Sanofi’s UK head Hugo Fry speaks exclusively to Pharmacy Business on how community pharmacy needs to plug into the next big innovations around a hybrid homecare model and diagnostics. He spoke with Priyankur Mandav…
HUGO FRY is a man on a mission: he’s passionate about protecting, enabling and supporting people on their health journeys, so they are able to live life to the full.
“We have always been a pharmaceutical company with a broad portfolio – from vaccines for babies and adults to treatments for long-term conditions such as cardiovascular disease and diabetes, from acute and chronic care to oncology and ultra-orphan treatment, and from treatment of rare diseases to consumer healthcare.”
I met the managing director of Sanofi UK via Zoom on a wet, windy and overcast autumn day to talk about Sanofi’s plans for community pharmacy in particular and the wider pharmaceutical industry in general. Dressed smartly in a grey jacket over a sky-blue gingham shirt, he spoke with graceful elegance and a ring of authority that befits his wide ranging experience in the industry for well over 25 years.
“I have worked in all areas of commercial operations from a rep to a managing director, leading global franchises. I have led regulatory teams that made representations at the European Medicines Agency and the US Food and Drug Administration. I have also led industrial affairs teams – both supply chain manufacturing and device development, especially pens for diabetic products such as insulin.”
A Geordie by origin, Fry spent most of his time working abroad in countries such as Germany, France, Russia and the US until about four years ago when he returned home to lead Sanofi’s innovative healthcare solutions in the UK market at a time when the government was “trying to turn the UK into a global life science stronghold.”
That was also a time when the country’s healthcare system was gearing up for a drastic cultural shift in order to facilitate the implementation of preventative strategies. Fry is a firm believer of the government’s prevention agenda which embraces a holistic approach to healthcare in the community.
He thinks by embracing and implementing preventative measures, community pharmacy teams can together make a big difference to the nation’s health outcomes.
He adds that the agenda should, however, not only include primary prevention, such as promotion of healthy lifestyle in the population, age-appropriate health checks and a push for vaccination programmes in preventing illness, but also focus on secondary prevention which will reduce the impact of a disease, avoid the development of co-morbidities and minimise the risk of adverse events.
“When people become unwell or have a preexisting condition, they must be well-equipped to manage their condition at home with the advice of a pharmacist. This approach can ease pressures on the NHS by avoiding unnecessary hospital visits or GP appointments in the short term. It can also limit unnecessary costs in the longer term, by reducing incidence of avoidable conditions and complications of pre-existing conditions.”
Well over three quarters of all care in the UK is self-care and many people feel comfortable managing everyday minor ailments themselves or by visiting their local community pharmacy for advice. Yet an estimated 57 million GP appointments a year are used by people with common conditions or medicines-related problems and one in seven emergency admissions are preventable. Pharmacists within a community pharmacy setting have considerable experience to manage these.
Fry said Sanofi UK was considering a potential partnership with community pharmacy in diagnostic health, following the completion of a successful pilot with the healthcare app Babylon in the summer.
The company joined forces with Babylon to raise awareness about irritable bowel syndrome (IBS), a life-restricting condition thought to affect more than one in five people in the UK. The objective has been to provide sufferers of digestive health with quick diagnosis via Babylon’s AI-powered symptom checker.
The three-month study found 64 per cent of sufferers of IBS had never sought treatment, while 30 per cent of those surveyed were not aware of the connection between the condition and anxiety.
Fry strongly feels this is one area which community pharmacy can own in a three-way partnership with Sanofi and Babylon.
“Research tells us that it takes on average four to five GP appointments for a patient to be diagnosed with an IBS. By contrast, it took just five minutes for a patient to complete the symptom checker. So rather than clogging up a GP surgery, the patient could go to a community pharmacy and say, ‘I’ve been diagnosed with IBS, what have you got?’”
He believes the findings of the IBS trial could be expanded further to detect, diagnose and treat many other disease areas such as diabetes, dermatitis, hypertension, among others, where community pharmacy can have a greater role to play. “We are building on that IBS example, which was a rather successful pilot.”
“The idea of community pharmacy being the first port of call and relieving pressure off the NHS is absolutely key and so is the pharmacist’s ability to point a patient in the right direction or provide value-added service in terms of patient recruitment and diagnosis.”
He advises that community pharmacists need to think in terms of being ready to get more diagnosis done of patients in the self-care category, understanding that and being ahead in the game.
“Community pharmacy are in a great position to provide value-added services to the people who come in. They know their patients and the local environment so well. They know their local doctors so well. I think they can add a lot of value. There is a lot of trust in there.”
By way of example, Fry talks about how his local community pharmacy which runs a diabetes testing programme can benefit from checking with the patient if they have had their flu vaccine because diabetics should have one.
“It’s the same with asthma and other diseases – there is so much added value in service offerings.”
