Critical Thinking (III): The Three Questions from Sergio and the AdQualis Team
A few weeks ago, I received a call from Sergio Hinchado and the AdQualis team, inviting me to participate in the third session of their executive meetings for Rare and Ultra-Rare Disease Laboratories, held earlier this month.
My initial response was to decline the invitation, as I tend to be somewhat reluctant towards these kind of events, which are often more about pomp than substance. However, Sergio made it very clear that there would be no pomp — just a brief mention with a photo on AdQualis’ LinkedIn profile — and that the real focus would be on content, discussion, and, of course, a bit of the usual networking. Sergio was absolutely right — the conversation did not disappoint, driven by these three well-posed questions or areas for debate:
- The current landscape of legislative initiatives in Spain.
- Rare diseases and their relationship with social media and traditional media.
- Employment impact: The rise of health economists (HEOR) as a new professional profile.
The three points are entirely interconnected and cannot be analyzed individually, which gives me the opportunity to share my third publication on Critical Thinking applied to the healthcare industry:
We are living in a historic moment of regulatory change in Health Technology Assessment (HTA) in Europe, along with three legislative initiatives currently underway in Spain: the Royal Decree on Health Technology Assessment, the Draft Royal Decree to reform the Law of Guarantees and Rational Use of Medicines, and finally, the Royal Decree on Drug Pricing and Reimbursement.
Beyond the technical analysis and the feared financial impacts on companies’ bottom lines, the message from payers to the industry is clear:
Listen, you are private companies commercialing in predominantly public environments, with more-than-limited budgets, an increasingly aging population with extremely high levels of public debt!
Connecting this to the employment impact, we are also experiencing a historic shift with digitalization and the move towards distributed work structures. In my opinion, it is indeed essential to have some education, training, and experience in Health Economics and Outcomes Research (HEOR) to conduct cost-effectiveness analyses (especially in rare diseases), quality-adjusted life year (QALY) assessments, estimate the specific number of eligible patients, assess the duration and cost of proposed reimbursable treatments, budget impact, apply the PICO methodology, etc. The social value of medicine (AELMHU/Weber) must also be considered in conversations that reflect the compounding interest effect in healthcare.
For example, in a country as complex as Spain in terms of its healthcare system, I foresee a more hybrid professional profile rather than ultra-specialization. No industry wants professionals who only master one subject — repetition will be replaced by automation (AI). Instead, hybrid, cross-functional professionals -with critical thinking skills- who can connect the dots and lead conversations gracefully are in demand-professionals who make things happen.
Focusing just on market access in Spain: could you master the shift from early, transparent dialogue to price and reimbursement negotiations with the relevant Ministries (not just Health)? Could you handle the 17 regional access scenarios by creating care pathways for a specific disease with those regions, their healthcare areas, and their Managers? How would you measure and evaluate a Health Technology in an ecosystem without a unified clinical and financial data architecture? Could you trigger tenders for your product while avoiding, as much as possible, individual product purchases — thinking like a financial stakeholder? What about interactions with Hospital and/or Community Pharmacy? Or managing commercial operations? Or handling public affairs scenarios? Or doing more with less?
That new professional profile is a hybrid one, an expert in CPS (complex problem solving). At this point, I can’t help remembering Recuenco, who recently talked about this topic.
Just a data point: in the town where I started out in this industry at the beginning of the century in commercial roles, there used to be 500 work plans for just as many professionals — today, only 65 remain active, and that number continues to fall. That’s why in some corporations, internal wars are more about survival than about focusing on what truly matters: the patient, their communities, and their needs. Let’s not forget that we will all be patients sooner or later.
In other words, we are witnessing the end of intermediation in healthcare. The structures of these private corporations will continue to slim down, selling or renting out their luxurious offices in prestigious buildings in major cities in favour of more modest spaces adapted to the distributed work model. And with technological advancements, suppliers will die and be born anew. Never place your entire strategy in the hands of a single supplier -only specific tactics -or you’ll lose control.
With all this on the table, and to conclude, Sergio and the AdQualis team asked those of us present about the relationship between Rare Diseases, social media, and/or traditional media.
It’s a very delicate matter within a highly regulated ecosystem. To begin with, I believe healthcare industry executives should maintain a low profile. As my brother Kiko Rial would say: “We need more ethics and less aesthetics in our executives.” Given all the circumstances mentioned earlier, I would leave this matter in the hands of the Companies’ Communication Departments, according to their internal policies -collaborating, yes, but giving the spotlight entirely to the patients and their associations, who are becoming increasingly vocal in public health matters.
As for professionals in the industry managing their own social media profiles, it’s a very personal decision. I wrote about this a few months ago -in my case, I dare to share content monthly, for personal learning, critical thinking, and continuous improvement, following the advice of the mentor of this humble online portfolio, the Great Enrique Dans:
“If you’re not present, you’re suspicious.”
EDUCATIONAL PILLS:
International Master in Medical Affairs. Program part of the educational offerings of the BioTech and Pharma School. In Memoriam César Nombela. Certified by the Catholic University of Ávila. Information
Advanced Management Program. IE Business School. Executive Development Programs. Information
READING PILLS:
Cognitive consequences of sleep and sleep loss. Matthew P. Walker
Cell Injury and Repair Resulting from Sleep Loss and Sleep Recovery in Laboratory Rats. Carol A. Everson, Christopher J. Henchen, Aniko Szabo, Neil Hogg.
Potential downsides of calorie restriction. Anyongqi Wang & John Roger Speakman.
Countries Choose Consensus on Pandemic Agreement, G7 Fait Accompli on Caveated Terms of Tech Transfer Compromises Policy Space for Developing Countries. Geneva Files. Newsletter Edition #126 [Treaty Talks — The Files Flash].
STARTUP PILLS:
Tetraneuron is pleased to invite you to an exclusive event where we will present the latest advancements in our gene therapy platform for the treatment of Alzheimer’s and other neurodegenerative diseases.
June 26th, at 6:30 PM CET in Madrid. Feel free to be registered on info (@) tetraneuron.com. In memoriam Vicente Martínez
Investment oportunitties: Capital Cell.
PODCAST PILLS:
I have to admit that when it comes to podcasts, I’m quite behind on the episodes of Kaizen with Jaime Rodríguez de Santiago. I’ve been a member of the community almost since the beginning, and I’m catching up now. I highly recommend it for activating critical thinking and continuous improvement. It’s in Spanish, though there are some episodes in English.
EVENT PILLS:
Fierce Pharma Week — September 8–11 | Pennsylvania Convention Center, Philadelphia, PA.
