Cover Story

Pharmaceutical industry: collaborating for health

LD-J-HR-8Cover IPHA President and Janssen Country Director Dr Leisha Daly talks to Owen McQuade about the pharmaceutical sector’s social and economic contribution to Ireland and the need to make cutting edge research available to Irish patients.

The pharmaceutical sector has been one of the major success stories of Ireland’s recovery and now needs the space to reach its next stage of development, according to Dr Leisha Daly. The Country Director of Janssen, one of the pharmaceutical companies of Johnson & Johnson, is pleased that the partnership with government is delivering for patients but she also states clearly that pharma companies can no longer afford to continue to provide the savings made in recent years.

Having taken up the presidency of the Irish Pharmaceutical Healthcare Association (IPHA) in September, Daly is the main spokesperson for the industry in Ireland. The IPHA has 40 members representing commercial pharmaceutical operations.

Most member companies are based in Dublin but are attached to manufacturing facilities in Ireland. Johnson & Johnson, for example, has four manufacturing facilities in Ireland employing approximately 2,500 people directly.

“At the top of the IPHA’s agenda is getting new medicines into the market and made available for Irish patients in as timely a manner as possible,” Daly remarks. “It’s really to ensure that, if there is a new medicine, that it becomes available to Irish patients as quickly as it becomes available in other countries around Europe.”

Medical procurement involves a partnership approach with the Department of Health and the HSE, and Daly states: “Collaboration is critical if we are to be successful in making Ireland a healthier place.” The industry’s contribution to the health of the nation is particularly visible when one looks at the extension of Ireland’s life expectancy over the last 20 years: “Ireland now has a higher life expectancy than the average OECD level and medicines have contributed significantly to that. Illnesses such as AIDS and hepatitis C were previously terminal but have now become chronic or, in the case of hepatitis C, can even be cured. The economic effect is that patients who would otherwise have been in hospital are now back to work.”

Value

The industry has been criticised over Ireland’s high drug costs but Daly is keen to point out that IPHA “does more than just make medicines available.” Companies work in partnership with patient organisations, hospitals and pharmacists to provide medical educational programmes and to help roll out new therapies.

Daly adds: “The value that we add goes beyond the provision of medicine alone. For example, we contribute significantly to medical education for healthcare professionals. The industry enhances Ireland’s international reputation and makes Ireland an attractive prospect to companies and researchers.

“Clinical research is another valuable contribution that the industry makes, not just to the health of Irish patients, but to global health needs. We are all following with great interest and also fear the Ebola outbreak in West Africa. Ebola is a significant and growing threat to the people of West Africa and it has the potential to impact people around the world. I know that many of our member companies are committed to helping to prevent and treat this deadly disease. And we know we cannot do it alone: we are closely collaborating with each other, the World Health Organization, Médecins Sans Frontiéres, as well as other key stakeholders, governments, and public health authorities on the clinical testing, development, production and distribution of new treatments to fight this disease.

Collaboration is a strong theme for Janssen and other pharmaceuticals. Historically, its business model was based on getting medicines licensed by the Irish Medicines Board (renamed the Health Products Regulatory Authority as of 1 July) and made available to clinicians. However, IPHA members now employ an increasing number of staff who communicate and collaborate with patient advocacy groups and health economists who work to ensure access for innovative medicines.

“That follows on from how the environment has changed,” Daly surmises. “Ten to 15 years ago, we had to get a product licensed and then it was pretty much available to patients but now there is an extra piece of work that needs to be done – proving the cost-effectiveness of the medicine.”

The HSE and Department of Health reimburse the costs of medicines and the IPHA works with them to ensure that products meet patients’ needs and that all relevant data is collated and made available.

LD-J-HR-5 Change

When Daly started in the pharmaceutical industry, most general managers came from a sales background but there are now more scientists, medical professionals and economists working in the industry. She sees this reflecting the increasing complexity of the sector which engages with a wider range of stakeholders.

Many of the newer medicines seek to meet very specific needs – e.g. oncology or the potential new medicines for treating Alzheimer’s disease – whereas the market was previously dominated by antibiotics and cholesterol-lowering products. “Lifestyle changes such as declining exercise and bad nutrition are also giving rise to diseases such as diabetes and heart disease. In response to these global trends, the pharmaceutical industry is focused on developing new medicines to protect the health of our nation,” explains Daly.

