were involved in alternative therapy. Today there are 3,000 doctors involved
and this number is increasing.” Lozoya compares his
management technique to the Overview Effect, first
described by author Frank White in 1987, an experience that transforms astronauts’ perspectives of the
planet and mankind’s place upon it.
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CHILE AUGUST 2014
16
Interview with: Ricardo Avila, Medical Director &
Carlos Murillo Medina, Country Manager - Pfizer Chile
Pfizer’s USD 21 million investment
in Chilean biomedicine
PharmaBoardroom: September last
year Pfizer announced the opening
of a USD 21 million precision medicine center of excellence in Chile.
What is the importance of this center
and how will it contributes to Pfizer’s
commitment to Chile?
CARLOS MURILLO MEDINA: This is
definitely a big step for Pfizer, not only
in Chile but worldwide. It is the first
center of excellence that we are building in Chile and in Latin America.
The investment is intended to
enhance Pfizer’s precision medicine
approach to help understand the
underlying biology of disease and identify patients likely to benefit from a new
drug. In the future, this approach could
make it possible to precisely select disease targets and improve the safety
and effectiveness of medical treatments in real-world practice. The center, located in Santiago, will coordinate
with our precision medicine center in
La Jolla, California, and where until
now this type of research was conducted. In line with the goal of making
Chile an innovation hub in the world,
we are moving towards basic research
with developed technology.
The construction of this center of
excellence will contribute to the consolidation of Chile and the region as a
center of research in biomedicine for
the rest of the world. We are confident
that others will follow, and that our
commitment and success will attract
more investment and research programs in Chile and Latin America.
We have chosen to build the center
in Chile because of the country’s favourable R&D incentives. Moreover Chile is
one of South America’s most stable and
prosperous nations.
RICARDO AVILA: In fact, we just came
out of a meeting at the Camara de la
Industria Farmaceutica de Chile, the
chamber that groups the innovative
pharmaceutical companies, where the
members got together to listen to our
plans. The feedback has been extremely
positive and as a result we have received
many inquiries about the newly build
center. It seems that there is an increasing interest from the industr y to
increase investment in the country.
We expect to begin operations in
2014, and among our objectives is that
our work will be in collaboration with
Chilean universities and research centers with the goal of developing qualified and experienced human capital in
R&D in the medium term. We are open
to all sorts of collaboration and are currently in the process of building a network.
What makes this project special is
that we are partnering with the government to develop technology and
research. The Chilean Economic
Development Agency (CORFO) is
inves ting USD 7 millio n in t he
research center and it must be said
that CORFO’s International R & D
Centers of Excellence program has
been fundamental in forging the
path to make Chile a regional innovation hub.
Ricardo Avila, MEDICAL DIRECTOR & CARLOS MURILLO MEDINA, COUNTRY MANAGER - PFIZER CHILE
CHILE AUGUST 2014
17
Using the latest technology, the center of excellence for precision medicine,
will focus on research for the treatment
of cancer and to establish more accurate
diagnoses. The center will be developing data that is going to allow the company to apply and use around the world.
Pfizer Chile will therefore be increasingly
important to our global operations and
not only in terms of sales.
PB: What is Chile’s potential to position itself as a biotech hub for Latin
America?
CARLOS MURILLO MEDINA: I believe
that Pfizer has opened the door to this
possibility and I expect the ecosystem
to start flourishing soon.
The country and therefore the pharmaceutical market are relatively small. But
for us it is not about the size of the market. T he Chilean gover nme nt has
approved incentives aimed at generating
an environment more favourable for innovation. Together with Pfizer there have
been a growing number of businesses in
Chile pursuing innovative projects.
We have started to recruit people and
the level of talent in Chile that we have
been able to find has been really interesting. Chileans are extremely professional
and distinguished, and I think it is important to showcase these qualities and
make use of this potential. I believe that
Chile can contribute to the talent pool of
Pfizer and the biotech area in general.
PB: Pfizer’s previous Country Manager
for Chile, Monica Zerpa, told us in
2010:” One of our biggest challenges
in Chile involves the government´s
dominant role in regulating the healthcare system”. “Because of budget constraints, the government favors lowcost generic medicines produced by
loc al laboratories”. How has this
evolved over the past four years?
We expect to begin operations in 2014,
and among our objectives is that our
work will be in collaboration with
Chilean universities and research
centers with the goal of developing
qualified and experienced human
capital in R&D in the medium term.
CARLOS MURILLO MEDINA: What you
find in Chile is not different than any other
market. On the one side there is the need
to provide access and on the other to control costs. A logic consequence is that governments are moving to lower cost suppliers. This global trend drives the growth of
the generic industry.
Some however regard Chile as a contradiction. The countr y is one of Latin
America´s fastest growing economies and
has one of the highest GDP per capita in
the region. Moreover looking at the macro
statistics of health, Chile has one of the lowest infant mortality rates and has one of the
highest life expectancy. In this regard the
country is performing extremely well.
A particularity for Chile is the reimbursement issue or access to high value therapies. Today the country has developed to
a point where citizens are no longer satisfied with what they have. Chile has made
tremendous progress over the last decade
in terms of improving the quality of life of
its citizens but at the same time cancer
patients do not have access to the latest
treatment. And patients who do are paying
huge amounts of money out of pocket. This
is a tipping point and the new government
will need to work on this. There needs to
be change in providing reimbursement and
access to high value therapies to patients.
CHILE AUGUST 2014
18
Interview with: Ciro Caravaggio, General Manager - Roche Chile
Agility and flexibility the key to
successful product launches
PharmaBoardroom: How sensitive
and reactive do you think are KOLs
in Chile? What have you found is the
recipe to “have their ears”?
