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In a rare interview, the head of Anglo- Swedish pharmaceutical company Astra Zeneca, Pascal Soriot, gives his personal view on the company's plan to increase sales with more than 30 percent in just a few years, on what might happen to the company if it doesn´t manage to develop new state-of-the-art cancer medicines and on his rough childhood.
How long will you stay around?
RESPONDENT, PASCAL SORIOT: As long as it takes.
PS: Four years, time flies.
But you know if you look at it in our industry the cycles are quite long.
I can see the other side of the river now.
So we are half way through this journey on.
Where is home for you?
Is that Australia or France or?
PS: Three times a year only.
CF: You have a daughter and a son?
PS: Yeah, they both live in Australia, and my wife spends four months a year in Australia.
But I travel a lot and I miss my grandson.
CF: What do your children do?
Are they in the pharmaceutical industry?
PS: No, no they are not, no they are not.
CF: Is your wife in the pharmaceutical industry?
PS: No, no my wife is not.
CF: How old is your grandson?
CF: Does he play football?
He plays cricket, he plays tennis.
CF: Where do they live?
PS:They live in Sydney.
Actually Swedes and Australians are a bit the same.
There are no surfing opportunities here.
PS: But you have skiing opportunites.
Different sports, different climates, similar lifestyle.
CF: I read you consider yourself as an adopted Australian?
CF: Do you surf?
PS: I do a little bit, but my son is a big surfer.
My son loves surfing.
I love bike riding more than surfing I have to admit.
My sport is bike riding.
CF: What kind of bike do you have?
PS: I have a road bike.
I have a Cannondale.
CF: At what weight?
PS: Six and a half kilos.
CF: Where do you use it?
PS: At the weekend, every weekend I try to go biking.
PS: Sometimes in Cambridge, sometimes I go to the Swiss Alps.
I have several bikes.
I have one in the Alps, I have one in the US and I have one in Cambridge.
CF: I read in the Financial Times that you had a tough childhood in the "banlieue"?
CF: Which suburb was that?
PS: It was in the northern part of Paris.
My parents lived in an area with high rise buildings.
I had a pretty, I mean rough time.
CF: What were the fights about?
PS: Oh, kids fights, physical fights, you know … CF:Fist fights?
PS: I know, I know.
My son had zero fist fights.
My son never fought.
I think about it often.
My son never had a single fist fight in his whole life, and I had so many.
Until I was 18 and then I went to university and never had one after that.
Before that I had many.
I was fighting for myself you know.
CF:Was it in gangs?
I mean there were gangs, but I was in a team of people.
I mean you know this is how it is in this "banlieue".
I mean you have your territory and you have to defend it.
But what you learn is … you learn the team spirit.
You need to stand up for yourself.
You need to learn.
You learn to stand up for your friends and your team.
CF:You had a management meeting here yesterday.
PS: Well, I come here a few times a year.
But I did a few things.
We had … the whole executive committee met here.
So we meet in China, we meet in the US, we meet in the UK.
We meet here, so that was one goal to bring my leadership team here.
Two years ago Two.
We had a town hall with the people who are here on site.
And you know, answer their questions, because they have questions.
We have a few other objectives, like meeting you and you know … PHOTOGRAPHER, SÖREN HÅKANLIND: About the photos, is it okay to shoot all the time.
PS: Yeah, yeah you tell me.
PS: A little bit of both, I mean a scientist to start with.
But you know, in our industry it starts with good science, to produce good medicines.
But then you have to make sure you bring them to as many patients as possible, so marketing is also important.
I give you an example.
We have just launched a new drug for cancer.
For a specific type of cancer, lung cancer with a so-called Eg5EGFR-mutation and patients have a cricket session betting rules resistance to that mutation.
To treat patients you have to diagnose them.
And so for instance making sure we educate physicians so that every patient is tested is part of marketing.
CF: I have read that you love learning in the laboratories, is that true?
PS: Well the "New Astra Zeneca" is the company that is emerging after we finish with our patent expiries.
You know, Astra Zeneca many years ago invented several very important medicines, Crestor, Nexium which was invented here also, Seroquel was invented in Sweden actually, and a few other products.
And these products lost patent protection over the last three years.
So to give you an idea, in 2011 out of 30 billion dollars of sales, we had almost 20 billion coming from products, that are losing patent protection.
CF: These years now?
In fact the 20 billion are becoming two, two and a half billion by 2018.
So we will have lost 17 billion of sales to patent expiries.
This is what I call the "New Astra Zeneca", the innovative Astra Zeneca that is launching new products, and will have no patent expiry until 2024.
PS: Basically we are finished with our patent expiries by 2018, early 2018.
And cricket session betting rules we have no patent expiry until 2025 almost, 2024.
Until then no patent expiry.
CF: I come back to these questions.
