In a wide-ranging interview, AbbVie’s Flavio Devoto outlines some of the key access challenges and opportunities in the diverse Latin American pharma market, his approach to being a transformational leader while balancing demands from headquarters with realities on the ground, and the enduring importance of LatAm to the global group.
Could you begin by introducing yourself and your career trajectory?
I’m Flavio Devoto, AbbVie Vice President for Latin America. Before joining the pharma industry, I was a doctor and did my residency in clinical medicine with a specialisation in clinical pharmacology. After 10 years as a doctor, I switched to pharma area and began as a medical advisor before moving through market access, public affairs, and commercial roles at Pfizer and then Novo Nordisk. My first general manager position came at Novo Nordisk Argentina back in 2007, a role in which I stayed for eight years. Follow that, I joined AbbVie, initially as lead for the Southern Cone countries before becoming VP and general manager for Brazil, and recently as VP for Latin America.
Given the diversity of markets that exist in LatAm, are you able to sum up the state of access to innovation on the continent today?
You must see both sides of the coin. On the positive side, LatAm has improved a lot in terms of access over the past 20-30 years and many countries – such as Brazil – have enshrined healthcare as a right in their constitutions. However, healthcare systems and the roles played by the public and private sectors differ significantly between countries in the region, creating varying challenges. Nevertheless, LatAm has improved access thanks to the alignment of different stakeholders with patients and the public now having a much stronger voice than before, which can only be a positive.
On the more challenging side, many patients in LatAm still must wait a long time to receive the proper diagnosis and access innovation post-approval. We have seen improvements in some countries, but significant delays remain. Every year, new medications and new diagnostic tools come online, so preparations need to be made to ensure that these innovations are made available to the patient and affordable to the system.
How significant an impact does the swing in LatAm governments between left and right have on the healthcare environment?
Our view is that all stakeholders – not just payers – have responsibility for ensuring access, meaning that building on strong collaborations and public-private partnerships will be crucial. The investment dedicated to health, in many countries of the globe, is insufficient, which is a chronic problem regardless of the political winds. There is, however, an opportunity to create more efficiency which would free up resources for innovation, as the conversion to digital tools did during the COVID-19 pandemic.
What is the relevance of the LatAm region to AbbVie globally today?
LatAm is a huge opportunity for AbbVie and we are committed with patients in the region. We have a strong and long presence here and, with the acquisition and integration of Allergan, there is a major opportunity to expand our therapeutic areas of focus. As well as a manufacturing plant in Brazil, the company has offices across the continent which will support our efforts to broaden access to our portfolio across the company’s key therapeutic areas of focus.
How do you manage to be a transformational leader while balancing demands from headquarters in the US with local realities on the ground in LatAm?
It is important to have a good understanding of the different healthcare systems that exist in LatAm in order to engage with the various stakeholders and maximise patient access. In our case, being based in Sao Paulo is a significant advantage as we feel close to our customers and we can travel easily across the continent.
Naturally, it’s part of my job to explain our region specificities and, of course, meet global standards. The global team has an understanding of the specific context here. For example, diagnostic rates are a lot lower here than in the US, meaning that there is a lot of work to do to catch up and become more patient centric. In chronic diseases especially, many patients lack access to physicians, medical check-ups, advice, and ultimately treatment.
The pandemic, while obviously challenging, put healthcare in the spotlight and asked the question of how countries and societies should react. People realised the benefits of strong national healthcare systems and the importance of dedicating time and effort to building them. Digitalisation also got a boost, with countries such as Brazil now combining virtual follow-ups with face-to-face visits for chronic disease patients. Digital tools are also increasingly being utilised in medical education, relieving some of the burden on overworked physicians to attend trainings in person.
One area where LatAm is something of a laggard is electronic health records (EHRs), which are essential to this digitalisation push. What is your take on how this issue can be resolved?
In healthcare systems that contain a mix of private and public providers, such as most of those in LatAm, it is very complex to implement an effective EHR system. Creating consensus on which systems to use and how to share information while respecting data privacy is highly challenging, although something that we should continue to build towards, bearing in mind its potential positive impact on patient outcomes.
AbbVie globally is growing the size of its clinical development and clinical trials operations. How is this playing out in LatAm?
I am pleased that LatAm is part of the company’s clinical development operations and hope to see this trend progress further. Clinical trials are all about using good science to improve patients’ lives and also set up patients to access the best care available following their trial.
In some parts of the world, society seems quite resistant to participating in clinical trials; is the same true in your region?
Some countries are more accepting than others. Communication with patients as to the purpose of clinical trials and their benefits is key. Patients should also understand that clinical trials are a very regulated process from the beginning, that the care provided will be of the highest standard, and that all the professionals involved are very well trained. Clinical trials are a fantastic way of involving the LatAm population in drug development, tracking their reactions to different treatments, and ultimately creating medicines that are more effective for them. While the US also has a sizeable Latino population which could be involved in clinical trials, environmental factors such as the food that people eat are also important, meaning that LatAm-based clinical trials will continue to be relevant.
What are AbbVie’s portfolio priorities in LatAm in the coming years?
By working closely with patients and physicians, we solve the real, complex challenges they’re facing right now, first with science and support. This is a reality in Latin America also, we have significant launches in all our areas in the next five to seven years: immunology, neuroscience, oncology, eye care and aesthetics are key for our organization.
Additionally, AbbVie plans to continuously update its products with new alternatives that are aiming to always elevate the standards of care.
How strong is the intellectual property (IP) protection system in LatAm?
We are committed to science and innovation at AbbVie. Having strong IP protection is very important and beneficial for innovation in society. Strong IP protection is key to foster innovation and brings investment, new jobs, and has a positive impact on society.
What are your expectations for AbbVie LatAm in 2023?
I am optimistic about the future! Post-pandemic, healthcare has been put at the centre of policy and societal debates and there is a greater dedication to ensuring health across the board as well as more robust stakeholder alignment, from patients, medical societies, to policymakers. Ultimately, our industry has a long-term view and the ability to ride out the shorter-term challenges and, on a company-level, I am very excited to increase our presence in LatAm.
Do you have a final message for our international audience?
LatAm is an important driver of AbbVie’s international business growth. Our geographical footprint is very strong with affiliates across the continent, the region is a talent hub, and I am confident that we will be able to bring a lot of innovation to patients here via several product launches for the most complex and serious diseases. Our ultimate goal is to bring the entire global portfolio to patients in the region.
Photo credit: Germano Lüders, 02/03/2021
