Lilly Saudi Arabia’s Dimitri Livadas shares some of the misconceptions he had before moving to the Kingdom a couple of years ago, highlights the evolution of the Saudi healthcare system with its current focus on digital health, the big opportunities for the Indiana-based company’s diabetes portfolio at a moment when the world celebrates 100 years of the discovery of insulin, a peptide hormone first commercialized by Eli Lilly in 1923.

 

Can you begin by introducing your career within Lilly and your transition from Japan, which is the third-largest market in the world, to Saudi Arabia?

I started my journey with Lilly 13 years ago back in Japan working on digital marketing, something new at the time. Reflecting on the past, Lilly gave me the opportunity to serve in different roles and therapeutic areas; I have been active in neuroscience and diabetes in a number of geographies, from Japan to the United States and now the Middle East. It is a testament to the way Lilly operates because the company is committed to talent development where a career grows through sustained performance over time.

 

What were your first impressions upon taking the helm of Lilly Saudi and define your current assignment with the affiliate?

Having never been to the Middle East prior to accepting the Saudi assignment, I took the position believing it would not be an easy task given the perception reflected in foreign media. But to my surprise, the reality on the ground could not be more different: it is a genuinely beautiful country, and the people are truly amazing. There is a level of positive energy that I have not seen in any other place around the world. Vision 2030 is compelling, giving clarity on the common objectives and the rapid transformation is a once in a lifetime opportunity.

Diabetes is our most important therapeutic area given the prevalence of the disease in the Kingdom, and therefore helping patients with Diabetes is a priority for me. I came in 2018 just when the Saudization strategy had been announced so it was a matter of rebuilding a company that was already up and running from the ground up while generating growth at an uncertain time. We had to carefully rethink our approach to recruitment, engagement, and retention of professionals.

More than short- to mid-term growth objectives, our focus was on putting the right people in the right place and building a culture that would ensure sustained performance over time.

Lilly Saudi Arabia Ltd. is the largest standalone affiliate within Lilly’s SAMETA (South Asia, Middle East, Turkey & Africa) region.

We are committed to a future in, with, and for Saudi. Because of that, becoming one of the first pharma companies to establish a fully owned legal entity was a logical step back in 2018. Recently, we also became the first pharma company to sign a MoU with the Ministry of Investment to establish new regional headquarters in Riyadh.

 

Can the country really succeed in attracting regional headquarters for pharma companies which tend to look for favourable tax conditions, agility, access to talent and mobility?

Accessibility, transportation, infrastructure, environment, and taxation all matter and are quickly improving, and the commitment of the local authorities to make that transition and the speed of work is impressive. Today, the reality on the ground, both in terms of talent and the environment required, is more than sufficient to make Saudi Arabia and Riyadh a serious consideration in the industry’s decisions.

 

Vision 2030 places a great emphasis on local manufacturing, but clearly companies like Lilly cannot have a production plant in every market in which they are present, what has been the company’s approach?

When analyzing our industry, it is important to differentiate between innovators and generics manufacturers. Separating those two categories in Saudi, it becomes clear that the priorities of innovator companies such as Lilly are very much aligned with Vision 2030’s objective of transforming the Kingdom into a knowledge-based economy.

Generics manufacturers are about production, whereas innovators are focused on R&D where the investment is much more significant. Since 2017, Lilly conducted about 10 Phase III and Phase IV studies in the Kingdom. The Kingdom has the essentials to succeed in this area with its skilled clinical professionals and strong healthcare infrastructure. This is why Lilly, along with other stakeholders, has been working with the Ministry of Investment to establish a Clinical Trials Coalition aiming to strengthen the environment in the country.

In 2019 around 4.3 million patients benefited from the innovative medicines brought to market by innovation-driven pharmaceutical companies, a very significant number. Moving to investment, innovators made direct investments in excess of SAR 2 billion during the 2014-2019 period to foster the country’s knowledge-based economy.

