Care Providers

2Care Providers

A limited budget and a fragmented sector have challenged care providers to find innovative ways to approach patients and provide equal solutions to a population with unequal access to healthcare. The lack of a preventive healthcare culture among patients has pushed care providers to reformulate their offering and to communicate the dangers of poor health and unhealthy lifestyles through creative, yet functional methods. Technology is now key to creating a new approach to healthcare. From independent physicians to insurance companies, digital solutions for providers and patients are revolutionizing the sector. After the COVID-19 pandemic, patients will require flexible approaches that guarantee safe, continuous care provision as providers will face faster integration of digital tools, limited contact with patients and virtual learning.

This chapter exposes the titanic efforts to provide health 24/7, while finding ways to cope with daily updates on COVID-19 and learning how to integrate digital solutions to connect with patients and colleagues to ensure that patients receive the promised solutions that the sector is moving toward.

2Care Providers

17 Analysis

The Road to Universal Healthcare

18 Analysis

Long-Term Public-Private Collaboration to Fight COVID-19

19 View From the Top

Oliva López Arellano | Minister of Health of Mexico City

20 View From the Top

Patrick Devlyn | President of the Health Commission at CCE

21 Analysis

How Has the Centralized Purchasing Scheme Worked So Far?

22 Analysis

UNOPS Medicine, Medical Supplies Purchasing Scheme for 2021

24 View From the Top

Héctor Valle | Executive President of FunSalud

25 View From the Top

Javier Potes | Director General of CMH

26 View From the Top

Héctor Martínez-Said | President of SMEO

27 Spotlight

Chiesi: Writing a Better Future for Patients With Rare Diseases

28 View From the Top

Jorge E. Valdez | Dean of the TecSalud School of Medicine and Health Sciences

29 View From the Top

Juan Galindo | Chief Medical Officer of CHRISTUS MUGUERZA

30 View From the Top

Misael Uribe | President of Médica Sur

31 View From the Top

Alberto Sanchez | Operations Director of Faro del Mayab

32 View From the Top

Juana Ramírez | CEO and Founder of Grupo SOHIN

33 View From the Top

Rocío Bermudez | General Manager of Olarte y Akle Bacteriólogos

34 View From the Top

Mario Sicilia | Director General of Laboratorio Médico Polanco

35 View From the Top

Eduardo Lara | Vice President, Head of Health Latin America at RGA

36 View From the Top

Salvador Arceo | Director General of Plan Seguro Juan Pablo González | CFO of Plan Seguro

37 View From the Top

Alejandro Luna | Partner Litigation and Life Sciences Co-Chair at OLIVARES

38 View From the Top

Juan Luis Serrano | Partner-Life Sciences of Sánchez Devanny

39 View From the Top

Fernando Becerril | Partner and President of BC&B

40 View From the Top

Miguel Prida | President of Grupo Consulmed

41 Roundtable

What Can the Health Sector Learn From the COVID-19 Pandemic?

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The Road to Universal Healthcare

In 2020, Mexico welcomed the new Health Institute for Welfare (INSABI), with the goal of achieving universal healthcare by offering social security to people outside IMSS and ISSSTE coverage, which is around 69 million Mexicans. INSABI offers primary and secondary levels of care and it is contemplating scaling up to tertiary care.

Regarding primary care services, INSABI covers the following:

+ Preventive healthcare

+ Health promotion

+ Disease prevention

+ Outpatient care for the most common illnesses provided by general practitioners and nurses

In the secondary level, the institute covers:

+ Basic specialties at general or specialty hospitals + Laboratory and imaging diagnostics + General surgery, gynecology, obstetrics, internal medicine and pediatrics

At the beginning of 2020, the Institute explained that for tertiary coverage, INSABI would initially charge a modest fee, expecting that by December of this year it would no longer need to charge for its services. People affiliated with INSABI can go to public medical facilities, such as health centers, health centers with extended services (CESSA), IMSS Bienestar medical units, medical specialties units (UNEMES) and rural, community and general hospitals.

The institute has faced many challenges since its introduction, the most obvious being medicine shortages for cancer patients. “(INSABI is) viable and necessary as a breaking point that breathes life into the healthcare system, which I think will be good for the population,” said Alejandro Sancen, Director General of MASZ, during an interview with MBN. “(However,) the way INSABI was implemented generated doubts and challenges, such as medicine shortages.” From a logistics point of view, Javier Calero, Commercial Vice President of GNK Logistics, told MBN that, “the arrival of INSABI created an operational gap that has hindered talks with the government as authorities themselves do not have the functioning rules to know which funds can support a project like ours.” For the pharmaceutical industry, the issue is clarity. “There has been a lack of clarity on who is responsible for medication purchases. INSABI has not really taken the reigns and there are still discussions on which dependency should be responsible for this,” Cecilia Bravo, President of ANAFAM, told MBN.

How can the government put INSABI on track to achieve its goal of universal healthcare coverage? During an interview with MBN, Vinicio Orea. Deputy Director of Health and IT Business Unit at Grupo Altavista, reflected on the subject. “The current steps that the government is taking to improve healthcare with INSABI are good but very ambitious. When the government realizes that the burden cannot be tackled alone, it will start looking to the private sector.”

Long-Term Public-Private Collaboration to Fight COVID-19

Read the complete article When asked by MBN about the greatest challenge to providing healthcare during the COVID-19 pandemic, Oliva López, Minister of Health of Mexico City, pointed to “the fragmented nature of the healthcare sector and how it complicates proper care provision.”

Most industry observers agree with that assessment but COVID-19, for all its tragic consequences, is also highlighting what the sector could look like when the two sides that control healthcare in the country – the public and the private sectors – come together. Patrick Devlyn, President of the Health Commission at CCE, told MBN that “recognizing the fragmented nature of Mexico’s health system is key to be able to move to a simpler, more efficient one, where the private sector plays a relevant role in improving access for everyone.” COVID-19 is a great example of the private sector’s efforts to support the government through partnerships, he added.

A unified healthcare sector was necessary to share the unprecedented burden brought about by COVID-19. The agreement reached between the two sides, called Juntos por la Salud (Together for Health), brought together hospitals, insurance companies, academic institutions, banks and communication groups, among others. Public and private hospitals shared their patient burden, related to both COVID-19 and non-COVID-19 patients, starting in April 2020. “Juntos por la Salud has a role in helping to close health access gaps and supporting the development of remote systems,” said Héctor Valle, Executive President of FunSalud, to MBN. Valle adds that this initiative has served to donate infrastructure to support hospitals with developments such as ventilators, diagnostic solutions, medicines and devices.

In an interview with MBN, Javier Potes, Director General of CMH, recommended making this partnership a long-term solution for the sector. “Before COVID-19, the private sector would have around 40 percent bed availability. The unused space could perfectly be used to attend patients from the public sector at referenced prices.” According to Potes, the private sector could start investing in infrastructure to provide care for government beneficiaries, focusing on service provision rather than the building itself as in regular PPPs.

Plans like Juntos por la Salud and the preventive measures encouraged by the government were linked to a decrease in hospitalizations in July and August. In September, hospitalizations bounced back but the response has been much smoother and with fewer shortages in supplies. The agreement with private hospitals allowed broader access to care for COVID-19 patients while giving public facilities the opportunity to open up other services.

For the alliance between sectors to continue, Devlyn said the same level of engagement from both parties is required, especially after the economic crisis brought by the pandemic. “The challenges brought by COVID-19 require people, companies and governments to quickly adapt to this new normality to protect people’s lives, while helping our economy restart and grow sustainably.”

Oliva López Arellano

Minister of Health of Mexico City

Pandemic Exposes Limitations of a Fragmented Healthcare System

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More about this person Q: How is SEDESA promoting healthcare in the city?

