Specialty medicines are the mainstay of today's pharmaceutical pipeline, with companies betting big on prospects for a few
pearls to emerge from the sludgy drain of high costs, missed targets, and thwarted expectations. No other company is making
a bigger commitment to leadership in the specialty class than Pfizer, which is managing a diverse portfolio of biologics and
vaccines through a uniquely autonomous business unit (BU) structure that many regard as the organizational equivalent of targeted
To explore the Pfizer strategy in detail, Pharm Exec sat down with the Specialty Care Business Unit's President and General
Manager, Geno Germano. A pharmacist by background, Germano, 49, is an import from Wyeth, where he ran the US pharmaceuticals
business from 2007 until the merger. What follows is a conversation covering the complexities and emerging challenges of building
a successful franchise in this still lucrative—but increasingly crowded—sector. Will Pfizer's sheer size trump the competition
and win critical provider and payer support in a line of business that prizes niche-driven focus and an intimate connection
to the patient?
—William Looney, Editor-in-Chief
Pharm Exec: Let's begin with an overview of the business segment you are vying to serve. In a word, what's so special about specialty
Geno Germano: Because of the broad diversity within the category, it is difficult to provide one simple definition. Commonalities across
Specialty Care typically include medicines that are innovative, sometimes difficult to manufacture and possess clinical profiles
of high value to small, but well differentiated customer bases, such as hemophilia or kidney transplant patients. But we also
have large customer bases as with our psychiatry and ophthalmology businesses. Leveraging the therapeutic assets of these
medicines depends on extensive commitments to clinical exploration, strong, field-based medical support, well trained and
knowledgeable sales capabilities and sophisticated deployment of evidence and outcomes data. The entry hurdles are high, often
requiring extensive investments in complex biologic manufacturing processes and expertise working with targeted distribution
channels. It is also critical that we be deeply engaged with physicians, many of whom dispense our medicines directly to patients,
and that we demonstrate a strong commitment to patient education and support.
PE: How well is Pfizer positioned to compete in this segment?
GG: Specialty connotes an image of smallness but the skills and resources required to compete successfully in this segment are
actually quite significant. Size and scale count, and Pfizer has these assets in abundance. The combination with Wyeth moves
us from number five in revenues in this category to number one. The Specialty Care BU is itself a $15 billion business; standing
alone, we'd rank 15th in the league table of the Big Pharma top 20. The combination with Wyeth has already helped us achieve
an 84 percent boost in revenues on a year on year basis, reflecting the impact of leading-edge therapies like Enbrel for the
treatment of rheumatoid arthritis and psoriasis, and Prevnar for the prevention of pneumococcal disease. And assuming expansion
of our pipeline, we are poised for further growth.
PE: What about the reputational pressures associated with the high price of specialty products? Is it fair to state that specialty
is a litmus test for how society supports innovation?
GG: The factors I mentioned do add to the cost base, so specialty medicines are frequently priced at a premium compared to other
drugs. Nevertheless, specialty medicines have traditionally been seen as an enormous driver of benefit to the healthcare system
because of the therapy options they provide for patients with life-threatening conditions, where there are few other treatments.
This rich vein of value—still largely untapped—is a distinctive characteristic of the specialty class that Pfizer is putting
front and center as we develop the business.