Transforming the Lives of Patients: A Conversation with Ron Menezes
When Ron Menezes, President and General Manager of Almirall, LLC, took the helm of the U.S. market for the global, Spanish-based company, his mission was clear: become a leader in innovation in the dermatology market. The company set out to refine its pipeline by focusing on the science, in order to help transform the lives of patients who suffer from dermatological conditions.
Almirall, based in Barcelona, Spain, had started out with a diverse product portfolio that ranged from respiratory, to over-to-counter products, to dermatology, among other conditions. But after the company acquired Aqua Pharmaceuticals in 2013, the leadership made a strategic decision to focus on the therapeutic area where it could have the greatest impact: dermatology. The executive team believed there was an opportunity to deliver treatments that would change the lives of patients. With the appointment of Peter Guenter as CEO in 2017, the corporate strategy evolved further to focus on innovation in product development and delivery. Almirall LLC, the U.S. entity formerly known as Aqua Pharmaceuticals, is continuing that approach.
“We want to impact our patients’ lifestyle, improve their lives, and the lives of their families," Ron says. “We are focused on listening to patients and making sure we 
get the right products to them, as well as make it easy for them to get those products. Our goal is to be the No. 1 dermatology company in terms of innovation, even when that may not necessarily translate into being the largest company. We want to offer patients and clinicians a variety of treatments to address their conditions — from psoriasis to atopic dermatitis to actinic keratosis to acne."
That patient focus is apparent throughout the entire company. When a new product comes out, Almirall doesn’t just seek feedback from dermatologists, it also looks to patients for key insights.
“We involve patients in market research while also listening to physicians about what’s important for patients," Ron says. “We know cost is important, but we also know that how patients access information and conduct their own research about treatments is changing. When we launch a product, we want to make sure that we’re not just approaching the dermatologist, but addressing what patients are looking for as well. The voice of the patient is heard at the beginning of the planning process versus as an afterthought."
Ron cites the example of a teenage boy whose acne was so severe he didn’t want to leave his house. The boy’s dermatologist decided to start the teenager on an Almirall acne product and just a few weeks later the boy’s acne had improved; it appears the treatment continues to improve his condition to this day. The teenager 
is now socializing with his friends again and his mother could see the difference in his confidence, even though his acne wasn’t fully gone.
While Ron and his team understand that every patient experience is different, they look at this example as one success story, and to Almirall every patient matters.
“When we’re talking about transforming the patient world, we’re really talking about changing how patients see themselves, how patients act, and how patients are able to interact with their peers and their families," he says.
An Exciting Approach To Innovation
Almirall takes an exciting approach to innovation through its proprietary platform AlmirallShare, which enables anyone with a great idea — scientist, medical student, physician, etc. — to put forward their proposal and apply for funding and scientific support.
“So far we’ve had 200 project applications come through," Ron says. “These ideas are assessed by a global medical team and R&D team, who make a recommendation. This is a great way for anyone who has a good idea for a treatment in any of our dermatology disease areas to apply for support."
What the company looks for in all of these approaches is true innovation, or a way to transform the patient’s world. Ron cites actinic keratosis (AK), as an example, where topical treatments can have unpleasant side effects, such as blisters, which can limit patient acceptance and treatment compliance.
“For me, innovation is all about a product that is effective, and that doesn’t produce those types of side effects," he says. “In the area of atopic dermatitis, innovation is helping patients with treatments that aren’t cost prohibitive. I’d also like to see new topical treatments for acne that would meet the unmet needs of the millions of patients of all ages with this condition."
Ron says there is a feeling in the dermatology community that once you are in dermatology you want to stay in dermatology. And this is true for him.
“Dermatology is a therapeutic area that allows one to connect and collaborate with fantastic professionals — from dermatologists to physician assistants to nurse practitioners, and their medical assistants; all of these people truly care about their patients," he says.
After leading a commercial team for a diversified pharmaceutical company for four years, he was excited to return to dermatology, although he found the market had changed significantly. Today, he says the only way for a dermatology company to differentiate itself from other companies is through innovation and novel approaches.
