Brazil market access poses unique challenges and opportunities for pharmaceutical companies, as leaders from Servier and LEO Pharma reveal how they tackle public-private divides in this vast market. In Pharma Boardroom interviews, Matthieu Mendil and Hagh Yeghiaian discuss reimbursement hurdles, innovation pathways, and operational tactics, offering practical guidance for executives aiming to serve Brazil’s 220 million people effectively.

Brazil’s Healthcare Landscape

The Sistema Único de Saúde (SUS) covers about 75% of Brazilians, while private care serves the rest, with new medicines often entering private channels first before ANVISA approvals and ANS listings follow—yet SUS integration lags behind. Taxation complexity and geography intensify these issues, even as retail pharma grows at 6% yearly, and dermatology and oncology highlight gaps, as Yeghiaian and Mendil note.

Enhancing Patient Reach in Brazil Market Access

Servier imports oncology therapies pending local production, and Mendil points to three 2025 approvals for solid tumours, blood conditions, and brain cancer—the first major advance in two decades—while the firm offers five therapies total, including paediatric options from Shire and treatments for leukaemia, gut, colorectal, and gastric cancers. Single-pill combinations aid cardiometabolic adherence in diabetes, hypertension, heart failure, and varicose veins.

LEO focuses on dermatology biologics, where Yeghiaian describes brodalumab, the initial IL-17 inhibitor for moderate-severe psoriasis, as cost-effective in private settings, and a Boehringer acquisition brings the only IL-36 inhibitor for rare psoriasis, which raises hospitalisation risks, while tacrolimus from Astellas eyes atopic dermatitis guidelines.

Both pursue outcome-linked payments, as Servier explores linking reimbursement to survival gains, and such steps could free SUS funds from legacy drugs, thus improving Brazil market access when firms prove long-term value.

Achieving Profitability Amid Constraints

Profit demands discipline, so Servier follows its 5-year global plan across oncology (70% R&D spend), neurology, cardiometabolic diseases, venous issues, and generics, while LEO spans six segments—government bids, generics, over-the-counter, retail, biologics, rare diseases—outperforming averages. Key levers include volume growth and pricing control, and Yeghiaian stresses early invoicing to manage northern deliveries, just as Servier shifts its 340-vehicle fleet to over 80% ethanol, targeting full conversion soon.

Regulatory delays hit launches, yet firms adapt by conducting local studies with Brazil’s Ministry of Health to back Servier’s combinations, and LEO bids at state levels for psoriasis topicals, sustaining margins in a tax-heavy environment.

Strategic Guidance for Executives

Firms build ecosystems, as Servier’s AS ONE integrates medicines, patient apps like Sempre Cuidando and Elfie (gamified tracking), and CARE physician training on lifestyles, yielding CMVD evidence through partnerships. LEO’s Gilead tie-up strengthens alliances, digital platforms engage doctors nationwide, and data analysts interpret limited biologics/rare disease info for payer talks.

Talent matters most, so Servier fills 90% of leadership roles internally via tailored programmes emphasising behaviour, with annual training weeks fostering growth, while LEO retains experts through simple structures, and foundation ownership supports patient focus over short-term gains.

Brazil tests resilience, and Mendil urges field visits to Brasília or São Paulo, while Yeghiaian warns against importing tactics from Mexico or Argentina—local mastery counts. Firms recommend value-based models, digital tools, and stakeholder ties, as data and partnerships unlock SUS potential, and sustainability, like Servier’s 100% renewable power, adds credibility.

Servier and LEO show Brazil market access rewards patience and precision, as they blend chronic care with breakthroughs to serve patients profitably, so executives should assess portfolios against these tactics. What steps will you take in Brazil?

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