A: SEDESA employs an integral healthcare model, which was articulated on primary care attention. We have strengthened areas related to sanitary jurisdictions through health centers and ambulatory attention.

The Ministry’s general program is Salud en tu Vida (Health in Your Life), and from that we derive Salud en tu Casa (Health at Home), Salud en tu Escuela (Health at School) and Barrios y Colonias Saludables (Healthy Boroughs and Neighborhoods). What we offer is integral territorial attention.

Throughout 2019 and 2020, we have accomplished the opening of first-contact health units. We started with 10 units that worked on the weekends and by the end of 2019 we had 150. We are now up to 190. This substantially increases healthcare attention, providing much faster care to those who have no social security.

Sanitary security for all people in the city, regardless of whether or not they have social security, is also very important for SEDESA. This implies providing safe conditions across neighborhoods and the monitoring of open spaces. Our brigades ensure water and food safety but also clean community areas to mitigate sanitary risks in crowded spaces, such as markets.

We are also working with the city’s Escuelas Saludables (Healthy Schools) program. We have 100 permanent brigades that work at those schools to implement sanitary and health measures. To date, we have 100 schools accredited as Escuela Saludable.

Q: How did SEDESA react to the COVID-19 outbreak in Mexico City?

A: SEDESA began taking action from the first signs of the pandemic in December 2019. When the first case arrived in Mexico, we were quick to alert the population and disseminate information and recommendations on the subject. We implemented a monitoring system and epidemiological vigilance to identify and analyze all data, because, as we have seen, the pandemic has acted differently depending on the particularities of the population. Thanks to this, we were able to implement sanitary protocols at the Mexico City International Airport.

In the city, the Digital Public Innovation Agency contributed greatly by creating a text message option to filter patients with mild symptoms and encourage them to stay home, allowing SEDESA to offer telephone follows-ups and to provide general recommendations of isolation for suspicious cases. This also allowed us to register patients’ addresses to trace the cases and be able to approach them in case of complications.

In Mexico, the serious cases are concentrated among people of 50-60 years of age with morbidities such as hypertension, diabetes or obesity. In the city, 12 out of 100 people suffer from diabetes, 20 out of 100 people over 20 years old suffer from hypertension and 75 percent of the population over 20 years old suffers from overweight or obesity. The text message method also allowed us to identify cases with morbidities to encourage them to go to the hospital or more carefully monitor their symptoms.

Patrick Devlyn

President of the Health Commission at CCE

CCE: Private Sector Shares Government’s Goals

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More about this person Q: What measures has the Mexican healthcare industry implemented to address the challenges brought by COVID-19?

A: The current situation is a great example of the private sector’s efforts to partner with the government to mitigate the impact of COVID-19. Private hospitals offered 50 percent of their beds to the public health sector, to be used for both non-COVID-19 and COVID-19 patients. The insurance industry almost immediately confirmed coverage of COVID-19 expenses for users and they also offered insurance coverage to healthcare workers on the frontline of the pandemic. Moreover, there is the initiative Juntos por la Salud (Together for Health), which brought together private sector companies, NGOs and academic institutions to donate medical supplies to hospitals treating COVID-19 patients.

Q: How is CCE representing the interests of the healthcare industry in this difficult scenario?

A: The private sector, including healthcare players in Mexico, share the same goals the president has defined, which are transparency, guaranteed availability of medications to the population, cost savings in the acquisition of medications and complete access to quality healthcare. However, profound change creates uncertainty and anxiety within the healthcare industry. CCE’s Health Commission has been a platform to constructively communicate the industry’s concerns, as well as to share experiences and best practices that can support the government to implement these initiatives successfully. In the end, tension within the system can translate into a negative impact on patients and end-users, which we must avoid.

Q: What are CCE’s main priorities regarding the healthcare industry?

A: CCE’s Health Commission, together with the 12 privatesector organizations that conform it, key allies like FunSalud, patient associations and academic institutions, agreed on a health agenda based on five main pillars. The first is the implementation of an integral public health policy on prevention to create and encourage a preventive healthcare culture. The second is to improve access to quality healthcare, which includes reinforcing first-level care and improving access to innovative medications. The third pillar is to increase investment in health and to use these resources more efficiently by improving transparency through public-private collaborations. The next pillar is recognizing the fragmented nature of Mexico’s health system. We need to move to a simpler, more efficient health system, where the private sector plays a relevant role in improving access for everyone. The last pillar is working toward national health coverage for all Mexicans, understanding our financial limitations and providing complementary access through private sector insurers.

We need to put the patient at the center of what we do, both in the public and the private sectors. We must increase effective collaboration and redirect the country’s current health trends in ways that will help our people have prosperous levels of economic development.

How Has the Centralized Purchasing Scheme Worked So Far?

Read the complete article At the beginning of 2019, the Mexican government announced a new centralized purchasing scheme for medicines that aligned with President López Obrador’s general goal to fight corruption. According to an official release by the Ministry of Finance and Public Credit (SHCP), the new scheme sought to “achieve transparency, through the participation of the United Nations Office for Project Services (UNOPS), contracting procedures, as well as the establishment of competitive mechanisms that open the door to a greater number of suppliers in this industry, promoting at all times the best conditions for the State, in terms of price, quality and opportunity.” As described by the SHCP and the Ministry of Health, this scheme is based on an international public tender procedure for the purchase of medicines and healing materials required by the federal government and the federal entities. Minister of Health Jorge Alcocer expected that this change would allow savings of up to MX$608 million (US$26.8 million) in 2019. To date, this figure has not been confirmed.

At the beginning of 2020, President López Obrador blamed laboratories for medicine shortages at public hospitals. To understand the context, MBN spoke with legal firms about the benefits and challenges of this purchasing scheme and also gathered the opinion of many pharma laboratories on the subject. Hogan Lovells Life Science’s experts Ernesto Algaba and Cecilia Stahlhut shared their opinions on how the scheme had been working for laboratories. “We are in a process of maturation, recomposing the structures and strengthening the supply of medicines for the public sector. In that sense, maybe the actions that have been taken were necessary an adequate strategy is still necessary to ensure that needs are properly satisfied. The government’s goal should be to ensure that new measures stick to the law and that they respect the industry’s rights. They should also comply with the legal framework and guarantee the interests of patients, including proper supply of products,” explained Algaba.

Added Stahlhut: “Especially in this sector, fair competition is key. This goes beyond costs and prices. Medicines undergo a long and sometimes difficult process in Mexico to reach the market and competing with products that do not have to go through that process can distort the market and lead to shortages or unreliable distribution models that only endanger the consumer.” Director General of S&S IP LAW Agustin Azcatl said that the scheme could present both opportunities and challenges. “The new distribution scheme has opened the market, which will boost competition and lead to lower prices. Also, it enables SMEs to participate. A lack of legal protection would put these SMEs at a disadvantage against big players, however.”

For his part, General Manager of Chiesi Marco Ruggiero said change is good, but that clarity was also necessary. “We all need to be open to change because this is how we evolve and make things better. What is missing is a clear plan for everyone to follow, as well as a timeline. In terms of communication, this year has not been the best because it has been difficult to follow all the changes that happened from one day to the other while trying to understand them with the little information that was provided.”

UNOPS Medicine, Medical Supplies Purchasing Scheme for 2021

On July 2020, the Ministry of Heath announced it would start acquiring 80 percent of the medicine supply needed for public institutions through the United Nations Office for Project Services (UNOPS), following WHO and PAHO guidelines. The estimated investment will be between MX$60 billion (US$2.7 billion) and MX$70 billion (US$3.1 billion).

