Global vs Local

Have you ever wondered about the complexities that arise within pharmaceutical companies due to the division between global and local operations?

Why do these realms often operate with such distinct perspectives, and how do they impact our mission to deliver effective healthcare solutions globally?

Drawing on my firsthand experiences working on both sides, today I dive deep into these questions, exploring the tensions and potential for collaboration in pharmaceutical development and beyond.

Join me as I clarify this global-local dynamic and discuss ways to bridge the gaps for better outcomes.

Here are the key points I discuss:

  • Global vs. Local dynamics
  • Organizational structure
  • Centralized R&D
  • Global and local roles
  • Interdepartmental communication
  • Tensions and conflicts
  • Impact on healthcare delivery
  • Collaboration opportunities
  • Role of statisticians
  • Importance of understanding both perspectives
  • Strategies for effective integration
If this episode enlightened you, please share it with your friends and colleagues who might also benefit from understanding these critical interactions.


Global vs Local

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[00:00:00] Alexander: Welcome to another episode of the Effective Statistician. Today I want to talk about the separation that [00:00:10] I’ve seen again and again happening within big pharma companies. And if you’re not working for a big pharma company, but for CRO stay [00:00:20] tuned. You will benefit from this episode as well, because it is very important for you to understand certain behaviors, [00:00:30] certain problems within the big pharma companies.

[00:00:34] Alexander: Now there is a structure that is very similar [00:00:40] to all pharma companies. Small or big, they all have the same structure, at least if they have marketed [00:00:50] compounds. They have usually Pretty centralized R& D function, yeah, because we don’t [00:01:00] develop products for Germany or the U. S. or for Japan or whatsoever.

[00:01:04] Alexander: We develop products for the globe. So we have one R& D [00:01:10] function. And that is usually a so called global function. We have, very often, just One head [00:01:20] of R& D and there’s a, I don’t know, very often a VP of statistics or something like this. And this VP of statistics reports [00:01:30] into the head of R& D. Very often.

[00:01:33] Alexander: And, you know, maybe directly or maybe indirectly somehow. And many [00:01:40] statisticians work in this function. That function is very often responsible for clinical development, sometimes also [00:01:50] responsible for preclinical development and for statistics sometimes in, in other more global areas like manufacturing and things like [00:02:00] that.

[00:02:00] Alexander: Now the other side of the company is the more commercial side of the company. That [00:02:10] organization always has different levels. It will have a global level thinking about marketing and [00:02:20] a couple of these other functions that works on a global scale. You will usually have some kind of global marketing [00:02:30] head, a global medical affairs head, These type of people.

[00:02:35] Alexander: And then you will also have Local [00:02:40] heads and maybe sub local heads. So maybe something like a European and then a German or maybe that is a, there’s a [00:02:50] southeastern cluster or something like this. And then within this southeastern cluster, you have maybe another head that heads Greece, whatsoever. Yeah.

[00:02:59] Alexander: So [00:03:00] you will, for sure have these more local organizations and whether that is on a European level or on a country level doesn’t [00:03:10] matter so much. The difference is that all the sales really happens in the [00:03:20] local affiliates. In Germany, in Spain, In the Philippines, in Japan, in whatever [00:03:30] country, including also the US.

[00:03:34] Alexander: And very often there’s a [00:03:40] pretty significant separation between the people that support global and the people that support local. [00:03:50] And now they have Often different interests, different incentives, and they understand things [00:04:00] very, very differently. And that leads very often to challenges. Now I’ve worked in both local [00:04:10] and global organization.

[00:04:11] Alexander: And by the way, also international. Something that you could call a regional organization like a European organization or [00:04:20] international business unit organizations, these kind of things. In the global organization, people think about, okay, [00:04:30] what happens across the world? What is needed by everybody? Or at least by the major players, [00:04:40] yeah, like for example, it will be needed by Japan and U.

[00:04:44] Alexander: S. and Germany, and maybe a couple of other [00:04:50] important and big players. And then they will kind of focus on these activities and work on these things. Now the [00:05:00] local affiliates. may have very, very different perceptions about what is important for them. And [00:05:10] they may or may not be able to explain that to the global organization.

