Tuesday 20 February 2018

Medicines pricing deal with State was a tough pill to swallow, says the public face of big pharma

Pharmaceuticals president Dr Leisha Daly talks to Dearbhail McDonald about combining a career with family and why she's encouraging more girls to consider a career in the science sector

Dr Leisha Daly, Country Director of Janssen
Dr Leisha Daly, Country Director of Janssen

It's probably fair to say that there won't be too much public sympathy for some of the pharmaceutical companies nursing price cuts of up to 20pc on certain medicines following the completion of a new drug price deal between the State and the pharmaceutical industry.

The four-year Framework Agreement on the Supply and Pricing of Medicines, which will be renewed annually, was agreed last July between the State and the Irish Pharmaceutical Healthcare Association (IPHA) which represents most research-based pharma companies in Ireland including Pfizer, AstraZeneca, GSK and Janssen.

The new deal followed months of complex and at times torturous negotiations between IPHA and the State.

The latter dispatched a team of officials from the Department of Public Expenditure and Reform (DPER) to help the Department of Health and the HSE make inroads - under the explicit orders of the Troika - on Ireland's drugs bill which was around €1.7bn last year.

On the opposite side of the negotiating table was Dr Leisha Daly, country director of Janssen, the pharmaceutical subsidiary of Johnson and Johnson who this month completes a two-year term as IPHA president.

The sides are at odds on the actual savings to be delivered. The agreement, which does not deal with the generics market, will see medicines going off-patent losing their exclusivity, automatic rebates for HSE community schemes and publicly funded hospitals and the expansion of the 'reference basket' used to set prices from the current nine to 14 countries.

The use of list prices in the reference basket, in circumstances where companies negotiate individual deals on medicines with member states - including Ireland - has drawn a degree of scepticism.

But there's no doubt Ireland's drug spend trajectory is on the way down for now.

IPHA says its members will deliver €785m in savings by 2020 while the HSE says the savings will amount to €600m with cost savings generated elsewhere from non IPHA companies.

The €185m gulf in the projected savings and the manner in which the detailed breakdowns have been calculated will be probed by the public accounts committee (PAC).

But Daly insists that while feedback from some of its members has been 'very mixed' -including those companies dependent on older drugs which face a 50pc reduction in their original price once a patent expires - it is the best outcome for patients and taxpayers and will prioritise the funding of innovative new medicines.

"What was different from the last agreement was the fact that this time we had the Office of Public Procurement and the DPER around the table as well as the HSE and Department of Health," said the Laois native.

"We wanted a better system of getting medicines onto the market and a clearer system for reimbursement because we were struggling to get new drugs available for Irish patients. They [the State parties] certainly got what they wanted in terms of savings, which is very challenging for our members.

"We wanted a better system. That wasn't on the DPER's agenda, but in fairness to them, we went on that journey together. It took us a bit longer, but we got there in the end."

The completion of the drug pricing deal marks an important milestone on Daly's journey from a one-time aspiring flight attendant to one of the most prominent leaders in Ireland's highly competitive, and traditionally male-dominated, pharma sector.

Recently honoured as one of Ireland's top 25 most powerful women by the global Women's Executive Network (WXN), the married mother of two is also leading the charge to get more children, especially girls, interested in the science, technology, engineering and maths (STEM) subjects required to maintain the skillsets that make Ireland attractive for pharma companies.

"It starts with parents and it starts with primary schools," says Daly whose own love of science was nurtured by a primary school teacher who had an interest in nature.

"It was in primary school that that curiosity for science came through," recalls Daly who graduated with a PhD in Clinical Medicine from Trinity College in Dublin in 1989.

Daly worked for almost 10 years in clinical research, her curiosity in pharma piqued by representatives who visited the lab at Trinity.

Daly applied for a sales representative position with Hoescht Ireland, the German pharma company, but accepted a role as scientific adviser which the company had not yet advertised.

When she joined Janssen as head of medical affairs, Daly harboured a nascent idea that she one day might run the company, despite having no sales, management or corporate experience.

She knew she wanted the role but was unsure how to get there. But after a number of years, she asked her UK medical director if he would support her in an "alien" bid to manage a team of three sales representatives,.

It was only a request to manage three people, but for Daly, it was a big ask.

"Coming from a scientific background, we try things out and if the experiment doesn't work out, you try a different one," she explains following the launch of a new treatment for rare blood cancers that has just been made available to Irish patients by Jannsen.

"It's a much different story when you are given a sales target".

Daly's rise in the pharma sector, crossing the road less travelled from laboratory to boardroom, has in many ways been meteoric. But she is refreshingly honest about a lifelong struggle with self-belief. "I mightn't sound like it a lot of the time, but I have struggled with self-confidence all my life and I've really had to push myself to get to where I want to and push myself beyond my comfort zone," said Daly who has a son and daughter aged 17 and 18 contemplating their own future careers.

Daly, who had her first child at the age of 38 (her husband was 45) has huge sympathy for women trying to manage a career and childcare.

"I was back in work before anyone noticed I was gone," she says of her own, three-month maternity leaves. "I wholly support all of my colleagues who are having children, but I do encourage them to stay in touch in work when they are on maternity leave.

"If you are gone for a year, people can pass you out, particularly if you are gone for another year." At Janssen, Daly has overseen a flexible working policy for all staff and avails of the opportunity to buy five days holiday every year to facilitate her own family commitments.

"Flexible working is about trust at the end of the day, you have to build up that trust with people".

To young women making their way in the business world, Daly advises them to network and speak up, something she grappled with in the early part of her career, particularly when there was a majority of men around the table.

"That's not a criticism of men," she says, adding that there are many men around the table who struggle to be heard too.

"It's tough if you are the kind of person who reflects on what they are going to say or if you do say something, you are ignored. There are people that don't say very much but when they do speak, are worth listening to. We need to encourage those people to speak up more."

Corporate life is busy for Daly.

Janssen has just brought a new, three monthly injection for the treatment of schizophrenia to the market and has an "exciting" pipeline in the area of rheumatoid arthritis, oncology and haematology.

But she worries that Ireland will experience a skills shortage - Janssen currently has around 100 vacancies for engineers - unless children engage with STEM subjects.

Daly is reluctant to discuss whether issues arising from the controversial Apple tax ruling will affect big pharma here. "J&J has been in Ireland for 80 years, so it's not a newbie," she says of her own company adding that company specific issues such as tax are not discussed at the IPHA table.

"We do a lot more than make medicines, we need to change the conversation from the cost of medicines to the value of pharma," says Daly whose ambition is to deliver for patients. Having delivered for the industry, Daly can now comfortably work on completing that task.

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