PICTURE this: You are headed to Beijing for work or for leisure. Before you arrive, you will have taken preventive medications to protect your health against pollution. When you leave the city to fly home to Singapore, you will then have popped another pill that can ward off infectious diseases like bird flu. Raman Singh, president of Swiss pharmaceutical group Mundipharma for the Asia-Pacific, Latin America, the Middle East and Africa, believes it is only a matter of time before this healthcare scenario becomes an everyday reality.
Dapper in a grey tailored suit, with slicked back hair, the 46-year-old describes a future when consumers will be able to get their hands on tailor-made medicine, and not have to take a cocktail of drugs for various conditions, and when there will be a central medical database that can directly connect healthcare companies and drug makers to patients.
This, says the CEO, will be where the true value of medicine emerges – when people around the world fall sick a lot less often, and live longer and happier with preventive products readily available. The picture he paints is one that will be brought about by “the big disruption in the healthcare space”, and even though “tremendous progress” has been made so far, the road ahead is still a long one. “It’s highly-regulated, it’s data-driven, you just can’t have medications approved without having enough information for regulators,” he says of the pharmaceutical industry, pointing out that “we haven’t seen much progress in the digital space by healthcare companies”.
Pharma companies are typically protective of their research and products, these being the jewels in their crowns, so he agrees that for significant progress to be made, there must be greater collective effort – among not only the major companies but also with regulators – to jointly embrace technology and to innovate.
An American citizen, Mr Singh grew up in the United States wanting initially to perhaps become a Silicon Valley techie, and so took a degree in mechanical engineering at Arizona State University. Instead, campus recruitment led him overseas to a job as a shift engineer in a factory in Thailand making surgical gloves – and eventually to the
pharma industry. Now, as someone who has built his career in the sector – he had been with three other drug companies before joining Mundipharma in 2011 – he is acutely aware of the reality that industry players that fail to innovate will be left behind, and “somebody will do it for us”.
The silver lining is – the healthcare, and notably pharmaceutical, space is indeed beginning to see “open innovation”, where companies share data so that others do not make the same mistake, he says. “For the first time they are sharing information about trials they have done, that have failed, that can enable innovation to come. Also, what pharmaceutical companies are doing now is that they’re collaborating with a lot of startups rather than building everything in-house, and that, again, enhances innovation. And we’re doing the same.”
Mundipharma – one of the world’s largest privately-owned pharma companies – decided a few years ago, as part of a bigger strategy on innovation, to hire from the tech world. That gamble seems to have paid off. Sales representatives peddling the company’s respiratory product Flutiform can now employ virtual reality, using a Google Cardboard (or similar) headset, to walk physicians through what the drug does exactly inside the airways.
Mr Singh explains: “So you can actually see how the drug behaves versus the competition and that helps us to explain to the physician a lot better rather than just ‘this is how it might work’. And then what we’ve done for consumers and patients is we’ve got an app that uses the lens to tell them how to use the device. So it measures your face and it actually tells you this is how you need to put (on) the device so the drug deposits in your body the right way and if you don’t do it appropriately, you won’t get the full benefits.”
So far, the VR headsets are in use in Hong Kong and the Middle East, and will be handed out to the sales team in the markets where the product receives approval. Singapore regulators, says Mr
Singh, have given the green light for the product.
More broadly, the use of technology promises to improve the way patients are assessed in terms of, for instance, their pain levels. Typically, pain is measured on a scale of 1 (barely feel it) to 10 (unbearable).
“Based on what the individual is able to perform on a daily basis, one then understands what level of pain that person is going through. And again, Big Data then plays a huge role there,
where every day, millions of activities from waking up to coming down the stairs to eating food to driving a car – all of these get monitored and the impact of medication is actually seen,
whether the individual is able to lead a quality life, rather than the very subjective ‘is it working or it’s not’,” says Mr Singh.
Mundipharma, whose roots are in pain management, splits its global business into three regions – the United States, Europe and the rest of the world – with each area run by a president. The three entities are associated but operate separately.
Little is known about the family-owned group that was founded in 1957 in Switzerland and subsequently expanded its operations to the United Kingdom in 1966 and later to Australia and Asia. In 1991, it opened its Japan office and two years later started operations in China, before setting up in South Korea in 1998.
The Singapore regional office, which takes charge of the emerging markets, was set up in 2004. Just last May, Mundipharma announced that it would invest S$100 million in Singapore over five years. It said then that a portion of the funds would go into setting up a facility to make and distribute Betadine antiseptics as well as conduct research and development (R&D). The
Tuas plant – its first facility manufacturing consumer and over-the-counter (OTC) products and the largest for Betadine – is expected to be ready by January 2018.
Under Mr Singh’s watch, Mundipharma has seen rapid expansion. It launched operations in Indonesia, Hong Kong, Thailand, Vietnam and Taiwan in 2012. The next year, operations in Latin America, the Middle East and North Africa began, with regional offices set up in Brazil and Dubai. In 2014, it spread its wings to Mexico and Egypt, before venturing into Lebanon in 2015.
In 2016 alone, he completed 15 business development deals, growing the drugmaker’s offerings to 40 in six therapeutic areas – analgesia, oncology, oncology supportive care, ophthalmology, respiratory and consumer health.
Mr Singh does not disclose much about the company’s financials beyond saying that the markets under his purview have grown “north of 40 per cent in the last five years”. In 2011, when he came on board, revenue for his regions amounted to US$65 million, he says, and this year, “we will be very close to US$750 million”.