CIRO CARAVAGGIO: Stakeholders in
the private system are very on top of
the newest innovations and many of
them are early adopters. Access to
those drugs moves relatively quickly.
Naturally we still need to conduct work
to ensure the drug is on the formulary
and insurers cover it but overall we see
good results here.
In the public system the healthcare
professionals are also very open to
educational events. The issue here is
that very few high value high cost
drugs are covered and therefore there
is less value in educating on drugs they
cannot use.
PB: How is this reality reflected in
the way you conduc t produc t
launches or organize your sales
force?
CIRO CARAVAGGIO: Depending on
the drug, sometimes we have distinct
efforts in the private and public sectors. A great example of this is our
HER2 franchise. We have a robust
portfolio that includes Herceptin and
Roche’s new subcutaneous (SC) formulation of Herceptin. This SC form
reduces the time breast cancer
patients spend receiving treatment,
can free up healthcare provider time
and helps improve health centre efficiency. In fact we were the first country
for Roche to launch this SC form of
Herceptin, which is important for Chile.
In the public system the country has
access issues in terms of chemo chair
Ciro Caravaggio, GENERAL MANAGER - ROCHE CHILE
CHILE AUGUST 2014
capacity. If we can free up capacity by
giving SC treatment it is a huge benefit for the hospitals and improves the
quality of life for patients.
Additionally, we have Roche’s new
HER2 products, Perjeta and Kadcyla.
Perjeta is used before surgery in people
with HER2-positive early stage breast
cancer and Kadcyla a drug for advanced
HER2-positive breast cancer. Because
both drugs are not reimbursed in the
public sector we have a medical sales
representative focusing on those specific drugs in the private system. In the
public sector other representatives are
working with Herceptin, which recently
received financial coverage. Their focus
is on education around the drug in
order for the patient to get the most
benefit and value out of the drug and
in addition provide access to the SC
form of Herceptin.
PB: How has Roche been performing
since you arrived three years ago
and what has been your main challenge?
CIRO CARAVAGGIO: We naturally get
directions from our global headquarters to excel and do our best in every
area. However, for a small country such
as Chile we have to prioritize. Our
focus has therefore been getting our
high value drugs such as Herceptin
reimbursed in the public system which
serves 80% of Chileans. Because we
had success in getting some of our
products reimbursed in the public system, we have grown tremendously
over the last three years.
Personally, one of our main challenges has been developing trust and
19
credibility internally. Initially I sensed a real
distance between senior management
and the people. That is why listening and
following up on commitments is important. Moreover it was critical to get out
there with the medical sales representatives to understand the different perspectives and see what we were doing well and
where we could improve.
Conducting clinical trials in Chile can be
expensive, the process can be slow, and
requires significant approval hurdles.
Furthermore, many don’t see the value
the trials can bring to a hospital or a
patient.
PB: Roche ranks between the 3rd and
the 5th largest company per sales in the
World, yet in Chile you are still far
behind this figure (15th). This is of
course not a “race”, but still, do you
believe that this reflects where Roche
should be, or is there room for performing and ranking better in Chile?
CIRO CARAVAGGIO: First of all, this figure, captured by IMS Health, is based on
retail sales in Chile. As Roche is a biotechnology company only a small percentage
of our sales derive from retail.
When I look at our overall position in
the Chilean market we are in a good position, ranking among the top three multinational pharmaceutical companies in
Chile. For oncology, our key business, we
are the market leader. In terms of growth,
we exceeded the growth rate of the Chilean market both in 2012 and 2013 and we
expect to exceed market growth in 2014.
The key to success lies in identifying the
areas where our efforts will have success.
With that said, you may have a very good
product but you also need the right people
in the organization. Even an outstanding
product can flop if you don’t have good
people. Therefore, I want people working
for Roche to understand that they as an individual can make a difference in patient treatment, access, and helping the medical community get the best benefit out of our drugs.
This has been a challenge, but I believe
today we have people with the right mindset
in the right places within our organization.
PB: Roche has a long history of conducting Clinical trials in Chile. Some are saying that this is often a way to “wage off”
criticism that foreign companies are not
doing real investment in the country.
How do you react to this? Why is it so
important and how active have you been
on that front?
CIRO CARAVAGGIO: As you mentioned
Roche has been very active in clinical trials
in Chile. We have 19 on-going trials in 10
different disease stages and we are eager
to conduct more in the future.
Conducting clinical trials in Chile can be
expensive, the process can be slow, and
requires significant approval hurdles. Furthermore, many don’t see the value the trials can bring to a hospital or a patient. For
a major oncology hospital, clinical research
is an integral part of care and not an afterthought; it is critical! So many patients are
at the end of their treatment and want new
hope.
We would love to do more and we
believe conducting clinical trials is a significant investment we make in the country. In
addition, we invest in education, fellowships,
screening programs, diagnostic infrastructure and in patient support programs. Moreover we do a lot to ensure drug access with
differential pricing. I believe we do more
than national firms in this regard.
CHILE AUGUST 2014
20
Interview with: Gerardo Sanchez, General Manager - Nutrapharm
Building a network for natural products
PharmaBoardroom: Could you start
by giving an introduction to Nutrapharm and explain why the company
is interesting for the market?
GERARDO SANCHEZ: Nutrapharm
has been established in 2008 in
response to the worldwide tendency
to opt for natural products without
toxins and harmful elements that contribute to people’s better health. At
the time many supplement manufacturers were exploiting the low standards for safety and efficacy for natural health products and supplements.
I saw an opportunity here to create a
company offering natural food supplements with scientific back up.
