INTERVIEW WITH Martina Perharič, Medis CEO

We All Deserve the Same Treatment Options

We All Deserve the Same Treatment Options

We are pleased to announce the publication of an insightful interview with Martina Perharič, PhD, Medis CEO, in Lekarništvo Magazine, issued by the Slovene Chamber of Pharmacy in April 2023. The interview explores Dr. Perharič's career trajectory, her commitment to fostering equal access to innovative medicines, and her distinctive, intuition-driven management approach. Conversation was led by Darja Potočnik Benčič, Editor-in-Chief of Lekarništvo Magazine.

Martina Perharič, PhD, has an interesting career, from researcher to manager. She is active in many fields, full of ideas and above all full of optimism. She is an active member of the Slovenian Pharmaceutical Society and a recipient of the 2021 Minařik Award. 

She has worked at Medis in various management positions for 22 years and sees herself as a driving force behind efforts to ensure that even economically less attractive countries have access to advanced new medicines. She describes her management style as intuitive and often says that she has a "good nose" for colleagues. When you talk to her, you can sense authenticity, determination and, above all, love and respect for medicines. 

First of all, a rather cliché question, which is quite appropriate in your case, as your career has been very varied. Why did you study pharmacy, why not management, economics, maybe law?

I have always been a natural scientist and have always followed medicine with interest. Looking back, I can actually see that I have somehow managed to combine all my interests, my sense of people management and my need for continuous progress, into a personally very fulfilling profession within the pharmaceutical industry. This is where I can put my skills to best use – by bringing advanced therapies to the countries of Central and Eastern Europe.

Of course I am a manager, but personally I am first and foremost a connector of companies and people, or their knowledge and their ideas. In my role as a leader, I commit them to a common goal, which is the same for all of us who are in any way connected to the healthcare segment: we are here to work well and to do good – for the well-being of patients.

I admire medical progress and believe that we as a society should be grateful for every therapeutic discovery. Perhaps it is we, as pharmacists, who do too little to ensure that this crucial added value is truly understood and recognised by the general public. Tell me, how would we be treated in a hospital or at home and what would our average life expectancy be if it were not for all these remarkable medicines?

Bringing new medicines to the markets, talking to industry partners – that is what attracts me and drives me forward. I find it completely unacceptable that patients should be bypassed by scientific advancements simply because they come from a country with a lower GDP, or because their country, due to its small population, does not meet the economic criteria for the production and launch of a particular specialised medicine. A patient in Bulgaria is the same as a patient in Germany, and everyone has the right to equally rapid access to optimal and modern treatment. Unfortunately, this is far from being the case! Patients in Germany wait approximately 133 days for access to new medicines, while patients in Romania wait 899 days. In other words: less than 30% of centrally approved medicines are available in the smaller and Eastern European EU member states, compared to 92% in Germany and the EU average of 46%.

At Medis, we are making a significant contribution to reducing these disparities in access to new medicines, not only when it comes to Central European EU member states, but also in the Balkans, where these gaps are even more significant. We are successfully convincing manufacturers that with the help of our highly skilled local experts in marketing and sales, medical support, financing and regulatory affairs, we will do everything we can to ensure that a medicine reaches the patients who need it and when they need it. We are very proud of these efforts, especially because we do it all in the only way we can – ethically and transparently. Every time we close deals with global pharmaceutical and biotech companies, it is a confirmation for us that we are doing good. The result that one or more new medicines will be added to our existing portfolio of over 160 medicines also reinforces my personal conviction as a pharmacist that our contribution to improving healthcare is outstanding.

If I am not mistaken, you were first attracted to scientific research. What was your area of research? And how long did you stay in this profession?

Yes, for the first seven years after graduating in pharmacy, I was a young researcher and PhD student under the mentorship of Prof. Zoran Grubič, PhD, at the Institute for Pathological Physiology (PAFI) at the Faculty of Medicine in Ljubljana, Slovenia. My initial research work in the field of regulation of the neurotransmitter acetylcholinesterase in skeletal muscle under the influence of soman nerve agent was followed up with research at the mRNA level, where in the PAFI laboratory, with the help of the development of a new analytical HPLC method, we tried to obtain answers regarding the synthesis and degradation of skeletal muscle proteins under the influence of long-term glucocorticoid treatment.

