Mexico Health Summit 2021 Impact Report by Mexico Business Publishing

IMPACT REPORT

MEXICO HEALTH SUMMIT 202O/21

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2020/21 Healthcare has been vital for Mexico’s survival, stability and prosperity. Never before has this sector been put to the test as rigorously as in 2020. While the country faced a global pandemic, it also faced ambitious public reforms based on the government’s austerity policy to move toward universal healthcare. Success was only possible through collaboration and communication.

Companies embraced technology to secure business continuity, medicine and medical devices supply and, most importantly, treatment continuity. Ensuring health provision for both COVID-19 and non-COVID-19 patients had to be a key priority, especially considering Mexico’s epidemiological profile. Amid this turbulence, the country also showed its potential to thrive as an R&D and innovation center.

During the first digital edition of Mexico Health Summit, industry leaders approached the sector from different perspectives, touching on value-based models, new market ventures and investment coming to emerging market niches. This exclusive forum also provided unique networking opportunities through the intent-based, AI-driven matchmaking technology platform Brella.

C O N F E R E N C E I M PAC T

CONFERENCE IMPACT

conference participants

270

How would you rate the quality of the conference program and speakers?

166

companies

13% Greatly exceeds expectations 30% Exceeds expectations 48% Meets expectations 9% Below expectations

CONFERENCE SOCIAL MEDIA IMPACT

speakers

Breakdown by job title

sponsors

6.4% President/ Board member/ Partner 17.7% CEO/ Director General/ General Manager/ Country Manager 2.5% VP/ CFO/ COO 30.5% Director 27.1% Senior Manager/ Manager 9.4% Associate / Executive 3.9% Doctor 2.5% Researcher / Analyst

PRE- CONFERENCE SOCIAL MEDIA IMPACT

11,938 direct impressions during MHS

63,784 direct pre-conference LinkedIn impressions

6.11% click through rate during MHS

6.01% pre-conference click through rate

26,600 direct impressions during MMF

51,300 direct pre-conference Twitter impressions

BRELLA

Mexico’s leading B2B conference organizer introduces the world’s leading event networking platform. Delivering intent-based matchmaking powered by Artificial Intelligence that connects the right people. Network, no matter where you are.

1,777 matchmaking communications

270 participants

How would you rate the quality of the matchmaking on Brella?

190 1:1 meetings conducted

13% Greatly exceeds expectations 35% Exceeds expectations 39% Meets expectations 13% Below expectations

MATCHMAKING INTENTIONS

1,681 Networking 1,200 Trading Total

3,491

204 Recruitment 406 Investment

C ompany Attendance • 3M MEXICO

• CHRISTUS Muguerza

• AbbVie

• CIRCUTOR Mexico

• AES

• Citieffe

• Aesculapius Baer

• Consejo Mexicano de Neurologia

• AIDICARE

• Consorcio Mexicano de Hospitales

• Akza

• ConvaTec Mexico

• Allen Laboratorios

• Croda

• Allergan/AbbVie

• DEG

• Alvarez & Marsal

• Dell Technologies

• Amazon Web Services

• DocPlanner

• AMELAF

• Edwards Lifesciences Mexico

• AMIIF

• ekomite

• ANADIM

• Eli Lilly & Company

• Analitek-BioSafety

• Embassy of Canada in Mexico

• ANICANN

• Embassy of The Netherlands in Mexico

• Apolo Health

• Energy to Market

• Apotex

• Eolis

• Ascendis Capital

• Ergotron

• Asociacion Mexicana de Laboratorios Farmaceuticos

• Everis

• ASPEN LABS

• FANASA

• Atramat

• Farmacias Yza

• Axios International

• Farmacos Continentales

• Baker McKenzie

• Farmalisto

• Becerril, Coca & Becerril

• Ferring

• Beckman Coulter

• FrontierView

• Biocodex de Mexico

• Generac Mexico

• bioMerieux

• General Consulate of Canada

• Boehringer Ingelheim

• Gilead

• BPF Part of QbD Group

• Gobierno de Ontario en Mexico

• Brightsea

• Google Cloud

• Bristol Myers Squibb

• GRE Relaciones Estrategicas

• British Embassy in Mexico

• Grupo Angeles Servicios de Salud

• Bupa Mexico

• Grupo Bruluart

• Cal y Mayor

• Grupo GSMexico

• CANIFARMA

• Grupo Promotor de la Industria de Cannabis

• Cardinal Health

• Grupo Sanfer

• Carestream

• Grupo Viso

• Carmen Amezcua

• GSK

• Centro Medico ABC

• Hospital Moscati

• CHG-Meridian Mexico

• Hospitales Star Medica

• Chiesi Mexico

• Hospitaria

• CHRISTUS CEI

• ICAN

C ompany Attendance • Icon Group

• PLM

• Inosan Biopharma

• Prevem Seguros

• Instituto Mexicano del Seguro Social

• RGA, Reinsurance Company

• Insumos para la Salud

• RM Pharma Specialists

• Internacional Farmaceutica

• Roche

• Janssen

• San Luis Potosi City Council

• Johnson & Johnson

• Sanchez Devanny

• Jones Day

• Sanofi

• Kimberly Clark

• Sartorius de Mexico

• Klockner Pentaplast

• SBL Pharmaceuticals

• Labaratorios Liomont

• Seca

• Laboratorios Alfasigma

• Servicio de Logistica Empresarial y Comercial

• Laboratorios de Especialidades Inmunologicas

• Siemens Healthineers

• Laboratorios Sophia

• Silanes

• LAVARTEX

• SocialDiabetes

• LifeSciences Consultants

• Sociedad Mexicana de Oncologia

• LMP

• SOHIN

• MAG Medical Group

• Somar

• Medartis

• Speaker de Negocios

• Medica Sur

• Stripe

• Medistik

• Synthon Mexico

• Medix

• T5DC

• Merck

• Tecnologico de Monterrey

• Merck Biopharma Distribution

• TecSalud

• Mexico Salud

• Teva Pharmaceuticals

• Microport

• Total Integridad & Certeza

• Minsait Indra

• Trifermed

• MSD

• Trilations

• Multiplica

• UANL

• Multivac

• UDIMEB

• Mural Med

• Ultragenyx Pharmaceuticals

• Nadro

• Universidad de Monterrey

• NEWLINK

• Universidad Iberoamericana

• Novartis

• Veeam

• Olivares

• Vitamedica

• OLIVARES

• Viveo Health

• Omron

• Willscot

• Pantaleon

• Wood

• Particular

• Zacsoft

• Pascual Asesoria y Consultoria

• Zydus Pharmaceuticals Mexico

• PharmAdvice • Pierre Fabre

P rogram

JANUARY 27 TH , 2021 08:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

08:55

WELCOME TO MHS 2020/21

09:00 STATE OF THE SECTOR: FROM STRUCTURAL REFORMS TO COVID-19 Speaker: Patrick Devlyn, President of the Health Commission at CCE

09:45 THE HEALTHCARE SECTOR IN THE NATIONAL ECONOMY Moderator: Juan de Villafranca, Executive Director of the Mexican Association of Pharmaceutical Laboratories (AMELAF) Panelists: Arturo Morales, Corporate Affairs Director at Landsteiner Scientific and President of AMELAF Deyanira Chiñas, Commercial Director of T5DC and President of the National College of Pharmaceutical Biologists of Mexico Carlos López Patán, Director General of Medix Luis Verduzco, Director General of Gelpharma Fernando Riedel, CEO of SBL Pharmaceuticals

10:30 PHARMACEUTICAL INDUSTRY GOING THROUGH INTENSE THERAPY Moderator: Rafael Gual, Director General of the National Chamber of the Pharmaceutical Industry (CANIFARMA) Panelists: Arturo de la Rosa, General Manager of AbbVie Mexico Karel Fucikovsky, Pharma Director at Pierre Fabre Mexico Juan Luis Serrano, Life Sciences and Intellectual Property Partner at Sánchez Devanny

11:15 HOW TO THRIVE IN THE NEW CENTRALIZED PURCHASING SCHEMESSY Moderator: Benjamin Vega, Commercial DIrector of Allen Laboratories Panelists: Marco Ruggiero, General Manager of Chiesi Mexico José Luis Ortiz, Director General of Medistik Carlos Gutierrez Muñoz, Account and Sourcing Implementation Director of Christus CEI

D AY 1

12:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

12:45 IMPORTANCE OF PREVENTION AND COST OF CHRONIC DISEASES Speaker: David Kershenobich, Director General of INCMNSZ

13:30 VALUE-BASED HEALTHCARE: A NOVEL APPROACH TO CARE Moderator: Rosa María Galindo Suárez, Corporate Affairs and Access Director of GSK Panelists: Diego Guarin, Regional Market Access Lead for Latin America of Merck MSD Augusto Muench, CEO of Boehringer Ingelheim Mexico, Central America and Caribbean Javier Pico, Partner of LifeSciences Consultants Sandra Sánchez-Oldenhage, President of PharmAdvice Consulting