The move required substantial modifications to Article 1 of the Public Sector Acquisitions, Leases and Services Law (LAASSP), related to the changes to the supply scheme of therapeutic goods and its implications. In addition, in August 2020, the Mexican regulatory agency COFEPRIS was attached to the Deputy Ministry of Health Promotion and Prevention.

At the beginning of 2020, when the new centralized purchasing scheme came into effect, the government also announced an international tender to acquire medicine from abroad due to what President Andrés Manuel López Obrador called “corrupt acts on medicine acquisition during former presidential administrations.” The open tender raised concerns among players in the local pharmaceutical industry because they feared a lack of proper regulations and standards being managed by manufacturers entering the country.

In an interview with MBN, Rafael Gual, Director General of CANIFARMA, described the action as “the exclusion of the acquisition of medicines and health supplies from public bids, which led the industry to file an appeal for protection and a large group of senators to submit an Action of Unconstitutionality to the Supreme Court.”

The agreement between INSABI and UNOPS for the 2021 supply of medicines sets the ground for foreign companies to participate in an open international bid, with no regard for the commercial agreements Mexico has signed, Gual said.

According to Gual:

+ The value of the pharmaceutical market in the Mexican public sector in 2019 was over MX$70 billion (US$3.2 billion).

+ During the same year, over 1.7 billion medicine units were required and/or consumed by the National Health System.

Considering the total expense in pesos and consumption in units in Mexico in 2019, the medicines and vaccines that could be procured from international and intergovernmental agencies amount to just over MX$3.5 billion (US$178 million) and about 65 million units, which represent 5.09 percent and 3.82 percent of the national public demand, respectively.

Impact on the Local Industry

During an interview with MBN, President of the Mexican Association of Pharmaceutical Laboratories (AMELAF) Arturo Morales explained what an international tender for medicine

acquisition would involve for the industry. “Holding an open international tender was a step that could have been avoided because the purchase could be dangerous if not done under the same regulatory measures that COFEPRIS establishes, not to mention that it is unfair to national companies that do follow the national acquisition law.”

Regarding the government decision to involve the UN in the process, Morales said that UNOPS allows the entrance of those medicines to underdeveloped countries or in cases of a crisis or emergency, which is not the case for Mexico.

He also addressed one of the most vocal criticisms of the pharmaceutical industry. “We are not facing a shortage; the Mexican pharmaceutical industry has the capacity to cover those gaps but has no certainty from the government. We depend on what the public sector requires and if there is no clarity, the result is that medications cannot be manufactured on time, leading to shortages.” Cristóbal Thompson, Executive Director of AMIIF, agreed that Mexico’s industry was in position to deliver the necessary supply. “The Mexican pharmaceutical sector has the capacity to supply the local market. To date, medicinal supply has been covered. What caused most of the delays were tender discussions,” he told MBN.

President of ANAFAM Cecilia Bravo also expressed her concerns about the international tender and said that “the openness to imported products from anywhere is adversely affecting national production. Products are being bought from countries that have lesser sanitary standards.”

Bravo added that the matter is complex, pointing out that the measure endangers pharmacovigilance and could have implications in terms of tax revenue losses and, therefore, lost job opportunities. “Other countries could be subsidizing their industries, thus creating an unfair competitive advantage over Mexican companies,” said Bravo.

What the country needs, these experts agree, are dialogue and cooperation between the private sector and the government. “We want to defend our national industry to help it grow and to maintain the level of high-quality jobs we offer,” said Morales.

Not content to wait, the industry is also taking its cause to the courts. “(ANAFAM is) filing an amparo against a disposition proposed by the government that lowers the import requirements for many products, particularly in the oncological area. The government is opting for direct purchases without any bidding process,” said Bravo.

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Héctor Valle

Executive President of FunSalud

Public-Private Collaboration Key to Tackling the Pandemic

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More about this person Q: What are the main challenges in Mexico to start applying remote healthcare models?

A: Some of these models are already under development. However, we still need quality internet access. In 2019, the first remote surgeries were performed in Asia. This happened in a 5G environment. If we tried to do that in Mexico, the signal could fail at any time. While doctors here have no problem providing remote consultations in the main cities of the country, there are still problems in more remote areas. The biggest challenge, without a doubt, is high-capacity connectivity. This is a joint effort between the telephone and internet companies, the Ministry of Communications and Transport (SCT) and the federal government.

Q: How can society, government and the private sector use COVID-19 as a learning opportunity to improve overall health conditions in Mexico?

A: Significant progress has been made by the Mexican Health Foundation, together with Juntos por la Salud, the federal government and the leadership of Marcelo Ebrard, Zoé Robledo and Jorge Alcocer. There are positive instances of the public and private sectors working together. The most relevant examples are public-private partnerships for hospitals. At the beginning of the pandemic, we were able to perform medical interventions together that had nothing to do with COVID-19. In that same way, there is a great opportunity to treat chronic degenerative diseases. The private sector, for example, can help to monitor patients with diabetes, hypertension or high cholesterol.

Q: You have said that the public-private project Juntos por la Salud should become permanent. How can this agreement evolve beyond COVID-19?

A: Juntos por la Salud is a great initiative that came out of the collaboration between the Mexican Health Foundation, the BBVA Foundation, TecSalud and the UNAM School of Medicine. It includes more than 580 companies. However, there is a health access gap that still needs to be addressed, which forces us to migrate to distance care models. Juntos por la Salud has a role in helping to close these gaps and supporting the development of remote systems. Regarding infrastructure, at Juntos por la Salud we work to realize donations of ventilators and even support their development. The same goes for diagnostics, medicines and devices. We have to support the government so medicine purchases are adequate to avoid crises like the lack of oncological medicines in the country.

Q: What are the main challenges that the country faces with the arrival of the vaccine and its distribution?

A: The Mexican Health Foundation is available and willing to work with the government. Together with Hugo López-Gatell, we have been discussing ways to collaborate. The government has already presented a strategy for the distribution of the vaccine and now we have to ensure that it is well-executed. Logistics will undoubtedly be one of the biggest challenges. This is where the private initiative can help to ensure that the vaccine reaches the right places. We will also have to find ways to ensure that vaccines that require two doses are applied correctly. We have to guarantee that people do not miss the second dose. This is a matter of communication and social awareness.

Javier Potes

Director General of CMH

Democratizing Private Medicine Through Public-Private Agreements

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More about this person Q: What is CMH doing to mitigate the impact of COVID-19 in Mexico?

A: CMH established a partnership with the government to support patient care during the pandemic. Together with ANHP and other state hospital associations from Jalisco, Sonora, Mexicali, Queretaro and Nuevo Leon, we created a common front to approach the government and establish a bridge that would allow the creation of the needed structure for this project.

We analyzed the capacity of the private sector to collaborate with the public sector. When the outbreak started spreading, private hospitals had wider capacity as already programmed surgeries were being postponed due to fear of contagion. This allowed us to negotiate with the government and to collaborate by offering our services to treat non-COVID-19 patients coming from public institutions.

Q: How can this partnership improve healthcare access?

A: The lack of structure and human resources to provide healthcare in Mexico is evident. Most of our indicators regarding healthcare fall behind compared to other OECD countries. Right now, we are working on a proposal to secure healthcare attention in Mexico beyond profit. In the near future, hospital building might be limited to take advantage of the already existing infrastructure within the private sector to ensure the best service offering. This dynamic could follow the same transparent scheme proposed during the COVID-19 crisis in which the government would pay for our services at the same prices determined for the same procedure in the public sector. This opens a great opportunity for both sectors.

Before COVID-19, the private sector would have around 40 percent bed availability, which could perfectly be used to attend patients from the public sector at those referenced prices. Under the right collaboration framework, the private sector could start investing in infrastructure to attend government beneficiaries, focusing on service provision rather than the building itself as in regular PPPs. Within this model, the private sector would charge for its services instead of rent for the building. This is a much more effective way to secure patient access in both sectors. The private sector has been promoting these initiatives knowing that it would involve more agreements, finding new financing models and creating more accessible insurance products to democratize medicine.