Transparency around clinical trial data or how the industry interacts with the medical profession “is vitally important to the pharmaceutical industry. We have worked hard to make progress in this area and we completely support whatever transparency is needed … we’re behind that 100 per cent.” From 2016, all interactions with healthcare professionals will be publicly declared in Ireland and the rest of Europe. “We have committed to publishing all data about support we give to doctors and other healthcare professionals from 2016,” says Daly.

As for the future, treatments for many of the ‘easier-to-manage’ illnesses have been found and the challenge for the industry is to ensure that it continues to research – and has the available finance to explore new areas where medicines are not yet available.

Daly explains: “You hear a lot now about personalised medicine and there will be a time where, before you’re given a specific medicine, you will have a test done which would guarantee that the medicine would work for you. That’s going to take a significant amount of investment from companies and that’s obviously going to be a challenge – to keep investing in developing new medicines.”

The greatest challenge will, as always, be to ensure that those medicines are made available as quickly as possible to new patients. The IPHA therefore needs to continue working closely with the Department of Health and HSE.

At present, the delivery system is working but she would like the Department of Health and HSE to receive more resources in order to deliver access to innovative medicines in a timely manner. The other challenge is that the IPHA wants to be seen as a partner that contributes more than just medicine. For example, the Healthy Ireland Council “is a fantastic idea and has great potential but it’s disappointing that there is nobody from the pharmaceutical industry on that council.”

From the industry’s perspective, it has “a lot to bring and solutions to offer” on the Healthy Ireland agenda. Many pharmaceutical companies encourage people to take their medicines regularly as this helps patients to remain healthier for longer. Apps to help manage illnesses are increasingly available and IPHA could work with the Healthy Ireland Council on that issue.

“I do think that the future is to empower patients to take more ownership of their well-being.” Daly continues. “We don’t want to be just seen as the companies that ‘sell pills’. We have a much bigger interest in ensuring that patients get better and stay better for longer and in continuing to do research in areas that will be of benefit to patients in the long run.”

Irish footprint

The pharmaceutical industry in Ireland employs 25,000 people directly and another 25,000 indirectly. Several medicines now coming to market are being developed and produced in Ireland and the sector has made a major contribution to the State’s economic recovery.

“Whilst our primary objective is to make Ireland a healthier place, the investment in Ireland by our companies is a great source of pride for us,” she comments. “However, over the last two to three years, within our own sales and marketing operations, there have been significant price reductions and savings.”

Indeed, €800 million in savings have been achieved since 2006. The industry’s view is that it has borne its “fair share of the pain” and now needs to work towards “ensuring that we get the new medicines on to the market as quickly as possible at a fair price.” Companies are not in a position where they can take more cutbacks.

On a positive note, Daly continues to be optimistic that the industry can get the medicines to market quickly: “Certainly, when you read about the number of innovations that are coming, there is plenty of scope for optimism. We’ve got a lot of really dynamic, innovative people working for our companies – people who have worked already in research and development and are passionate about research and ensuring that the products of the research get to the patients.”

She senses a high quality, commitment and determination among the people working in IPHA and its member companies.

On R&D, Daly welcomes Ireland’s strong structure for oncology-related clinical trials but wants to see this approach replicated in other areas. Many companies are “happy to invest” in Ireland’s R&D base but long processes for setting up trials can discourage investment. “It would be useful if there was a better structure in place for research and clinical trials in particular,” she notes.

The relationship with the Department of Health and HSE has “worked well historically” and the industry has “huge respect” for its partners in government and how they have handled their budget constraints.

“We’re at a point now where we’ve done that,” Daly reflects on the savings programme. “We certainly can’t deliver more savings looking into the next number of years because the impact, the savings we have already delivered had on our companies, has been significant.”

Profile: Leisha Daly

Hailing from Laois, Leisha attended the Carlow and Dublin Institutes of Technology before completing a PhD in clinical medicine at Trinity College Dublin in 1989. After that, she worked for German pharmaceutical firm Hoechst for nine years – on animal health, plant protection and human health. She joined Janssen as Head of Technical Affairs in 1998, and since then has served in a variety of senior positions in medical, sales and marketing. Leisha is also a member of the Janssen UK Board of Directors. She is married to Paraic with two teenage children, Niamh and Finian. Interests include yoga, walking and cycling and she enjoys spending time with the family holidaying

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