14:15

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

15:00

DIAGNOSING HEALTHIER SCENARIOS, STRENGTHENING HEALTHCARE PROVISION Moderator: Montserrat Galindo, Market Access Manager of 3M Healthcare Division Panelists: Alejandro Paolini, Vice President of AMID Cesar Marron, General Manager of Cardinal Health Mexico Adriana De Villa, Commercial Director of Atramat

15:45 CANNABIS: WINDOW OF OPPORTUNITIES Moderator: Erick Ponce, Cannabis Industry Promoting Group (GPIC) Panelists: Cristina Viruega, Director General of TIC INTL Fernando Becerril, Senior Partner of Becerril, Coca & Becerril (BC&B) Guillermo Nieto, President of The Mexican Association of the Cannabis Industry (ANICANN)

17:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

19:00

END OF DAY 1

P rogram

JANUARY 28 TH , 2021 08:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

08:55

WELCOME DAY 2

09:00 RUNNING AGAINST THE CLOCK: DEVELOPING A COVID-19 VACCINE Speaker: Cecilia Padierna, Business Development Manager of LEI Panelists: Yolanda Cervantes, Vaccine Medical Director at GSK Mexico Mario Sturion, Managing Director of Janssen Mexico Juan Silanes, CEO of Inosan Biopharma

10:00 OUT-OF-POCKET EXPENDITURE VS COVID-19 Moderator: Eduardo Lara, Vice President, Head of Health Latin America of Reinsurance Group of America (RGA) Panelists: Héctor Martínez-Said, President of the Mexican Society of Oncology (SMEO) Javier Potes, Director General of Consorcio Mexicano de Hospitales (CMH) Eduardo Garcia Luna, Vice Chancellor Of Health Sciences of UDEM

10:45 DEVELOPING A COVID-19 DIAGNOSIS TEST – BIOMÉRIEUX Speaker: Héctor Barillas, Director General of bioMérieux

11:15 HEALTHCARE INDUSTRY: LESSONS LEARNT FROM THE PANDEMIC Moderator: Graciela Teruel, Director of the Research Institute on Sustainable Development and Social Equity at Universidad Iberoamericana Panelists: Jorge Valdez, Dean of Tecnológico de Monterrey School of Medicine and Health Sciences (TecSalud) Sonia Pérez, Executive Director at UDIBI-IPN Sandra Ramirez, General Manager Mexico, Colombia and Venezuela at BristolMyers Squibb Mauricio Hernandez Avila, Director of Economic and Social Benefits of IMSS Juana Ramirez, CEO and Founder of Grupo SOHIN

D AY 2

12:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

12:45 PHARMACY-ADJACENT MEDICAL OFFICES: SOLUTION TO INCREASE ACCESS Moderator: Lourdes López, Executive Director of the National Association of Medicine Distributors (ANADIM) Panelists: Santiago Gonzalez Reyes, Operations Director of Farmacias YZA Gabriel Zavala, Executive Commercial Director of Farmacias del Ahorro Juan José Aguirre, Commercial Director of Grupo Bruluart

13:30 TELEMEDICINE TO INCREASE HEALTHCARE ACCESS: THE IMPACT OF COVID-19 Moderator: José Antonio Crespo, CEO of Farmalisto Panelists: Juan Manuel Cáceres, CEO of Aidicare Christian López-Silva, Partner and Head of Healthcare & Life Sciences at Baker McKenzie Ricardo Moguel, Country Manager for Mexico, Colombia and Argentina at Doctoralia Alessio Hagen, Director of Smart Cities Latin America of Dell Technologies

14:15

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

15:00 TECHNOLOGY ENHANCING PATIENT CARE Moderator: Mario Sicilia, Member of the Board of Laboratorio Medico Polanco and Managing Partner of ProActive Capital Panelists: Jesus Diaz Garaygordobil, CIO of Christus Muguerza Ricardo Renteria, Sales Management Enterprise Lead Latam of Amazon Web Services (AWS) Mario Muniz, General Manager North LATAM of IQVIA Enrique Mendez, Territory Account Manager of Ergotron

15:45 INTERNATIONAL PERSPECTIVES OF COVID-19 Speaker: Corin Robertson, Her Majesty’s Ambassador to the British Embassy in Mexico

17:00

NETWORKING OPPORTUNITY - AI-POWERED 1:1 MEETINGS

19:00

END OF DAY 2

H ighlights STATE OF THE SECTOR: FROM STRUCTURAL REFORMS TO COVID-19 “The current healthcare system has grown ineffective over the years,” Patrick Devlyn, President of the Health Commission at CCE, stated on Wednesday, Jan. 27, during the opening conference of Mexico Health Summit 2021. Devlyn exposed the current state of the Mexican health industry in the face of a pandemic, coupled with public reforms that impacted both the public and private sector. Devlyn reflected that it is key for Mexico to prioritize healthcare. “Before COVID-19, it was clear that Mexico had to reformulate its approach to health from a fixing scheme to a preventive one. We can no longer live with this heavy burden of chronic diseases,” he said. Among the main challenges the sector has gone through, Devlyn highlights the following: • Lack of incentives for doctors, research, infrastructure projects and investment. • Low investment in the sector, which reflected in public health performance and negative economic outcomes for out-of-pocket patients. • The impact of economic reforms that is still not being measured. • A fragmented public health system, which is a challenge to navigate in and makes it even more complex to coexist with the private sector. • The establishment of INSABI to replace Seguro Popular, despite the latter’s palpable effects.

At the same time, Mexico is going through significant changes and reforms. Devlyn addressed the changes to the medicine purchasing schemes, which impacted the integral logistics services for medicine intribution. The government began purchasing medicine from laboratories directly, which generated further challenges. In addition, the government established a single consolidated purchase, which means states could no longer prioritize their epidemiological profile nor destine budget for their individual health priorities. Meanwhile, more actors are now involved in the purchasing process, including the Ministry of Finance and Public Credit, the Administrative Office and the Ministry of Health. The government also enacted changes to the LAASSP, opening the door to acquiring medicines through UNOPS, which generated much uncertainty among suppliers that could no longer plan their stock, investment or time of production. Authorized third parties have also been limited in their functions, which has increased approval times from COFEPRIS. Finally, many projects under a public-private association scheme have been cancelled. “Regardless of whether we agree with these changes, we need to properly base them on the understanding of a positive impact for people’s well-being,” says Devlyn “If not, they will end up damaging the population and their health.” According to Devlyn, the private sector can play a significant role in helping the government achieve its goals, “which could therefore prosperity over

H ighlights time.” Moreover, Devlyn encouraged the use of technology as a key element in the new normality following COVID-19. “Tech can empower both sides, doctors and patients, and it can effectively promote prevention strategies”. To conclude, Devlyn highlighted the future opportunities of the healthcare sector following COVID-19. 1. Establishment of triple-helix research centers, which have the potential to generate innovation

and development, helping Mexico to move beyond manufacturing. 2. Public and private sector collaboration. “Seeing us as enemies will never detonate investment nor foment technology,” he said. 3. Reimagining public-private investment to bring effective, efficient and universal primary, secondary and third level care.

HEALTH SECTOR’S ESSENTIAL ROLE IN MEXICO’S FUTURE At this year’s Mexico Health Summit, panelists agreed that the national health sector has made great advances in preparing for the future. However, collaboration, particularly coming from the government, is key. On Wednesday, Jan. 27, Juan de Villafranca, Executive Director of AMELAF, kickstarted the panel ‘The Mexican Health Sector in the National Economy’ by asking what role the sector plays in the national economy. Arturo Morales, Corporate Affairs Director at Landsteiner, pointed out that the sector was declared strategic in 2018. Unfortunately, this had not been reflected in support and communication from the government, particularly from the Ministry of Economy. Morales pointed out that the sector makes up for about 3 percent of the GDP and provides 100,000 direct jobs and more than 300,000 indirect jobs. Moreover, the sector is essential to provide the constitutional right of access to healthcare. “Having national research and manufacturing is key to ensure that Mexico is not dependent on other countries to provide quality medicine in a timely manner to the population,” said Morales. When talking about how the latest technology was helping to position Mexico as a global reference, Deyanira Chiñas, President of the National College of Pharmaceutical Biologists of Mexico and Commercial Director of T5DC, pointed out how the industry has evolved over the years, learning key lessons about critical processes in manufacturing and supply, while also designing key pharmaco-vigilance standards. “The country is making important advances in personalized treatment and medication for personalized health conditions,” she said. The achievements of the national sector are so significant, she stated, that international companies have flocked to adopt many of these techniques.

Carlos López Patán, Director General of Medix, lauded the achievements of both transnational and national companies in Mexico. However, he stated that Mexico needs to strengthen clinical research and take advantage of the incredible talent that is has developed over the years. “Tech should be enabled, so doctors and laboratories can be part of a virtual chain that uses artificial intelligence to not only develop medicine but also create a more accurate profile of patients,” he stated. Luis Verduzco, Director General of Gelpharma, recognized that technology is key to making medicine more effective, leading to less adverse effects and lower total costs. He pointed to the benefits of genetic medicine and virtual simulators that run on artificial intelligence algorithms to create more personalized therapies. He emphasized the need for greater exchange between authorities, academic institutions and the private sector. Morales said that ultimately, efforts have to be coordinated by the government while being executed together with the private industry. “The industry has to keep doing what it is doing, investing in innovation and in people,” he said. He believes that the new minister of economy will be more open to this kind of collaboration. In this sense, the next four years will be key to define the industry’s future.