Q: What challenges have CMH hospitals faced to maintain their regular activity and income during the COVID-19 crisis?

A: One of the main challenges was economic. We had to convert our hospital spaces because, even though we agreed to take care of non-COVID-19 patient flows, we still needed to be prepared to treat other patients as we would not deny them service. Therefore, we established rigorous measures to protect staff, patients and families.

As for our COVID-19 patients, we were in constant communication with AMIS to monitor service costs and determine which protocols would be useful to provide the most reasonable healthcare costs for both insured and out-of-pocket patients.

Héctor Martínez-Said

President of SMEO

Cancer Treatments Must Continue Regardless of COVID-19

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More about this person Q: How has the pandemic impacted cancer treatment services in the country?

A: People with cancer are at high risk with COVID-19, not just because of the cancer itself but also because of the condition of their immunosuppression. In addition, many cancers are associated with other major pandemics in this country, including obesity and metabolic syndrome, which in turn are linked to hypertension and cardiovascular disease.

Our cancer patients have been affected in three ways. Firstly, in terms of care, both in the public and private sectors, we have had to reassess priorities. We have had to find a way to treat cancer, which cannot wait, and protect patients against COVID-19. We have had to prioritize patients at the National Institute of Cancerology according to their diagnosis, addressing the challenges this involves.

The second way in which patients have been affected is through the reconversion of hospitals into COVID-19 clinics. This has led to displacements of patients to other centers. However, in many other hospitals around the country, assistance for cancer patients was postponed as the option of moving them to other COVID-19-free hospitals did not exist. The result is that people were not diagnosed and assisted at an early stage, which means they will have more advanced cancers by the time they are treated. Mexico’s cancer-related deaths currently stand at 85,000 a year.

The third impact has been on research. The pandemic has shifted CONACYT’s focus from cancer, as well as resources, to COVID-19. The council is looking into the impact of COVID-19 on subgroups, such as cardiac patients, children and pregnant women. In SMEO, through Cooperative Groups of Research, we have a national plan in which 103 researchers at 143 centers of IMSS, ISSSTE, federal and state health institutions are reporting on the impact of COVID-19 on cancer patients. This will help us understand the risk and allow us to adjust our steps.

Q: Regarding the government’s plan to create a more universal health system, what have been the main challenges in this area?

A: There are many challenges. There is a need to harmonize the different perspectives of players in the sector to overcome these challenges. The system is still too fragmented. The government, civil societies like SMEO, pharmaceutical companies and medical distributors should join forces by focusing on one objective: better care for the patient regardless of background. I hope that by the end of this or next year we can return to this agenda, which will also be boosted by the social commitment of pharmaceutical companies.

I am convinced that universal healthcare should not be limited to oncological drugs. The treatment of cancer is multidisciplinary, combining chemotherapy with surgery and radiotherapy. To limit access to just medication, you are dealing with only a third of the problem. All cancer treatment centers should be drawn into one vision. In the area of surgery, we need to ensure that anyone can have access to surgery performed by oncological specialists with the right experience. This harmonized approach is what the government and SMEO are moving toward.

Chiesi: Writing a Better Future for Patients With Rare Diseases

Read the complete article Driven by the belief that no patient should be left behind, Chiesi created a business unit in 2019 specifically dedicated to the development and commercialization of products for those with rare diseases. Patients with these diseases can encounter many difficulties, from receiving a timely and accurate diagnosis to accessing effective medical and social care. Chiesi believes this therapeutic area is of great importance, with equally significant impact.

One of the key projects for Chiesi’s Rare Disease division is alpha-mannosidosis. This is a rare genetic disease caused by the impaired function of the lysosomal enzyme alphamannosidase. Due to this deficiency, oligosaccharides are only partially broken down and over time, they build up in the body, causing increasing damage to cells and leading to many medical problems.

Alpha-mannosidosis is a heterogeneous disease, presenting a wide range of symptoms. The most frequent are recurrent chest infections and problems with hearing loss, distinctive facial features, cognitive impairment and progressive muscular weakness. Lack of voluntary coordination of muscle movements and skeletal and joint abnormalities can occur, as well. In adulthood, few patients manage to be completely independent socially, needing help with many activities and possibly requiring a wheelchair. High levels of oligosaccharides in urine can point to alpha-mannosidosis. Testing of the mannosidase enzyme’s residual activity and genetic analyses are used to confirm the diagnosis. Alpha-mannosidosis affects approximately one in 1 million babies born worldwide.

Founded in 1935, Chiesi is an Italian company that specializes in the research, development and production of medicines for respiratory, neonatological and cardiovascular diseases. It distributes its products in more than 80 countries. Chiesi entered Mexico in 2006 with CUROSURF, a treatment for RDS.

Jorge E. Valdez

Dean of the TecSalud School of Medicine and Health Sciences

TecSalud’s Response Levels to Face COVID-19

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More about this person Q: How has TecSalud contributed to the fight against COVID-19?

A: TecSalud created a COVID-Committee to analyze how the pandemic would affect Mexico, the healthcare sector and our institution. Thanks to these efforts, TecSalud and Tecnológico de Monterrey could support their decision-making and respond quickly to the upcoming challenges of COVID-19. As an educational institution, we were the first private education institutions in the country to cancel classes in campus and migrate to 100 percent online educational model. As for our medical academic centers, we assessed our bed and hospital capacity to optimize resources and expansion of our facilities, particularly in the ICU area. Based on the figures from other countries, we had a rough idea of what to expect in regards to hospitalized patient numbers and ventilator demand. All cases of COVD-19 that require hospitalization are assigned to our San José Hospital, which became the largest private COVID-19 hospital in the country. This has allowed us to standardize our attention as we have doctors fully dedicated to COVID-19 patients. We moved all postgraduate students doing their medical training specialty, to support our COVID-19 efforts. Our students in the mental health area are also joining our efforts to support families and medical professionals during these difficult times.

After this, we started a training program for all our medical staff so we could have them ready to act but also to protect them from contagion. Finally, we have strongly driven our research capacities to contribute to find a cure or treatment and also to generate scientific information to prevent and fight COVID-19. We are doing clinical trials on some drugs to test their effectiveness against COVID-19 and developing our own technology. This has led to many initiatives, including biomedical engineering projects such as the first Mexican ventilator VSZ-20-2.

I think that our integral response has demonstrated the huge potential that healthcare systems such as TecSalud, which integrates public-private initiatives, have to continue supporting the country to increase its healthcare coverage and to start developing its own research and technology to be competitive against other countries. If initiatives like these were supported around the country, we would develop Mexican potential to its fullest and greatly contribute to foster adequate healthcare. Mexico City and Monterrey have this part covered; the capital hosts the most important institutes in the country, which have also demonstrated that they are what the country needs because of their academic and professional approaches to healthcare.

Q: How are TecSalud’s students creating better opportunities for people who need it most?

A: One of the main characteristics of the school is social accountability. We have alliances with local health authorities that allow us to reach around 2 million people and create an interaction between the nonprofit private sector and the public sector. This reinforces students’ involvement in social issues and makes them more aware. Through these agreements, we contribute to providing care to the disadvantaged population with top-notch attention and equipment.

Juan Galindo

Chief Medical Officer of CHRISTUS MUGUERZA

Undisrupted Operation Through Effective Planning, Safety Measures

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More about this person Q: How has CHRISTUS MUGUERZA responded to the COVID-19 pandemic?

