Big pharma was not always Deb Mangone’s world. At one time, she was betting on building her career on the back of an ill-fated dotcom era VC-funded startup, called Kozmo. It was only when that came crashing down that Pfizer appeared on her radar.
“The dotcom went out of business and I was unemployed, living in Manhattan and needed a job,” she recalls. A trained engineer just two years out of college, she was looking at opportunities in a range of sectors when Pfizer came calling.
“My dad, who worked at IBM his entire career, said to me: ‘Deb, you know, [in] a company like Pfizer, you can have a ton of different careers. You should take it’.”
She did. And the subsequent 22 years have proved her father right as she has moved across a dozen different roles in the business. Six months ago, she arrived in Ireland as the newly-appointed country head of a sprawling business employing around 5,000 people.
Her arrival comes at an inflection point for the industry – boosted by the success of its Covid vaccine but now working with reducing revenues as the crisis of the pandemic has passed.
Revenue topped $100 billion for the first time in the company’s history last year, up around 30 per cent on the previous year in operational terms, although unfavourable foreign exchange issues dragged that figure back to around 23 per cent.
Over half of those sales came from the vaccine Pfizer had developed with German group Biontech, and its Covid antiviral medicine Paxlovid. Strip those out and revenues grew just 2 per cent.
Inevitably, they will falter, with the company predicting Covid vaccine sales to fall by close to two-thirds and a marginally more modest 58 per cent slump in business for the antiviral medication. In part, Pfizer says, this is because governments, especially in the US, still had significant vaccine supplies at the start of the year. It actually expects Covid product sales to rise again in 2024.
“The way we’re talking about post-Covid, is that it’s a post-’Covid crisis’, because we see Covid as here to stay,” says Mangone. “But the crisis part and the pandemic part have gone away, thankfully.”
My dad, who worked at IBM his entire career, said to me: ‘Deb, you know, [in] a company like Pfizer, you can have a ton of different careers. You should take it’
Even as those valuable Covid sales subside, the US drug giant expects the rest of its portfolio to deliver operational revenue growth of between 7 and 9 per cent this year.
“In 2022, our performance was unprecedented on multiple fronts, but it also includes double-digit growth for some of our inline brands which are not part of our Covid franchise, which we expect to continue to grow,” says Mangone.
“As we look to 2023, we see it as a transition year but we have 19 new products or indications coming to market in the next 18 months alone. And these are in areas like prostate cancer, multiple myeloma, vaccines for pneumococcal, meningococcal, RSV. Medicines for diseases like alopecia areata and ulcerative colitis.
“So we have a strong pipeline, the strongest it’s ever been.”
Looking further out, Mangone remains excited by the prospects on the horizon, particularly in gene therapy, an area of ever-growing focus for Pfizer. She cites therapies for haemophilia A, haemophilia B and Duchenne’s muscular dystrophy, all of which are currently in trials, as well as ongoing studies of a flu vaccine building on the mRNA technology that delivered for Covid.
Her enthusiasm for Pfizer’s medium-term prospects closely mirrors that of group CEO Albert Bourla in the company’s most recent presentations. And why wouldn’t it? Mangone has worked closely with Pfizer’s chief executive since he was group president of innovative health at Pfizer in 2016, following him first to his chief operating officer role and then when he was appointed CEO.
She was Bourla’s chief of staff and the first site lead of its New York headquarters as Covid broke and the company, along with its industry peers, tore up the traditional rules of medicine development to try and get ahead of the burgeoning pandemic.
For Mangone, it was an odd time. She had been named as country head for Finland in February just as Covid was starting to spread worldwide.
“Back in March 2020, when I was sitting next to our CEO, what I remember most vividly is the last executive team meeting that we had in our offices before the lockdown started. And he said to the executive team: ‘If not us, then who?’ And that was our rallying cry that science will win, that we have got to figure this out,” she says.
As she recalls it, five days after the World Health Organisation declared the virus a pandemic, Pfizer called on industry colleges to “collaborate in unprecedented ways, to marshal our people, to share insights and technologies, to apply our drug discovery expertise, to offer excess manufacturing capacity and then to improve future pandemic responses”.
The company’s link with Biontech was fortuitous, established 18 months previously in search of a flu vaccine, “but we were able to accelerate that partnership”. She adds: “Being with Albert and the executive leadership team at that time was phenomenal, but I had also been announced as the Finland country manager.”
She put that on hold, nominating someone in Helsinki to hold the fort. “I had to make sure that the community of our colleagues kept engaged and going and managing our executive team, and Albert specifically, and helping to make sure that people understood the importance of what we needed to do. So, it was a truly exciting humbling experience and exciting.”
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By the time the Covid vaccine had secured FDA approval, Mangone had made it to Helsinki. After barely 18 months, much of it under lockdown conditions, she was on the move again – to Italy, where she served as lead of its European hospital business for nine months before Dublin beckoned last September.