“My vision is very much aligned with that of Almirall’s CEO Peter Guenter, which is a focus on innovation and creating a culture that is committed to patients, clinicians, and employees," he says. “I’m hyper-focused on bringing new assets and products to the company to help us sustain our growth, and on bringing on board employees with a similar commitment to innovation. This has been my focus for 
the past two years. In addition, we’re committed to helping payers — be these managed care organizations or governmental entities. We’re working with them to understand what they are looking for and what’s important to them."
Since returning to the world of dermatology, Ron has noted some big changes in payer expectations. These include higher scrutiny over the price of medicinal products, and a heightened focus on the need to demonstrate innovation in order to be included on a payer formulary.
People-Focused Transformation
Over the last two years, Ron has intensified the company’s focus on transformation by bringing on board a team of innovators who have extensive experience in dermatology, which he says adds to the company’s credibility in the field.
“We’re still in the process of getting the Almirall name out there so that specialists understand what we stand for, and we want to make sure dermatologists know about our products, initiatives, and patient programs. We want them to know we’re a major player in medical dermatology and we’re here to stay. And this is an important message when so many companies are leaving dermatology. While overall investment in the field is declining, we’re doubling down in this space."
Under Ron’s leadership, Almirall continues to add new talent to the business across marketing, R&D, and medical affairs. “Our efforts are having an impact.
Recently, I’ve started to field calls from deans of some of the most prestigious dermatology programs in the country to identify individuals who might be a good fit for the company."
In terms of its outreach to its patients, Almirall is looking beyond traditional means and developing a strong digital focus. Ron says the times have changed and as such the company is using different digital channels to share the results and patient outcomes when using Almirall products. “Digital is also key for connecting patients and practitioners as well as connecting patients to patients," he says.
“We are embracing different methods of getting our products to patients, different ways of conducting patient outreach, and different ways to help patients connect with dermatology resources," Ron continues. “We are excited by newer technologies that allow the use of tele-dermatology. We are committed to ensuring that patients have the right information when they’re researching treatment options or need information about dermatologic disease states."
A Long-Term View for the Future
Although Almirall is publicly traded in Europe, 66% of its shares are owned by one family — the Gallardo family. Dr. Jorge Gallardo is chairman of the company and two other members of the family are on its board of directors.
“The family’s focus is on developing a company focused on helping patients," Ron says.
Almirall also is focused on community and good environmental management. The company’s manufacturing facilities and a major R&D facility with 300 scientists are based in Barcelona.
“Barcelona is a very progressive city; we worked closely with different groups in the city to make sure our manufacturing is carried out correctly from an environmental perspective," Ron says. “And our U.S. offices in Exton, Pa., are very much part of the Greater Philadelphia community with a clear focus on continuing to grow through hiring local people and agencies and contributing to the business community."
Since first entering the U.S. market in 2013, Almirall has been increasing its focus and commitment to the market.
“We’re finding ways to bring new products to the U.S. market and looking at how we can specifically help U.S. patients," Ron says.
He cites Almirall’s acquisition of Allergan’s dermatology portfolio in 2018 as an example of the company’s commitment to the U.S. market. This acquisition brought in several key products for the treatment of acne as well as a product to treat dermatoses.
According to Ron, in addition to acquisitions and organic growth Almirall also partners with, and invests in, smaller companies such as X-Chem Pharmaceuticals, Evotec Pharmaceuticals, and Nuevolution to name a few. And some products have been added to the portfolio through in-licensing. For example, in December 2017 the company acquired the U.S. and European marketing rights for a treatment in Phase III clinical trials for the treatment of AK, and expects to have other products launching in the mid-2020s.
“We are always looking for new opportunities, and we’re certainly not done from an acquisition standpoint," Ron says. “We are committed to living our corporate purpose: to transform the patients’ world by helping them realize their hopes and dreams for a healthy life."
This article was created for and commissioned by Almirall LLC.