PS: Well, you know, I think in this world, we are all global citizens, and companies are global companies.
We are a global company, but you need to remember your roots.
She is based here also.
And the Head of Research for Cardiovascular diseases is also here.
The Head of Research for Respiratory diseases is also here.
And also we have quite a number of senior leaders based here.
CF: But having the top management in Sweden and in Cambridge and elsewhere … is that a strategic advantage?
PS: Yeah, basically we are based on three main sites.
One is Gothenburg, one is Cambridge, and the last one is Gaithersburg in the US near Washington.
Those are the three main sites.
And our leadership team is spread across those three sites.
CF: How do you run the company?
PS: Well, actually we run the company by, you know, we have basically concentrated the global teams in Sweden and in Cambridge for cardiovascular and respiratory diseases.
And so we are running Cambridge and Gothenburg as if they were integrated.
We have an Astra Zeneca flight that goes back and forth every day between Gothenburg and Cambridge airport.
And for oncology they are concentrated in the US and in Cambridge.
And for the leadership team we use technology.
We use tele-presence, We have a tremendous network of video conferences and tele-presences.
CF: How often do you meet as you did yesterday?
PS: I meet, well we meet in the team every month, once.
And we meet physically three, four times a year.
The rest of the time we meet by tele-presence, by video conference.
And we have a great network, in fact this year, the whole company has reduced its travel budget by 25 percent.
Because we told people, you know, we have a tremendous network of tele-presence and we want to use that.
We have to operate like this, we have no choice.
We are truly global.
CF: I understand that Mölndal here is one of the three research units in Astra Zeneca.
And that was stated out three years ago.
For how long is that decision valid?
PS: Well as long as we produce new products here.
You know we just need to be successful and the question is really if we produce.
If this site invents new medicines, then it will be here forever.
I mean this is a very important site for us.
Respiratory we have products also, so you know, so far it is a very productive site.
But we also have a presence in Södertälje, near Stockholm.
CF: But the research?
PS: Research is here, yeah.
And it is true that there were not a lot of products coming out of this unit.
That we have … started developing.
We had too many sites.
CF: Why is it that you want to share future incomes with Lilly?
We have decided to focus on oncology, in cardiovascular diabetes and respiratory disease.
And commercially they will do a good job.
So we will get 50 percent of a big product, if it works, rather than 100 percent of a very small product, because there is a lot of competition.
There is competition in this field, and we need to move very quickly.
CF:When will it emerge then if you are successful?
So another couple of years, it will take time.
But if it works it will be very big.
But you know, we will only know by then.
PFIZER BID CF: It´s three years now this coming spring since the Pfizer bid.
And the share price is now traded at lower levels than the bid.
CF: What reactions do you get from shareholders?
PS: Well the first thing to remember for you but also the shareholders, is that the offer that Pfizer made at the time would never have existed, because as you probably remember, the US government stepped in, in September of that year and changed the rules.
CF: They were about to use the fact that you were a British company?
PS: Yeah they were going to use the fact that it is a British company.
They wanted to relocate their head office to the UK, and their tax office mostly.
And they wanted to save a lot of taxes.
And then Pfizer tried again with Allergan last year.
So they had to stop.
So it was a mirage if you will, it was a price that could never exist.
We said our company has more value long term.
So we still believe that we will exceed this share price.
We believe that next year with the news flow we have, people should start seeing the value we create in our pipeline and our share price should over time reflect a value that is higher than the 55 pounds that we were offered.
CF: We read the rumors every week about new bids.
Well, I mean essentially you will continue hearing about those because you know what does it tell you?
It tells you the company Astra Zeneca is an attractive company and why is it an attractive company?
Because you have an attractive pipeline.
CF:Has there been any suitors since the Pfizer bid?
PS: We never comment on these rumors as you can imagine.
So it actually shows you that other companies would agree with us that there is value in our pipeline and the company is more valuable than the current share price would indicate.
LONG TERM PLAN FOR 2023 CF: A key area for your future success is that you, in the coming years, will be able to raise your sales?
CF: And the last figure I read about sales were 41 billion USD in 2023.
CF: Can that number be changed again?
PS: So far we just finished our long range plan and we presented the long range plan cricket session betting rules our board and our chairman.
We presented the plan to the board three weeks ago and we have another discussion with the board in December, and our forecast is still reflecting the same kind of number.
PS: However, we believe we will have more oncology sales and less diabetes sales than we had forecasted originally.
Because you know we do very well with diabetes around the world, but in the US there is tremendous price pressure.
So you know we have raised Farxiga Astra Zenecas largest selling diabetes medicine to 42 percent volume share globally.
CF:Next year your sales will reach a saddle point?
CF: How will you maneuver to get the sales to reach yet another record?
By next year we have no sales left of Crestor and on Seroquel, so the growth of the new products will be emerging.
