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Pedro Komatsudani

DOMINICAN REPUBLIC - Health & Education

Clinical Touch

Country Head, Novartis


Pedro Komatsudani has been with Novartis for the last eight years, and is currently Country Head of the Dominican Republic. Prior to joining the company, he worked for Actelion Pharmaceuticals and Eli Lilly & Co. He has a Degree in Business Administration from the Universidad de Lima and later obtained an MBA from Duke University.

"We promote our pharmaceuticals products through our sales representatives to physicians."

How does Novartis integrate research into its business model?

Novartis is the number two company in R&D spending in the world. We invest 21% of our pharmaceutical net revenue back into research. We believe that there are still unmet patient needs and things that we can do to make their lives better. That’s our contribution to society and that is what we look for in the future.

Do you carry out your R&D in the country?

We conduct clinical research around the world, and we currently have research running here in the Dominican Republic. We have around three clinical development projects going on right now. The reason for that is because you need to power the studies with a certain number of patients in order for the product to show effectiveness. Novartis needed to open up research bases, not only in Europe and the US, but elsewhere. We do research in Latin America, Eastern Europe, and Asia because it is important for us to continuously evaluate our treatments to ensure efficacy and safety in different types of races, genders, and age groups and ensure we are offering the right treatment to the right patient. At Novartis, we are looking for unmet needs in different areas, but we definitely believe that there is a need for more targeted treatments, so we are increasing our investments in specialty care while maintaining our interest in primary care. We continue researching in the cardiovascular arena, but we’re also focusing on harder-to-treat diseases such as rheumatoid arthritis, psoriatic arthritis, and other, less common diseases. There is an unmet need, and these patients suffer, so our mission is to find a treatment. We try to understand the biology of a disease and, once we understand what happens at that level, then we find the solution around a mechanism. We are trying to understand the root causes of diseases, so we can attack them. We conduct research in a different way, and that takes allows us to be a little narrower in focus.

“We promote our pharmaceuticals products through our sales representatives to physicians.”

The Caribbean region is increasing in health facilities and demographics. How does this affect your sales?

I think one of the most important things about the Dominican Republic is that there are about 10 million people here. As the economy progresses, people have more access to information, and as a result diagnostic standards improve, and the market expands. Our responsibility lies in terms of walking with that development. We work globally in different countries with different realities, and there are markets that advance faster than others. We use our experiences from these markets to help those that are less advanced. If we can contribute in terms of expanding people’s access to medicine, it can really make a difference. That involves continuous medical education because new therapeutic areas are being discovered, and we want to share our findings with physicians. We also believe it is important to collaborate with the Ministry of Health on health economics data as we believe that healthcare spending is an investment, not just a cost, and that health research offers a means to identify and demonstrate value. Medicine can prevent re-hospitalization, reduce the length of stay in hospitals, reduce additional care required by patients, or contribute to returning patients back to the workforce. For example, instead of providing a patient with life-long dialysis, the government should facilitate a transplant so the patient can come back to society with a better quality of life and begin to contribute again.

How do you educate public and private clinics directly?

We promote our pharmaceuticals products through our sales representatives to physicians. Our marketing promotion and sales activities are in compliance with high ethical standards to ensure the effective and appropriate use of our products and services by patients and healthcare professions. We also have a medical department that contributes with scientific knowledge through different activities such as congresses, forums, and clinical experiences.

How different is the Dominican Republic compared to other markets in which you’ve operated?

I have been on an international track for 17 years now. And, living in different cultures such as the US, Switzerland, Russia, Chile, Uruguay, and the Dominican Republic has widened my horizons. By understanding and absorbing each individual culture, it has allowed me to get a local buy-in and build rapport. This enables the company to win hearts, laying out a course of action and building excitement around it. Also, we have to realize that we are not all unique. The similarity involved in the challenges a medical sales representative faces in Moscow and in Santo Domingo is striking. People from the US and Central America can also be motivated in the same way.

Which line of products is growing the most in this market?

Our pharmaceutical division is our fastest growing as we are bringing in new products to the market. General medicine and oncology are our fastest-growing divisions, as opposed to over-the-counter, generics, or eye-care products. We will have completed 16 worldwide launches in the next three years in different disease areas, providing breakthrough medicine to a yet unsatisfied market in oncology, cardiology, respiratory, rheumatology, and dermatology.

Do you interact with insurance companies?

In terms of insurance companies in the Dominican Republic, the list of basic medicines has not been reviewed since 2006, so it’s quite outdated. If there is not a constant review, patients will not benefit from new and advanced therapies because they will not be covered. For example, from 2006 until today, Novartis has launched a number of products that are not covered.

What is your outlook for this market in the coming years?

I think we’re going through a transformation in this market and, as we develop as a country, the population should seek to satisfy the next level of their needs. The first priority is to expand access to quality products. It’s not just a matter of giving people a copy of the original because it’s cheaper; I think we need to give the right medicine to the right patient, ensuring efficacy, quality, and safety. Novartis is committed to R&D in treatments for patients with unmet medical needs. Sustainable access to medicine requires sufficient healthcare infrastructure, distribution, and financing. Governments play a principal role in addressing these problems. I believe the Dominican Republic has growth opportunities as it develops and modernizes its infrastructure and healthcare provision. For example, the government is doing a very good job to ensure the population has access to medicines through the Protegido Program, designed to help needy patients with high-cost treatment programs, including for transplants, renal insufficiency, hepatitis B and C, Crohn’s disease, rheumatoid arthritis, lupus, hormone therapy, and multiple sclerosis. This is a program that covers the diagnosis and treatment for patients and, depending on your socio-economic status, you can gain full coverage or partial coverage for your medicine. This country is blessed to have such a comprehensive program that helps the needy. Public-private partnerships (PPPs) are essential because we all contribute to benefit patients. For example, INDEN is an institution dedicated to treat diabetes as a whole, as it affects many organs in the long run. Its role is not just to cover interventions and treatments, but also to educate, prevent, and ensure long-term care for a successful outcome. This is where we become partners of value, because we offer education hand-in-hand with innovative medicines. It is also our interest to collaborate with the local health authorities to protect patients by establishing quality standards for the registration and approval of medications while maintaining good manufacturing and distribution practices.

© The Business Year – November 2013



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