Novartis, the leading pharmaceutical company in Taiwan and much of the East Asian region in terms of sales, views its mission as developing breakthrough treatments to extend and improve people’s lives. In its focus in Taiwan on the fields of oncology, hematology, cardiovascular, neuroscience, and immunology, the Swiss-based multinational “puts the patient at the center of everything we do,” says Fran Milnes, president of Novartis (Taiwan).
Part of this people-focused approach is the inclusion in clinical trials of patients who are often neglected in such research. In one recent example in collaboration with Dr. Lu Yen-shen of National Taiwan University Hospital, Novartis conducted a clinical trial for new oncology drugs that included patients with aggressive metastatic breast cancer who would normally receive chemotherapy as the priority treatment, which is common in Asia. The clinical trial results confirmed the safety and efficacy of the treatment, potentially benefiting patients throughout the region and demonstrating Taiwan’s capability as a research center.
Phase III clinical trials conducted by Novartis have also shown promise in treating broader patient populations of early-stage breast cancer (EBC), which remains a significant unmet medical need. Milnes is excited that Novartis can help more breast cancer patients in earlier stages and have the opportunity to cure rather than merely prolonging life.
The Novartis approach also involves working closely with patient associations to empower them to engage in policy advocacy more effectively. “These groups understand the disease and the therapies, but they don’t always understand the ins and outs of the regulatory system and the process of getting a drug reimbursed for use in the National Health Insurance system,” says Milnes. “We help give them more confidence and a robust voice.”
In 2021, the multinational organized and funded the Alliance & Partnership for Patient Innovation & Solutions (APPIS) platform to forge a multi-stakeholder community to accelerate patient access to optimal healthcare. Over 10 patient groups from Taiwan participated in the hybrid APPIS Summit in March this year, discussing such topics as health technology reassessment, health literacy, the shaping of health policy, and digital health and communications.
Novartis’s commitment to addressing unmet medical needs is exemplified by what the company calls its “Unblocked Movement” – an initiative to co-create with partners to remove barriers to heart health for patients with ASCVD (atherosclerotic cardiovascular disease). The condition, known as “the silent killer,” often goes undiagnosed but can lead to premature heart attacks and strokes. The three pillars of the initiative entail LifeUnblocked (creating more patient awareness such as importance of dealing with high cholesterol levels), CareUnblocked (helping doctors treat the condition more effectively), and NationUnblocked (making ASCVD a priority in healthcare systems).
Heart disease is the number-two cause of death in Taiwan and annually accounts for 10% of National Health Insurance expenditures. Considering indirect costs from disability and loss of productivity, the burden of heart disease on society, now estimated at NT$170 billion per year, is continuing to mount. “Without aggressive action to tackle this problem at a population rather than individual level, could significantly impact Taiwan’s public health and the economy,” says Milnes.
She notes that Novartis and other drug companies have accumulated a plethora of information about the disease. “We look forward to cooperating with others in the industry – and hopefully with the Ministry of Health and Welfare’s Health Promotion Administration – to mobilize support for the needed initiatives,” she says. “Last year’s cooperation with AmCham in holding the Taiwan Healthy Aging Forum was a good start.”
Novartis attributes much of its success to a highly supportive corporate culture that inspires employees to strive to meet challenging goals without fear of disparagement for failure. “We define this culture as being ‘unbossed, inspired, and curious,’” says Milnes, meaning that “everyone has accountability and takes responsibility for the work they produce, so that they are invested in what they’re working on and encouraged to come up with innovative ideas.”
Another increasing area of focus for Novartis has been cell and gene therapy. The company pioneered the introduction of CAR-T cell therapy as an approved treatment for B-cell malignancies. Its partnership with the University of Pennsylvania since 2012 has led to the first approved CAR-T cell therapy, a treatment now approved in two indications in Taiwan.
The Novartis culture, Unbossed, Inspired, and Curious, also emphasizes providing a work environment that enables associates to maintain a sound balance between work responsibilities and family wellbeing. For the past three years, Novartis has been regularly recognized with a “Best Company to Work For” award from the publication HR Asia.
Looking ahead, Milnes expresses concern about delays and difficulties in introducing innovative medicines to the Taiwan market due to an excessively time-consuming and restrictive reimbursement price-setting process. She notes the low level of public healthcare spending in Taiwan as a percentage of GDP – 4.0% a year compared to 5.2% and 9.3% in South Korea and Japan respectively.
“It hinders patient access to the latest treatments and shows in outcomes like lower life expectancy and worse mortality rates for cancer and heart disease for Taiwanese patients,” Milnes says. “We need a recognition that increased investment in health will improve the future wealth and wellbeing of Taiwan, versus the shortsighted view of healthcare as purely a cost.”