Based on IQVIA data, there were 192 innovative medicines launched in Saudi Arabia during that same period, compared to 270 in the UK, 275 in Germany, and 309 in the US. The United States had over 30 percent more innovation getting to patients. There is an opportunity to close that gap, but we have to look at a few things, there needs to be headroom to reward innovation, we need to accelerate access to patients in the public sector following Saudi FDA approval of medicines, and there needs to be an environment where intellectual property (IP) is fully protected.

 

Moving to your therapeutic areas, what are the current priorities for Saudi Arabia, especially considering the high prevalence of diabetes in the country?

Lilly focuses on the most serious debilitating chronic health issues such as diabetes, cancer, autoimmune, chronic pain, and Alzheimer’s. We have a heritage in diabetes and, in fact, are celebrating 100 years since the discovery of insulin as the first company in the world to commercialize insulin in 1923. The amount of innovation coming out of diabetes, which includes both medicine and beyond-the-medicine technology-enabled solutions, is exciting to see. There is a clear opportunity to drive better patient outcomes given the high prevalence in Saudi, and we will have solutions to leverage technology to help patients take the right dose at the right time.

 

What is your view on the role of NUPCO in the revamped and centralized procurement process for pharmaceuticals?

It has been impressive to see the level of unification and transparency that NUPCO has been able to bring, something that not necessarily existed before. The establishment of NUPCO addresses some of the pain points caused by the level of fragmentation in the public sector. NUPCO is a professional supply chain organization and is very well positioned to drive greater efficiencies while ensuring availability for patients.

An important pillar of Vision 2030 and the transformation of the healthcare sector is digital health. The authorities are committed to digitizing their engagement, from telehealth to e-prescriptions, which is opportune as technology today allows for that while being cost-effective at scale.

 

How challenging has the requirement to nationalize the majority of your workforce been?

As I said, Saudization was the first thing on my plate after landing in 2018. We did not look at it as a problem, we saw it as an opportunity, embracing it from the beginning. We only had eight percent Saudi nationals when we started that effort almost three years ago and our team was predominantly made by men. Today, we have more than 70 percent Saudi nationals of which more than half are women, and three quarters are millennials.

Our recruiting strategy has been recruiting predominantly off campus.

The biggest surprise for me was that the talent in Saudi Arabia is absolutely world-class; they are highly educated and extremely hard-working. They have a high sense of purpose, and are very engaged. I expect and predict that soon the Lilly Saudi affiliate will become an exporter of talent to other Lilly affiliates around the world.

I can provide an example of how Lilly is approaching its own organization in terms of maximizing the use of local professionals. Because of the 2019 establishment of the legal entity’s articles of association, we appointed a board of directors which previously was only occupied by non-Saudis. We appointed Dr Mustafa Al Jawadi and Dr Ahmed J. Al Buraidi as members so we could have the representation of very seasoned Saudi executives. We were also very proud to bring not only one of the first highly qualified Saudi physician on board as a medical director, but also one of the first women, Dr Mona Obaid.

The perception of Lilly as more than a commercial organization has put us in a unique position to be able to attract professionals. People want to join us because we do not take shortcuts, we want the right person on board, and we will help develop them to maximize their career opportunities.

 

How do you foresee the Saudi healthcare market evolving and the place that Lilly will have shaping the healthcare system as it moves towards Vision 2030’s national transformation?

To Lilly, Saudi Arabia might be one of the key focus areas because we believe in its potential and the value our therapies can bring to the population. We encourage and welcome the authorities’ actions to create a stable and predictable business environment.

The way the country has approached COVID-19 was impressive and reflects the capacity to react to challenging situations. The Saudi FDA, Ministry of Health, Ministry of Investment, NUPCO and all other stakeholders are essential partners to bring innovation to the patients who need it.

The key element in this situation is to establish trust, I want to ensure that the authorities look at Lilly as a trusted and reliable partner in the healthcare system.