We also published these findings in high-profile international journals. After completing my PhD in basic neurobiology, I joined the local branch of the pharmaceutical company Hoechst, later Aventis, as Marketing and Sales Manager. In this job, in-depth medical knowledge of selected therapeutic areas and continuous training are key to success and, for me, to a great joy of working in the pharmaceutical industry. 

Medis is a Slovenian family-owned company that is growing steadily. The start was, of course, a brave and bold decision by your fellow pharmacy colleague, Tone Strnad. Can you briefly describe the "career path" of Medis?

Medis was founded in 1989 by Tone Strnad, MSc Pharm, with the aim of promoting medicines in Yugoslavia. A year after that, the country started to fall apart and Medis had to adapt quickly. It soon became one of the fastest growing Slovenian companies. As the manufacturers of the medicines for which Medis took over the entire marketing and distribution were satisfied with the work and results in Slovenia, they started to discuss with us the expansion of all marketing activities to other countries. I joined the company when we were launching activities on the Croatian market with programmes of two manufacturers. Our international expansion has progressed in line with the development of our portfolio, as new partner companies have entrusted us with overall marketing, thanks to our excellent references.

Today, Medis is an internationally recognised, strong and modern company, with state-of-the-art systems and tools, competences and a reputation in the professional community that has been built up over decades and always justified by our highly skilled and enthusiastic employees. Our partners are often surprised when we tell them that we employ 400 people and are present in 18 countries, and that we have digitalized our business with systems that exceed their very high standards.

Over 34 years, we have become the region's leading company for comprehensive marketing of innovative prescription medicines, hospital and over-the-counter medicines, food supplements, medical devices and medical equipment. Some of our medicines are the result of our own development, but the bulk of the products in our portfolio are manufactured by our partner companies, which are mainly large pharmaceutical companies from the EU, Switzerland, the US and Japan. Some of the medicines we market are very niche, targeting narrow groups of patients with rare diseases, with some therapeutic groups having as few as five to ten patients per country.

In all the years we have been conducting business successfully, we have managed to remain independent, we have remained a Slovenian-owned company and we are not part of a corporation or a foreign financial fund. We have created everything ourselves, with our own knowledge and work. Moreover, Medis has never, neither under Mr Strnad's leadership nor under my leadership, looked for quick deals that come overnight and do not require any special knowledge. We have always carefully selected our partners and their products to meet market needs and the highest quality. We are all very proud of that.

You mentioned that you are striving to convince medicine manufacturers. How do you manage to convince them?

(laughs) It is hard, but we are good! Our strengths are our excellent knowledge of the local markets, our long experience and the expertise of our employees in marketing medicines. As an expert and above all a reliable partner, we are known by practically all medical specialties, associations, institutions and regulatory bodies in the Eastern and Central European territory from Albania to Estonia. We work mainly with large and medium-sized pharmaceutical companies who, instead of opening their own office in the country, prefer to partner with us. As a regional partner with knowledge of the local specificities and stakeholders in the chosen market, they trust us to handle all the activities necessary for the comprehensive marketing of a specific medicine in that country.

In this way, our partner manufacturers can ensure that the work is done to a high standard and they can focus on larger markets. We must keep in mind that manufacturers already cover around 80% of the global pharmaceutical market with markets such as the USA, the cluster of large European markets (France, Italy, Germany, Spain and the UK and China and Japan. Simply put, the successful launch of medicines in large markets is crucial for them, and often sufficient to succeed and cover the huge costs of developing a medicine. Smaller countries add a lot of complexity. Each country has its own regulatory requirements, its own language, different pricing policies and other specifics. As a pharmacist, I am constantly striving to ensure that these markets are not overlooked by global medicine manufacturers and that all patients have the same treatment options. And at Medis, we have really done a lot to achieve this. But it is a long haul and very hard work.

There is a lot of talk in the business world about the need for companies to specialise even more in the future, while at the same time networking much more widely with other companies that can further build and complement our competences and activities. An example of such a unique international alliance within the industry is the World Orphan Drug Alliance (WODA), which I initiated. Medis is one of the founding members of this alliance of related companies working to bring orphan drugs as quickly as possible to all those areas of the world that would otherwise have delayed access to them, or perhaps not at all. There are now eight WODA members, covering 76 countries worldwide. As each WODA member is an expert in the selected region, we are able to offer manufacturers access to these markets through a single-entry point, and this simplification reduces the time it takes to reach agreements with manufacturers.

Given the development of the company and your role in it – where are you and Medis headed in the next decade?