He has set his sights on hitting the US$1 billion revenue mark in 2018. Worldwide, the company has presence in about 160 markets and employs 5,000 staff.
According to Mr Singh, Mundipharma’s timeline can be marked by “pre-2011” and “post-2011 phases.
“Until 2011, the company was primarily dominated in the developed world – the US, the developed part of Europe and parts of Asia like Singapore, Australia and Korea.
Post-2011 (after I came in), I was from GlaxoSmithKline working for a similar region and that’s the time they recruited me, wanting me to come in and expand their operations in this part of the world, including the Middle East, Africa and Latin America. And post-2011, we have not only expanded geographically but also from a portfolio standpoint, (we have) diversified our businesses.”
Today, the emerging markets portfolio makes up about one quarter of the group’s global business; by 2020, it will become the biggest contributor by region, he says.
The growth trajectory is promising but headwinds remain.
To counter the problem of patent cliff – when revenue plunges as key products go off-patent – Mundipharma is actively diversifying its product portfolio. The company has done “almost 40 different deals in the last five years” and is now looking at at least six or seven new deals, says Mr Singh, who professes to preferring inorganic acquisitions.
High costs or low?
Mundipharma also develops medicines for specific parts of the world – Betadine, for instance, is available only in the emerging markets. This brings up the related issue of differentiated pricing for different markets – the same pill could cost astronomically more in the US than, say, in India – and raises the question whether patients in developed countries are penalised for higher standards of living.
But Mr Singh begs to differ.“The analogy I would give you is: even among taxpayers, people who earn more pay more in taxes. Now, you could say it’s right or it’s wrong, but it’s similar – you’re living in a world where nations that are richer have an obligation to (help) countries that are not well-off… Is it fair or unfair, I mean, that’s debatable.”
Wealthier countries are also pushing back on drug costs as pressure mounts on governments around the world to keep a lid on escalating healthcare budgets, he adds quickly.
That explains why in recent years, various governments have pushed drugmakers, already coping with slower growth and rising costs, to deliver value to patients. For example, British drug maker GSK has come up with a proposal to calculate the value of a drug and prove that it is value for money, while health officials in the city of Manchester wants to pay pharma companies for medicines according to drug efficacy.
“What Manchester is doing is more of a pilot. We’ll see how it works but I think there needs to be a dialogue between the regulators and the companies. Nobody can work in isolation and I
think it’s very promising to see that that’s now happening more proactively rather than reactively,” says Mr Singh. Different pricing mechanisms are used by different countries. In Australia, for example, drug prices are tied to the number of patients. Pricing is “more brutal” in Korea, which has its own formula to drive down costs. Similarly, Japan which “historically used to be very, very good on drug pricing” given that it prizes innovation, has started to mandate price discounts in the last couple of years.
Profit is a sensitive topic in the pharma industry and one that is, according to Mr Singh, “debatable”. “It’s subjective – what is a lot or what is minimal – because for any industry to
thrive on innovation, to constantly put their dollars in R&D to develop newer products, you need to make money to put it back.
“Now, what one fails to understand is that the regulatory hurdles have really gone up in terms of getting a product approved because there’s a lot of data that regulators like the FDA (Food and Drug Administration) in the US or European regulatory bodies need, to justify (that) this drug really works and hence, that costs a lot of money.”
The cost of an approved drug can run up to US$1 billion, he says, adding that in the journey of developing a drug that works, “most of the drugs fail”. “So, to get a drug to the market that’s
actually approvable and that you can charge, (could cost) as much as a billion dollars.”
Like performance on steroids, Mundipharma’s growth story has been phenomenal. Asked if the company is on track to achieving his target, Mr Singh says he is “hopeful”, but not before briefly showing slight hesitation, reflecting perhaps his “constant healthy paranoia that things will go wrong”, which he says keeps him awake.
The paranoia produces doggedness, he says, and in fact “forces us to keep finding the next right answer”.
Looking back on his decision to join Mundipharma after stints at Bayer, Abbott and GSK, he says: “It was a white canvas and I felt I could really make a difference for people, for myself,
for the company. It was just a huge opportunity for me that I could actually build something.”
Along with his role as a leader, the self-described risk taker wants to preserve his team’s entrepreneurial spirit.
“I think one of the big strengths of this organisation is we just don’t give up easily, we push boundaries. It’s where people say: Do you think in the box? Should you think outside the box? I
say, you should think without the box. We’ve created an organisation where walls cease to exist; it’s a boundary-less organisation.”
President, Asia-Pacific, Latin America, the Middle East and Africa
Born in 1971
BS in mechanical engineering, Arizona State University EMBA, Thunderbird School of Global Management, Arizona State University MBA, Assumption University, Thailand
Started as an engineer with Ansell in Thailand 1999-2004 Director, global strategic marketing, Bayer 2004-2005 Director, Antivirals, Abbott 2005-2007: General manager, Korea, Abbott 2007-2008: Area head and general manager, Australia, New Zealand & Pacific Islands, Abbott 2008-2011 Vice-president, commercial operations for emerging markets and Asia-Pacific, GlaxoSmithKline Since Oct 2011 President, Asia-Pacific, Latin America, the Middle East and Africa, Mundipharma
Named in Pharma Voice’s Top 100 Inspiring People 2014
Ranked 6th in the Medicine Maker Power List 2015
Ranked 4th in the Medicine Maker Power List 2016
Asia Healthcare Excellence Awards’ CEO of the Year 2016
BY CLAIRE HUANG