Next year Bergström must tackle the sensitive challenge of finding a new president for EFPIA. The term of office of Andrew
Witty has been extended until 2013, and he will be a hard act to follow. Bergström observes that it is not uniquely his job
to choose the next president, and that he is "in conversation" with several CEOs on the subject. Being president is, he recognizes,
a demanding role, and he does not expect to be flooded with candidates. "The job of a president demands a degree of faith
in the idea of Europe and the corporate culture from company to company dictates how far individuals are prepared to engage
in European questions."
To prepare for the changeover, he is rejigging the 30-strong team he inherited in the EFPIA office, with some abrupt changes
and reallocation of responsibilities that will likely require additional fine-tuning. He has established the equivalent of
an inside kitchen cabinet, in which Thomas Cueni, the accomplished power broker with CEOs and long-standing head of the Swiss
industry association, carries the title of 'special adviser to the EFPIA director-general.' Among staff, there is respect
for his energy and ambition—many find it hard to keep up with him; it is even harder to get face time because of the incessant
travel. Member company committee members find his direct, "why not?" approach refreshing, even if it occasionally provokes
criticisms that he is too out in front of the process. It is accepted that his readiness to engage has created a positive
impression among many of the groups that EFPIA deals with in the healthcare sector and beyond—the challenge is that, for them,
access must have its deliverables.
In fact, although most of Bergström's areas of concern are familiar to those who know the industry, his approach can take
a distinctly unconventional path. For instance, his determination to see resources for innovation maximized leads him to take
a very distinctive position on IP protection. Patents have a role in stimulating development—but "we also face the fact that
when they expire we are not going to make any more money." So, once products are off-patent "we should try to maximize the
benefits of low prices of generics as quickly as possible and with as many products as possible." He adds, contentiously,
"on that point, we don't say enough from my industry." Indeed, his focus on finding money for innovation by making bigger
savings on off-patent medicines does not go down well with all the companies that EFPIA represents, many of whom operate in
a business environment that still seeks a premium from branded off-patent drugs. It is just one example of the areas where
his outspoken, "tell-it-like-it-is" approach can ruffle feathers rather than smooth them.
Bergström responds squarely: "I'm not a bullshit merchant. I know my facts and I speak directly to my audience rather than
reading from a sheet of pre-fabricated principles." His impatience with outdated formulaic approaches to pharma policy is
Put pricing first!
His priorities for next year include driving the science agenda, and winning greater support for innovation through flexible
regulation (particularly a more transitional, evolutive approach to product authorizations) and better reimbursement based
on good evidence and more sophisticated HTA. At the same time, he will keep delivering on his trust agenda and disclosure.
And in hard business terms he wants to see a growth agenda for Europe based on developing conducive trade and industrial policies
(and not, he insists, by convening more of the roundtables so beloved of EU officials). Above all, he wants "straight talk
about the real issues on pricing"—which for him means recognition of the need for differential prices to protect the EU market
as a whole from the impact of Greece and other countries with knockdown prices.
That's an ambitious agenda. Small wonder that he admits that he no longer has time for hobbies—although he runs as often as
time permits. "I worship the sun, and fortunately so do my wife and my three daughters, so we try to get some every season."
It will be a still bigger challenge for him to engineer the European operating context so that drug firms there get the chance
of a bit more sunshine too.
Peter O'Donnell is a freelance journalist who specializes in European health affairs and is based in Brussels, Belgium.