The total company will be growing by the new products.
We should launch Roxadustat and next year we should launch ZS-9 for hypercalemia.
So we have many new products to launch.
CF: Based about 500 Swedish crowns now and then.
PS: I have not checked it.
Do you know the answer to that?
PS: What I can tell you is the change since I joined because this one I … JL: I think when Pascal joined it was around 270 here in Sweden.
CF: You are the only CEO that has seen the share price rise in Astra Zeneca.
So we tracked it since January 2018, and we look at the so-called TSR, the Total Shareholder Return which is share price increase plus the dividend we pay.
And our TSR is 90 percent.
It's the highest TSR in the London Stock Exchange.
CF: You basically say that shareholders should be … PS: Should be happy?
PS: Those who were here in 2018.
So you have to look at it over three, four, five years not over two months you know.
CONSOLIDATION CF:I have a question concerning consolidation.
It seems to continue but at a lower pace than earlier, why is that?
PS: Well, there has been a … science has made a lot of progress and there has been quite a wave of innovation in our industry, so we have a very strong pipeline, probably one of the best in the industry.
But many other companies have also been able to produce new products, and so companies feel they can continue on their own because they have products.
If you have new products that help patients you can do well on your own.
So those companies that have good pipelines stay on their own.
More companie have decided to stay on their own in the last few years, because science has made good progress.
CF: Does that mean new major mergers are coming up?
PS: I think personally there will be more mergers absolutely.
CF: Between the larger companies?
PS: Between larger companies because if you want to develop a new medicine that is really differentiated and will make a difference and be reimbursed, you have to really bet big on new science and that's risky.
So if you have size and firepower you can take on a few projects.
CF: Can you… share with us … your view on the industry in five or ten years from now?
Will the larger companies be even larger or will they …?
PS: I think some companies will be larger but I personally believe companies will have to specialize and there will also be a lot of collaborations.
So you know I think companies will do more of this.
There will be mergers, bigger companies, but there will also be companies that specialize and partner with others.
CF: What role will Astra Zeneca have in five years from now?
Will it be an independent company as now?
You know, you never know, you can never say, but we certainly are working hard to remain independent and succeed as an independent company.
And again collaborating is one way to become bigger without merging, right?
CF:That is a new way for the industry?
We believe we can be independent.
EXPENSIVE DRUGS CF: New products and new medicines are sold at higher and higher prices.
At the same time health care systems are having tighter and tighter budgets.
Who will pay for new medicines?
I mean not all medicines are that expensive.
Brilinta diabetes for instance costs maybe one dollar fifty, two dollars a day, right?
CF:But other companies sell medicines for 100 000 dollars per year.
So you have the Brilinta of this world where you keep patients alive for a relatively low amount of money, and then you have the expensive ones, and we also have expensive products in development in cancer.
But there will be savings coming from the biosimilars.
You know there is a lot of … CF: In another 10 or 15 years?
PS:No, no, no in the next three, four years … two, three years.
There are biosimilars coming.
Biosimilars of Amgens Enbrel rheumatoid arthritis where launched in the Nordics and they took 90 percent of Enbrels market and the price was reduced by 50, 60 percent.
Then there will be biosimilars of Humira breast cancerRituxan cancer and Avastin cancernext year or 2018.
That will save the payers a lot of money over the next three, four, five years.
CF: But in the Swedish health care system and in the UK system I believe there are … the people responsible are hesitant to using the new drugs because they are too expensive.
That saves money, which they can spend on new drugs.
For cricket session betting rules in oncology the future treatment model is to combine products.
We try to have many products in our pipeline so that we can price a combination at a lower price.
So we want to combine all the products and give the payers a rebate, so it costs less.
CF: That is a pay if it works system?
There are all sorts of innovative methodologies the companies can use; pay when it works, or combine products and give a rebate for the combination.
So all sorts of different ways to help the patients and payers.
Immunotherapeutic cancer drugs CF:I understand most of your research and development costs are now in the new cancer drugs.
PS: Half, about half, yeah.
CF:And the main focus area is the immunotherapeutic area.
How much do you believe in this area?
Well immuno-oncology is … two answers here.
One is the cricket session betting rules of immuno-oncology on cancer as a whole and then how much we believe in our own products.
So immuno-oncology oncology overall I think is totally transforming the cancer care.
If you think about melanoma patients, skin cancer five years ago … CF: Yes, there are two medicines against melanoma?
Two medicines from BMS but also one medicine from Merck.
And so five years ago if you had melanoma you were dead.
The question was not whether you were dead, the question was how long you would survive, which usually was only a little over six months.
And today with immunology 30 percent, 35 percent of the patients live many, many, many, many years.
Some of them are cured.
Unfortunately not 100 percent, so we have to find new combinations to further increase the response.
The overall survival there with immuno-oncology is far better than chemotherapy.