Nutrapharm’s products improve the
quality of life of people through
healthy products, with strong scientific
and clinical support. Our excellence
products help in the treatment of
some diseases and, more importantly,
to the prevention of others and to
improve, in an effective and safe way,
the population’s life quality. Our products are 100 per cent natural and contain either by nature or by later development an ingredient or a set of
ingredients which, in a specific concentration and with the recommended
consumption frequency, show in studies to reduce the risk of getting chronic
degenerative diseases or to improve
people’s general state of health.
Chile witnessed increasing demand
for vitamin and dietary supplements
as a result of improvement of disposable incomes and living standards.
Chilean consumers are more willing to
spend their money on vitamins and
Gerardo Sanchez, GENERAL MANAGER - NUTRAPHARM
CHILE AUGUST 2014
dietary supplements because they are
more aware of the preventive qualities
of these products. Our products are
used and recommended by doctors of
different specialties.
We are currently in the process of
registering our products in Latin American countries according to the requirements of the country. And, this year
we are completing the registration
process. The first country we will
export to is Uruguay. We have concluded the relevant contracts and have
already received the first order. Other
countries we are looking at are Peru,
Colombia, Mexico and Ecuador
PB: What could you tell us about the
regulatory environment for supplements?
GERARDO SANCHEZ: Within Latin
America, food supplements are subject to diverse regulations. One of the
main challenges is the categorization
of supplements fall under either the
food or the medicine umbrella. In
Chile, food and health supplements
fall within the food category.
A number of food supplements
have clinical studies showing various
health claims but are not regulated
separately. And, because there is no
control of these supplements, some
companies with so-called “miracle
products” do not meet quality standards and are a detriment to those
producers who sell supplements with
scientific backing. Furthermore consumers are limited in their options to
access many quality products that are
available in most developed countries.
21
I have always guided the company
believing in assuring the highest quality
standards for our products and this is
illustrated by the fact that we have the
only plant for food supplements that is
GMP certified. Moreover our quality control laboratory is certified as an external
pharmaceutical laboratory; our facilities
cover all the requirements for a pharmaceutical laboratory. Nutrapharm’s healthy
products and functional foods are prepared with the latest technology. Nevertheless, our products are still labelled as
food supplements. And this, I would like
to see changed: to create a category in
order to properly regulate products that
benefit people’s health.
To achieve this, I have recently brought
this matter under the attention of the
N a t i o n a l P h a r m a c e u t i c a l A g e n c y,
ANAMED, which is charged with the registration and regulation of pharmaceutical products. Furthermore, I am the President of ALIMSA, the Association of
Producers and Importers of Food and
Health Supplements. As ALIMSA we have
held a series of meetings with the Public
Health Institute (ISP), the Chilean Medical
Association and the Health Commission
to bring this under the attention and
emphasize the urgency to regulate the
food supplement segment.
PB: How could you describe the network of natural products here in Chile?
GERARDO SANCHEZ: The Chilean market is characterized by the vertical integration and dominance of three major
pharmacy chains and four supermarket
chains in the country. Since one and a half
year ago, supermarkets have started selling natural health products and supplements. Since then supermarkets have significantly increased their share in the
sector but is still very young.
Another sales channel is the independent pharmacies. However this is a challenging market for us. Firstly because of
the logistics; covering the remote areas
where the pharmacies are located. And,
secondly payments from the independent
pharmacies can take up a long time. Delay
of payment is of course a difficult situation
for a young company.
PB: What is your strategy to demonstrate the importance of your products?
GERARDO SANCHEZ: In terms of education we are focussing on three groups:
physicians, pharmacies and the end-consumer. For every group, we use different
approaches toward education and sales.
We use a tool called: Publi Reportage, an
infomercial. The infomercial is a newspaper article that aims to show the relevant
aspects of our products. In addition we
are currently in the process of launching a
television commercial to bring our products under the attention of the end consumer.
My ambition is to grow awareness for
the food and health supplements together
with the ALIMSA members. Our products
are beneficial for overall health and, more
importantly, to the prevent people from
getting sick. To this end I believe it is
imperative to work with the authorities to
train people about our products to follow
healthy lifestyle habits.
Overall we see health awareness rise
and perception increase that our products
help improve the health and the body’s
defence mechanisms in a safe way. On an
international scale food and health supplements grow on a double digit rate,
which is faster than the prescription drugs
segment. Therefore we expect this area
to grow significantly in Chile too.
CHILE AUGUST 2014
22
Interview with: Gonzalo Valdebenito, Country Manager - Medtronic Chile
Bringing Medtronic to Chile
PharmaBoardroom: Could you please
begin with a brief overview of this
affiliate with some of the recent key
achievements?
GONZALO VALDEBENITO: Medtronic
has been present as a direct operation
in Chile since October 2013 and the
commercial office currently employs 35
employees. We decided to set up offices
in order to optimize our products and
services offering to patients and physicians in the country. To achieve this, we
concluded termination agreements with
our former distributors with the objective to enhance our presence in some of
our key therapeutic focus areas.
Medtronic is the world’s largest medical technology company, offering an
unprecedented breadth and depth of
innovative therapies and we therefore
focus on training and educating Chilean
physicians and patients to help them
understand the technologies that we
have available. We are closely collaborating with physicians in order to develop
products and services to fulfil their
needs.
We are focusing on strengthening
the company’s pillars, building an efficient business model and investing in
key support functions such as educators
and clinical specialists. In Chile we are
making sure that Medtronic’s strategy is
properly executed by bringing our
global expertise to the local market.
With a global reach that extends to
more than 140 countries, we have a
deep understanding of many universal
healthcare challenges that we translate
into the Chilean market.
PB: Medtronic was founded in 1949
in Minneapolis, United States and has
been present in Latin America for a
Gonzalo Valdebenito, COUNTRY MANAGER - MEDTRONIC CHILE
CHILE AUGUST 2014
long time. Why did it take Medtronic
so long to open offices in Chile?
