Lilly’s president and general manager for its Italy hub, Huzur Devletsah, explains the company’s broad footprint in the country – where Lilly maintains a large manufacturing site that produces over half of their global insulin output and from which it oversees 28 countries. In addition, she comments on the upcoming changes to the Italian pharma landscape and how the organization plans to capitalize on its promising pipeline.

 

Huzur, having worked with Lilly for over 24 years, the last time you spoke to Pharmaboardroom was nearly ten years ago in Dubai! Where have you been since then?

As you may recall I joined Eli Lilly in 1998, on the same day I lost my father, who was suffering from complications related to his diabetes. Since then, I have spent more than 24 years working for a company that is trying to be part of the solution for diabetes patients across the world. My career in pharmaceuticals began in 1993 in Turkey, my home country, after finishing my chemistry degree and MBA.

The first roles I had within Lilly were on the commercial side, across marketing, sales, and corporate affairs; changing assignments and earning promotions before moving to the Middle East region as general manager, based in Dubai, where I remained for five years.

My first general manager role was followed by my first assignment at Lilly’s Indianapolis headquarters after being named head of strategy and operations for the Biomedicines business unit. From 2016 to 2018 I was responsible for the unit’s entire value chain, from research to global commercialization, designing the strategy for neurodegenerative diseases, immunology, and pain; it was a great development journey since it allowed me to gain experience across the entire pharmaceutical value chain.

I was also responsible for the business development parts of the business, which provided me with the opportunity to be involved with phase I-III acquisitions, either M&A or in-licensing agreements. During that time, I oversaw the commercial operations of Lilly Canada Biomed BU.

In March 2018, I moved to the international business unit in charge of the diabetes portfolio, where I worked for seven months before being promoted to my current role as president and general manager of Lilly Italy, Central Eastern Europe, Russia, CIS, and Israel. I am responsible for 28 countries, over one billion dollars in revenue, and 2,000 employees; it is Lilly’s third largest business outside the US and Japan.

 

Can you share the rationale behind grouping those 28 countries together and making Italy the hub?

The intention was to create strong synergies to accelerate the business in different countries with different needs. The Italy Hub cluster does combine a variety of zones with different opportunities and challenges. The core of this structure is Italy, a solid country with an established business that can function as a center of excellence for the other countries while at the same time benefiting from a positive cross-cultural influence.

Lilly Italy, founded 63 years ago, with more than 1300 employees throughout Italy, a constantly increasing turnover and more than about 600 million euros invested over the last 17 years, is a center of excellence from which surrounding countries gather best practices. The company has a large production site in Sesto Fiorentino, near Florence, that manufactures around 50 percent of Lilly’s global insulin, 45 percent of autoinjectors for a Type 2 Diabetes medicine and 90 million pre-filled syringes, benefiting approximately 6 million patients.

An FDA approved site, it exports 98 percent of its production to 70 European and non-European countries. The company has also been leveraging the great experience garnered at the Sesto biotechnology center to new manufacturing sites in places like China. Italy is, however, more than a great manufacturing destination, it is a country where Lilly continues to find great talents giving them opportunities to grow, develop and take leadership roles at home and abroad.

In addition to the insulin hub, Lilly has a research lab in Catania, Sicily, active in diabetes, osteoporosis and obesity, through which we have created a partnership with the University of Catania and the University of Rome that will continue until 2025; the research activities have been included in the framework of European funds and projects.

Moreover, we have the Eli Lilly Foundation present in Italy, founded in 2006, which supports research and contributes to defining paths and projects for the sustainability of the national health system, raising its quality level.

 

How would you describe the mandate given to you by the global organization?

“Take what you find here and make it better and better” is one of our Founder’s guiding principles that keeps inspiring Lilly Leaders. In this role, indeed, I am called on to lead and foster the organization through change, and it is vital to have the vision to do so. It’s my responsibility to provide the direction that drives the Italy Hub to function and grow.

The success of my organization will be guided by the priorities we define. I perform a thorough analysis of every area to set clear priorities for my team and I make sure my analysis is extensive and well explained. A clear vision with clear objectives to place the key bets are essential elements to manage a complex organization as the Italy Hub.

Our first goal is staying true to the mission of the company, continuously driving the improvement of patient outcomes; by the end of this year, we will be helping 4.4 million patients. To achieve that ambition, we must bring the company’s latest innovations to patients at the fastest speed possible while preparing for future launches; there will be a maximization of the portfolio in the coming years. It is a very exciting time for Lilly’s pipeline.

 

What are the current dynamics shaping the pharma market in Italy today, especially given the current government is committing EUR 32 billion to healthcare?

2022 marks the second full year of the COVID-19 pandemic, and it continues to dominate health systems’ attention and resources.

The pandemic has also decreased access to and demand for non-COVID-19-related medical care. Patients are postponing or forgoing a wide variety of services, including emergency treatment of acute conditions, routine check-ups, and recommended cancer screenings.

The long-term health effects from the failure to intervene early, lack of chronic disease management, and undiagnosed conditions will be significant.