A: CHRISTUS MUGUERZA’s plan considered three aspects. The first was the safety of our associates and physicians who were to treat COVID-19 patients. Secondly, to ensure the best care for people suffering from COVID-19. The last factor was to educate the community on the disease and ways to prevent contagion.

We organized response teams at all of our hospitals in the country to ensure a coordinated response. These are formed by the medical director of each hospital and another three to five specialists, ideally a pneumologist, an infectologist and/ or an intensivist.

Our response has resulted in a 7.4 percent mortality rate and at our best performing hospital, the number falls to 4 percent. These are low rates. Despite facing an overflow of patients at one point, we were able to balance the workload and ensure our associates’ safety and our patients’ prosperity. From the emergency room to the intensive care unit, we defined protocols that detailed the actions of everyone involved in the process, from the physicians to the cleaning services team.

Furthermore, it was very important for us to provide continuity for our regular medical appointments. Emergency situations do not stop and nor do treatments for patients with chronic diseases, so all our hospitals followed a hybrid modality to ensure continuity of attention for non-COVID-19 patients.

Q: How is CHRISTUS MUGUERZA participating in the digital transformation of the CHRISTUS network?

A: One of our hospitals in Saltillo, Coahuila has been fully digitalized. We were aware of the need to integrate our system to an interconnected digital world that could improve our personalized attention. We began by integrating an electronic medical record (EMR) at our facilities to encourage full digitalization. The EMR we use covers the complete care of a patient and every member of the staff has learned to use it. The implementation process took years and so did the training. However, we have had positive results from its implementation. The EMR allowed us to interconnect all areas of the hospital and provides higher levels of safety for the staff. It can help avoid mistakes in everything from medications to room availability.

Q: How does the network ensure that more patients have the access to your integral service offering?

A: CHRISTUS MUGUERZA is a nonprofit organization. All the earnings we generate go to taxes, reinvestment to strengthen our performance and to social community service. Our social responsibility has enabled us to provide expensive care to children in different parts of the country. We have attention centers that range from primary care to higher levels of care and we take our services to zones that lack access to healthcare. Moreover, we invest MX$50 million (US$2.4 million) in our residency training program that is directed at 150 medical students.

Misael Uribe

President of Médica Sur

Knowledge Needs to Be Generated

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More about this person Q: What makes Médica Sur one of the best private highspecialty hospitals in Mexico and the best in Mexico City?

A: This is thanks to our social scope and objectives that have shaped Médica Sur from its origins 40 years ago. The hospital was founded by a group of doctors and academics who perceived the difficulties of providing good healthcare and of finding a hospital with good practices and values. These factors, alongside rules and obligations, have shaped the quality of services found at Médica Sur. Innovation and education have also been differentiators for our patients.

Q: What does you association with Mayo Clinic on neurology mean in terms of services?

A: This important association speaks of quality and education. Médica Sur is open to partner with international and national institutes in all specialties because we know there is a lot to learn. Médica Sur also has a great deal to teach.

In Mexico, we have an alliance with Médica Santa Carmen to attend renal insufficiency by creating a hemodialysis unit. We have also partnered with technology groups that allow us to develop our own software and robots that help diminish risks for patients and doctors at Médica Sur. The digital part of the hospital is very important and we focus on always developing and introducing tools that are going to benefit patients and doctors. We are consolidating a super safe hospital where you can go for treatment without fear of any kind. This is especially important now that we are facing a pandemic and safety inside the hospital is key to avoid further contagion.

Q: How does Médica Sur promote medical education and research?

A: From the beginning, Médica Sur has been a university hospital. To date, we offer 17 graduate courses and we have from 120 to 170 doctors who work and study at the hospital. Aside from institutional hospitals in Mexico, we are the ones that dedicate the most to research. Knowledge, beyond learned, must be generated and we have the mindset and tools to do it. Médica Sur believes in innovation and we encourage the use of technology, such as robots.

Q: How is Médica Sur facing the pandemic caused by COVID-19?

A: Médica Sur has created a document about the protocol and steps to follow for other hospitals which follows the Ministry of Health guidelines. This operating manual was created out of our experience attending COVID-19 cases and also the situation inside the hospital, guidelines and protection for our staff and the patients at Médica Sur.

We have dedicated a separate area of the hospital to attend COVID-19 cases. We took this decision based on the patients we already have at the hospital and to also provide the proper attention to COVID-19 patients during the crisis. We knew we needed clear guidelines to approach this epidemic, which is why we developed an operational manual based n the official guidelines of the Ministry of Health and decided to share it with the facilities that need it.

Alberto Sanchez

Operations Director of Faro del Mayab

Innovation, Social Responsibility Define Faro del Mayab in Mexico’s Southeast

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More about this person Q: What makes Faro del Mayab one of the best hospitals in Mexico’s southern region?

A: In December 2020, we celebrated our first-year anniversary. We have been able to offer an innovative approach to health through the use of technology and state-of-the-art equipment. We are a top choice among the C+ to B population in the Mexican southeast in a developing and growing region of the country. Due to its prosperity, Merida is experiencing an influx of many people to the city and this has enabled us to recruit doctors from different parts of Mexico. This has distinguished Faro del Mayab as a highly inclusive hospital with high-quality standards of attention. Moreover, as part of the CHRISTUS MUGUERZA Health System, we guarantee international quality standards for patient attention and safety. At the hospital, we perform thoracic surgery, cardiac catheterization, highly specialized orthopedics and neurosurgery. I can confidently say that we are the best highly specialized hospital in the southeast of Mexico.

Our social responsibility program is another advantage. We work with Global Spine Outreach to provide free scoliosis surgeries to children. Moreover, alongside Operation Smile, we perform around 250-300 free cleft lip and palate surgeries per year. At a local level, Faro del Mayab works with local health authorities and public entities like DIF to treat these ailments, which is also enriching for medical professionals as we work with foreign institutes and state-of-the-art technology.

Before implementing any new social program, Faro del Mayab solicits the local support of doctors and authorities. This ensures we can expand the programs so they reach the people who need them the most.

Q: How has Faro del Mayab integrated new technology to improve its offering and performance?

A: Our imaging department is well-equipped, with 1.5T resonance equipment for traumatology and orthopedics’ studies. Faro del Mayab offers angioresonance studies and high-resolution equipment for diagnostic studies. Moreover, we have X-ray machines and the best and newest mammography equipment in the region. Faro del Mayab’s hemodynamic equipment is also the most advanced in the region. In addition, we have a strong department for clinical analysis and a blood bank.

All of these are complemented by highly competitive medical professionals who work in our five ORs. Our doctors’ input has been a watershed for our growth as their generational differences have complemented each other and enriched the way we approach and treat patients.

Q: What potential does Faro del Mayab have to become a reference for medical tourism in Mexico?

A: Faro del Mayab is working with three companies that focus on medical tourism. They work as intermediaries for foreigners living in Mexico or who have a foreign medical insurance policy and are seeking medical attention with us. Faro del Mayab works with recognized physicians and intermediaries to be able to grow as an international care center.

Juana Ramírez

CEO and Founder of Grupo SOHIN

Connected Health Ecosystem a Lesson and a Challenge From the Pandemic

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More about this person Q: How effective have personalized healthcare services been, beyond personalized medicine?

A: For more than 11 years, Grupo SOHIN has dedicated its different service areas to patients living with a chronic or degenerative noncommunicable disease or highly complex infectious disease. We are talking about 1 percent of all the patients with a public or private insurer. We are also talking about those who represent more than 60 percent of healthcare spending. In this sense, what we have shown throughout this time is that a patient who is correctly cared for and assisted is a patient who has better therapeutic response to treatment. They are patients who obtain better results and who benefit the health system financially. We stress the need to treat the patient as a person, as a social being, rather than just a page number with a diagnosis.