“The country is making important advances in personalized treatment and medication for personalized health conditions.” Deyanira Chiñas

President of the National College of Pharmaceutical Biologists of Mexico and Commercial Director of T5DC

H ighlights

How did COVID-19 change the dynamic? Fernando Riedel, CEO of SBL Pharmaceuticals, confirmed that especially during this pandemic, many important collaborations have emerged between companies, associations, hospitals and the government, that could be scaled to other health areas. Verduzco pointed at opportunities to innovate in areas where COVID-19 might have longterm effects, such as heart conditions and immune systems. Chiñas highlighted team of 18 researchers

from different institutions that were tasked with developing a vaccine. However, she said these could not advance due to a lack of resources. That being said, the crisis has driven pharmaceutical companies to work closer with hospitals and doctors at the frontline of the pandemic. It has also reinvigorated pharmacovigilance activities on the adverse effects of treatments against the virus. To Morales, the pandemic has demonstrated the necessity of open doors to the government, to stimulate research and development of the industry. After all, Morales states: “we are not enemies but a single team.”

PHARMACEUTICAL INDUSTRY AT THE FRONT LINE OF THE PANDEMIC The pharmaceutical industry is going through intensive therapy, not as a patient but as an ally in supporting the health sector and its users, agreed industry experts on Wednesday, Jan. 27, during the first virtual edition of Mexico Health Summit. “The industry is trying to help patients. The pandemic has certainly complicated things for both the public and private sector but as an industry, we are trying to be as collaborative and creative as we can to move forward,” stated Arturo de la Rosa, General Manager of AbbVie Mexico.

“Today is the time to unite, more than before, and to seek the empathy from authorities regarding our value propositions. A united country is a more productive country.” Karel Fucikovsky

Pharma Director at Pierre Fabre Mexico

Despite the challenges, de la Rosa added, the current crisis has allowed the pharmaceutical industry to prove its worth. “Now is when we show our strength and value. Due to the industry’s innovation effort in developing a vaccine, the world can see a nearer end to the pandemic. Vaccine development is the only thing allowing for a return to normality Unfortunately, the pharmaceutical industry still has to overcome major obstacles,” he noted. One of these challenges is the approval of molecules and government authorizations that have been put on hold due to the pandemic, panelists noted. Juan Luis Serrano, Life Sciences and Intellectual Property Partner at Sánchez Devanny, stressed that the state and regulatory agencies have no reason to do this despite the COVID-19 crisis. “API approvals were stopped as they were not labeled as an essential activity. But everything that is done in this industry is essential: vaccines and treatment of chronic

H ighlights and non-chronic diseases. It is all about patient support,” Serrano pointed out. “We have seen how miracle products are being sold to prevent COVID-19 infection, for example. To avoid that, a regulatory agency is needed. I do not consider that stopping has been the best strategy and it is important that the authorities rethink their strategy,” said Serrano. If action is not taken in time, added Karel Fucikovsky, Pharma Director at Pierre Fabre Mexico, the health system will lose the opportunity to improve in Mexico for at least the next five years. “Since before the pandemic, it does not seem that innovation, development and technology are priorities of the federal government. Now we are running against time,” he said. Nearshoring, boosted by the pandemic, is one of the country’s opportunities to support the local industry and to strengthen the sector. “It is necessary to attract productive chains to Mexico. Local companies are concerned about getting ahead in the face of purchasing processes with international companies that have not gone through the same regulations as companies in Mexico,” said Arturo de la Rosa, General Manager of AbbVie Mexico. “You also have to have the same level of intellectual property protection as them so there is no unfair competition,” he added.

“We have to work together with the authorities to show that local pharmaceutical innovation proposals can help solve many of the problems we are currently experiencing,” added Fucikovsky.“Today is the time to unite, more than before, and to seek the empathy from authorities regarding our value propositions. A united country is a more productive country,” he said. On the legal side, Juan Luis Serrano noted, there has to be an approach that involves the entire pharmaceutical industry supply chain. “The objective is the same. We all want the system to be better, that the level of care is excellent and that if we have a condition we get the best possible treatment.” “The rule of law, clear rules for all, and open and transparent dialogue with the state allow us to know how companies will compete. The worst thing that can happen is that we are seen as a divided sector,” Serrano concluded.

“The industry is trying to help patients. The pandemic has certainly complicated things for both the public and private sector but as an industry, we are trying to be as collaborative and creative as we can to move forward.” Arturo de la Rosa

General Manager of AbbVie Mexico

HOW TO THRIVE IN THE NEW CENTRALIZED PURCHASING SCHEMES The arrival of a new government administration brought significant changes to the public health model in Mexico. “Changes began in 2019 with the medicine purchasing scheme and eventually reached INSABI and the integration of UNOPS to the purchasing process,” explained Marco Ruggiero, General Manager of Chiesi Mexico, during Mexico Health Summit 2021’s panel How to Thrive in the New Centralized Purchasing Schemes on Wednesday, Jan. 27. “The advantages I see is that having one centralized purchase increases transparency and compliance,” added Ruggiero. However, there are areas of opportunity in the litigation’s administrative processes. “During 2019 and 2020, there were no clear times for tenders, which affected our logistics planning and

increased costs.” Ruggiero said that payment is also unclear. “There are laboratories that are still waiting for payment of 2019 medicine orders.” According to José Luis Ortiz, Director General of Medistik, there are three key points to consider in the centralized purchasing scheme: efficient management systems, efficient transportation and efficient distribution of the demand. The combination of these three elements ensure an effective service for all health entities: however, this is a burden the public sector cannot bear alone. “The local and international industry has the capacity to distribute large orders and ship supplies to public distribution centers. However, to date, there are millions of pesos being lost due to the lack of organization in the public system,” said Ortiz. Collaboration with the private sector would also cut down bureaucratic processes as

H ighlights private companies use technology to optimize performance, he adds. Carlos Gutiérrez Muñoz, Account and Sourcing Implementation Director of Christus CEI, said the local industry perfectly complies with the regulatory measures and quality to offer the best product, according to the standards of the centralized scheme. He recognized that such an initiative can help supply but it is risky to look for products outside the country. Gutiérrez shared his concerns on the government underestimation of the logistic complexity of medicine distribution in the country. “Are they considering Mexico’s geography and the distribution to 22,000 facilities in metropolitan and rural areas? That implies distribution dangers, which increase costs. What is the point of saving costs on purchases by taking over distribution if the logistic costs will be larger due to inexperience? All three experts gave their input on how to create a better system. “We need to create a dialog to generate a positive outcome and fair business strategies,” said Ruggiero. “We have

one same goal, which is to treat patients and generate better outcomes.” Ruggiero’s main concern is Mexico risking supply due to a focus on price. “This approach is ignoring innovation and research investment.” Gutiérrez said that collaboration in this sector should not be neglected. “We must not create a divide between public and private players. We all experience the same health ailments and regardless of the provider, the solution comes from one same industry,” he said. “After the pandemic, the challenge will be to maintain an efficient supply chain in the public sector. The private sector wants the chance to reach an agreement that will benefit not companies but the nation,” said Ortiz. As the moderator of the panel, Benjamin Vega, Commercial Director of Allen Laboratories, concluded that the purchasing scheme is a national health matter. “Together, the public and private sector are able to create investment plans that will create tangible and real outcomes. It is not easy, as we are speaking of health. However, we must see this work as investment, rather than a cost or waste of money.”

C H R O N I C D I S E A S E P R E V E N T I O N : C H A L L E N G E O F S O C I E TA L PROPORTIONS At this year’s Mexico Health Summit, David Kershenobich, Director General of the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), called for a preventive approach to chronic nontransmissable diseases that embraces a holistic understanding of the causes and possible solutions. On Wednesday, Jan. 27, Kershenobich began his presentation, titled ‘Importance of Prevention and Cost of Chronic Diseases’, explaining that, in reality, our understanding of health has evolved through millennia, impacted by social, cultural and historical processes. Nowadays, the predominant scope that is used to define

“A movement is the best way to create a society-wide commitment.” David Kershenobich

Director General of the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ)

disease is biomedical. However, to move toward prevention, we need to include individual and collective social processes that go beyond just science and technology, Kershenobich stated. Health must be understood not through the presence or absence of a disease, but a broader set of physical, mental and social factors. This is important, he noted, because we are increasingly aware and able to act on both genetic, epigenetic and environmental factors leading to a disease. Kershenobich pointed out that there are different types of prevention. Primary prevention, he stated, refers to lifestyle: diet, physical exercise, living environment and access to health services. Secondary prevention starts when a person is already ill but actions can be taken to prevent complications related to that disease. Finally, there is tertiary prevention, which is when a person already has complications but steps are taken to prevent them from worsening. “Considering that we have different levels of prevention, we require an approach that includes

H ighlights actors beyond medical professionals,” he said. This need is further strengthened by the fact that a chronic degenerative disease is generally a long-term condition, which means it is not just an immediate threat to health of an individual but also a significant factor in deciding quality of life and overall productivity.

monitor and provide continuous feedback to patients. They were reminded to follow up on patients in the long term, driven by financial incentives. The result was that patients ended up having significantly less complications.