GONZALO VALDEBENITO: Our business model via distributors in Chile has
been successful for many years; these
local partners contributed to develop
the market and build adoption of our
therapies. As a leadership team, we
are constantly evaluating and looking
for ways to do business more effectively and expand access to our products and services. Chile is a stable
country with a solid economy, a clear
institutional framework and wellrespected democratic institutions. And,
considering the country’s overall economic growth we see an increase in
healthcare spending. These are all
good reasons to open local offices.
Moreover the country has welldeveloped hospitals and excellent doctors, which means that medical professionals in the country see the advantage
and usefulness of our high-tech medical
devices and want to partner with us
directly to offer them to their patients.
Furthermore there have been notable changes in the market. There have
been positive changes on the reimbursement side. In the field of pacemakers we initially did not receive reimbursement while today it is a standard
of care both in the public and private
sector. Additionally we are supporting
physicians by providing data to the
authorities with the goal to obtain reimbursement for other innovative products. Again, we have the best technology available in the world but without
reimbursement our products are not
accessible for every patient who needs
it. In the end what matters is that
patients get quick access to our technologies.
23
To take our diabetes division as an
example: our insulin pump, with a fine
catheter delivers the exact amount of insulin required and significantly contributes to
the quality of life of people living with diabetes. For this product we are currently
working together with the relevant stakeholders in order to obtain reimbursement.
PB: As a high technology medical device
company, how do you assess the quality
of healthcare in Chile – and what could
be done to improve it?
GONZALO VALDEBENITO: I see room for
improvement in two areas: the first is a
move towards effective universal coverage
and the second is training and education
for physicians and patients. This is also our
responsibility as industry partner. In Chile,
there are a number of therapies that are
still underdeveloped and this is where we
need to provide solutions to help patients.
With regard to the healthcare system we
do see improvement on the reimbursement
side of new therapies. We believe that in a
way, the government and relevant institutions need more clinical and economic
studies to better understand our therapies
and how to apply these in the private as
well as public sector.
Sometimes the cost of the device looks
like a barrier. It is important to look at benefits in the long term such as reduction in
hospitalization costs and length of stay. The
implantable defibrillator is a good example.
Initial costs look more expensive than to
treat a patient with pills for congestive
heart failure. However, over the long term,
the defibrillator will prevent the patient
from visiting the hospital for the treatment
of fluid in the lungs, swelling, renal failure
or other complications. Our device, which
is implanted, can alert the physician if there
is a fluid build-up in the lungs. The physicians can intervere much faster and not wait
to subsequently treat these complications.
That being said, it is a challenge and our
responsibility to influence decision makers,
to make them look at the long term and
adopt a long term cost benefit approach
to treatments.
PB: Mr. Valdebenito, Medtronic opened
its office in Chile eight months ago and
you were appointed Country Manager.
What made you the right man for the
job?
GONZALO VALDEBENITO: Prior to this
position I worked seven years for one of
Medtronic distributors. I have therefore
gained significant experience working as a
partner with Medtronic. Medtronic is the
company with the broadest and most innovative product portfolio in the industry and
due to my previous experience I learned
about the tremendous solutions the company offers to the public and private sector
in Chile.
At Medtronic, we seek to deliver truly
innovative and life-changing devices for our
patients, in order to improve lives worldwide. There are still a lot of patients who
need our products and do not have access
to them. Our greatest goal is help people,
and whether we are a young or an established organization, this ambition does not
change. I am extremely motivated to continue to build what we have started here.
CHILE AUGUST 2014
24
Interview with: João Simões, head of integration - Grunenthal Chile
Grünenthal on how to blend the cultures
of two family companies
PharmaBoardroom: The big news for
Grünenthal not only in Chile but in the
whole of Latam is of course the acquisition of Andrómaco. Why did this fit so
well in Grünenthal’s strategy to multiply
its Latam revenue by two?
JOÃO SIMÕES: Prior to the acquisition
we were looking at companies present in
the fastest growing markets in the region
and having the right critical mass. Companies with a robust commercial presence, generating sales through medical
prescription, and not by pushing their
products through the channel.
These conditions eliminated quite
some players on the market and eventually led us to Andrómaco. Furthermore
Andrómaco had a strong presence in therapeutic areas like gynecology and Neuropsychiatry (CNS), areas which Grünenthal
aims to strengthen.
Andrómaco was present in markets
where we were strong already and thus
becoming an even bigger player.
PB: You were appointed leader for
Grünenthal Chile, right after the friendly
IPO was successfully concluded in order
to conduct the acquisition process.
Until today how far has the integration
process evolved?
JOÃO SIMÕES: We have prepared the
integration process well in advance. The
first moment we started the negotiations
for the acquisition we immediately internally began the process. As a result we
had a well-structured process once the
acquisition materialized.
Currently and with our new colleagues
at Andrómaco we are taking the time to
validate the process we have defined and
João Simões, HEAD OF INTEGRATION - GRUNENTHAL CHILE
CHILE AUGUST 2014
are aligning our goals. Subsequently we
will start implementing changes. It is
imperative that we are taking the right
decisions and therefore take our time.
Our aim is to merge the best of both
worlds, not imposing the Grünenthal way
of working over what we have acquired.
PB: In M&A, one of the toughest thing
is “cultural” integration. Both Andrómaco and Grünenthal have a very
strong corporate identity, with long
family history. How difficult is it to
“blend” the two cultures?
JOÃO SIMÕES: From an outsiders perspective the two cultures could look very
far apart. However in reality the companies are not so different and the things
that we have in common should be the
pillars of the new culture we are building.