Medis is 34 years old. It is thanks to our continuous investment in the development and knowledge of our employees and in digitalization that today we are able to offer our partners the highest level of service, or everything they need to effectively enter any market in Central and Eastern Europe. Despite the constant adaptation to changes and trends in society and the business environment, which are of course necessary, we have remained true to ourselves: we know who we are and why we are here. This is the key to our success and our reputation. We are not one of those companies that every few years think about what our core business actually is, whether it is wholesale, support, regulatory services or even manufacturing. We have always been and remain experts in medical marketing, in fact we sell knowledge. Foreign pharmaceutical companies choose us as a long-term partner precisely because of our knowledge and our track record of success, because they can trust us with their medicine without worry and know that we will take the best possible care of their product. At the same time, healthcare professionals trust us to provide them with exactly what they need: key and, above all, clear expert information to prescribe medicines safely and correctly.

We have been working with many partners in this way for decades, and when they visit us they are surprised time and again by what we have been able to do for the medicines we represent in their chosen markets. They often say it is even better than if they had opened their own representative office. That is why I believe that more and more pharmaceutical companies will choose to enter small and complex markets together with a strong regional player which has local knowledge of the specifics of the different countries in the Central European region, rather than on their own, because our approach is a lower-risk model for them.

Medis will continue to play an extremely important role in the future, both internationally and locally. We will co-create the future of pharmacy and medicine. We have the means and the potential to do business on an even larger scale and with even greater international visibility. And, of course, we will be a bigger and stronger company financially. But business success, i.e. the growth and long-term viability of a company, is only possible if the interests of all stakeholders are respected. This is what I would like to say to other companies in the sector and beyond: the understanding that we should not grow at the expense of anyone – patients, employees, the environment or society – must become the starting point for everyone!

For Medis, I want us to remain a company that is able to bring innovative medicines to the countries of our region, but above all to remain a company with a heart, to which all employees contribute. To maintain our genuine Medis culture where employees feel good and do not have to pretend, but can focus on their personal and professional development.

When I talk about people development, I am not only referring to ongoing internal or external training and mentoring programmes, but above all to succession development: what will we leave behind if we do not pass on our knowledge and enthusiasm for the business to our successors? 

Being even more deeply involved in what I have always been most passionate about, and being freed from the day-to-day operational tasks, is where I am personally headed. I am interested in long-term projects, especially development projects, international networking and perhaps even expanding our activities.

And I am grateful that I was able to convince our founder, Mr Strnad, to let Maja Strnad Cestar, MSc Economy, currently Chief Operating Officer, succeed me as Medis Chief Executive Officer as of 1 August 2023. I will remain a member of the Management Board for the professional and development area and Chief Business Officer, Pharmaceuticals, which includes prescription and over-the-counter medicines and the non-invasive medical aesthetics programme. I am proud to be able to give the opportunity to the next generation in this way, but above all to maintain continuity in the company and to continue to work towards a better society and better health for people, thus maintaining and strengthening sustainable and healthy development of the company.

Pharmaceutical companies often have a negative connotation among the general public in terms of excessive prices, high profits, etc. You are actually contradicting this with your mission. How do you see the role of pharmaceutical companies – innovative and generic?

High medicine prices are a topic often highlighted in the media, mainly because it is interesting for the media to write about the astronomical prices of medicines, especially now with the emergence of gene therapies. But these most expensive medicines, which are usually for patients with very rare diseases, are very few in number, and we as pharmacists of course know that we can be very, very grateful to the handful of development companies that have set out to develop them, despite their low potential!

Every new molecule that passes all clinical trials and is cleared for clinical use by the regulatory authority is a remarkable success, the result of knowledge, technology and a huge investment of more than 2 billion euros. On average, just over 30 new molecules are registered in the world per year, and for many patients this will be the turning point between life and death. And when it comes to this, it is of course difficult to define the value of human life, but we can think about the right to access treatment if it is available, and the right of everyone and everything to live with dignity. 

The topic that should be discussed much more is the problem of medicines that are so cheap that they are in fact too cheap and can no longer bear all the costs of handling and managing, especially when it comes to small batches intended for small countries. How else are we going to ensure their availability? The price of such a medicine simply cannot not bear all the fixed costs, the specifics of production and regulation, and the standards of supervision, not to mention the necessary investment in the education of healthcare professionals with the aim of safe and correct use of medicines, because they are not feasible in any case.