Q: How has Grupo SOHIN’s integration of technology and innovation improved your health treatments?

A: Grupo SOHIN has been working on telemedicine for 10 years. Long before the start of the pandemic, we were already advocating for this model. For a long time, we have stated firmly that patients with immune deficiencies should only go to hospitals when necessary.

Q: During the COVID-19 pandemic, how has Grupo SOHIN ensured continuous care provision?

A: At Grupo SOHIN, we have a team of 150 people working full time and 400 professionals who we hire on demand. This allowed us to be very flexible toward the needs of our patients in 25 cities in Mexico. Likewise, the alliances that we have generated during all these years allow us to coordinate medical care in different hospitals very quickly. We know the processes of each one of them in depth and we can support our patient in every part of the process.

A couple of weeks before the pandemic hit, we launched the Cuidarte clinics. This is an integrated outpatient care model focused on complex autoimmune and onco-hematological diseases. The first Cuidarte clinic was opened in Mexico City but we have opened mobile units in Guadalajara, Veracruz and Queretaro. What we seek with this model is to bring medical services closer to patients and to optimize the costs associated with these diseases.

Q: Grupo SOHIN is a pioneer in genomic diagnostics for cancer patients, especially for breast cancer patients. How can this become available to more people?

A: We continue to urge public institutions to provide patients with molecular diagnostic tools that optimize resources and improve the response to treatment. We have also made progress in implementing genetic prevention tests. Today, we not only work in that area but also genetic diagnostic tools for cardiometabolic diseases and rare diseases. We do this with partners around the world, such as major diagnostic laboratories. We have also successfully included genetic prevention testing. This means understanding the potential for cancer, heart attack or metabolic diseases from genetic information. Having this information allows people to develop personalized care and prevention plans.

Rocío Bermudez

General Manager of Olarte y Akle Bacteriólogos

Precise Clinical Diagnosis to Strengthen Portfolio

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More about this person Q: What are the benefits of offering simple home tests?

A: Before the COVID-19 pandemic, Olarte y Akle’s crown jewel was its home tests. We have provided this service for years and while it may seem unimportant, we are aware of the challenge of welcoming our staff at home. Patients at any laboratory facility already feel uncomfortable because of why they are there and how invasive tests can be. However, we have been able to break this barrier and make them feel comfortable at our facilities and at home. It has been gratifying to see them trusting our services and welcoming our collaborators comfortably into their homes.

Q: How did Olarte y Akle become one of the first labs authorized to perform COVID-19 tests?

A: We were the first private laboratory to receive authorization for COVID-19 tests in Mexico. Olarte y Akle is highly committed to supporting early diagnosis of the virus, so we had to quickly understand the methodology and protocol for taking samples. We have a lab for molecular biology, an expert chemist, a pathologist medical director and a committed staff that allowed us to start validating tests. We based our process on the Berlin protocol for swabbing samples, developing a technique that allows us to be gentle with the patient. Despite working with half of our staff during the highest peak of the pandemic, we were able to cover our demand while maintaining all safety measures for our collaborators in and out of our facilities.

Q: How is Olarte y Akle contributing to fostering prevention and decreasing Mexico’s disease burden?

A: There are special cases that require more investment or specialized services and our laboratory has found ways to respond to this without charging an additional cost to our patients or physicians. This has been of great help to the medical community because it saves them time and cost and provides them a clear view from which to act.

Q: What alliances have been key to your success?

A: We have alliances with global laboratories, as well as the Mayo Clinic and the College of American Pathologists (CAP) to provide better information to our patients and to remain up to date on new technologies or platforms. Through these alliances, Olarte y Akle adopts new diagnostic practices or ways to approach a disease to add further value to our services.

Q: What are the company’s near-term goals?

A: We are focusing on the institutionalization of the company to continue growing. This is part of our 10-year strategy to achieve organic growth and be present in more states with our own facilities and home services. We are working on new home tests such as ultrasounds or X-rays. Olarte y Akle is looking to invest in state-of-the-art portable equipment for such studies. We are also waiting to introduce more COVID-19 tests, as well as tests for food sensitivities and allergies. To tie all of this together, we are strengthening our efforts on creating more personalized diagnostic approaches based on the patient’s profile, age, gender and genetics.

Mario Sicilia

Director General of Laboratorio Médico Polanco

Developing World-Class Technology Solutions for Mexico

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More about this person Q: How has Laboratorio Médico Polanco adapted and responded to the needs brought by the pandemic?

A: Our laboratory in Puebla, Laboratorios Clínicos de Puebla, has more than 70 years of experience and performs molecular diagnostics. Thus, we have vast knowledge of polymerase chain reaction (PCR) tests. While this technology already existed, we developed a test to detect the COVID-19 strand using worldwide accepted protocols. In March 2020, Laboratorio Médico Polanco became the first to develop this test in Mexico. Thanks to this proprietary technology and an agnostic platform that allows different reagents, we had the flexibility to switch brands while the country faced reagent shortages. This resulted in business continuity and an important competitive advantage. Laboratorio Médico Polanco’s initial capacity was of 250 tests per day. We decisively invested in technology and human resources. Allowing us to scale to more than 1,000 tests per day in four months and eventually 4,500 test per day. We believe that this capacity makes us the largest national laboratory for PCR testing in Mexico. Cumulatively, we have applied close to 810,000 tests to date and we are convinced that testing is key to control and overcome the pandemic.

Other than PCR testing, we have developed antibody tests to detect immunity against the SARS-CoV-2 virus, as well as home service, telemedicine, online payment and IT solutions to interact with our patients. We are convinced that these abilities will play a key role in the new normality.

Our hope is that this pandemic will force people to realize the importance of prevention and early diagnosis. The pandemic has demonstrated how dangerous it is for people to be unhealthy or to suffer from other chronic diseases that could be easily prevented. Unfortunately, Mexico is among the top countries regarding diabetes and obesity. Eighty percent of the health budget is destined to treat four chronical degenerative diseases. These resources could be better used to early detect high-risk individuals.

Q: Aside from COVID-19 testing, what else is Laboratorio Médico Polanco introducing to its services portfolio?

A: We are working on a D-dimer test that detects inflammation and can help predict how a patient will evolve during an infection. For COVID-19, this is very valuable. We are also working on early detection of cancer and diabetes tests and we have a new promising test to measure vitamin D, which should be ready soon.

Regarding the pandemic, we have been given the opportunity to operate the laboratory at the temporary hospital at Centro Citibanamex. This is a world-class hospital that was built to create additional capacity to face the pandemic. It is an extraordinary project with top medical staff. This experience has been very gratifying; we are seeing the impact of this initiative on families, since the service is free of charge and it has already saved thousands of lives. While this center has had outstanding results, it has not been used as much as we had initially anticipated. Its capacity has been only partially used because of the criteria to take patients and the difficulty to transfer patients through the healthcare system.

Eduardo Lara

Vice President, Head of Health Latin America at RGA

Digitalization to Make New Market Segments Financially Sound

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More about this person Q: How has RGA used its global experience to focus on the Mexican health insurance context?

A: Each year, we do a retreat in which we analyze ways to strengthen collaboration among regions more effectively and in line with our customers’ needs. Digitalization is the new normal and RGA is embracing this because it is also in the best interest of our customers. In Mexico, we need to try, to fail and to learn. I believe we are still in this stage in the country of launching new products and seeing how they fare. If they fail, we can fine-tune all different variables involved. For instance, we are conducting a global study on COVID-19 and its potential financial impact. Given our reinsurance schemes, if we need to deal with a pandemic, we will be required to pay a lot of money.