Currently we are taking our time to better
understand the culture in detail.
Naturally people are the most important element in an acquisition. Since the
acquisition we have treated people with
transparency. Each and every one is fully
informed about the steps we are taking.
We are not imposing change, we have the
people be part of the change.
PB: How far will the integration go, and
what should be the impact in terms of
development strategy and positioning
for both companies?
JOÃO SIMÕES: There is space for all the
businesses we have today. We are currently assessing the attractiveness of all
businesses in order to decide where the
focus will be.
As Grünenthal, we do not want to
destroy the important assets that we have
acquired. We will understand first subse-
25
quently decide what is best for the future organization that we are building.
PB: Besides the immediate registered
growth in revenue and market share Grunenthal will make in many Latam countries, what
else do you think can be learned by the company from this acquisition?
JOÃO SIMÕES: More important than what we
can learn is what can we leverage? Andrómaco’s way of doing business has been fundamentally different than Grünenthal but at the same
time extremely successful. We are learning
about Andrómaco’s way of doing business and
determine how we can leverage portfolio, business model and structures of people.
PB: In Chile, through this acquisition,
Grünenthal gets propelled from being a midsize/mid-market company, to one of the top
four, which is probably a unique case for
Grünenthal anywhere in the world. How is
this “changing the deal from a manager’s
point of view”? Do you think this comes with
special responsibilities?
JOÃO SIMÕES: It is not about imposing
Grünenthal into Andrómaco. We need to evaluate what is best for both businesses. If we have
portfolio, which is valuable and adapted to the
needs of the patients we will take it. Again, we
are taking best of both worlds no matter what
side it comes from. That means we have to
adapt the new company to the new responsibility.
As a German company our processes are
extremely structured. We are following each
step in order to make the right decision.
PB: Can you give us a brief overview of
Chile’s importance and contribution to
Grünenthal’s target of USD 450 million
revenue in Latin America?
JOÃO SIMÕES: Speaking about the Latin
American revenues Chile accounts for approximately a third. In terms of operations outside
Chile, Grünenthal has a higher critical mass than
Andrómaco, whereas in Chile it is the other way
With our new colleagues at Andrómaco
we are taking the time to validate the
process we have defined and are aligning
our goals. Subsequently we will start
implementing changes. It is imperative
that we are taking the right decisions.
around. As Andrómaco was born in Chile the
company had a bigger presence in this country
than in any other Latin American country.
The acquisition has allowed us to be a relevant player in the Chilean market and shape
the environment. Grünenthal’s objective is to
become the most patient-centric company and
we take that very seriously.
PB: Where would you like to take the organization in the next three years?
JOÃO SIMÕES: We have an ambition to
become a key player in the Chilean market. Our
strategy, which we are currently defining, will
be based on growth. We do not merely aim to
become a key player in terms of numbers but
also in the healthcare market. As Grünenthal
we are committed to the country and
collaborate with the different stakeholders
including authorities, doctors and patients.
Grünenthal’s international objective is to
expand in the emerging Latin American market,
which has included the acquisition of
Andrómaco. Due to this acquisition we acquired
the best regional company that has complemented our own business and our therapeutic
areas within the countries of the South and Central America. The acquisition was the right step
to leverage our presence in the Latin American
market. But if we want to become a big player
in the region we will have to grow in Mexico
and Brazil. Today we are present in these
markets and aim to grow the organization
significantly in order to become a major
geographic player in Latin America.
CHILE AUGUST 2014
26
Interview with: Matias Vial, Executive Vice President - Cells for Cells
Leading Chile’s biotech wave
PharmaBoardroom: Could you start
by giving an introduction to Cells for
Cells?
MATIAS VIAL: The company is a spinoff of the University of the Andes, and
seeks to innovate in basic research on
stem cells, as a way to lead to new therapies that address highly prevalent
degenerative diseases. We also aim to
provide effective and proven treatments for patients Chilean and Latin
American through clinical trials in hospitals and health centers that have the
necessary infrastructure. Our strategy
is to move along with clinical studies,
focusing on phase 1 and phase 2 studies.
Located at the University of the
Andes, Cells for Cells has advanced
GMP facilities and modern and functional infrastructure that has been built
to meet the highest quality standards
to ensure the process of research and
development of innovative and reliable
cell therapies. Currently we are in the
process of building our second GMP
Lab within the Universidad de los
Andes Hospital. From there we will be
able to take studies to proof of concept, and produce therapies with the
aim to bring to the market. Cells for
Cells is the first biotech company in
Chile with such value proposition.
Chile has taken significant steps to
incorporate biotechnology into its
economy. Through a series of powerful
initiatives, including a new regulatory
framework and economic incentives, it
seeks to develop a world-class biotechnology sector. The company has
opened the door to a new industry in
Chile with the goal to be competitive
on an international level.
Matias Vial, EXECUTIVE VICE PRESIDENT
CHILE AUGUST 2014
- CELLS FOR CELLS
In order to illustrate our international
ambitions we have named the company
Cells for Cells instead of “Células para
las Células” in Spanish; we are thinking
worldwide. We are pleased with the
appointment of our Chief Scientific
Officer who has prior experience at the
Singapore-MIT Alliance (SMART) Labs
in Singapore. SMART is a major research
enterprise established by the Massachusetts Institute of Technology (MIT)
in par tnership with the National
Research Foundation of Singapore
(NRF) in 2007. His appointment has led
the way for a cadre of top notch
researchers to join this initiative in Chile.
PB: What does Chile has to offer for
a company such as Cells for Cells?
