Despite little fanfare, Portugal’s health cluster has doubled its exports over the past decade. Preliminary data from 2020 suggests volumes have continued to grow throughout the pandemic. The uptick is driven by strong demand from Germany, the UK and the US — and for good reason. Portuguese breakthroughs in recent years belie its lack of tradition in medical research and development (R&D), and have put the country on the global pharmaceuticals map. 

The country is home to a growing number of firms delivering innovative treatments, from generics producers differentiating their products from competitors to those dedicated to patented compounds and technologies. One firm that embodies the sector’s transformation is Bluepharma, which started life 20 years ago by manufacturing drugs for bigger pharma companies and now has nearly 20% of its staff working in R&D. 

The firm now runs a PhD programme which sees doctoral candidates doing experimental work in Bluepharma’s labs. “This has been fruitful,” says vice president Sérgio Simões. “We have been granted patents on new technologies developed in-house, incorporated them into novel products and then licensed those products,” he says. One example is oral films, which deliver the same therapeutic benefits as a tablet to patients that find it difficult to swallow. 

Bluepharma is making big strides in oncology, both internally and via spin-offs it has launched in partnership with universities. Luzitin, for example, is developing a cancer treatment that is currently in phase 2 clinical trials. “The next step is a phase 3 study and then going to market,” says Mr Simões. Its major benefit is efficacy: “It has a very localised effect on the tumour, and without some of the adverse effects that we usually see during chemotherapy,” he explains. 

Fighting the pandemic 

In early 2021, Portugal’s Covid-19 situation deteriorated, recording among the world’s highest cases and deaths per capita. Thankfully, local players are making headway with treatments. Last year, when scientists abroad made promising findings regarding the use of a drug called Ivermectin in treating the virus, Bluepharma realised it was not clear how much of the drug patients would need. “With Covid-19, it is a race against time; so we decided to develop a formulation that adjusts the dose depending on the result of the ongoing clinical trials,” says Mr Simões “This will help the treatment be rolled out as quickly as possible.”

Hovione is a Portuguese firm that is vital to the rollout of Remdesivir — the first drug approved in various countries to treat Covid-19. It is the sole producer of a substance called Captisol, which must be combined with Remdesivir for it to be effective. Last March, Hovione was asked to increase production, but there were no official predictions of the scale of the pandemic. “Based on an Imperial College report, we decided to expect one million patients a month,” says chief executive Guy Villax. “That was a massive challenge as it meant every month we had to produce as much as we normally produce each year.” Separately, the firm received a grant from the Bill & Melinda Gates Foundation to develop an inhaled formulation for an antiviral to be used as Covid-19 therapy.  

The company has made its name creating ingredients and products for other pharma companies, and is currently supporting the development of 120 compounds that its clients have in clinical trials. Up to six of these could be approved in 2021. The US Food and Drug Administration generally approves 40 to 65 new drugs per year, and Hovione has supported the manufacture and development of three to four of them every year since 2015. Of the four drugs developed in the past decade that cure Hepatitis C, three of them required technology that only Hovione offers. “It’s hugely satisfying to know that around three-quarters of the five million patients that have been cured for Hepatitis C used tablets made with product that came from our plants,” says Mr Villax.  

Supporting young and old

As life expectancies extend, people’s central nervous systems are put under increasing pressure. It is this exact area where Bial, which is headquartered just north of Porto, excels. One of its patented drugs, Opicapone, is a daily treatment that people with Parkinson’s disease can take in addition to Levodopa (the gold-standard medication for the disease). “The feedback from clinicians is that this is being useful to the management of Parkinson’s patients and that’s really remarkable — to imagine how our research is making a difference in patients’ life,” says chief executive António Portela, whose great grandfather founded the firm nearly a century ago.

Another of its patents is for an epilepsy medication eslicarbazepine acetate. “The drug we have developed is simple to use for patients and clinicians,” says Mr Portela. “This is important because epilepsy patients normally need to take a cocktail of drugs.”

Bial has truly internationalised over the past decade, selling its medicines in some 60 countries and investing more than 20% of revenues in R&D. One promising drug in phase 2 clinical trials aims to extend the short life expectancy of people suffering from pulmonary arterial hypertension by working alongside other drugs available in the market today.

While Bial’s innovations support ageing populations, Laboratórios Basi has had great success in children’s medicine. Basi’s over-the-counter products are available in 60 countries and while Africa remains its biggest market, Europe has been its major source of growth in recent years. According to chief executive Joaquim Chaves, the key to Basi’s initial success was its improvement of common products including paediatric medicines, such as cough and pain syrups. “We upgrade formulations according to scientific and technical progress to increase product quality and stability,” he says. “And to introduce new features like the removal of sugar, product-specific measuring devices, child-proof caps and so on, creating a safer and easier to use product.” 

This power of reinvention is still part of Basi’s strategy, but the firm is also focused on advancements shaping the future of pharma. In late 2019, it opened a new manufacturing plant configured for Industry 4.0. One year later it spun-off a biopharmaceuticals business called Basinnov. Indeed, Basi has the Portuguese talent for leveraging the best of the past while still being firmly focused on the future.

This article first appeared in the February/March print edition of fDi Intelligence.