Latin America, especially Mexico, is at the forefront of one of the newest products RGA is about to launch. A special insurance product that provides coverage for people who live with a chronic disease. Traditionally, insurance covers the potential risk of being ill but not a pre-existent illness. We designed a product that will be completely digital. After more than a year in development, we are combining artificial intelligence and Big Data to embrace the digital revolution.

Q: How is technology transforming insurance companies?

A: The digital revolution has impacted the healthcare industry greatly, as well as insurance companies. In particular, health insurance companies are suffering a double impact. On the one hand, you have genomics, personalized healthcare and smart medicine, among other technological advances that are being integrated into patient treatment. On the other hand, insurance companies are trying to expand their distribution channels and are adopting blockchain technologies and smart coverage, among other features, to make the client’s journey as smooth as possible.

Thanks to technology, we have an extraordinary opportunity to make processes smoother for our customers. Most importantly, technology will enable us to participate in different market segments. Today, private insurance companies have been focused on the upper and upper middle-class segments, where a broker or agent model usually works well. When thinking about mass products, we need to think about other distribution channels. Smartphones and other technological features will enable us to participate in other segments while reducing our costs. For instance, we can employ a chat box where patients can talk to a doctor before going to the hospital. Telemedicine provides filters that will provide the user with a better service while greatly reducing costs.

Q: How will RGA help insurance companies to take this next step?

A: We are creating these products and solutions so direct insurance companies can distribute them. At the end of the day, we will absorb the financial risk. Insurance companies need more focus on satisfying the needs of individuals and companies. RGA has been supporting them directly, understanding end customers’ current and changing needs so we can truly serve them. We have all the infrastructure to design a product that actually satisfies those needs.

Salvador Arceo

Director General of Plan Seguro

Juan Pablo González

CFO of Plan Seguro

Digitalized Company Delivers Effective Insurance Plans

Read the complete article Q: How successful is your preventive healthcare approach in improving user outcomes?

SA: The model has been a total success because all of our plans are specifically targeted to provide users with easy access to health, while bringing them closer to preventive healthcare opportunities and encouraging them to maintain a healthy lifestyle. We offer both basic and more complex, complete plans. Our flexibility and variety allow users to choose the policy that best meets their needs, without having to pay for extra services that are not going to be required. Plan Seguro also offers traditional coverage, including major medical expenses given the demand for these products.

Q: How do you measure the impact of your products on people’s lives?

SA: We track this through the use of our policies. Through providers, we can also measure the impact of our plans and follow up on patients. So, through providers and the use of facilities, we measure how our policies benefit patients.

Q: How has technology changed Plan Seguro’s operations and products?

SA: Plan Seguro’s digital transformation began years ago. Looking ahead gave us an advantage to face the challenges that emerged with COVID-19. While the whole world had to accelerate its digital transformation, we had already adopted the technology. The more we dabble into digital tools, the more efficient the company gets. For over a year, we have worked on creating more personalized plans, which we have now launched. We offer four plans that can be customized according to the user’s needs. A digital tool is available to the broker to sell the plan.

JG: Four years ago, the company started to digitalize its process to have a robust system that would allow constant product innovation. We had to digitalize the foundations of the company: policy administration and claim management. Once this was done, we could start transforming our service offer and practices. To date, more than half of our new policies are offered digitally. Moreover, we moved to digital paperwork 24 hours after the COVID-19 contingency began to ensure a safe service and to fully work digitally. Any user can now request a quote for their ideal policy digitally. This ensures functionality for our users and our own employees. Furthermore, Plan Seguro offers an app that allows users to follow up on their benefits and explore our network of hospitals and doctors. This helps them make the most of their plan. Technology is the basis for our growth.

Q: What other measures should be implemented to increase insurance penetration in Mexico?

SA: It is the industry’s task to offer creative policies and health coverage plans. With a wider offer, people would find a solution that fits them best and really be able to pay for something they will use. I think that education should be highly encouraged and the authorities should take action to promote the importance of health and its prevention. Today, people prefer to insure their car rather than themselves.

Alejandro Luna

Partner Litigation and Life Sciences Co-Chair at OLIVARES

Mexico’s Weak Health Regulations Threaten Well-Being

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More about this person Q: How can Mexico improve the enforcement of IP law regarding pharmaceutical products?

A: For many years, new uses of known products, including primary and secondary medical uses, have been patented by the Mexican Patent and Trademark Office (IMPI). The express recognition that new uses are patentable would provide the required legal certainty for these products. Better definitions and clear standards for novelty, inventive step and utility, along with the preparation and issuance of an Examiner’s Manual would benefit the patent law with particular impact on the pharmaceutical sector.

Q: With the ratification of USMCA, what would you identify as the main concern the pharmaceutical industry has regarding IP protection?

A: The concern would be proper implementation of some obligations established in USMCA. Important areas for implementation relate to patentability, including new uses, although this is not a USMCA obligation. It is necessary to review IMPI’s current practice and the integrity of patent linkage, including the eventual amendments to notices in the Mexican patent linkage process. Also, there is need for the proper establishment of patent term compensation for unjustified delays in the patent process.

Regarding enforcement, there are very important opportunities for improvement, such as direct civil remedies available in case of any violation of IP rights, including trade secrets. The current system in which the titleholder is required to exhaust two different proceedings, administrative and civil, in order to get as compensation an award of damages derived from the violation of an IP right is inefficient, absurd and only encourages illegal activities due to the long period of time before there is a real sanction.

Q: How will the recently approved labels for food and non-alcoholic beverages hurt or benefit the goal to reduce obesity and overweight in Mexico?

A: I do not believe in the rationale behind the Official Standard recently enacted. In my opinion, the NOM is illegal. One of the main concerns refers to provision 4.1.5, which states that pre-packaged food and non-alcoholic beverage products that include one or more warning seals or a sweetener inscription shall not include on the label children’s characters, animations, animated cartoons, celebrities, athletes or mascots, interactive elements such as visual-spatial games or digital downloads (all of them addressed to children) that encourage or promote consumption, purchase or selection of products that have an excess of critical nutrients or sweeteners and shall make reference on the label to unrelated elements of the product. It must be stated that this NOM violates the human rights protected by our Constitution, such as freedom of profession, industry, commerce or work, information rights, freedom of speech, property rights, economic rights and copyrights. It also contravenes provisions that preserve the use of intellectual property contained in our IP Law, Federal Copyright Law and Federal Law for Protection of the Consumer. It also violates several international treaties to which Mexico is a party.

Juan Luis Serrano

Partner-Life Sciences of Sánchez Devanny

Opportunities Abound in Mexico’s Life Sciences Sector

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More about this person Q: What is the scope of Sánchez Devanny’s work in the healthcare sector?

A: We work with all industries regulated by COFEPRIS so our clients include pharmaceutical companies (both innovators and generics), medical device manufacturers, technology companies venturing into the healthcare sector, for example through telemedicine, CROs, hospitals and companies that provide laboratory analyses. We also offer consulting regarding government procurement processes, as the main provider of health services in Mexico is the government – both federal and state level. Many legal issues often arise when selling medications or medical devices to the government and we advise manufacturers when purchasing problems arise. While we do not do regulatory submissions, we advise on the process.

We also deal with import issues and with crossover IP and regulatory matters, such as approval of brands for life sciences companies. We work with the tobacco and vaping industries, advising them on local regulatory issues, for example in challenging COFEPRIS’ recent position against vaping devices. We also have important clients in the cosmetics sector, which we support on labeling and consumer protection issues.

Q: What opportunities do you see in the recent regulations regarding cannabis products?

A: Cannabis finally moving forward in Mexico, in great part thanks to the litigation process, but a significant threshold was reached this month with the issuance of the Regulations associated to health products containing cannabis derivatives. We are also waiting to see the final version of the law, which will regulate adult use. The Senate already passed it but we are still waiting for Congress to approve it. Once cannabis is legalized, there will be significant opportunities for local and international companies in this market.