Kershenobich highlighted the enormous cost of treating chronic degenerative diseases. The first example he mentioned is diabetes mellitus, where the average cost of treatment is MX$1,500 (US$74) a month. He pointed out that 85 percent of Mexican diabetes patients receive treatment. For renal insufficiency, the cost of treatment, which can include dialysis and medications, varies between MX$8,000 (US$394) and MX$15,000 (US$739) per month. Arterial hypertension, a condition that affects an estimated 31.5 percent of Mexicans, is estimated to cost between MX$1,000 (US$49) and MX$3,000 (US$148) a month. About 70 percent of Mexicans with hypertension are said to receive treatment in some way for this condition.

Kershenobich emphasized that the health system in Mexico needs to define ‘key concepts’ and ‘key indicators’ that can help homogenize care models around the country. This way, patients, and doctors, can move between different institutions. At the forefront, he stated, stands primary care. General practitioners need to have an active role in not just diagnosis and treatment but also educating patients and other doctors. Besides doctors, patients also have a responsibility to educate those around them, and realize that there are people in their lives who are at similar risk of developing chronic disease. Furthermore, Kerschenobich suggested that patients should be able to be attended by medical professionals from different specializations, in addition to nutritionists and sports coaches, in one single location.

Given the high-cost burden and obvious impact on well-being at an individual and society level, what can we do to prevent chronic degenerative diseases and complications? Kershenobich presented a study published by Lancet, which addressed the impact of an integral care model to treat diabetes mellitus. Measures taken went beyond just administering insulin. Patients were educated on self-care, risk behaviors, their social environment and doctors were given tools to

Behind a more integral approach to chronic disease lies public policy. This process needs to be supported by far more data collection through studies, not just in the medical area but in other fields too. Kershenobich mentions economists, sociologists and urbanists as valid actors. The end goal, Kersenbobich said, is to create a movement. “A movement is the best way to create a society-wide commitment,” he stated.

H ighlights VALUE-BASED HEALTHCARE: MORE THAN A STRUCTURAL CHANGE Value-Based Healthcare aims to make the system more efficient without sacrificing the quality of patient care, improving the health of the population and consequently reducing costs. However, there are still many challenges ahead to introduce this system in Mexico, stressed panelists on Wednesday, Jan. 27, during the first virtual edition of Mexico Health Summit.

“The COVID-19 pandemic is a historic opportunity. For the first time, society, politicians, businesses and citizens have realized the value of health. Regulatory changes are now needed.” Javier Picó

Partner at LifeSciences Consultants

do as it is an issue that has generated a lot of resistance and people find it counter-intuitive. Sánchez-Oldenhage’s recommendations include the definition of metrics and outcomes to drive continuous quality improvement, increased efficiency and reduced costs. “We also have to work together with the sector, providers and patients. Reducing costs while improving quality will only be possible when we all share the benefits and risks.” “In OECD countries, healthcare costs are growing on average 1.5 times faster than GDP. If we take into account the objectives of ValueBased Care, the health system in Mexico today has to be substantially reformed. We have to change the model from fee-for-services to feefor-performance,” Oldenhage pointed out.

This system is not new, said Diego Guarin, Regional Market Access Lead for Latin America at Merck MSD. However, the fragmented health system in the country has not allowed this model to be deployed. “The different health plans that exist in the country, which depend on people’s labour affiliation, have generated a fragmentation that does not allow Value-Based Care to be developed,” he pointed out.

Ironically, countries that have the infrastructure in place to establish better health models are the ones that need it the least, said Augusto Muench, CEO of Boehringer Ingelheim Mexico, Central America and the Caribbean. “Mexico, on the other hand, with more than 130 million inhabitants and without infrastructure for individual patient follow-up, is one of the countries most in need of such models,” he said.

One of the first steps toward a migration to this system in both the public and private sectors, Gaurin explained, is the development of tools or technology platforms for coordinated patient follow-up. In addition, there is a need for outcome measurement and an integrated system. “You need a patients’ registry, including healthy people and those in treatment or rehabilitation. If we are integrated, we can see how the patient evolves; we can prevent illnesses and manage crises,” he added.

In the future, such a system could bring great benefits to the country by being able to predict public spending around a condition, Muench noted. In addition, wasteful procurement in the health system would be reduced. “It is inconceivable that the public budget is focused on a purchase that is then not used. The value of the product has to be assessed to ensure that it is used for what is needed,” he said.

In agreement, Sandra Sánchez-Oldenhage, President of PharmAdvice Consulting, said that change requires the participation of the entire healthcare ecosystem. It is not an easy thing to

According to Javier Picó, Partner at LifeSciences Consultants, this system has not been accepted largely because of perception. “If the public sector talks about this model, it is believed to be intended to reduce spending. But if the private sector talks about it, it is believed to be because

H ighlights they want to improve access to complex or expensive treatments,” he said. “The COVID-19 pandemic is a historic opportunity. For the first time, society, politicians, businesses

F O S T E R I N G H E A LT H I E R HEALTHCARE PROVISION

and citizens have realized the value of health. Regulatory changes are now needed,” Picó stated. “The pandemic has also made investors fight for the vaccine. This increases the GDP in health through private funds.”

SCENARIOS;

During the first day of Mexico Health Summit 2021 on Wednesday, Jan. 27, Alejandro Paolini, Vice President of AMID shared his input on the critical role that medical devices play in Mexico. “The country plays an active role in the medical device sector. However, we have little consumption. Lack of financing is essential for patients’ access to these technologies,” said Paolini. Lack of financing has been a long-time hurdle for the medical devices sector. However, the importance of equipment and medical technology has expanded as a result of COVID-19. Paolini explains that in February 2020, AMID began building a dialogue with authorities to fight the pandemic and it opened up the door to introduce the type of technology the country can have access to. “We are very interest in having a strong efficient regulatory sector. This step is key to combat lack of financing and promote innovation.” To increase the role and the importance of the sector, Adriana De Villa, Commercial Director of Atramat, highlighted how Mexican high regulator y standards allow loc al manufacturers to export and have a relevant

STRENGTHENING

role at a global level. “We have been able to adapt to technological requirements from other countries and bring economic growth to the country.” De Villa broke down the contributions of the local medical devices to Mexico in three key points. In first place, there are financial benefits as transactions generate currency exchange and contribute to the national economy. Second, De Villa highlighted the industry’s tax contribution, which is highly valuable. Finally, she addressed employment benefits, as the medical devices industry offers specialized jobs directly and indirectly. “We employ 691 people directly. However, indirectly Atramat generates a large economic spillover through logistics, sterilization, etc. This virtuous investment flow is critical, not just for health provision but for micro and macro-economic operations.” César Marrón, General Manager of Cardinal Health Mexico, introduced the concept of Salutogénesis and how it is fundamental to achieve the desired health outcomes that the whole industry works toward. “Salutogénesis is how the individual takes care of their own health and promotes a healthcare education in a holistic and integral way.” Marrón explained that the sector can take COVID-19 as a

H ighlights learning curve to approach healthcare with more integral solutions “that need to involve physical, mental and emotional health.”

“...if the pandemic left a lesson, it is the demonstration that this sector and all its players want to be better.” Adriana De Villa

Commercial Director of Atramat

To address the financial barrier that the medical sector faces, Marrón said that it is important to recognize that different cost-benefit integral models are slowly arising and those actions will foment new measures and policies. These, in the long term, can transform the sector profoundly. The moderator of the panel, Montserrat Galindo, Market Access Manager of 3M Healthcare

Division, introduced the topic of technology and how it has been essential to ensure health provision during these challenging times. “Technology adoption is also important for recovery and health provision in the future. It can boost our internal performance and provide more flexible solutions for our own collaborators,” said Galindo. “I need to highlight that with technology, we are not looking to replace the medical professional whatsoever. Wwe are proposing improvement and support to their professional practice,” added De Villa. To conclude the panel, Paolini mentioned that “if the pandemic left a lesson, it is the demonstration that this sector and all its players want to be better. We are looking to increase our opportunities as a company and this can only happen by creating more efficient, accessible health solutions, he said.

CANNABIS: WINDOW OF OPPORTUNIT Y? The legislation that permits the development, pro d uc tion a nd comm e rcialization of pharmaceutical products derived from cannabis is a major economic opportunity for Mexico. However, a lot of details remain that need to be worked out. This was the consensus during the panel, ‘Cannabis: Window of Opportunities’, at this year’s Mexico Health Summit held on Wednesday, Jan. 27. Erick Ponce, President of GPIC, kicked off the discussion by asking participants what we can expect for Mexico’s economy now that cannabis’ medicinal use has been legalized and that legalized recreational use is on the horizon.