However, despite COVID-19’s many devastating impacts, it does present the healthcare sector with a powerful opportunity to accelerate innovation and reinvent itself

From the perspective of the Italian market, we appreciate that the pharmaceutical industry has been fueled with additional resources through the 2022 national budget. Of course, there is still a need for reforms that go beyond cost containment to focus on value-based evaluations and improved access to treatments, something that has been mentioned by the Ministry of Health. The Italian pharma sector can flourish, achieving more than manufacturing capabilities, and establishing itself as an innovative sector with high economic, social, and strategic impact. From a multinational company perspective, the more political and economic certainty available in a country, the better its options to attract investment.

Overall, Italian institutions and government are doing a fantastic job.

Lilly just added employees in the country and will continue to do so in the future; we are also expanding our manufacturing capabilities with the help of local and regional authorities.

The expectation is that future provisions and legislation will acknowledge the industry’s request for new governance for the pharma sector, thereby ensuring that the best treatment options reach Italian patients equally, independent of the region in which they live.

We must look at this holistically; it is not just about the budget or political will. Different stakeholders must come together with a vision to reform the system and guarantee equal access; I cannot think of a reason why it cannot be done.

One solution lies in digital transformation and healthcare delivery model convergence—a trend that has accelerated during the pandemic. Social distancing measures have already forced many providers to employ virtual care technology for scheduled outpatient appointments. Hospitals and health systems will have to turn to cloud computing, 5G telecommunications, artificial intelligence (AI), and analytics to address current challenges and build digitally powered care delivery models for the Future of Health.

Digitalization can drive an unprecedented enhancement of the entire healthcare value chain. Virtual health can indeed increase the overall capacity of the healthcare system. Therefore, the definition of an adequate organizational and regulatory framework can facilitate a new healthcare era for Italy, especially for the adequate treatment and management of specific pathologies, like diabetes, with a consequent improvement in the quality of life of patients, more efficiency of treatment pathways and healthcare spending – a huge opportunity for the sustainability of our healthcare system.

During COVID-19, the Italian government did an excellent job in this regard, for example, boosting digital prescriptions and making telemedicine widely available. Those are big steps that were taken during an emergency and should not be stopped.

 

Having mentioned the wide range of Lilly’s pipeline, how does Italy fit within the regional clinical trials effort?

Eli Lilly aims to respond to the world’s most urgent medical needs, just as we demonstrated during the COVID-19 pandemic. In this period the company took a responsible approach, evidenced by the fact that Lilly was the first company to make monoclonal antibodies available for the treatment of COVID-19. We are now looking to leverage research efforts to improve our core therapeutic areas: diabetes, oncology, immunology, neurodegeneration, and pain.

The organization has constant and constructive dialogue with national institutions to find clinical trials opportunities, from phase I to III, in order to have a greater impact on Italian patients; the country is prioritized in every disease area. Italy is extensively involved in clinical trials and remains an important country for Lilly to engage in clinical development close to USD 20 million invested in R&D last year by Lilly in Italy. In terms of legislation, quality of centers and highly skilled investigators. Italy is extremely competitive, which is why I foresee further investment from Lilly in the future.

 

Last year, the world celebrated 100 years since the discovery of insulin. What does that mark mean to your organization and how do you foresee the future of diabetes care?

Eli Lilly’s heritage is diabetes, and the future will continue to be diabetes; we have been a global leader in this field since 1923, when we introduced the first commercial insulin to the world. Today, we are building on this heritage to meet the diverse needs of diabetes patients and those who care for them.

Through research and high-quality manufacturing, we strive to make life better for patients, offering a wide range of therapies, which are not limited to medicines but also technologies. Connected Care is the next phase of insulin management, it is patient-outcome-based, and we have made huge investments in the space. We are committed to bringing Connected Care to Italy and continue to research ways to improve current treatments that are not only about glycemic control but also the associated comorbidities.

The numbers are scary all around the world; Italy currently has around four million people with diabetes, a number that continues to grow. As I said, this disease requires holistic management because otherwise, the burden on healthcare systems will become too great. Additionally, the huge financial burden in diabetes is related to the management of its complications and not the cost of the medicine itself, making early diagnosis and treatment a priority.

We are currently planning new launches in Italy in this field; diabetes will continue to be a big part of our future and our company will continue to invest in the Diabetes pipeline.

 

What are your priorities in the upcoming years to continue driving the performance of the regional organization?

I am committed to fulfilling my mandate, which is making life better for about 4.4 million patients in the geographies covered by the Italy hub. Lilly enters 2022 with significant momentum after a successful 2021 and an unprecedentedly strong pipeline. We must prepare for the arrival of innovation that will address important unmet medical needs, Lilly has the fastest-growing portfolio in the pharma industry and a pipeline that is considered the most valuable in the sector by financial analysts. Our responsibility is to bring these innovative solutions to patients by executing the best strategy possible for each country, ultimately doing the right thing for our patients, customers, and employees.

I have a clear perspective on what an essential organization is, and I will lead my Hub to become a best practice on that.

Moreover, I believe it is more important than ever to build a truly diverse and inclusive organization. Therefore, I will keep acting with conviction and confidence to develop diverse talents that can contribute to creating an environment where people can unleash their full potential and thrive to contribute to our organization success.

I see a bright future ahead of us and I can rely on a highly competent and motivated team to shape the best version of it.