I can back up this claim in very concrete terms with the piece of information that about 60% of medicines cost less than €5 per pack and 85% of medicines cost less than €10. I probably do not need to ask the readers, pharmacists, why the pharmaceutical industry is expected to treat a chronic patient optimally at a cost of one or two euros a month and to make this sustainable for the industry, despite the enormously increased costs of production and the ever-new fees from the regulatory bodies, while at the same time that same patient will easily spend several times that amount of money on treats, not necessarily healthy ones, on a daily basis.

You are also a member of the Managers' Association of Slovenia and three years ago you received the Artemis Award for outstanding achievements in the field of management, which the Association awards to female managers. Congratulations! What does this award mean?

The Artemis Award is presented to women who have broken through the glass ceiling and taken the top management position for the first time. Of course I was very happy to be recognised, although for me the greatest success is to see genuine, enthusiastic, excellent colleagues respecting each other, pushing things forward themselves, becoming great leaders. They are and will be our successors and we must do our best for them and because of them! I have never approached things with just my head and my hands, because I realised very early on that lasting success only comes if you also work with your heart. I feel that this award is mainly the result of my natural efforts, but above all of my genuine leadership. We are all only human, with all our shortcomings and lack of knowledge. You are a leader not because you know everything, but because you trust people to know and to be able to do it.

I believe that we need this award above all because of the wider social context. When I look back, I realise that it was actually men who have always supported me on my journey. And this is also proof that gender does not and should not matter, only our breadth of knowledge and our abilities. I have clearly found a place in my career where I have been able to pursue my professional passions wholeheartedly and help develop many successors. I love doing the latter so much that I have often thought that perhaps I should also be a teacher.

Senior management is still heavily male-dominated. What do you think is the reason for this, as women in Slovenia certainly have opportunities for education and employment, and are quite equal in this respect?

On this year's International Women's Day, the UN Secretary-General António Guterres warned that the world's progress on women's rights is disappearing before our eyes, and that it will take another three centuries to reach the increasingly distant goal of gender equality. Three hundred years! Of course, there are huge differences between countries, cultures and even industries, but this is simply unacceptable.

Fortunately, the situation is very different at Medis. 75% of our employees are women, and we have the same percentage of women in management positions. We offer a hybrid way of working and support our employees to better balance their work and private life. We welcome everyone who brings knowledge, a passion for work and progress and enjoys their chosen role. You simply have to love your job. And above all, you have to be authentic, your own person, regardless of race, religion, gender or age. Authenticity in the workplace is valuable, but unfortunately not a given, even though we know that people do not trust or believe fake smiles and empty promises. 

Medis is the initiator and sponsor of the International Medis Awards for Medical Research. Although the contest is already well established, I would like to ask you to briefly describe it. In particular, I would like to know how the idea of this contest came about.

I mentioned that as a pharmaceutical company, we are focused on comprehensive commercialisation of innovative therapies in the countries of Central and Eastern Europe. As these are often new therapies, we are all the more aware that it is our responsibility to deliver medicines quickly and – most importantly – safely to the patients. That is why we consider doctors, pharmacists and other healthcare professionals as our most important stakeholders. We support them with accurate and timely information about the medicines in our portfolio and answer their questions about product safety and efficacy.

Thus, in our close collaboration with them, we have observed that doctors and pharmacists carry out their research work in addition to their daily clinical practice and work with patients, and they most often do that in their spare time. We found this wholehearted commitment to research incredible and inspiring. We therefore felt that their dedicated work deserved wider attention from both the professional and the general public. Moreover, it has happened many times that these researchers have had their work published in reputable international publications and have received recognition from the international professional community, while the local public knew nothing about it. This was the fundamental motivation behind the decision to establish the International Medis Awards (IMA) in 2014 to recognise outstanding research achievements of doctors and pharmacists in our region.

The IMA is therefore first and foremost a public recognition and commendation of doctors and pharmacists, their efforts, their knowledge and their perseverance to make breakthroughs and help people towards better treatment options and a better quality of life. All the research submitted to the contest has been previously published in renowned scientific journals with a high impact factor, even in the highest-ranked medical publications in the world, such as the Lancet. We are proud that the IMA has become recognised and highly respected over the years. This year, 238 entries were submitted, of which 185 met the strict criteria to be nominated for the award.

Who can apply and how do you choose the winners?