There are many different potential players in the cannabis market, from large multinational companies’ small stores and farmers. The main challenge for local companies is to fully understand the law, its implications and the possibilities it brings. As long as the rules are clear, there is an opportunity for everyone to participate.

Q: How are the recent changes in government procurement processes affecting the Mexican healthcare sector?

A: I do not believe this is the best policy, to be honest, as the government must ensure that all companies participating in the Mexican market adhere to the same regulatory standards and policies. These regulatory changes are forcing Mexican companies to work extra hard to compete.

Q: What measures should be taken to strengthen the role of local regulators?

A: It is necessary to pay greater attention to COFEPRIS, which has been underfunded for the past year, and to clarify and strengthen its role as an independent regulator. COFEPRIS should be at the same level as the regulatory agencies of major powers in the world such as Europe, the US, Australia and Canada. A strong regulatory framework and regulator can ensure the industry has a good combination of multinationals and strong national companies.

Fernando Becerril

Partner and President of BC&B

IP: Life or Death Situation for Branding

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More about this person Q: What tools does BC&B offer entrepreneurs in the area of intellectual property?

A: BC&B supports entrepreneurs by guiding them to find the right corporate purpose for their company so they can be legally protected. We also help them in making their business plan, seeking profitability, finding the DNA of what they intend to undertake, looking for investors and building a commercialization model. In Mexico, consulting services are perceived as an expense and not as an investment.

Q: Is the lack of knowledge regarding IP an exclusive problem of startups?

A: Every company should be clear about IP. Some very large companies like Carso, Grupo Modelo, Bimbo and Televisa have IP departments in-house and are self-sufficient. But in general, companies do not have these capabilities and then believe that their general practice lawyer or even their accountant, who is dedicated to 10,000 different things, should also be aware of branding issues.

Q: What is the biggest risk that a company takes when not paying attention to IP matters?

A: Companies could be jeopardizing the profitability of the business and even its existence. Many businesses now depend on a valuable brand to represent them, which may contribute more than 50 percent to the company’s sales. But if its brand IP right is not properly protected and is challenged, it puts the company in a crisis situation because they can no longer market or advertise its products.

Q: How do you think the new IP law presented to the Senate will benefit the health industry?

A: Promotion of a healthy ecosystem to innovate and protect IP will generate benefits for all, not only in the pharmaceutical industry. This initiative to reform the law is intended to promote and encourage innovation and technological development and thereby boost the economy and our competitiveness globally.

Q: Have you detected a lack of investment in Mexico from pharmaceutical companies?

A: There has been a lack of investment. We are fortunate to manage a good portfolio of pharmaceutical laboratories that file patent applications in Mexico. Many main players have submitted their applications through us and some of the leading laboratories submitting an average of 100 patent applications some years ago. Today, those same laboratories are submitting around 25 applications a year. This implies a decrease in investment.

Q: What factors drive drug counterfeiting in the country?

A: Definitely it is mostly cost. People are not normally aware of the impact that a fake product could have on their system and on their health; they just want to get a better health condition and may not have the resources to acquire an original product, which leads people to purchase products of questionable quality and origin. Shortages within the public health system also influence that people try to get their medicines by any means available.

Miguel Prida

President of Grupo Consulmed

Varied Healthcare Portfolio Helps Brave Pandemic

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More about this person Q: How did Grupo Consulmed face the COVID-19 pandemic?

A: The first two months of the pandemic were difficult because a large number of our health personnel who were at the front line and could not continue working as they were among the vulnerable groups to COVID-19, either by age or by suffering from a chronic degenerative disease. They were sent home for indications and government orders, however, we made sure that none of those doctors or nurses lost their jobs. This was a challenge from a financial perspective that Grupo Consulmed had to continue paying salaries at 100 percent. Another problem was also that our clients had fewer staff in their facilities, which forced them to suspend operations.

In addition to our occupational health service, Grupo Consulmed has other business units that helped us face the pandemic, such as the supply of medicines, healing materials and medical equipment and that was strengthened during the pandemic, since we incorporated products that were essential to combat COVID-19. As a long-standing trusted provider of medical supplies, we faced little competition from companies that sporadically started offering these products. Our sales in this division grew by 500 percent, which helped us balance our occupational health and pharmaceutical divisions that had been experiencing financial difficulties.

To date, our balance is recovering as we have experienced even greater demand for our services as companies expanded the number of doctors or nurses in their facilities to ensure the safety of their staff. We also have an IMSS certification that ensures we understand the official guidelines for the new normal.

Q: How has Grupo Consulmed innovated in its business divisions?

A: Our membership division grew but instead of offering presential visits, we migrated to phone and digital consultations. To this service we added psychological and thanatology attention and medical orientation in case of a suspected COVID-19 case. Our occupational health service works with clinical laboratories and has been supporting them with COVID-19 diagnostic tests or other specialized services to respond to the pandemic, such as ambulance services.

Due to our service continuity, expertise and reputation, Grupo Consulmed stood its ground during the pandemic. We never sought to abuse prices on supplies or to offer services that we had no experience with. Grupo Consulmed also allied with MAG Medical Group, which has a strong healthcare offer. Through this strategy, our collaborators are getting healthcare services at preferential prices.

Q: What infrastructure plans does Grupo Consulmed have?

A: We have a project for infusion clinics that will resume after the pandemic comes under control. Together with pharmaceutical companies, we also developed mobile clinics to ensure treatment provision during COVID-19 as fear of contagion kept patients away from hospitals. Moreover, we are betting on medical tourism and we are interested in developing infusion clinics in the country’s main beach destinations.

What Can the Health Sector Learn From the COVID-19 Pandemic?

Javier Potes

Director General of Consorcio Mexicano de Hospitales (CMH)

Fragmentation of the Mexican health system and the existent barrier between the public and private sectors represent a broad area of opportunity to build a united system based on personalized health responses for patients, regardless of the entity they reach out to. The COVID-19 pandemic opened up long overdue communication channels with the government, resulting the organization of multisectoral efforts with potential to last beyond the duration of the pandemic. How can the sector take advantage of this tragic event to improve healthcare in the long term?

A: We faced many scenarios that will impact the hospital environment. For instance, patients with mild COVID-19 symptoms were sent home to recover because they did not need to be hospitalized. However, this raised the potential of sending a message of abandonment to the patient, even though this was not the intention. This scenario opened up the spectrum for telemedicine and digital consultations and checkups but it has also brought to light the many needs and deficiencies of this practice in Mexico, such as payment methods, clinical records or medicine prescriptions. We are well aware that all of these solutions exist but their implementation is still not a reality in the country. By implementing the right telehealth tools, hospital care could be delivered at the patient’s home with all the necessary equipment.

Héctor Valle

Executive President of FunSalud

A: There are positive instances of the public and private sectors working together. The most relevant examples are publicprivate partnerships for hospitals and the Juntos por la Salud initiative. At the beginning of the pandemic, we were able to perform medical interventions together that had nothing to do with COVID-19. In that same way, there is a great opportunity to treat chronic degenerative diseases. The private sector, for example, can help to monitor patients with diabetes, hypertension or high cholesterol.

A: There is no amount of money that can structurally resolve the extreme needs of our country’s health system. The best and most effective way to have a positive impact on people most in need is clearly through increased public-private alliances. Infrastructure, technologies and human resources from the public and private sectors are required to close the access gap to quality healthcare services. The sector is here to help provide critical services to the population and give people the opportunity to grow and to pursue and achieve their dreams. We can find many more ways to use our strengths and complement each other. CCE wants Mexico to become a country that truly provides quality of life and opportunities for economic development.