MATIAS VIAL: In a world of constant
change, Chile is a beacon of economic
and institutional stability. In international comparisons of competitiveness
and economic freedom, Chile is at the
forefront of South America, and despite
its emerging status, it´s in a very good
competitive position. I was in Spain earlier this month and I realized that Chile
has huge credibility abroad. In the last
few years, Chile has emerged as a pole
of innovation that is spoken about
throughout the world.
Our research aims to move “from
bench to bedside” or from laboratory
experiments through clinical trials to
point-of-care patient applications.
When I am speaking about the term,
“bench to bedside” I refer to the concept of translational medical research.
This concept aims to “translate” findings in basic research into medical
practice and meaningful health outcomes. In order to achieve this we have
27
established partnerships with Chilean hospitals and research centers abroad. Chile
provides the opportunity to reach patients
faster and cheaper compared to developed
markets.
PB: We hear substantial hurdles on way
to further growth for biotech companies,
among others lack of capital. For you,
what have been the challenges in raising
capital?
MATIAS VIAL: We have been extremely fortunate with three private investors who
founded Cells for Cells three years ago. The
company started with USD 3 million in private equity, and 3 years after we received
another USD 10 million from the same investors. In addition we have obtained USD 2
million from CORFO and Conicyt, a Chilean
governmental organization overseeing a
variety of programs aimed at generating the
economic development of Chile.
Chile’s biotechnology sector is very
young and as a result lacks a platform,
framework or policy. For that reason we
applied for another CORFO funding, with
the objective to create a platform for open
innovation to scale clinical, technical, commercial and regulatory part. Together with
Clinica Davila, the largest private clinic in
Chile, we obtained through competitive
funding by CORFO USD 10 million for a
period of 10 years to create a new company,
REGENERO, that will be focused in the
develop of allogenic stem cells therapies
(lupus, diabetes, skin ulcers and chronic
renal failure)
Together with the University of the
Andes, the public and the private sector
Cells for Cells is forming a new cluster for
stem cells. And, as a result the Ministry of
Education awarded us a grant for USD 10
million six months ago. In total we have
therefore received more than USD 40 million
in grants and private funding for stem cell
therapies.
Chile has taken significant steps to
incorporate biotechnology into its
economy. Through a series of powerful
initiatives, including a new regulatory
framework and economic incentives, it
seeks to develop a world-class
biotechnology sector.
Cells for Cells has obtained more than 15
projects in the sphere of stem cell therapy
and we expect to have more than 100 people working here. Having that said, this will
be an important hub for biotechnology in
Chile.
PB: How do you rate the commitment of
the Chilean government of fostering the
right environment for the biotech industry?
MATIAS VIAL: The country remains overwhelmingly reliant on copper and therefore
highly vulnerable to fluctuating commodity
prices. As a result, the outlook has encouraged Chile to diversify its mining based
economy. And biotechnology is a great
opportunity.
To bring our work under the attention
of the government I believe that it is necessary to demonstrate quick success; that as
an industry we are building something substantial. It would be a major achievement
if we could cure a patient disease with Chilean technology.
As Cells for Cells we have invited government officials at our facilities in order to
show the potential we have here. Furthermore we have managed to attract USD 40
million in funding and several great
researchers; showcasing our progress.
CHILE AUGUST 2014
28
Interview with: Raúl Sánchez R., General Manager - Peri Logistics
Chile’s geography proves challenging for
logistics companies
PharmaBoardroom: What have been
the main milestones of the company?
RAÚL SÁNCHEZ R.: Peri Logistics was
established in 2004. At the end of that
same year we completed the construction of our facility and were fully operational.
2009: We added a new area of the
facility, adding a 100% more capacity
for storage.
2013: ISO 9001:2008. According to
current Chilean legislation, logistic
providers are categorized as “droguerías”, which are not allowed to have
Good manufacturing practices (GMP)
cer tification. In this regard, we
obtained the ISO 9001:2008, an international standard related to quality
management system, applicable to
any organization from all types of business sectors and activities. This has
allowed us to be the only pharmaceutical logistics operator with such
accreditation in Chile. It is a guarantee
of quality for our prestigious clients.
However according to the new
medicine law droguerias will be controlled by ANAMED, the national pharmaceutical agenc y, which might
change the status of logistic providers.
In that case, Peri Logistics will opt for
GMP certification because we believe
this serves as a warranty to existing
and potential customers. Furthermore,
Peri Logistics already works according
such high standards.
PB: What would you say is Peri Logistics comparative advantage versus
large global logistics providers such
Raúl Sánchez R., GENERAL MANAGER - PERI LOGISTICS
CHILE AUGUST 2014
as DHL or UPS that are heavily
investing in the country?
RAÚL SÁNCHEZ R.: One of the main
features that distinguish Peri Logistics
as a pharmaceutical logistics operator
is our flexibility. Peri Logistics has the
ability to adapt to the needs and
requirements of its customers. And,
opposed to large international logistics companies such as DHL and UPS,
Peri Logistics only works with pharmaceuticals or supplements; we are a
specialized company. Moreover we are
an independent logistics provider, not
involved in any other activities.
Additionally the Chilean market
place is very particular. For example
the pharmaceutical market is characterized by the vertical integration and
dominance of three major pharmacy
chains in the country, which control
together 92 per cent of the market.
This is something you don’t see anywhere else in the world. And, international logistic providers that decide to
come to Chile must take such particularities into account.
One of Peri Logistics’ strengths is
its cold chain expertise. Since 2007 we
are working with the Ministry of Health
for the distribution of vaccines and one
of our first customers was CENABAST,
the public purchasing entity and distributor for all public hospitals and clinics; the pharmaceutical industry’s de
facto biggest purchaser. Peri Logistics’
facility accommodates seven cold storage rooms, which allow us to successfully conduct the annual vaccination
campaign.
