Q&A: Geno Germano - Pharmaceutical Executive

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Q&A: Geno Germano
Geno Germano, president of Pfizer's Specialty Care Business Unit, talks about how to win support in a sector that prizes connection with patients


Pharmaceutical Executive


The second is building a strong database around the economics of treatment, linked to health outcomes. For example, we have amassed evidence to show that early use of our lead inflammation product, the TNF inhibitor Enbrel, results in an approximately 50 percent rate of remission in patients with rheumatoid arthritis. Likewise, since the introduction of our best-in-class Prevnar vaccine, the incidence of pneumococcal disease caused by vaccine serotypes in children has dropped by 98 percent. Both demonstrate a significant public health outcome that payers can accept as providing real value for money.

The third is negotiating pricing and reimbursement models that allow for some flexibility in how others pay for our medicines. Strategies involve tier copay positioning, rebates, patient access programs, and conditional reimbursement. This moves us beyond traditional contracting models: the emphasis is on linking price and reimbursement decisions to care guidelines that produce better outcomes.

In this regard, one of our principal objectives is to relieve the growing burden on the patient in paying for the cost of specialty medicines. Insurers are targeting specialty drugs for higher tiered copays and co-insurance, a strategy that we believe is self-defeating as it can force patients of limited means to forgo therapy or skew adherence to recommended treatment. The result is medical complications that raise expenditures on other health services.

We are committed to reversing this cycle through initiatives like our Pfizer Bridge Program (PBP). The PBP works with patients to help them navigate the complex reimbursement thicket for growth hormone products, providing our medicines free-of-charge until insurance coverage is secured. It also includes coaching, education and survey work to identify patients most at risk for non-compliance, with follow-up counseling to ensure they stay on therapy.

PE: How do you know your customer-facing efforts are working?

GG: We employ a number of analytical tools to ensure we are fostering alignment around each of these customer-facing approaches. Our Medical Differentiation Index (MDI), a sophisticated modeling program, can quantify precisely where our potential offerings improve on the current standard of care and channel new sources of value to the customer. It integrates a vast stream of market statistics, observational data, and stakeholder analysis. We've found it useful in sharing our findings in negotiations with Health Technology Assessment authorities and other decision-makers.

PE: Where do you see the Specialty Care BU in two years? What are your key metrics for success?

GG: A strong platform for organic growth is the goal. That entails maintaining sales momentum for our in-line portfolio while ensuring registration and uptake of our Phase III pipeline, led by three leading edge therapies: Prevnar 13 and its expanded adult indication, which we hope to file later this year; tasocitinib, a JAK inhibitor and the next generation oral treatment for rheumatoid arthritis; and bapineuzemab, our collaboration with Janssen AI, which represents a potential first-in-class treatment for the underlying causes of Alzheimer's disease. Real progress here is essential to fill the gap from patent expiries, maturing life cycles, and concluding partnership deals affecting some of our other medicines.,

My other priority is more subjective. It involves closer integration of the Wyeth and Pfizer clinical development and commercial pathways to make Specialty Care a truly cohesive business unit. We want an engaged, high-performing workforce operating at the highest level of integrity in delivering consistent results to our customers and patients—and superior returns to shareholders. In two years, I can count on you seeing us as not just the biggest specialty company, but the best. And it will be our customers who say that, not us.

PE: What do you see as the primary obstacles to successful execution of this vision?

GG: Making sure that our growth does not impair flexibility, speed, and accountability in decision-making. Bigness must not obscure our "line of sight" in responding to the accelerating pace of change in the specialty drug market.


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