Guillermo Nieto, President of the Mexican Association of the Cannabis Industry (ANICANN), said the new regulation is unique in the world, as it specifically focuses on pharmaceutical products derived from cannabis. This, he stated, opens the window for pharmaceutical research that can generate patented products both for the domestic and global market. He pointed out that there are over 100 conditions that can be cured or palliatively treated with cannabisderived medical products. There is a huge difference between herbal artisanal products and pharmaceutically

H ighlights developed and tested products, Nieto emphasized. He supports a model where doctors will have to prescribe a product before patients can use it. This, he says, adds to the value of the products. Without a doubt, the economic potential of clinically approved pharmaceutical products is huge. There is only one cannabisderived product that is currently partially approved by FDA and last year, its manufacturer, the British company GW Pharmeceuticals, netted over U$500 million. Nieto also pointed out that now is a good moment for legalization, since Mexican pharmaceutical companies are struggling. “Mexico needs to think how it can become the biggest producer of cannabis medicine patents worldwide,” he said, full of optimism. Cristina Viruega, Director General of Total Integridad & Certeza International, said the new regulation still requires more details to be defined. Pharmaceutical development would have to be subject to regular pharmaceutical standards to ensure security, quality and effectiveness. Considering the novelty of cannabis-derived medications, new molecules will need to undergo clinical studies. This will need to be done at laboratories, which also need to meet the same standards as any other pharmaceutical player. Furthermore, pharmaceutical companies will need to ensure

that their primary active ingredients are traceable and that best practices are followed in the production of cannabis products and the supply chain. This requires elaborate documentation and management of information. Viruega warns that a lack of detail in regulation may create a grey area for certain products. She advises more detailed categorization of different types of cannabis-derived products. Any oversight should be managed by COFEPRIS, like with any other pharmaceutical product. Fernando Becerril, Senior Partner at Becerril, Coca & Becerril (BC&B), said the most promising area is the legalization of recreational use of cannabis. This, he stated, will provide greater opportunities to Mexico’s entrepreneurs. He also points to the massive potential of industrial hemp, which can be transformed into paper, food supplements, biofuel, material for construction and much more. He emphasizes that for any cannabis-derived product, there needs to be ‘judicial security’ for authorities, growers, manufacturers, sellers and users. Entrepreneurs should have a comfortable environment to develop and sell their products. The same is important for state governments, which will need to anticipate and prepare services for entrepreneurial hubs in advance. On the other hand, he warns of the danger of overregulation. Bureaucratic burden could hinder emergent entrepreneurship, he said.

DIABETES AND COVID-19: WAKE-UP CALL FOR THE HEALTH SYSTEM? Diabetes is, without a doubt, one of the main ailments afflicting the Mexican population, said Héctor Valle, President of FunSalud, on Wednesday, Jan. 27, during the first virtual edition of Mexico Health Summit. This remains one of the most costly diseases for the country and the problem will only increase as the population in Mexico grows older and older. In 2019, diabetes ranked as the second leading cause of death in Mexico. That same year, the country ranked among those with the lowest number of consultations per patient. “In the case of diabetes, there are only 893 endocrinologists in the entire country. We are talking about a country where between 12 and 14 percent of the population has diabetes,” Valle said. In addition to the lack of medical professionals, the expert emphasized, the distribution of endocrinologists is poor since Mexico City has

more than 500 specialists in this field, while states such as Morelos have less than six. “It is difficult to think that doctors will move to other states because of the insecurity in the country. Access to an airport for those going to congresses in the US and Europe is not easy either,” said Valle. Between 2025 and 2030, the population with diabetes in the country is expected to reach 20 percent.

“The mortality rate dropped as the health sector learned how to treat these patients.” Héctor Valle

President of FunSalud

When the health crisis hit the country, health authorities warned that people with chronic diseases, such as hypertension or diabetes, were

H ighlights more likely to be at risk of presenting severe symptoms. “When they heard this, some people did not leave their houses and abandoned their doctors and treatments,” Valle explained. According to data from FunSalud and IQVia, 94.5 million units of medication for diabetics were consumed in 2018. In 2019, the figure rose to 99.6 million. However, in 2020, when the pandemic reached Mexico, the figure dropped to 95.6 million. The same study, conducted in weeks 0-46 of the pandemic, showed that at the beginning of the pandemic, half of the hospitalized patients with diabetes died. “The mortality rate dropped as the health sector learned how to treat these patients,” said Valle. During the first months of the health crisis, Valle noted, INSABI was one of the most affected health institutions. IMSS, on the other hand,

brought medicines to patients’ homes. “New alternatives are still being sought out. The pandemic is not over and we have to find a way to not neglect these patients”. The pandemic, however, could also mark a turning point in the treatment of chronic degenerative diseases, such as diabetes. “In the country, only 5.5 percent of the GDP is invested in health. When we underinvest, it impacts access to health,” said Valle. “Before the pandemic, access to health was complex. Now, unfortunately, it is clear that a completely different health model is needed. It is not only about medicines but also about infrastructure, human resources and diagnostics.” To meet these challenges, Valle said, FunSalud is betting on a preventive, personalized and participatory health system.

RUNNING AGAINST THE CLOCK: DEVELOPING A COVID-19 VACCINE Time is gold in healthcare, especially when developing innovative solutions to respond to global threats. On Thursday Jan. 28, Mexico Health Summit brought together three key leaders of the pharmaceutical industry that are working on developing a treatment and a vaccine against COVID-19. “This has been a challenge for the industry. However, we are the right people to tackle it,” said Yolanda Cervantes, Vaccine Medical Director at GSK Mexico. Derived from endless research, the current vaccine developments

are moving forward. “The industry has around 10 technology platforms running for vaccine development. This accelerated results.” Mario Sturion, Managing Director of Janssen Mexico, said having a vaccine ready and many other developments in Phase 3 of clinical trials would have been unthinkable before 2020. “We experienced historic collaboration in the name of common good,” he said. However, regardless of how hopeful and positive companies may be regarding their development, Sturion said this is a process that should not be rushed.

H ighlights “Development takes its given time and that is what has enabled the current vaccines. For instance, Janssen has used the vector method for vaccine development that had already been used for other conditions, like Zika and HIV,” he added. Without the time invested in developing previous vaccines, finding a solution to COVID-19 in record time would not be possible or safe. “Previous time invested in research gave us an advantage to reach Phase 3 trials in rushed times.”

We need to communicate the importance of vaccination to boost prevention.”

Cervantes explained that development was indeed the first challenge for pharmaceutical companies. However, this was followed by three new hurdles: distribution, access and application. Juan Silanes, CEO of Inosan Biopharma, said information is the cornerstone to achieve goals regarding treatment and vaccination. Inosan Biopharma is a national company developing antivenom solutions. Its unique treatments are used globally and comply with diverse international regulations to treat diseases like Ebola. To date, the company is developing a treatment for the early stages of COVID-19.

In terms of access, Cervantes congratulated multilateral initiatives where GSK is participating, like COVAX and CEPI. Mexico is part of both agreements and is expecting large number of doses as a result starting in March. Sturion also mentioned that Mexico has preestablished a contract with Janssen for a large number of vaccine doses, which is expected to be confirmed very soon.

Silanes explained that there is a gap in understanding how treatment and vaccines are used and how they complement each other. Production efforts and maximum work capacity will be wasted if access and use of treatment are not understood properly, he said. “Treatments must be included in preventive measures. These and vaccines have different goals and are critical for different moments in terms of contact with the virus.” Cervantes also highlighted the importance of communicating the details of vaccine development, especially regarding relevance and safety. “Around 2-3 million lives are saved because of vaccination.

For communication to be effective, Sturion said it is important to implement strategies in close collaboration with government and local institutions. “This is an important step to bust fake news and spread the benefits of a solid, safe scientific background from decades-old pharmaceutical companies that have already tested treatments and vaccines in the market.”

“The industry has around 10 technology platforms running for vaccine development. This accelerated results.” Yolanda Cervantes

Vaccine Medical Director at GSK Mexico

“Every country has different conditions, which is something important to have in mind to keep advancing with different developments,” conclude d Ce cilia Pa die rna , B usin ess Development Manager of LEI, as moderator of the panel. To overcome the pandemic, at least 70-80 percent of the world population needs to be vaccinated. “The entire industry has one goal, which is to treat people and bring them hope that things can improve,” she said.

