Cristobal Thompson
Executive Director
View from the Top

Collaborate to Innovate

Wed, 09/06/2017 - 17:09

Q: Research, development and innovation are AMIIF’s top three core values. Which is the most important for 2017?
A: Innovation is always at the top of the agenda. It is the reason why we exist and we have been working on this. The goal of AMIIF’s 2024 vision, its midterm plan for innovation, is to contribute to improving Mexico’s productivity and competitiveness through pharmaceutical innovation. That is our key goal. As President Peña Nieto has said, we are experiencing a renaissance for innovation. For example, hepatitis C products, which have a 95 percent rate of cure, have just been approved for inclusion in the public health system, which is an incredible breakthrough. There are new treatments in HIV and patients are living almost as long as nonpatients and with minimum side-effects. There are also new innovations in cancer treatments.

One issue for pharmaceutical innovation is how to finance it. We sat down with IMSS and now we have three teams working with the institution to establish innovative access models based on patient health outcomes. The project began between February and March 2017. Our first group is working on the analysis of the cost to the system and the epidemiological impact of the main therapeutic areas to be prioritized in this project (potentially: diabetes, cancer and cardio-vascular diseases). The objective of the second group is to analyze new performance indicators and criteria to align patients and institutional needs in said therapeutic areas. The third group is a legal team discussing how and when the government could be able to implement innovative access models, aligned with the proper legal framework. Financial and legal experts and doctors also attend these meetings.

We are also looking at how we can bring in more resources via clinical research. In January 2017, there was an agreement made between all parties with President Peña Nieto present. Its objective is to increase investment in the sector from around US$250 million to above US$600 million. A meeting in early May 2017 brought together COFEPRIS, IMSS, ISSSTE, the decentralized institutions, ProMéxico, the Ministry of Economy, SAT, Customs and the industry. We will have monthly meetings to provide updates on each area, understanding that by the end of 2017 we should have a better process for getting protocols approved to bolster the amount of funds coming into Mexico.

A pillar of increasing access to innovation is to make understood its potential impact on productivity and competitiveness. Last year, we presented a study with the automotive industry in Guanajuato, which tried to show the impact of lost productivity on a sector. In the case of the auto industry, the impact of lost value was around 7.3 percent of the industry’s value, of which 1.3 percent was absenteeism and 6 percent was due to presenteeism. We are close to the big employers such as the Business Coordinating Council (CCE), COPARMEX and CONCAMIN to make sure that everyone has a voice in making sure our health system, social security and Seguro Popular deliver a better job.

Q: How much awareness remains to be raised among governors?
A: At the beginning of May 2017, Dr. Narro, Minister of Health, attended our board meeting for the first time. He said that health and education are the two highest social equalizers. At the federal level, we have done a great job and awareness is higher than it was three years ago. Having said this, budgets were cut last year, showing that although there is awareness, this does not correspond to action yet.

At the governor’s level, we have to improve awareness. Investment must be holistic: people must be healthy and with a good level of education. They must have infrastructure and public services, but there must be a good health system too. We have been asked by the Ministry of Economy to undertake another study like the one we did in Guanajuato, a state that is growing at 6-7 percent per year. If employment continues to grow but the health system does not keep pace, there will be a bottleneck, a problem of too much success too quickly but with a gap in these kinds of public services for workers and their families. Again, investment usually goes to places with good infrastructure. If this is not addressed, there will be limitations in economic development.

In May 2017, Mikel Arriola, Director General of the IMSS, announced tests in Nuevo Leon in which IMSS would follow up on company employees to see who was at high risk and to begin taking preventive measures early on. The more information we can give the government, the better.

Access to innovation is low, as only 10 percent of innovative medicines approved by COFEPRIS are in the public health institutions. Early diagnosis and secondary prevention is much less expensive than waiting five years for patients to get out of control. Then, by the time you give them innovation, the cost will still be too high. In Guanajuato, we asked companies what they were given from the government: land and tax incentives. They did not think to ask about health. Getting the big employers onboard is a big part of the agenda and this will resonate when we hold events. Investment will come but states have to look at how to maximize that investment.

Q: A renegotiation of NAFTA is likely. What will AMIIF’s top priorities be?

Hemophilia research

A: We hear a di erent version every day, from modernization of NAFTA, which is something we want and that the government is clear about in its position, to removing it completely. Although we do not know what will happen, we are prepared for various scenarios. The chairman of GE was here in May 2017. He made it clear that NAFTA was very good and he said that the big employers need to start speaking up. I think they will start coming out and saying that yes there are areas for improvement but overall commerce is highly integrated. How can it be disintegrated? Impossible. The companies here have been present for many years and they will not go back. It the treaty collapses, we will not see major issues, unless a tax is imposed on imported products, but we do not think that will happen. Overall, NAFTA has been beneficial for all three countries and I am sure renegotiation will center on optimization and on areas that did not exist when it began, such as e-commerce.

Q: How does the Accelerated Access initiative decided in the WEF in Davos this year complement AMIIF’s 2024 vision?

A: This is a huge initiative. Top pharmaceutical companies are joining together to develop a common framework that will help patients and countries battling NCDs in low and middle income countries. The industry is talking about looking for a full, holistic approach to the health system, trying to find ways to make overall improvements and enabling medicines to patients. For example, 300 billion units of medicine are donated every year to Africa, but it lacks distribution infrastructure. What we are implementing in Mexico is already a step ahead of what my colleagues in other countries tell me.

Q: What will AMIIF focus on in 2017?

A: Our main focus is how we can grant greater access to more patients. We will be finalizing steps to attract more investment to clinical research, to keep working with COFEPRIS to continue improving timings and processes for approvals of new molecules and finally to maintain the current standards of IP protection.