[00:05:18] Alexander: And that [00:05:20] usually creates tension. Typically, you hear things like, ah, these local people have no clue about what’s [00:05:30] going on, and what is the overall strategy, and they come up with all these kind of weird things. It’s a little bit like a Wild West. And [00:05:40] then, if you talk to the Local people, they speak about the global people and say like, Ah, these people in global, they have no clue what’s going on [00:05:50] with the physicians here in our country.

[00:05:53] Alexander: They have no clue about that we have a different health care systems than in the U. S. And all these kind of different [00:06:00] things.

[00:06:01] Alexander: That leads to a lot of friction. In terms of getting. Approved medications [00:06:10] to the patients. Through reimbursement channels, through marketing and sales channels. All of [00:06:20] these will need to come together to make sure that once we have an approved medication, it actually is also available for a [00:06:30] patient. If patients don’t get to know about it, They will not take it.

[00:06:35] Alexander: If they can’t avoid it, they will not take it. If [00:06:40] their physician isn’t convinced that this medication will help, they will not get it. So it’s again and again and again, yeah, [00:06:50] just getting an approved medication will not help you. Now, if you’re working in a local organization, then [00:07:00] I I would highly recommend that you better understand what are the concerns of the global organization and see [00:07:10] them as partners.

[00:07:12] Alexander: And the same holds true also for the global organization. Reach out to people in the local [00:07:20] organizations. If there are statisticians in the local organizations, even better, yeah? Work with them. If there are no [00:07:30] statisticians in the local organizations, then find other people there. Find the medical scientific liaisons, the [00:07:40] medical affairs physicians or any other people that work there and talk to them to better understand where they are coming from.[00:07:50] 

[00:07:51] Alexander: Now, I know there are Global organizations that have this, let’s say, a little bit like arrogant view [00:08:00] on local people. And there is these local people who have a little bit of a victim mindset compared to the [00:08:10] global people. I hope you don’t fall into this trap. Don’t become a victim and don’t become [00:08:20] arrogant.

[00:08:20] Alexander: NISA is very helpful. In the end, you all have the same mission. You want to make sure that [00:08:30] your new medications get to the to the patients who need them. So, please do work together. And [00:08:40] if you are working at a CRO, it is definitely helpful for you to understand that There’s [00:08:50] global organizations and there are local organizations.

[00:08:53] Alexander: And sometimes they don’t communicate to each other. And very often [00:09:00] local organizations have no support in terms of statistics, which I find is a disaster because [00:09:10] that’s where a lot of the communication between pharma companies and. The practicing physicians work. And if [00:09:20] that goes south at that point, well, there are no statisticians who can save that in terms of explaining [00:09:30] the data, explaining the results, explaining why the study was designed that way and not the other way.

[00:09:38] Alexander: All these different [00:09:40] things that we. care about in terms of making sure that evidence is understood and that evidence is used in the right way. [00:09:50] All that can go south at this last mile to the treating physician and to the patient. And I [00:10:00] think this is really a pity. You know, we can have The best regulatory reports, great publications, but [00:10:10] let’s face it, physicians and patients don’t access these, at least most, yeah.

[00:10:18] Alexander: Some key opinion [00:10:20] leaders will read the publications, but most of the physicians will never ever read any paper. Maybe they see an abstract here or [00:10:30] a poster there, but most will never ever read all the papers. They just don’t have the time. So, they rely on other channels of [00:10:40] communications. And here is where we can have a big impact.

[00:10:44] Alexander: But only if we make the connections. So, if you’re working in a global [00:10:50] organization, reach out to local. And if you’re working in a local organization, reach out to global. And Please make sure that in this [00:11:00] last mile, where the information travels, we have statisticians to answer questions, to provide [00:11:10] explanations, and make sure that our evidence is communicated well.

[00:11:15] Alexander: If you like the effective statistician and what I’m talking about here, then [00:11:20] please do share that with your colleagues, with your peers. It means a lot to me if we more spread the world and [00:11:30] that we make sure that we as an overall community become more effective. Because I very truly believe that the [00:11:40] more effective we are as a community, The better we will have evidence in the right place, at the right time, in the right format to make the right decisions [00:11:50] for patients.

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