H ighlights COVID -19 PANDEMIC: DRIVER OF NEW HEALTH COVERAGE? The COVID -19 pandemic presented an opportunity to be creative in designing insurance schemes that can help reduce the individual burden of out-of-pocket expenditure on health services. This was the consensus during the panel “Out-of-Pocket Expenditure vs COVID-19,” which took place on Thursday, Jan. 28 during Mexico Health Summit 2021. Eduardo Lara, Vice President and Head of Health Latin America at RGA, addressed the topic of how insurance companies were able to broaden their market penetration during the pandemic. He pointed out that health financing in Mexico is very inefficient and that the worst way to pay for healthcare is out-of-pocket, a very common practice. Eduardo García Luna, Vice Chancellor of Health Sciences at the UDEM, pointed out that previously, pandemics have not been covered by insurance. Now, insurers have taken steps to cover COVID-19 treatments. They eliminated the rules that stipulated waiting times of 30 days and included COVID-19 testing in their coverage. They also offered financing options that were monthly, quarterly or annually, individually or through partnerships with other financial institutions. Premiums could be paid in interestfree installments, using a credit card or other forms of credit in some cases. According to García Luna, there was an increase of 11.2 percent in health expenses coverage in the first half of 2020 against 2019, with 20 percent growth by the end of 2020. However, he emphasized the need to redesign schemes and create new ones to provide lower-cost options. While public coverage through institutions such as ISSTE and INSABI is available, overall coverage in the country remains low. Javier Potes, Director General of Consorcio Mexicano de Hospitales (CMH), stated the pandemic had definitely increased public consciousness of the need for health insurance. However, he went on to point out that out-ofpocket spending remains disproportionally high in Mexico. He concurred that schemes need to be

“The time is now to find a consensus on common goals and work together in a creative way.” Eduardo García Luna

Vice Chancellor of Health Sciences at the UDEM

redesigned to include minor medical expenses. One reason, he stated, is that out-of-pocket spending does not always involve large and costly procedures. Potes pointed at Colombia and Chile, where minor medical expenses policies have been successfully implemented. He lamented the fact that 25 percent of the Mexican population, approximately 32 million people, still do not have financial support for healthcare expenses. This represents an immense market for the private sector but it remains very disorganized. Collaboration between insurers and hospitals, doctors and laboratories is very important, he added. Lara highlighted that the industry does not have to wait for a government reform to change health insurance schemes to more holistic integral options. The industry requires an alignment of incentives between insurance companies, other financing actors and healthcare providers. He also pointed at the low insurance cancellation rate in Mexico, which is practically zero, showing how much insurance is valued by the users once they acquire it. The work between hospitals and insurers was also addressed during the panel, to offer more accessible premiums that are more in line with patients’ needs. Potes believes that care providers have a lot to learn about how insurance works. The lack of understanding is logical, considering that only 7 percent of the population has major medical expenses coverage from the private sector. Notably, he proposed that new insurance products are geared to services that will see high volume use. Insurance agencies can generate enough revenue from premiums. “The average occupancy at hospitals, not during a pandemic, remains at 60 percent, meaning that there is still enough capacity to attend more patients,” he said, calling on insurance companies to take more risk. Models such as Value-Based Healthcare could be part of this approach. Héctor Martinez Said, President of the Mexican Society of Oncology, recognized COVID-19 as a critical moment to shifting the insurance approach. The country was in a transition from Seguro Popular to INSABI and while 5060 percent of first level care consultancies for catastrophic disease happens at private clinics, only 6-7 percent of hospital treatment

H ighlights is handled by the private sector. This is a missed opportunity, he said. With 42 percent of Mexicans spending out-of-pocket for health expenses, many are at risk of falling into poverty. He specifies that the average money spent by a cancer patient in the last year of their life is US$5,000, a very large amount for a large segment of the Mexican population. Now, the pandemic has caused a delay in diagnosis and treatment of cardiovascular diseases, cancer, and other chronic conditions. Said believes the real burden of this will manifest this year. He called on both private and public sector insurers to create more accessible coverage, while also reducing waiting times. Garcia Luna also says the pandemic has led to gaps in diagnosis and treatment of diseases, as

well as in important programs for conditions such as cervical cancer. He believes the pandemic should not be seen as an isolated event but rather a situation that is pressuring the whole healthcare system. “We need to create schemes that use existing tech, bringing together financial engineering with technology, such as data analysis and artificial intelligence. This without a doubt, can reduce costs for schemes and also make treatment more effective,” he said. Lara concluded the panel by warning that if the current players do not devise new schemes to make health coverage more accessible, other players like Google, Microsoft, Insuretechs or even Walmart might step in. “The time is now to find a consensus on common goals and work together in a creative way,” he said.

DIAGNOSIS: POWERFUL WEAPON TO TACKLE THE PANDEMIC Among the most common medical errors today are hospital infections, mistakes while filling a prescription and late or erroneous diagnoses, said Héctor Barillas, Director General of bioMérieux on Thursday, Jan. 28, during the first virtual edition of Mexico Health Summit. The latter has become a challenge for the population, the health sector and private institutions. Countries around the world and WHO stress that the best and fastest way to end the pandemic is through testing. “Aviation and medicine share many similarities. Both require training and specialized staff. These industries need technology to have timely information and make decisions to keep people safe,” Barillas said. “Decision-making is where the importance of in vitro diagnostics lies. It allows us to understand what situation a patient is in and how their condition will evolve,” he explained. Up to 70 percent of medical decisions are based on a diagnostics test. Due to technological advances, Barillas said, diagnostics is evolving extremely fast. “When the Spanish flu virus arrived, it took the world 80 years to sequence the virus. Today, three weeks were enough to sequence SARS-CoV-2. Dealing with the pandemic was dramatically different.” Over the past few months, the role of clinical laboratories has been critical, stated Barillas. “No one is unaware of PCR tests anymore, which

are the most important of all and allow us to find out, at the right time, whether a patient has the disease or not, allowing for prognoses and monitoring,” he said. The expert also highlighted the importance of antibody testing, which allows us to know if a patient has had the disease and developed immunity. However, no test is perfect, Barillas stressed. “Not all tests are useful at all times. In the case of PCR, there is a time window where it is useful, but from the second and third week after contagion it becomes useless,” he said. In the case of IGM and IGG antibody tests, there is also a limited time window. “It is important to emphasize the sensitivity and specificity of the tests. “At bioMérieux, our mission is to improve public health through accurate diagnosis,” Barillas pointed out. The French-based company, with more than 50 years of experience in immunoscience, microbiology and molecular biology, has developed solutions for COVID-19.

“No one is unaware of PCR tests anymore, which are the most important of all and allow us to find out, at the right time, whether a patient has the disease or not, allowing for prognoses and monitorin.” Héctor Barillas

Director General of bioMérieux

H ighlights Among these solutions is molecular syndromic diagnosis. “This is a different approach to molecular diagnosis. It allows us to group a set of probable pathogens by type of syndrome, which allows us to quickly find out which pathogen is responsible for the disease we are dealing with,” Barillas explained. In the particular case of respiratory syndromes, traditional diagnostics results take hours or

days. With molecular syndromic diagnosis, “you can do a test and have a full report in less than an hour,” Barillas said. “This test increases the chance of finding the pathogen and contributes to the proper management of the patient and therefore helps to save more lives.” bioMérieux’s molecular syndromic diagnosis FilmArray system is a PCR test that allows simultaneous testing for bacteria, viruses, yeasts, parasites or antimicrobial-resistant genes.

HEALTHCARE INDUSTRY: LESSONS LEARNT FROM THE PANDEMIC Taking the pandemic as a learning experience is key to address its impact and to strengthen the industry for future challenges. On Thursday, Jan. 28, Mexico Health Summit presented the panel “Healthcare Industry: Lessons Learnt from the Pandemic,” where participants concluded that investment in R&D, internal collaboration and technology adoption were the three key elements to prioritize following the pandemic. “Billions of pesos have been invested in global R&D. However, Mexico has not followed the example of other countries,” said Sonia Pérez, Executive Director of UDIBI-IPN. “The pandemic did serve us to determine our needs from a scientific standpoint and to realize Mexico’s 100 percent dependency on foreign technology.” According to Pérez, lack of investment is what stops the country from moving from manufacturing to technology development.

“Mexico has to integrate new mechanisms that integrate qualitative and quantitate data and expose the real needs of the population.” Juana Ramírez

CEO of Grupo SOHIN

Moderator Graciela Teruel, Director of EQUIDE at Universidad Iberoamericana, addressed the topic of turning research projects into actual products. Pérez said Mexico has the needed infrastructure, professionals and regulatory entities to participate in product development. However, there needs to be an intermediary that is ready to commercialize products. “Regulation also has to adapt to respond to advances in product development” said Bertha Mancilla, Director of the Immuno-Oncology Business Unit of Bristol Myers Squibb (BMS) Mexico. “Innovation

needs not just investment but working with local industries to be able to land it and transform it into solutions.” Mancilla highlighted BMS has collaborations with local institutions and other private companies in projects that enables R&D seeds to bloom. However, these should no longer be isolated efforts, she said. About collaboration, which is the second strong point that panelists touched upon, Jorge Valdez, Dean of Tecnológico de Monterrey School of Medicine and Health Sciences (TecSalud), explained that one effective way to begin is through local and state projects. “That way, you can easily measure the impact and therefore, be able to set the ground to scale the projects to a federal level.” This scheme was used in COVID-19 vaccine developments, for instance by Curevac and the University of Oxford and AstraZeneca. “We need to let go of the absurd idea that we are two different entities. In Mexico, the public and private sector are heavily divided, regardless of the industry, which has been proven to be absurd.” David Barros Sierra, Chief of Operational Division at the Direction of Economic and Social Benefits of IMSS, said Mexico’s dependency on foreign markets was evidenced in every aspect of healthcare, from supply to technology development following the pandemic. “However, it also made everyone reflect and look at the strengths of our local industry,” he said. Public-private financing is a catalyst for innovation and research projects. However, Mexico has a fragmented system that creates a barrier in terms of data delivery, which reflects heavily in transparency. Barros Sierra also introduced the subject of technology and the adoption gap that Mexico faces. “Mexico has to integrate new mechanisms that integrate qualitative and quantitate data

H ighlights and expose the real needs of the population,” he said. Juana Ramírez, CEO of Grupo SOHIN, commented on the lack of infrastructure to address this issue. “Many communities still do not have internet connection nor computers, which stops many ideas from healthcare providers from becoming actual solutions.” Still, according to Ramirez, the pandemic has changed the way providers approach patients.