Fry says community pharmacists can play a key role in recruiting patients for its personalised patient support programme. It is dedicated to helping diabetes patients manage their condition in the most optimal way with the help of tailored education delivered by a specialist nurse or other professional support. The typical journey may include three months to complete the allocated modules and then up to nine months further support with regular ‘check in’ calls.
“Community pharmacies can play a key role in the enrolment of patients because they would know who would benefit from this type of programme.”
He argues that most R&D based pharmaceutical companies have their future portfolio embedded in some degree or another in biological products, many of which are injectables.
“These can’t just be dispensed and given in a bag and taken home, they need to be delivered. There is role for community pharmacists to be a hybrid where they deliver the medicine in pharmacy and eventually train the patients on how to do it safely at home.
“We are actively exploring how a hybrid homecare model could work in partnership with community pharmacies for this. The project is in its early stages, but we are working closely with our industry partners to move this forward.”
Biologics is shifting the makeup of the total pharmaceutical market and huge amounts of products in the pipeline will be injectables. He says delivering biologic injectable in pharmacy could be a great opportunity for community pharmacists.
“Do they get it, are they set up, are they ready?” he asks, adding: “My advice would be to keep your finger on the pulse and be aware of where the innovation is coming from and try and get plugged into it.”
Sanofi’s biologic innovations is at the centre of its ambition to transform scientific innovation into healthcare solutions. After Paul Hudson, renowned for his expertise in innovation and digital transformation, took over as CEO last year, the company has restructured its global strategy around three priorities – Specialty Care (immunology, rare diseases, rare blood disorders, neurology, and oncology), Vaccines, and General Medicines (diabetes, cardiovascular, and established products).
“It’s really nice working in a company that has that clear prioritisation,” Fry said, adding: “There is a laser focus on delivering fabulous medicines and vaccines to patients today, and there is a laser focus on our innovation piece which will deliver more tomorrow.”
Fry wants community pharmacy to know that the sector can play a critical role “in our broad portfolio of priorities” one of which is vaccination. “And never has it been clearer than with the expanded flu campaign right now.”
Fry said the Department of Health and Social Care (DH) is working hard to ensure that we have adequate flu vaccine supplies in place, and that pharmacies and GP surgeries will be able to order over the coming weeks and months.
“The DH have been flexible in the way they procure these additional doses and GP surgeries and community pharmacies will soon be informed how to order them.” The latest exciting news is that the MHRA have just approved the use of our latest recombinant flu vaccine previously only available in the US.
Fry, who also is UK general manager of Sanofi Pasteur, Sanofi’s vaccines business unit, explained that pharmaceutical companies have very long lead times for vaccine production. They would normally wrap up the flu vaccine orders for the season around February, months ahead of any season. But fears of a second wave or Covid-19 sparked a scramble for vaccines across countries in the northern hemisphere this year.
Amid the Covid-19 first wave back in the spring, it soon became clear that governments around the world would be needing a much greater flu vaccination supply.
Committing to meeting that rising demand isn’t easy even for Sanofi Pasteur, the world’s biggest producer of flu vaccine. But in light of the pandemic, it ramped up its production by more than 20 per cent compared to the previous two years.
Although this flu season has been an exceptional one for pharmacists with each of them having to vaccinate many more people than normal, traditionally, he laments that there has been a reluctance to reach out to all sections of the society and concentrating only on one age group; the elderly.
There is a large commercial and healthcare opportunity for community pharmacy here: Fry said a significant proportion of people under 65 in the UK with underlying health conditions, including asthma, diabetes and heart disease, miss out on their free annual flu vaccination.
“Even more could be done in the community to make sure that they are all protected,” he says, adding: “Which could be financially beneficial for pharmacy in these difficult times”.
“The current expanded flu programme is a good surrogate where community pharmacies have proved themselves commendably. Although there could be many ifs and buts along the way, my short answer is, ‘yes Covid-19 vaccine must be rolled out across pharmacies’.” (Fry said this just days before the DH confirmed to Pharmacy Business that community pharmacists will be allowed to administer Covid-19 vaccines when they are doled out to people across the country).
He gave an update on Sanofi and GlaxoSmithKline’s vaccine candidate, which is currently being studied in a phase I-II clinical study, with a planned phase III study set to begin in earnest before Christmas with the aim of providing up to 300 million of its doses.
He believes Covid-19 vaccines will become available towards the end of the year or early next year, and the Sanofi-GSK vaccine probably won’t be the first to come out in the market.
“But this isn’t a race among makers of vaccine because we will need several vaccines of different efficacies to fight the global pandemic.”
To immunise the world against Covid-19, it will need global collaboration from all parties involved to share the knowledge, experience and capability, and help protect the wider population, Fry added.
This Big Interview also appears in the November issue of Pharmacy Business.