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As a continuation of my post last June, a complement to understand the distribution and function segments of the Spanish employment in the health sector we are going to use different data. Data from the past 15 years of our executive search professional experience in EuroGalenus, in recruiting senior executives for our clients.
|Hospital products and devices||
The positions of General Manager and similar in Spain represent a 11% of the total and point two tendencies: an increase of territorial responsibility, including Portugal or other countries to become Iberia or South Europe. Another tendency is the reduction of competences of the Country Manager, losing areas like Manufacturing, R&D, Logistics or Clinical Research, with regional or HQ reporting or external outsourcing companies.
All the technical positions represent a third of the total and they are in clear ascent. Medical Affairs, Clinical Research, Market Access, Business Intelligence, Regulatory Affairs or Pharmacoeconomics are some frequent ones.
Another interesting information of this study is that, although the Pharmaceutical Industry is the biggest industrial employer, is not the only one. It has demanded a 41% of all the missions undertaken, complemented with another 12% of the segment without prescription: OTC/EFP, that includes Cosmetics, Nutrition, Toiletries and related.
Hospital Product companies and Medical Devices meant a 20% of the total in the period and those of Biotechnology/Diagnostics – in clear ascent a further 14%. Biotech and Diagnostics share some characteristics: high scientific contents, specialists target and Hospital or Lab environment. However, we must bear in mind that some Diagnostic products are not obtained through Biotechnology and also that many Biotechnology products are not designed for the Diagnostics market.
The current growth of the recruitment within the Health and Science Industries is taking place in the Services companies. Those that develop activities that the manufacturing companies used to perform previously in-house, like Marketing/Advertising, Market Research/Business Intelligence, PR/Communications, Editorial/CRM, Events, Human Resources and even Sales.
The number of Spaniards who work, directly or indirectly, in the Health Sector exceeds one million. Some authors even venture two million, counting more indirect employees. Surpassing the figure of one million is simple if we consider not only medical and pharmaceutical care, but related segments like elderly patients care, cosmetics, nutrition or animal health.
An increase in the next decades can be foreseen, given the continuous demand of health on the part of the population. The key of this increase in Spain is that, -unlike what happened in previous generations-, more and more citizens are willing to pay from their own pocket a complement for some treatments, on top of the contribution via taxes. Every day we see a growing tendency to use dentists, paediatricians, ophthalmologists, gynaecologists, hearing aids, plastic surgeons, etc. All this growth is translated into an increase of the employment in the sector.
A differential characteristic of this personnel working in Health is the professional qualification, that is remarkable with respect to other sectors, arriving to have almost 600,000 registered professionals. Farmaindustria esteems that more of 40% of the personnel employed by the pharmaceutical industry has a specific qualification, and there, University degrees are more than a half.
Employment in this sector shares three vectors that condition their careers: 1) permanent innovation that forces to a continuing update of knowledge, 2) specific legislation and regulatory subjects – a formidable challenge for outsiders, and 3) the role of the prescriber, -not in all cases the doctor-.
In Spain the biggest employer in health is the public sector. However, that no longer consolidates numbers in which was denominated INSALUD, since from the beginning of the century our 17 autonomous communities (CCAA) have HR competences transferred and count on his own personnel (SAS, ICS, Osakidetza, Sermas,etc.) and to collect homogeneous data is now a titanic task. As a last consolidated reference, -at the end of year 2000-, INSALUD counted 29,310 physicians, 68,225 non-physicians and 38,195 non-sanitary, totalling 135,730 people. It seems likely that in these ten years the CCAA will be using more personnel, although the total figure is now imprecise.
The data of registered sanitary professionals by theINE in year 2007 offers another valuable reference with nearly 600,000 professional registered, although some could be professionally non-active.
|ATS and DUE (Nurses)||
|Odonto and Estom.||
Source: INE. Registered health professionals in 2.007
On another segment, the Pharmaceutical Industry employs more than 39,100 people according to Farmaindustria data of 2007. A tendency observed is the encouraging growth of R&D activities , employing 4,616 professionals almost a 12% of the total. In traditional Pharmaceuticals growth is coming from hospital specialties like Oncology, Transplant, orphan drugs, etc, with reductions now widespread in Primary Care, and therapeutic areas already well covered like Digestive, Ostheoarticular, Respiratory, etc.
What makes Biosciences executives different from other economy segments? It is commonly argued that it is a different industry with a certain endogamy seen in their companies and some functions. Apart from the unpredictability associated with basic research, a basic difference is that Biosciences project a global approach from the very moment that a molecule is identified. Here are three others:
* Permanent Innovation. With a clear science-and-research culture, innovation is embedding in this sector DNA. The most successful corporations are the ones with a clear commitment to R&D. An average R&D investment of 15%, that may go as high as 20% is difficult to beat for most industries, except sometimes IT or Telecom. Successful executives must get used to project management and drug development in many innovative disciplines such as Molecular Biology, Genetics, Nanotechnology, Proteomics, etc. Any professional headhunter knows that Biosciences CEO’s and VP’s must not be sought from mature or “comfortable” sectors .
* Regulatory Affairs. A challenge for executives coming from other sectors is market access. Price is not free in most countries, packaging cannot be changed without notifying the health authorities, distribution channels are well established with the role of Hospitals and Pharmacies also regulated. Moreover, promotional claims or DTC advertising must pass previous approval in almost every country, particularly for reimbursed products. Business Development deals require a quick adapting to new segments with a strong focus on health economics, outcomes and reimbursement.
* The role of prescription. When the ultimate customer, the patient, is often remote and not in direct contact with the innovator, a pharmaceutical o biomedical product requires the professional advice of a prescriber. This works in cascades: international opinion leaders(OL’s), national OL’s and local OL’s. Nowadays, specialists -in a clear shift from primary care- again prescribe the most innovative and attractive products. And the number of stakeholders has grown in recent times, including now clinical boards assessing new drugs, patients associations, medical societies and -in countries like Spain- autonomous communities authorities, etc.
The advent of personalized medicine will mean more specialist drugs for smaller groups of patients and a shift back to science vs. marketing, -that was so effective in the me-too and blockbuster era-. Executives used to work with that type of products need to reset to the new targeted-only business model and the recruiters involved in these types of searches must have the “helicopter view” necessary to differentiate segments and cultures, on top of speaking the language of the industry.