29
PB: You conducted two studies for temperature with prestigious national institutions. What could you tell us about
these studies and who are the partners
you are working with?
RAÚL SÁNCHEZ R.: We worked together
with IDIEM, a division of the University of
Chile. They conducted a study in regards
to temperature fluctuations inside our storage facility. On the basis of this study we
took action to lower the temperature in our
facility. We conducted a second study in
order to further lower the temperature
focusing on natural solutions; no air-conditioning.
The collaboration with the university has
been a major success. The scientists groups
have visited us several times in order to
control the temperature systems that we
have installed after the studies, and today
our storage facility maintains an appropriate level of temperature throughout the
year; day and night.
PB: Usually the key to success for logistic
providers is in their excellent customer
relationship management. How would
you characterize your CRM efforts?
RAÚL SÁNCHEZ R.: Our comparative
advantage is the excellence of our service
and the fact that we are able to provide
fully integrated solutions to our clients. Due
to our vast expertise and our extensive network, Peri Logistics has the ability to adapt
to the demands of all our different clients
and to address their needs directly.
Along with the high level of service standards that we deliver, we have very positive
relationships with all of our clients and this
is something that we take pride in. We
don’t look at our customer relation as consumer / provider; Peri Logistics positions
itself as a partner to all its clients.
Our clients feel secure with our operations. The fact that the General Managers
we work with do not have to pick up the
phone is a sign that the process is running
smoothly and we are doing a good job. Our
clients focus is to generate sales through
the sales of their products and we contribute to this objective by providing the logistics.
PB: How are you targeting international
clients that wish to find a logistics provider in Chile that can help in the commercialization of their products?
RAÚL SÁNCHEZ R.: The pharmaceutical
industry in Chile is very small. Generally
customers that knock on our door heard of
us through word of mouth.
The beginning however was not easy.
Potential customers admired our facility but
getting our firsts customer took a while.
The companies that we were in contact
with asked us for references and as long as
we could not provide these they were not
willing to take the risk. Today however we
work with the largest pharmaceutical companies operating on the Chilean market.
Our focus is on high cost medicines,
from biotechnological companies. These
products arrive in little quantities but need
to be handled specifically.
PB: You are celebrating Peri Logistic’s
10th year anniversary this year. What
would you like to achieve in five years
from now?
RAÚL SÁNCHEZ R.: I believe that Peri
Logistics has positioned itself as a recognized player in the Chilean pharmaceutical
market. In the next five years I aim to
strengthen our position in the market. To
achieve this we are expanding our services
portfolio to our customers.
In addition we aim to be recognized
more as a partner than a provider to our
clients. And, offering more services than
we are now will contribute to us being a
partner of choice.
CHILE AUGUST 2014
30
Interview with: Paula Ithurbisquy, General Manager - Clinica Alemana
German hospital at the forefront of
private medicine in Chile
PharmaBoardroom: As an introduction, could you introduce Clinica Alemana to our readers?
PAULA ITHURBISQUY: Clínica Alemana is affiliated with the German-Chilean Beneficence Corporation, a nonprofit foundation established in 1905.
The German community in Chile
opened its first hospital in 1918, located
in the Independencia area in Santiago.
The building was sold to the Bank’s
Pension Fund 1970.In March 1973 the
current Clinica Alemana opened,
located where it is today. In the following years the clinic established itself as
one of the first private health facilities
in the country.
Chile’s health-care sec tor was
opened up to the forces of the market
by a new law in 1981 that allowed private insurance companies, called Isapres, (Instituciones de Salud Previsional) to compete for business. Prior
to that, all Chileans were obliged to pay
4% of their income into the state-run
Fondo Nacional de Salud (FONASA).
The new law gave people, who could
pay more, a greater choice and access
to better services. This development
has helped to open up the private
health sector in Chile.
Since then, Clinica Alemana has
been a leader in the field of private
health care, pursuing and ongoing
medical development as its main priority. Our outstanding professionals and
infrastructure make it happen. Our programs and services are designed to
enable the medical community, patients
and their families to take greatest
Paula Ithurbisquy, GENERAL MANAGER - CLINICA ALEMANA
CHILE AUGUST 2014
advantage of our wide range of health
care options. Clinica Alemana’s principal strengths are Preventive Medicine,
High Complexity Medicine, Emergency
Department and Intensive Care Units.
Today we have 4,000 people working
for Clinica Alemana!
Also, we have a partnership agreement with Universidad del Desarrollo.
In early 2002 the Faculty of Medicine
was created as a result of the partnership between the University and Clinica
Alemana.
PB: To which extent is Clinica Alemana a benchmark for other Chilean
clinics / hospitals to aspire to?
PAULA ITHURBISQUY: Today Clínica
Alemana is recognized as one of the
best and most advanced hospitals in
Latin America. The clinic has transformed itself as a reference for the
industry. Clinica Alemana has been
able to provide the latest in health care
technology and continuously expanded
its services.
I took over the helm of the clinic in
2012, with the ambition to continue
leading the private industry.
Our daily activities are always
focused on our patients. Clinica Alemana’s objective is to be the most
patient-centric clinic and we take that
very seriously. Therefore, we constantly
strive to provide the most modern technology, the best infrastructure and,
above all, the highest-qualified and
most caring professionals in order to
satisfy all our patients’ healthcare
needs. Our aim is to excel in the provi-
31
sion of these services, especially because
we are aware that the people we care for
are usually going through difficult moments
in their lives.
Naturally every hospital can purchase
the latest technology, attract the best doctors and build facilities. But what sets Clinica Alemana is the patient experience. We
have created an atmosphere where patients
feel at home, feel loved and receive the
attention they deserve.
PB: How do you evaluate the level of
patient care?