“We now see that hospitalization is not always necessary and that patients can be approached differently,” she said. Amid mobility restrictions, people are going less to hospitals, which ends up being counterproductive for diagnosis and prevention. Ramirez proposes the adoption of technology and the creation of ambulatory centers to offer customized attention, while reducing costs and providing timely diagnosis to improve outcomes.

P H A R M A C Y- A D J A C E N T M E D I C A L O F F I C E S : S O L U T I O N T O INCREASE ACCESS Medical consultations by certified doctors at pharmacies are providing a lot of added value to Mexico’s health system and there is still plenty of opportunity to provide better care. This was the consensus during the panel “Pharmacy-Adjacent Medical Offices: Solution to Increase Access,” which took place on Thursday, Jan. 28. The panel was moderated by Lourdes López, Executive Director of ANADIM, who pointed out that 10 out of 19 pharmacy chains associated to ANADIM already have pharmacy-adjacent clinics. This amounts to 4,000 different pharmacies providing this service out of a total of 16,000 pharmacies around the country. Gabriel Zavala, Executive Commercial Director of Farmacias del Ahorro, explained the advantages these clinics can offer. “Many doctors still work in areas different to what they were trained for and these clinics have given them a chance to apply their training.” The process took time

as both pharmacies and authorities required these doctors to have a degree before treating patients. In other cases, specialists in training, as well as already graduated specialists, started working extra hours as doctors at pharmacies to make some extra money. “As the number of pharmacy-adjacent clinics grew, the number of patients treated by doctors rose significantly,” said Zavala. The benefits are diverse. Pharmacies provide comfort and proximity. The cost of a consult is really low, if not free. Waiting times are much lower than at a public clinic. The doctors are very professional, receiving constant training by pharmacy chains to ensure they are up to date with the latest innovations. Juan José Aguirre, Commercial Director of Grupo Bruluart, agrees that low cost is a key added value. Proximity allows for lower costs of transportation, as well, compared to a regular

H ighlights clinic or hospital. In addition, many Mexicans who are not associated to any health institution are now receiving medical attention at these clinics, he said. “Those associated to ANADIM strive to provide high quality, securing generic products that are accessible and that the customer can get right after their consult,” he added. Santiago González Reyes, Operations Director of Farmacias YZA, said that for Mexico to really cover the health needs of its population, it needs further investment equivalent to roughly 2 percent of its GDP. “Unfortunately, the current economic perspective is bleak and those resources are not arriving. National oil revenues have dropped and other government income is going down. In addition, health is not the only priority for the government,” he said. With pharmacy-based clinics, paid for and managed by pharmacy chains, people are gaining more access to healthcare while putting less burden on the public system. The added value is further strengthened by the fact that an average trip to a pharmacy takes 20 minutes, while transport to a public clinic takes an average of one hour. Even more significant, perhaps, is the incredible rural reach that pharmacies have, which are present in towns of as little as 3,000 inhabitants. López addressed the role of these clinics in fighting chronic degenerative diseases. González stated that diseases that require follow-up treatment are already part of the consultation portfolio. He said that people can go to a specialist and then go to a pharmacy-adjacent clinic for follow up checkups and treatment. Similarly, these clinics can be a channel for

referral to a specialist. González emphasized the need for awareness among patients that require treatment for chronic diseases. He believes today’s medical protocols are too simple and linked reluctance to follow treatment instructions to lack of information and guidance. Zavala pointed out that respiratory and stomach issues make up 80 percent of all consultations. The remaining 20 percent are a mix between pains and conditions related to diabetes and hypertension. “Doctors check the vitals of all visitors and that they often receive information about available tests,” Zavala added. Doctors at pharmacy-adjacent clinics often develop a close relationship with the patient and become family doctors, said Aguirre. He also said these clinics have helped to reduce self-medication. Now patients have faster access to a doctor around the corner and they are less likely to act on the advice of someone who is not qualified. “Mexico used to be the champion of selfmedicating, which is a dangerous habit,” said González. Levels, fortunately, have gone down a lot. He believes that the care that doctors can provide to patients at pharmacies can still be much more specialized, especially when it comes to the treatment of chronic illnesses. This is dependent on the actions the pharmacy chain can take, including training for the treatment of particular illnesses. Other improvements are possible through technology. “Digital prescriptions, interinstitutional electronic patient records and telemedicine are promising ways of improving care at these locations and across the health system as a whole,” González concluded.

TELEMEDICINE: CHALLENGES, HEALTHCARE ACCESS Telemedicine was born as an alternative to faceto-face consultations. When the pandemic hit, this model caught on and there is no doubt it is here to stay, agreed experts on Thursday, Jan.

“Digital prescriptions, interinstitutional electronic patient records and telemedicine are promising ways of improving care at these locations and across the health system as a whole.” Santiago González Reyes

Operations Director of Farmacias YZA

OPPORTUNITIES

FOR

28, during the first virtual edition of Mexico Health Summit. The challenges, however, are still many and the entire industry will have to face them for this model to grow its penetration in a safe and regulated environment. “To reach full penetration, it is important to make an effort between all the different actors in the healthcare ecosystem,” said Ricardo Moguel, Country Manager for Mexico, Colombia and Argentina of Doctoralia. According to data from the McKinsey Global Institute, Moguel quoted, in 2019, US$350 billion was invested in digital health globally and the forecast says that by

H ighlights 2024, more than US$600 billion will be invested annually. “There is a big bet on digitalization. Long before the pandemic, psychologists, psychiatrists and internists were the most digitized doctors. When the health crisis started, many doctors from other specialties started to ask for support in using these platforms,” Moguel noted. Since April 2020, more than 3 million appointments have been booked through Doctoralia, the world’s largest healthcare platform. In addition, 48,000 specialists have enabled the online consultation function. In Mexico, the platform has issued more than 23,000 e-prescriptions. “Patients search for doctors in different parts of the country. Also, many Mexicans in the US are looking for virtual appointments with doctors based here,” Moguel stated. Telemedicine has helped to expand access to care at a time when patients could not visit their doctor on a regular basis. This model of medical care has proven to have great benefits, Moguel emphasized, such as reduced transportation times, lower costs compared to face-to-face appointments and the interactivity and speed with which doctors can store images and video and transfer them in realtime to other doctors. “This does not put patients at risk as they do not have to leave their homes and it also puts top specialists at their service, no matter where they are.” But not all is rosy, said Juan Manuel Cáceres, CEO of Aidicare. “How can patients be sure who is the person behind the screen making a diagnosis and sending out prescriptions?” he asked. Among the biggest obstacles that doctors at major hospitals in Mexico express, according to Cáceres, are a lack of tools to make a correct diagnosis, doubts about the billing process and a lack of training. Patients, meanwhile, say that one of the main obstacles to using such tools is the uncertainty of a correct diagnosis and that their doctors have not offered them this service, either. To overcome these obstacles, panelists said regulation is necessary. “In digital healthcare, there are players from the digital world and from the healthcare world. The former has a much bigger appetite for risk. They do not mind entering the market even if the rules are not clear. On the contrary, the healthcare sector is more risk-averse,” explained Christian López-Silva, Partner and Head of Healthcare

& Lifesciences at Baker McKenzie. “In Mexico, there are still legal and regulatory challenges before considering that everything is ready for telemedicine-related business models to flow,” said López-Silva. “As long as that is not resolved, the user experience will not work. There are patients who have their electronic prescription but pharmacies ask them to print it out or limit themselves to supplying medicines that do not require prescriptions,” he pointed out. In addition to public policy, added Alessio Hagen, Director of Digital Cities for Latin America at Dell Technologies, one necessary step to increase telemedicine penetration is the development of an open and integrated platform “that includes all players in the ecosystem, protects the user and serves as evidence for insurers, pharmacies and doctors.” He also pointed out that Mexico still faces serious connectivity problems in rural areas where it is very difficult to deploy this model.

