Coronavirus Report: The Hill’s Steve Clemons interviews Heather Bresch

The Hill’s Steve Clemons interviews Heather Bresch, CEO of pharmaceutical company Mylan.

Read excerpts from the interview below.

Clemons: What are the supply chain realities? Are we in trouble or are we secure?

{mosads}Bresch: As we are now well aware, there are absolutely issues with the supply chain. As you mentioned across many industries, however, nothing more critical than medicine at a time when you’re facing a global pandemic. I think that reality of being prepared is something that takes constant vigilance to build something sustainable. And I think even if we just start here in the United States, that’s something that has never really been done. Things that I will say are as simple as having a list of what are the critical medicines, that top 100, 200 products from hospital medications, ICU, important maintenance products for things like diabetes or something as simple as antibiotics to treat strep infections. We have never taken a holistic approach to that. We’ve reacted to things like H1N1 or anthrax and we’ve been reactive in the moment. But we’ve not done anything to build a strategic supply. And I think that now that COVID is giving us an opportunity, I hope to take this tragic event and really realize the importance of being prepared and having a strategic supply of critically needed medicines. I think though the other important balance to that is, I’ve heard many governments now urgently want to create more domestic manufacturing and have talked about, well, we want to be able to manufacture everything we need for our country. When it comes to medicine, there is not a country out there that would be capable of making everything from the starting ingredients, to the active raw materials, to the finished dosage form, for all of the people in their country. It’s just not remotely practical. So, balancing strategic supply versus global needs is going to have to be how we look at this, and it’s gotta have strategic sourcing, strategic alliances with countries. I mean, we know how to do this. We from trade agreements to strategic alliances  on many other fronts, we’ve just never approached our health care supply chain that way. And, as you rightly pointed out the time is beyond come that we need to do that.

Clemons: How should we deal both competitively with China, but also constructively?

Bresch: There’s no question there is an over reliance, both on intermediates as well as active pharmaceuticals and some finished dosage forms, on China. I think that the diversification you spoke of, what our supply chain, almost half of our raw materials come from China and India and almost half come from Europe or other countries. So, I think as a country, countries need to look at that same diversification. As I said, You’re never gonna be able to say we’re going to make everything we need in the United States. What we could do is have a much more strategic approach so there’s not an over reliance on any one part of the world, not only from a trade or a relationship perspective, but you never know how a crisis is gonna hit or could take a country offline for some period of time. So, I, you know, I’ve been in conversations with legislators and regulators thinking about, could we be more strategic about the Western Hemisphere? And thinking about countries that could be natural allies to help build up their capabilities. I think we’re gonna have to take a long-term view on this to not only strategically be diversified, but really think about the alliances and how we’re not over reliant on any one country because, as you know, those relationships are going to come and go and have their ups and downs.

Clemons: What is the hydroxychloroquine story? Is it being clinically successful? Is it not? Were the steps that we took to stockpile the drug a misstep?

Bresch: Let me start with this, science is important and plays a critical role in giving us information and insight to how drugs are working on treatments, and that is a necessary step. I think that the ups and downs and the surges with hydroxy has been we have not completely let the science vet out. And I think it’s gonna be until fall until a lot of these very large, statistically significant clinical studies, until those end points come back. I think obviously we’re seeing more anecdotal information that would say, perhaps it’s not being as effective as we had hoped. And I think to your point there are many other products, remdesivir being one. I don’t know If you saw that yesterday, Gilead announced partnering with companies — Mylan is one of the companies they’re partnering with — for us to be able to manufacture and produce the product. And we’re going to continue to be working with them to do just that globally. So hopefully given our platform and given the diversification us being able to partner with governments, with other companies that we’re continuing to be able to leverage this platform and be able to work very effectively and efficiently and very quickly to hopefully be able to, as science continues, as clinical trials come in, as we get more data, we’re gonna be able to respond to that pretty rapidly.

Clemons: How hopeful are you that we will get some therapies and vaccines at the end of this race?

