Paolo Casati, general manager for Santen’s new affiliate in Italy, discusses the company’s first full year in the country, its aims for contributing to the global group’s 2020 Vision by collaborating with Italy’s extensive network of key opinion leaders, as well as his desire to see Santen’s innovative drugs brought to the Italian patients.
To start off, Santen opened its subsidiary here in Italy just last year. Could you start off by explaining the company’s strategic reasoning behind setting up operations in Italy in 2014?
Let me start from the global strategy which, for Santen, involves becoming one of the top three ophthalmology companies in the world by 2020 as part of our Vision 2020 objectives. That involves growing our international business so that 40%-50% of the company’s top line is coming from outside of Japan. So Europe, being the second-largest ophthalmic market globally, will be crucial in achieving that target. This meant we needed to expand our presence here and Italy is one of the top five markets in which we did not have direct operations at that time, so the country has an important role to play in meeting our objectives.
Italy is an attractive market for us as it is still growing. It is true that it is also a fragmented and highly competitive arena, however more importantly the country is eager for new drugs, has a strong community of ophthalmologists and a wealth of highly respected key opinion leaders. Finally, there are still unmet needs here which the future Santen portfolio will be able to address. All of this made Italy very attractive for Santen when evaluating locations for a commercial operation.
You are certainly no newcomer to the pharmaceutical industry, having worked for Alcon for 31 years, but what have your initial experience been from the perspective of a start-up?
I think that, looking back at this year, we have achieved a lot. When I joined Santen Italy we only had a salesforce of thirty-one reps coming from our acquisition of Merck’s ophthalmology business. We had to establish a new office and set up all processes and procedures, obviously in compliance with the Italian regulations, as well as a local strategy for growth.
Building the operation from scratch has been a very enjoyable experience for me, especially as part of a company which has such a clear vision focused on ophthalmology and the ability to adapt its Japanese heritage and values to work very well in different cultures. For example, all of the people in the organization are evaluated not only on the basis of their performance but also on how well they reflect the company’s values in their work and attitude towards the company, the ophthalmologist, their patients and the society. To see the affiliate expanding in the market, and achieving the goals we have set out is very rewarding, so I would say the experience has been extremely positive.
A dedicated and highly competent staff is of course crucial to success for any company, and especially one looking to quickly rise through the ranks in the market. How have you put together your team here in Italy, according to your needs as a new entry to the market?
A key aim for us when building our team in Italy is to maintain our flexibility by selecting only highly qualified talent for the positions we need. These are employees which we can then nurture and develop further over time. This makes the hiring process very important to us. We need people who can take full accountability for their projects and who are fully on-board with our vision and values.
The prescription of ophthalmic pharmaceuticals accounts for more than 80% of Santen’s global revenues, however the company is also active in the OTC segment. Are there plans to introduce these medicines to your Italian portfolio as well?
Not at the moment. Santen entered the Italian market being entirely focused on glaucoma. Our aim is to become one of the very top companies of reference in our area, not only in terms of revenues but especially in terms of relationships with KOLs and the scientific community as well. So one of the key points is expanding our Italian portfolio in a smart way. This involves first establishing a strong portfolio in ophthalmic pharmaceuticals as a foundation for the affiliate, and only after that looking at the introduction of a wider, more diversified portfolio over time. This is especially relevant as we have four new ophthalmic treatments arriving over the next few years, and three of those address unmet needs. We want to be fully dedicated to getting approval for those medicines as quickly as possible and developing them in Italy.
As you look to register these new medicines and get them approved for reimbursement, what is your market-access strategy as a recent arrival to the country?
For market access we work very closely with a consultant who has thirty-five years of experience in the field, in order to ensure a smooth process. From our side, it is first of all key to deliver a very solid dossier from the beginning, and to develop this together with the KOLs. Secondly we must be flexible in our dealing with AIFA and recognize their needs as well as our own, to find a win-win solution. An example of this is Ikervis, which is the only ciclosporin approved in Europe and represents a truly innovative drug for the treatment of keratitis in severe dry-eye. For its approval we are working on the basis of a budget-impact model, trying to be flexible in our negotiations with the government.
We have also entered into a discussion through Open-AIFA around using the 648-regulation to make our most innovative drugs available for the uncovered patients.
With growth returning to the wider economy, what potential do you see for Italy compared to the rest of Europe regarding the concrete contributions it can make to the company’s 2020 objectives?
Italy’s contribution will go beyond reaching revenue and growth targets. The large network of globally-recognized KOLs in Italy makes this a very good country from which contribute towards our objective of becoming a world-wide company of reference for ophthalmology.
As an affiliate we are an ideal position to excel in this regard as our pipeline of innovative drugs allows us to work together with these KOLs around late-stage clinical studies and the training of ophthalmologist. We also have a salesforce which has an average experience of twenty years in the market, and which has built up a network of solid relationships. This experience proliferates our affiliate, starting with myself, and including our medical manager who had previously been working with Allergan and has very well-established relationships in the country. Combining this experience with our portfolio, our investments in R&D and our pipeline of future drugs, I think we have a very good recipe for achieving this aim.
What advantages does being one of the few companies in the world specialized in ophthalmic pharmaceutical products give your operations in terms of recognition amongst healthcare providers?
Currently we are working to establish the brand of Santen. We have completed a customer survey in Italy which showed that most of the KOLs in Italy knew Santen before we arrived in the market. However, of the seven thousand ophthalmologists in the country not everyone knows Santen yet. This is why it is necessary for us to establish and reinforce our brand among ophthalmologists in the country by presenting Santen and the innovation we bring to the patients, as well as our desire to form partnerships with them to collaborate on this. This is very important to us, and our global specialization in ophthalmology does help in this.
How did the skills and experience you built up during your time at Alcon prepare you to start a new company for Santen here in Italy?
Firstly, it gave me a deep knowledge of the market and all that entails, including the personal relationships I have with many ophthalmologists and KOLs. Besides this, in my last two positions for Alcon, as business head of the Italian pharmaceutical unit and then head of salesforce effectiveness for Europe across all divisions, I gained experience that has proven to be very beneficial. Especially the international experience I built up, because leveraging the company’s global and European team is crucial when starting a new affiliate. This is two-sided in its advantages because first you gain a large pool of resources on which to draw, but you also bring the voice of the local affiliate and its needs to the global organization. Secondly, as head of salesforce effectiveness I built up the European team, including the training team, and this helped me know what it means to truly start from scratch. Finally, during my last three years at Alcon I also worked in the surgical segment, and as the ophthalmic community is very close-knit, this can be useful in understanding the relationships between different stakeholders in the market.
I would also say that working at Alcon’s headquarters has given me the ability to adapt to different cultures and to see the strengths new approaches can bring to an organization. Working at Santen this has proven to be very helpful, as the culture here is very different but if you have an open mind, it is very easy to understand it and see its benefits. It is a culture that places a lot of importance on human values and developing its people, which is something I very much agree with. The openness this company has towards the different cultures of the countries in which it operates is a great strength for the organization, which will certainly aid it in its aims.
As a young company with a bright future, what is your vision for the future?
It is to establish ourselves as a reference company for ophthalmology in Italy. In the next four years this will contribute significantly towards our overall 2020 Vision. Finally, we would like to be successful in bringing our most innovative treatments to the Italian patients, as this will truly help them live better lives. If we can be successful in these two areas, our future in Italy will indeed be bright.