“In Mexico, there are still legal and regulatory challenges before considering that everything is ready for telemedicine-related business models to flow.” Christian López-Silva

Partner and Head of Healthcare & Lifesciences at Baker McKenzie

H ighlights TECHNOLOGY ENHANCING PATIENT CARE

U n d e r s t a n d i n g th at te c h n o l o g y i s a complementary tool to medical practice is key to integrate these solutions, said Enrique Méndez, Territory Account Manager of Ergotron during the panel “Technology Enhancing Patient Care” on Thursday, Jan. 28 at Mexico Health Summit. “Medical professionals are irreplaceable; we have seen this during the COVID-19 pandemic,” highlighted Méndez. To support this statement, Ricardo Rentería, Sales Management Enterprise Lead Latam of Amazon Web Services (AWS), exemplified how vaccine developing companies like AstraZeneca and Moderna use AWS to support their databases. According to Renteria, the current crisis is an opportunity for corporate culture to change in favor of innovation and technology. “If people start asking for digital solutions, companies and regulations will respond.” For, Mario Muniz, General Manager North LATAM of IQVIA, however, regulation is what is stopping technology from

“In Mexico, the first thing would be to ensure basic technology access. This can only be achieved through proper data management, the right infrastructure, basic digital tools and access to an internet connection.” Ricardo Rentería

Sales Management Enterprise Lead Latam of Amazon Web Services (AWS)

blooming. “Proper regulation could boost our solutions to provide better data that can generate adequate solutions and derive in costs savings. Mexico is a fertile soil for technology innovation, but as Ricardo said, cultural changes will allow it or prevent it,” said Muniz. Jesus Díaz Garaygordobil, CIO of Christus Muguerza, agreed with Muniz and said that hospitals are the best place to foster technology adoption. “They (hospitals) are the most likely to adopt these practices and to measure their impact. They have a whole supply chain and can optimize their practices greatly by using technology.” Meanwhile, lacking technology adoption at hospitals or clinics could lead to misinformation and mismanagement, which could become a great burden. “This scenario, however, has been neglected by the sector,” he said. Mario Sicilia, Member of the Board of Laboratorio Medico Polanco and Managing Partner of ProActive Capital, asked participants about the priorities of the health industry in terms of technology adoption. Most panelists pointed at ECR. “ECR is the priority. We have to implement this immediately because it is the foundation to evolve to a better healthcare system. With this, we would be able to integrate better solutions by knowing patients’ medical history,” said Mendez. “Beyond clinics and hospitals, ECR must also include public institutions. This would feed data

H ighlights bases much more and therefore, it would help to build a much clearer panorama,” said Muniz. Díaz added that ECR would democratize health. “Regardless of where the patient receives treatment, they will have the same medical history,” he said. For Renteria, technology still needs a push. “In Mexico, the first thing would be to ensure basic

technology access. This can only be achieved through proper data management, the right infrastructure, basic digital tools and access to an internet connection,” he said. Moderator Mario Sicilia concluded that to close the virtuous circle that ECR could provide, basic management is required. Without it, the use of basic technology will never be encouraged and digital solutions will forever be a neglected tool.

INTERNATIONAL COLLABORATION MORE IMPORTANT THAN EVER Now, more than ever, we need to foster collaboration, by connecting ideas, individuals and institutions around the world, to overcome the crisis and emerge with more resilient, just and sustainable health systems. This was the message of Corin Robertson, UK Ambassador to Mexico, during the Mexico Health Summit on Thursday, Jan. 28. She emphasized that this pandemic knows no borders and no country has all the answers. Everyone, including scientists, are learning every day and it is crucial that we continue to share that knowledge with each other.

UK’s Role in International COVID-19 Efforts Robertson pointed out that the UK has been working closely with international partners, like Mexico, the G7, G20, the UN, the EU, the Gavi Alliance, CEPI and COVAX, to ensure that adequate health responses are provided around the world. Last year, the UK supported Mexico’s Foreign Minister Marcelo Ebrard’s petition to the UN to make vaccines available to any country. In September 2020, UK Prime Minister Boris Johnson presented a five-point plant with the aim to strengthen international collaboration to not just ensure vaccine access but also build more resilience against future pandemics. The five points, the ambassador detailed, are as follows: 1. Setting up a worldwide network of zoonotic research hubs to spot a new pandemic before it starts. 2. D eveloping manufacturing capacity for treatments and vaccines. 3. Designing an early warning system to predict a coming health crisis, which would require

a vast expansion of the ability to collect and analyze samples and distribute the findings, using health data-sharing agreements among all countries. 4. Agreeing on global protocols to prepare for a future health emergency, which would include things such as information sharing and PPE supplies. 5. Reducing trade barriers which have impeded a proper response against COVID-19. The ambassador pointed out that her colleagues in the UK are working day-and-night to make this plan a reality. The UK has made significant contributions to global initiatives, including US$783.9 million to COVAX. In June 2020, the country hosted the Gavi Alliance summit, a program that is key in combating infectious disease and delivering vaccines to developing countries. The country has committed to donating US$453 million per year over a fiveyear period to this initiative, becoming its biggest contributor. Furthermore, it has donated up to US$343.2 million to CEPI to date.

“...this pandemic knows no borders and no country has all the answersults.” Corin Robertson

UK Ambassador to Mexico

The government is backing the collaboration between University of Oxford and AstraZeneca, which produced a low-cost vaccine that does not require significantly low temperatures during transport, allowing it to be delivered to many more countries. Regionally, the UK participated in pandemic summits in Argentina, Chile and Cuba. Also, the UK and Mexico organized a meeting with ministers from

H ighlights different Latin American countries focused on vaccine access. She also highlighted another program which involved the UK, Mexico, SouthAfrica and Brazil which aims to improve the safety of seniors living in retirement homes, among other objectives.

the embassy and Mexican organizations in combating domestic violence, which has grown significantly during the months of home confinement. Another project was launched to reduce the gender gap in terms of wages, which was another issue exacerbated by the pandemic.

Adapting Embassy Programs to COVID-19 Response

Key Lessons From the Pandemic

The ambassador explained how several programs at the embassy had been adapted to address the impact of the COVID-19 pandemic. One example is Better Health, which used to focus on training medical personnel and strengthening primary care for diabetes and obesity patients. During the pandemic, the program became a platform for sharing experiences between UK and Mexican professionals on how hospital resources could be re-allocated most effectively, how remote care could be best provided using technology, how tests could be carried out without risking individuals with comorbidity conditions and how to better model data, among other topics. For its Cities of the Future program, the embassy met with the Secretariat of Mobility of Mexico City to explore how post-COVID-19 mobility could be more inclusive, while also upholding sanitary precautions. The ambassador also mentioned the fintech Caravan. This was launched by the embassy to provide SMEs, particularly those led by women, with workshops and events where they could learn about the benefits of adopting financial technology to help them through this economic crisis and drive growth. Robertson went on to mention the collaboration between

The ambassador noted the most important lessons that the pandemic has taught us: 1. The need for international collaboration to develop science and innovation. 2. The need to construct robust health supply systems through input from a multitude of actors beyond the health sector. 3. The importance of business participation in this process. The ambassador mentioned the collaboration between University College London (UCL) and Mercedes F1 in developing a ventilator, which was then commercialized for the Mexican market by a Mexican company called Baja Ventura Breathing.

Mental Health: A Silent Giant Finally, the ambassador emphasized the need to have an open and stigma-free conversation about mental health. She pointed out that, partly due to this pandemic, it was estimated that up to 15 million people in the UK are in need of more mental health support services. She ended her contribution to the event expressing her gratitude and admiration for frontline health workers.

H ighlights

TECHNOLOGY ENHANCING PATIENT CARE In an increasingly digitized world, more and more data is generated every day. In the healthcare sector, this represents a huge opportunity, both for the public and private sector, as well as for patients. “This brings new opportunities like never before. We have seen how digitalization has been adopted in models such as telemedicine, the adoption of the electronic health record and even supply chains,” said Igor Fermin, Digital Transformation Advisor of Healthcare & Life Sciences in Latin America at Google on Thursday, Jan. 28, during the first virtual edition of Mexico Health Summit. “There have been many challenges but also many opportunities. Growing data volumes in healthcare, the most dynamic sector, are forcing many of the providers we work with to rethink their technology strategy, processes, resources and build new digital approaches,” Fermin pointed out. Challenges around interoperability, access to IT resources and the critical need for security and privacy protections, however, “have made it difficult for many companies to translate data into meaningful improvements,” he added. Data creation and collection have put pressure on many people and organizations within the healthcare system in Mexico and Latin America, Fermin explained. “This year will be a pivotal moment. The challenges and opportunities ahead are going to open the window to use data. This is the era where wearable devices are going to provide information about healthcare consumers like never before.” The current global situation, Fermin explained, has

created challenges in providing consistent healthcare and offering end-to-end solutions, such as data interoperability and technology infrastructure that seamlessly integrate data. The industry demands cost-saving methods for data management. “Google is on a mission to help the world organize information, make it more accessible and more useful,” he added. “That is why we are focusing our practices and partnerships on fostering sustainability of Big Data for businesses across different sectors, particularly in healthcare,” he said. Fermin noted that by organizing information and making it viable through technology, Google helps companies to have a more favorable impact on the ecosystem as a whole. “For years, the health sector has been a top priority for Alphabet (Google’s parent company). We have made it part of our mission to work with different organizations to expand access to quality care and have made investments to create solutions that deliver better healthcare outcomes,” said Fermin. Recently, Google has brought to market solutions that small, medium and large businesses can benefit from, Fermin continued. “We have other AI solutions that allow us to understand the social drivers of health, to understand how the social ecosystem of a patient impacts their health.” In addition, he noted, Google works hand-in-hand with experts “who understand the nuances of leading a digital transformation for healthcare providers, including doctors and researchers with deep knowledge of the sector.”

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