PAULA ITHURBISQUY: In fact, this year,
Clínica Alemana ranked first in a study,
known as the Praxis Xperience Index (PXI).
The Praxis consulting company recently
launched a survey to measure how customers view their experiences with the most
important Chilean brands. The investigation included 98 brands and 25 industries
in various sectors, such as retail, health,
financial services, home services, public
transportation and telco (cable TV, mobile
phones, triple pack), among others.
One of the reasons that Clinica Alemana
has been recognized as the best and most
advanced hospital in Chile is because we
are a branch of the German-Chilean Beneficence Corporation, a non-profit foundation. We have therefore been able to execute a longstanding policy of profit
reinvestment. In addition we have a longterm view on our strategy in order to be
prepared for the next century.
PB: Clinica Alemana has been ranked
second best for many years. Due to its
reputation the clinic receives patients
from all over the continent. Would you
outline what programs you have developed to reach out to international
patients?
PAULA ITHURBISQUY: Clínica Alemana
has the strongest program in Chile to reach
international patients. Our service is called
International Patient Service.
This program makes it easy for international patients to make appointments with
physicians, to seek a medical second opinion or treatment for a complex illness if it
is needed. Our International Patient Coordinator manages the following medical and
personal needs prior to your arrival, during
your stay and after returning home.
We are receiving many Bolivian and
Peruvian patients, who visit us for complex
surgeries. I expect significant growth in this
area.
PB: How does Clinica Alemana attract
and retain the best talent available?
PAULA ITHURBISQUY: Medical schools in
Chile deliver very good doctors. Looking
at Clinica Alemana, we are a prime location
for medical graduates given our high level
medical facilities and equipment and our
overall reputation. Therefore we are able
to attract the best medical personnel. Of
our consultants many trained and worked
abroad. Our doctors have the opportunity
to work and train at our partner hospitals
around the world. For example, if we purchase the latest technology in urology we
send urologist abroad to train and get
familiar with the equipment. When the urologist comes back to Clinica Alemana, he
transfers the knowledge to our specialists.
For example, MD Anderson, part of the
University of Texas is our sister institution.
Since 2003 when our agreement was
signed, MD Anderson have continued to
collaborate with Clinica Alemana in the
departments of Urology, Genitourinary
Medical Oncology and Radiation Oncology
regarding novel treatments and technologies used in the fields of prostate, renal,
bladder and testicular cancers. The standard of care received by a patient at Clínica
Alemana is the same as you will receive in
Western Europe and the US.
CHILE AUGUST 2014
32
Universidad de los Andes’ first scientific
spin-off
Cells for Cells
Cells for Cells (C4C) is a Chilean biotech
Company devoted to the research and
development of novel therapies based
on adult stem cells. Established in 2010
as the first biotech spin-off of Universidad de los Andes, C4C is part of the
regenerative medicine’s cluster that the
University is building with local and
international scientific and commercial
partners, plus the combined financial
support of private and public sectors.
Within 3 years, this cluster has raised
42 USD million for R&D for the coming
10 years. The final goal is the launching
of innovative solutions, therapies, services or devices to cover unsolved
degenerative diseases.
Matias Vial, Director of R&D and
Innovation at Universidad de los Andes
and Cells for Cells’ Vice President,
explains that the company’s fingerprint
is to do research “from bench to bedside”, which is so called translational
medicine. “To reach this objective we
are building collaboration alliances with
local hospitals and clinicians in order to
perform international-standard clinical
CHILE AUGUST 2014
studies, which is still a sub-regulated
area in Chile.”
With two international patent applications, a pioneer research line at C4C
uses menstrual fluid as a novel and minimum-invasive source of stem cells.
Menstrual stem cells (MenSC) have
demonstrated to have unique properties, which can induce therapeutic benefits for target diseases or indications.
Maroun Khoury, C4C’s Chief Scientific
Officer explains that MenSC are being
studied at their lab in health indications
such as cancer, inflammatory diseases
and tissue regeneration, with the aim
to develop early-stage and cuttingedge proprietary technologies.
Other C4C’s ongoing projects
involve the licensing of proven outsider’s technologies with minimal internal
improvements, as a way to speed-up
the innovation process to bring health
solutions into the Chilean society. This
is the case for cornea regeneration
using limbo-corneal cells, a licensed
technology, which will allow bringing to
Chile a world-class, safe and efficacy
therapy.
33
For exclusive interviews
and more insights, log on to
pharmaboardroom.com
CHILE AUGUST 2014
34
Company index
Abbott Laboratories .................................. 13 IMS Health.................................................... 9
Alliance Boots ........................................... 13
Janssen......................................................... 9
ANAMED.................................................... 10
Medtronic............................................... 22, 23
B Braun........................................................ 12
Biosano ...................................................... 14
Ministry of Health..................................... 8,9,
MSD..........................................................9, 10
Cells for Cells...................................26, 27, 32
Nutra Pharm .......................................... 20, 21
CENABAST................................................ 15
Pan American Health Organization.......... 10
Chamber of the Pharmaceutical Industry in
Chile (CIF)................................................9, 12
Peri Logistics.....................................15, 28,29
Chilean Economic Development Agency
Pfizer........................................... 10, 11, 16, 17
(CORFO)..................................................... 10
Clinica Alemana..................................... 30, 31
Deutsche Pharma....................................... 13
Public Health Institute................................ 9
Roche........................................... 11, 12, 18, 19
DHL.............................................................. 15
Tecnofarma.................................................. 11
Grünenthal........................................12, 24, 25
UPS.............................................................. 15
Heel.............................................................. 15
World Trade Organization.............................9
CHILE AUGUST 2014
35
CHILE AUGUST 2014