NextLevel Pharma’s Speaker Series: Sue Caleo-Naeyaert

As part of the upcoming NextLevel Pharma “Market Access in Key Asian Markets” event, the organizers have graciously connected AsiaHealthcareBlog with several of the industry experts who will be presenting and participating in panel discussions during the May 2012 event.  The first up in this series is Sue Caleo-Naeyaert, the Regional Pricing and Market Access Director for the Asia Pacific market at Merck Serono.

The Asia Pacific region poses a variety of interesting challenges for someone in Sue’s position.  The territory encompasses both developed and emerging countries, with widely ranging approaches to problems that vary in specifics, yet unite around a simple goal:  how to most cost effectively deliver healthcare to the people in these respective countries.

As Sue shared with me this week, Taiwan and South Korea remain the most advanced in her region (one that it should be noted does not include Japan for the purposes of how Merck has defined the area).  Of these two, South Korea is what she called the “most advanced” and Taiwan’s is the “most sensible.”  The latter because, in her estimation, it is the easiest to enter into a dialogue with and, of equal importance, their review process does not yet incorporate a mandatory economic review for drug reimbursement like South Korea’s does.

The national policies of both China and India pose, as Sue shared, very different challenges for a company like Merck.  India’s approach to pharmaceuticals is built around providing access to generic medicines.  China’s approach owes much to the Anhui pricing model and its provincial tender process for EDL and non-EDL drugs.  As Sue sees it, companies are having more success in China than India, a reality that is likely driving better improvements in access to life-saving drugs in China than India.

This having been said, China is not without its difficulties.  Sue commented that pharmas operating in China have to deal with, as she put it “so many levels of decision making”.  The fragmented nature of how healthcare decisions are made in China (or, it could be said, many policy-directed decisions made in the country beyond only healthcare) makes the role of having good people on the ground especially important.  One way to understand this challenge is to reflect on how health is financed in China, or as Sue put it, “who manages the budget?”

There are many government ministries and institutions involved in providing healthcare and health insurance that creates a highly fragmented and decentralized system.  Pricing decisions occur at the national level, provincial level and then hospital level, and different ministries have responsibilities for the budget and others for managing the drug lists.  Sue commented that this sort of fragmentation is something you see not just in identifying and managing the decision makers in China, but also in dealing with the disparate distribution channels of how a drug gets to the patient.

Among the trends that Sue is watching which will be a topic of conversation at the May NextLevel Pharma event is the role Health Technology Assessment or HCA plays in shaping the policies of governments in Southeast Asia.  This approach, which could ultimately mandate that a country’s reimbursement system must include economic evaluations to justify a drug being covered, is being explored by countries like Malaysia, Thailand and Vietnam and is likely to be a major trend companies like Merck will be watching over the course of the next several years.

Sue’s biography follows:

Sue has more than 18 years experience working in the field of health economics, and many years in a pricing and market access role. Sue began her working life as a community pharmacist but in 1993 decided to further her studies at the University of Sydney specialising in the area of health economics and working in academia. In 1998, she moved to Brussels, Belgium, because she was awarded a fellowship by the EORTC (European Organisation for Research and Treatment in Cancer) in the health economics of cancer. After a very rewarding experience, Sue moved back to Australia to begin her career in the pharmaceutical industry as a health economist with Janssen-Cilag. Following a few years of doing battle with the PBAC (Pharmaceutical Benefits Advisory Committee), Sue was finally attracted to go back to Belgium to work for Janssen Pharmaceutica in a Global Health Economics and Pricing role. Working with pre-launch and launched products over the next 5 years, Sue developed Global Value Dossiers and was in involved in managing a number of outcome studies. In 2009, Asia was calling, and Sue moved with Merck Serono to Singapore as their Regional Pricing and Market Access Director.