Tax and talent are traditionally the two “go-tos” for executives at Irish arms of multinationals, and Mangone does give both some time. The OECD 15 per cent tax rate “was expected” and hasn’t impacted the company’s investment plans here, as evidenced by its recently announced €1.2 billion investment to expand its biologics plant at Grange Castle in Dublin. Ireland’s highly skilled workforce and its status as the only English-speaking state in the EU are also mentioned.
But, tellingly, Mangone’s real focus is on reimbursement. Getting approval for new drugs in the Irish market has become an increasingly high focus issue for the pharma sector. It’s not the finances, clearly – Ireland is far too small a market to fundamentally affect the bottom line of a business like Pfizer – but the optics.
Ireland is used as a “gateway to Europe” by some 950 American businesses, including almost all of the top pharma and medtech groups. Persuading bosses Stateside to commit to further investment in a location where it struggles to agree terms that will allow its high-profile products to be used by patients is not the easiest ask.
“In terms of my priority as the country manager here, my first priority is patients and patient access to our medicines and vaccines in a timely manner,” Mangone says, quickly noting the increase in funding for new medicines in recent budgets that has seen more than 100 new medicines sanctioned for use in Ireland over the past three years.
She quietly presses the point that there remain “opportunities” in Ireland in terms of time to reimbursement and time to access, and welcomes the recent Mazars report on the drug approval process that showed more than a third of new medicines wait over two years for approval in a process that is supposed to be completed in under six months.
My first priority is patients and patient access to our medicines and vaccines in a timely manner
“It’s great to see the acknowledgment that more needs to be done with the process and engaging with stakeholders,” Mangone says. “But the fact that Ireland doesn’t rank as high as it should in terms of time to reimbursement, and that it can take two-plus years for a medicine once approved from EMA [the European Medicines Agency] to be approved here in Ireland, is where we really need to focus and make sure that we’re moving the needle in the right direction.”
With ever more costly medicines coming to market, including “transformative” cutting edge gene therapies, she is aware of the need for “equally transformative approaches to access and reimbursement”, adding the industry has already been in conversations about subscription-based and annuity payment models of reimbursement.
But she is also quick to note that medicines, including pharmacy and wholesale costs, account for only about 13.4 per cent of the overall healthcare budget.
Being the first woman to head the company’s Irish business doesn’t worry Mangone in the least, having been the only female in a class of 20 engineering students back in college. She notes that close to two-thirds of the staff at its Citywest offices are women, “and on our leadership team, [we are] 62 per cent women and 38 per cent men”.
But it wasn’t always so. She describes a visit to Sweden and Norway with Bourla as a pivotal moment in her career.
“At that time,” she recalls, “the country managers of the four Nordic markets were all women, three of them had relatively young families. And, having been an engineer where I was never surrounded by women leaders and role models, I said: ‘Well, how do I do that? And what do I have to do to get there?’ And then I literally asked that question, and got the answers, and took the actions to do that and make that happen.”
We see 2023 as a transition year, but we have 19 new products or indications coming to market in the next 18 months alone
As a leader, she says, her style reflects her background.
“I’m a New Yorker, right? So, by nature I’m fast-talking, I’m fast everything. And I’m a no-nonsense type of person as a New Yorker. So yes, I like to get things done but you also need to make sure that – I’m also an engineer, right? So I’m very logical, very detailed – I like to make sure that every I is dotted and every T is crossed. You need to balance the two in terms of speed and quality, but never sacrificing on quality.
“At the end of the day, we are not making some widget that somebody’s going to use. We are making medicines and vaccines that are going to help mothers and fathers live long enough to see their children graduate or get married. Help babies to live long lives and hug their grandparents. So you have to be able to balance the two.”
At the outset, taking the job at Pfizer might have been simply a sound career move. Mangone’s first role was negotiating contracts on carpets, chairs and furniture, where she says she told herself that the money she saved the company meant that more was available for drug research. But for her, it has become more personal, not least as both her parents were afflicted by cancer.
“The purpose of breakthroughs that change patients’ lives became personal to me,” she says. “My mom unfortunately died of cancer in 2010. And while I don’t know that the outcome would be different today, if she were diagnosed, I think she would have lived longer, with longer quality of life, than she did in 2010.
“And because of medicines and vaccines from Pfizer and the industry, my dad continues to live with quality of life in a great way.”
CV
Name: Deb Mangone
Age: 47.
Position: Vice-president and country manager, Pfizer Healthcare Ireland.
Family: Married to Chris with two children.
Outside interests: Travelling and fun with family, fitness and yoga, cooking and baking.
Something you might expect: A native New Yorker, she’s a no-nonsense, ‘tell-it-how-it-is’ person. During the pandemic, she told Pfizer’s global CEO he was not considered essential when he wanted to visit a manufacturing site.
Something that might surprise: While she has a demanding job, she makes time to experiment in the kitchen and enjoys spending her evenings having dinner in with her family.