Patients have less side effects and they live much, much longer.
So Immuno-oncology is working and will transform the care.
CF:There are side effects also in these medicines?
PS: Yeah, but actually the side effects of immuno-oncology are less, much less than chemotherapy.
And in fact over the last three, four years physicians have learned to manage the side effects.
Those side effects are immune related because of course this immuno-oncology product … so you play with the immune system, physicians know how to deal with those, so they look at the side effects and if the side effects appear they act very quickly to block them.
If you look at studies over the last three, four years the rate of side effects is dropping simply because physicians know how to deal with those side effects and they manage them much better.
CF: Yes, and there are two companies that are ahead of you.
So the two companies that are ahead of us are BMS and Merck but they have a monotherapy approach.
We are behind them, but we are ahead of them in a few indications.
We are ahead of them in so-called adjuvant lung cancer which is very early treatment of lung cancer.
We are ahead of them in first lung line … first line bladder and first line head and neck cancer in combination.
And to be ahead of them in combination between durvalumab and tremelimumab.
CF: And you will release the answer to that question next year?
CF: In the Mystic study?
CF:How important is the Mystic-study for Astra?
PS: It is an important study, and that study has several arms.
One arm is monotherapy durvalumab.
Another arm is a combination of durva and tremlimumab.
There are a range of scenarios, probably the lower range of the scenario is that only monotherapy durva works.
CF: What does the math say?
How big is the chance that they will work?
PS: Cricket session betting rules, the math tells us that the range of sales from monotherapy all the way to combination is very, very large.
CF: People tell me that there are game changers in the oncology care industry released every 20 years or so.
There was a target seeking medicine developed by Astra I believe?
PS: We have Tagrisso … CF: Twenty years ago.
http://casinoallsein.top/rules/cricket-session-betting-rules-1.html Twenty years ago.
PS: Yeah, yeah, so I suppose you mean Iressa for EGFR mutations.
That product, yes was a game changer at the time and for patients with an EGFR mutation.
But since then… cancer is smart.
So the cancer cells find new ways to escape the treatment.
CF:You mean new ways to escape also death in immuno-therapy?
It could be that we will have to find new combinations over time.
But certainly Iressa is still an important medicine for patients.
In Asia for instance, in China, half of lung cancer patients have an EGFR mutation.
We have reduced the price of Iressa in China so that it is reimbursed by the government.
So we can treat a lot of patients.
So it has enormous potential still.
PRICE PRESSURE WILL CONTINUE CF:We talked about consolidation trends.
What other trends can you spot in the industry?
PS: Well, I mean basically consolidation is one.
I think another trend is going to be price pressure.
Another trend will be digitalization … you know the way we interact with our customers will change over time and digital tools will become more and more important, in the interaction with our customers but also in the way we develop our drugs.
Those are really the big trends.
The big, big one of course is price pressure.
CF:How does the industry deal with this price pressure?
PS: We deal with it by making sure we come up with truly innovative medicines that can be cost effective and therefore reimbursed.
CF: The highest prices are paid in the States?
The price pressure in the US is strong in primary care, in diabetes and respiratory but it will come to oncology as well.
CF:You believe that price pressure will harden or soften?
PS: I think the price pressure will continue.
I mean most people assume that a Republican administration will be a better environment for the industry than a Democrat administration.
If you look at the stock price of pharmaceutical companies in the US after the election stock prices went up because investors think that the Republicans are better for the industry.
We have to wait and see.
I think the price pressure will continue.
Which do you prefer?
PS: You know I think the big difference is really, the American health care system is more willing to use innovation quickly.
And that is an important part.
Sweden is actually doing well from that viewpoint, but there are a number of countries in Europe where patients have to wait a long time before they benefit from new medicines.
If you look at Tagrisso for instance.
If you have an EGFR mutation and T790M mutation then there is no option for you.
Tagrisso will keep you alive and in … CF: Why is that?
PS: Because Tagrisso … CF: Is it too expensive?
PS: Well actually in the US we got approval quickly because the FDA saw that it is an important medicine, it was approved quickly and then the payers reimburse it.
Regulators at the EMA say this is an important medicine, we need to approve it - based on phase II data.
But then the payers say where is your phase III data showing cost effectiveness?
The product will be reimbursed because it is cost effective.
CF: But is that to say you prefer the American system?
PS: I think overall the American system is a better system for innovation.
I prefer that system.
But the Swedish system is a good system.
We also got approval and reimbursement quickly in Sweden for drugs that are innovative.
The UK system is not a good system.
CF: It tends to tighten budgets even more than other countries?
PS: Yeah, and they are too slow.
I mean it takes forever to … in the end our products are approved.
I mean our products are reimbursed in the UK, but it took a year and a half, and the system was much too slow.
CF: You know, thank for all this time.
PS: Thank you very much.
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