Doctors and pharmacists from nine Central and Eastern European countries can apply: Austria, Bulgaria, Bosnia and Herzegovina, Croatia, Hungary, Montenegro, North Macedonia, Serbia and Slovenia. Submitted works are evaluated by the independent International Scientific Committee of ten members from seven countries. Based on fully transparent and objective criteria, the Committee selects the nominees, finalists and winners for each field. In the 2021–2024 mandate period, the Committee is chaired by Prof. Borut Štrukelj, MSc Pharm, PhD, from the Department of Pharmaceutical Biology, Faculty of Pharmacy of the University of Ljubljana.

Over the last 9 years, the International Scientific Committee reviewed 1442 valid articles, and then selected 174 finalists and awarded 83 winners. The winners receive a unique statue called Bodočnost (The Future), a work of art by the renowned sculptor Jakov Brdar. However, I would like to add that making it to the final selection is already a remarkable achievement in itself, as the IMA criteria are extremely high.

As a pharmaceutical company, Medis is naturally linked to the pharmacy business. How do you assess the pharmacy business in Slovenia and where do you see untapped opportunities? What do you notice if you compare pharmacies in Slovenia with pharmacies in EU countries?

I can certainly say that Slovenian pharmacies are at a level that is fully comparable to, if not higher than, pharmacies elsewhere in Europe. The high level of professionalism and knowledge of pharmacists in pharmacies is something that we should be extremely proud of and we must insist that it remains so. Also, as a society, we are not sufficiently aware of the fact that pharmacists are the first line of expertise available to patients 24/7, even in times of emergency, such as during the COVID-19 epidemic.

I always enter a pharmacy with the greatest pleasure, and every time I talk to my fellow pharmacy colleagues, we agree what a remarkable profession they are following. Although it is difficult at times, especially recently because of staff shortages, one can hardly notice it. Every patient gets the medicine they are looking for, expert advice, a kind word and a genuine smile. It saddens me, however, when pharmacies are compared to traders or to profiteers. The only well-functioning healthcare team is one in which, in addition to doctors and nurses, pharmacists are also heavily involved in the treatment. All pharmacists should emphasise this more whenever they are featured in the media, because only strong messages that are constantly repeated can help raise awareness, as experienced marketers know. I applaud the efforts of clinical pharmacists who have already introduced the pharmacy profession into comprehensive patient care in many Slovenian hospitals. As far as I have been able to see, these hospitals can no longer imagine regular work without a pharmacist on the ward.

You are also active on social media. Through your posts, we can follow Medis highlights and success stories, as well as your personal sporting achievements. Where do you find the time and which sport do you enjoy the most, which one "recharges your batteries"?

Sport is really my release valve. Because I enjoy it, it is not difficult for me to be physically active every day. It is simply something that is part of my daily routine and that I can compare with other daily tasks. In the morning I always say to myself: Martina, do your workout now, or go for a quick walk on the Rožnik Hill in Ljubljana. And I tell you, after that, the day is all set! If we all really looked at how we spend and sometimes also waste our time, I would dare to say that everyone can take half an hour for sport.

A few years ago, I was the initiator of the Medis Sports Section, which is now active in several of our countries and under whose umbrella our colleagues participate in running, cycling and other events and competitions. I actually prefer to do sports alone, because I like to swim, which is hard to do in company. But when I swim long distances, I also like to swim in my thoughts and come up with new ideas. On my days off, I plan my time carefully with my husband, who is a big nature lover, and we go cross-country skiing, skiing, trekking or – if we are lucky and the weather is cold enough – ice skating on frozen lakes. But that does not mean we do not love the sun and the sea. On the contrary, we are both avid windsurfers and I can tell you that the freedom and thrill you feel when gliding is close to perfection. I highly recommend it!

In my marriage, now that my sons have left the nest, there are basically three of us: my husband, me and sport. I often tell myself: as long as we are healthy!

Last but not least, what would be your message to the readers?

I know this could be a moment for a deeply inspiring thought, but I will, as always, speak from my observations – what life and career have taught me: relationships are the most important thing, because we are human beings in a community, not in isolation, whether at home, among friends or at work. As a manager, I am even more aware of this, because the manager is only as good as the team. In addition, I think it is crucial to remain curious throughout your life, which is why I always say to my young colleagues: ask, ask and ask a lot. And lastly, sometimes you have to do something that seems like a waste of time, but is nevertheless worth doing. You are then rewarded with the feeling that you have done something right and for the good of others.

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