Bresch: I’m very hopeful. I mean, I think if COVID hasn’t done anything, it has showed not only the human spirit, the human resiliency and the human ingenuity. And I think as we see globally really coming together scientists from around the world, the best research in the world coming together, there’s no question that we’re going to, I very much believe, not only have treatment, but hopefully a cure. I think we’ve got to recognize time. You know, when you think back about HIV and the evolution of our understanding of that virus and how smart it was and how much it could manipulate itself inside the human body, that it would take a cocktail of products, it would take us years to figure out what that cocktail needed to be. When you think about something in the infectious disease, these viruses are smart, and it takes time to figure out how they’re going to mutate, how we build an immune response, the best effective way to treat them, whether that’s one drug, multiple drugs, ultimately a vaccine. But I absolutely believe that when this world rallies together, as I think we are around COVID, there’s no question we’re gonna accelerate those timelines. We’re gonna accelerate getting to a treatment that works. But unfortunately, the race against the tragedy of this disease and the lives it’s taking between now and then is just that — it’s tragic. But I totally believe that we’re going to absolutely have a treatment, you know, in the near future.

Clemons: There are a lot of skeptics out there that say, at the end of the day, we’re not gonna have enough supply. Not everyone’s going to get it. And there are gonna be some costs and accessibility issues. I’d love to get your thoughts.

Bresch: Look, that, the balancing act of accessibility and affordability is, you know, one that’s constant and the responsibility is significant. And I think as companies think about how to balance that act, there’s a lot of work in that area. There’s no question. I think Gilead is a great example here just recently. I think they were very upfront about what they were capable of supplying. And that’s why bringing on other companies to partner with them, to make sure that as the science develops, and if this product is going to show any hope for treatment, that they can quickly be able to ramp up and have these other companies ramp up production. So, I think as one of the largest generic pharmaceutical companies in the world, our focus and vigilance on reaching as many people as possible, getting medicine into the hands of the people who need it has been our mission for 60 years, and I can assure you that that’s front and foremost in our mind. I think that the pharmaceutical industry has cured many diseases over the hundreds of years that it’s been in business. It’s not only shown treatments and cures and has completely moved the needle on the quality of life that we live. But that’s only as good as getting it where it needs to be. So, yes, I think this industry will continue to come together and do the right thing and provide access to this medicine. And I think that obviously the costs that go into developing these products as you look across peoples, pipeline and products, there’s no question there’s cost and research and development is expensive, but the ability to partner and to lower cost economics and to lower cost countries, our ability to like I said, reach those people is utmost important. We showed we could do that on HIV and I think there’s no reason we can’t show that on COVID or any other crisis or disease that could be inflicted, you know, as we continue to be part of a very global economy.

Clemons: A lot of policy folks are watching this show. What do you think they most need to know?

Bresch: So, I think two parts to that. I think our first discussion around strategic supply, I think here in the very near term, not trying to do something that would have significant unintended consequences. I’ve seen bills being proposed that talk about having only American produced medicine. I can assure you that would do way more damage than COVID has done to our society. So, to be thoughtful about how we think about supply would be first. I think longer term, to your point, COVID is certainly illuminating the issues and the weaknesses of the drug supply system here in the United States from pricing to access. So, do I think that we hopefully now COVID has certainly brought this front and center, and we should take this opportunity to absolutely study and look at the system, why we are where we are, and some of the fixes that it’s going to take. And they’re not easy. There’s not one magic bullet, but we’ve continued to, you know, very much believe there is a road map to have a more sustainable, a more transparent system so that people know what they’re buying, what the cost for what they’re buying is, and how their employer or the government through their health care insurance can help supplement that. And today all of those areas are very, very opaque. There’s no transparency, and that’s something that I believe very much needs to happen. I think that that’s going to take a lot of leadership in Washington. It’s going to take people from both sides of the aisle to come together, and hopefully COVID is bringing a very unified look in response to this because that’s what it’s gonna take to fix the broken system that we’re participating in right now.