According to Helen Giza, new popular weight loss drugs such as Wigoby and Ozempic have additional benefits. It has the potential to extend the lifespan of people with chronic kidney disease.
The new weight-loss jab is expected to be transformative for Mr Giza, who runs Fresenius Medical Care (FME), the world's largest dialysis and kidney services company, and the patients it serves.
Giza, a native of Wales, joined by video link from Chicago, where he is preparing to begin advanced dialysis treatment in the United States.
The £8bn company grew out of a pharmaceutical business founded in 1912 by German pharmacist Dr Eduard Fresenius, and began selling dialysis machines in 1966.
FME's core business addresses some of the growing challenges as countries around the world grapple with aging populations. The typical patient FME treats in the United States is 65 years old, male, obese and has 10 to 12 other serious health conditions, Giza said.
These include chronic kidney disease, a debilitating, progressive disease that causes organs to stop working properly. Eventually, kidney failure, known as end-stage renal disease, develops, and if untreated, the person has only a few weeks to live. Other chronic diseases, such as diabetes, can also cause kidney failure, and without treatment, you may only have a few weeks left to live.
In the UK, 13.5% of adults, or 7.2 million people, are estimated to have chronic kidney disease, and in the US, 15% of adults, or 30 million people, are estimated to have chronic kidney disease. It affects one in ten adults worldwide and millions die each year due to lack of affordable treatment.
Dialysis or kidney transplants can help people live with chronic kidney disease for many more years. Dialysis filters waste and excess water from the blood and must be done at least three times a week for about three hours each time.
The study shows that semaglutide, the active ingredient in Novo Nordisk's diabetes and weight loss drugs Ozempic and Wigovy, can help people who are obese or overweight and have cardiovascular disease live healthier and longer lives. Eli Lilly's drug tirzepatide (marketed as Mounjaro and Zepbound) has also shown positive results in trials in patients with heart disease.
The cardiovascular benefits of weight loss drugs may allow chronic kidney disease patients on dialysis to live longer until their kidneys stop working, Giza said.
“Even if these new drugs have cardiovascular benefits, which studies say they do, people will still progress to end-stage renal disease,” she says. “They don't cure kidney disease, but they do increase protection. These drugs delay the onset of end-stage renal disease.”
She says it will take a decade before the effects of new weight loss drugs, known collectively as GLP-1, are fully evaluated. Currently, only about 5% of the company's patients take GLP-1, and 75% of them are tired of the “painful” side effects and having to take so many different medications. For some reason, I quit within a year. However, pharmaceutical companies are working to develop more effective treatments.
Meanwhile, Mr. Giza has high expectations for the launch of FME's advanced dialysis treatment equipment in the United States. High-volume hemodiafiltration (HDF) devices have been on the market in Europe for a decade, but are now being rolled out in the United States following approval from health regulator Food and Drug Administration (FDA). HDF approaches the natural function of the kidneys and significantly reduces mortality rates.
An international study led by Utrecht University Medical Center showed that patients who underwent HDF had an average 23% improvement in survival over two and a half years compared to those who underwent conventional hemodialysis.
Giza said this could extend the average life expectancy of people with end-stage renal disease by an additional 1.5 years, from 7.5 to 8.5 years in the United States. “This is a real opportunity to bring this treatment to the world's largest market and extend life expectancy.”
FME has 311,000 patients worldwide, including 206,000 in the United States. Mr Giza said there were 53 clinics and 4,300 patients in the UK, working “in partnership with the National Health Service”. “The promises the Labor government has made to the NHS will be a difficult challenge and rebuilding trust is important. But clearly, whether Labor or the Conservatives, managing health costs will be difficult. is.”
FME was formed in 1996 through the merger of Fresenius' dialysis division and the American company National Medical Care, and acquired a number of dialysis clinics in the United States. The company is listed on the Frankfurt and New York stock exchanges, and Fresenius holds a 32% stake after FME's group split last year. Giza says: “We don't say we're German or American. We're a truly global company.”
Home dialysis is not available to everyone. But it means patients can receive dialysis at their convenience and on their own schedule.
To ease the burden on hospitals and save money, the company offers home dialysis kits, which account for 16% of all dialysis performed worldwide. In the UK, 150 patients are currently receiving dialysis at home.
The practice was “growing fairly rapidly before COVID-19,” Giza said, but has since “stagnated” due to a lack of staff and the manpower needed to train patients at home. It was necessary to station them at the clinic to maintain business operations.
“Home dialysis is not suitable for everyone,” she admits, but says it is suitable for young, healthy, working-age patients. “This means patients can have dialysis on their own schedule. They can do it at night, go to work, and have much better control over their dialysis.”
She joined FME as chief financial officer in late 2019, months before the coronavirus outbreak, and was promoted to chief executive officer in 2022.
The company battled staffing shortages to keep clinics open during the pandemic. “If patients don't get the care they need and don't get dialysis every other day, they die,” Giza said. “We worked hard at the pump and successfully navigated the crisis that ensued.”
Giza has embarked on a turnaround program that includes cutting around 5,000 managers and managers as the company reels from a series of profit warnings for 2022.
The company has been embroiled in a series of product recalls and lawsuits over the years. Labor practices in the United States and the Philippines have also been criticized by labor unions. FME said it is committed to following labor relations laws and practices and respects its employees' right to collective bargaining.
Last October, the attorneys general of New York, Georgia, and New Jersey filed a lawsuit against the company's vascular care division, accusing it of defrauding the Medicaid system by subjecting patients with end-stage renal disease to unnecessary surgeries. FME disputes the allegations in the lawsuit and is “vigorously defending the lawsuit.”
Following concerns raised by U.S. regulators, FME in April announced a recall of certain dialysis machines, saying patients weighing less than 40 kg could be at risk from chemicals leaching from silicone tubing. did. 88 children and young people are using these products. No health problems were reported. The company is working on developing a catheter extension set using silicone tubing that won't leach chemicals.
Giza grew up in a small town in Wales and his first job was in car manufacturing, which had replaced coal mining in the area. “It was a tough industry in the ’90s, and the fifth decimal place in cost really mattered,” she recalls. Her manufacturing experience led her to be headhunted by the British pharmaceutical company Abbott.
She then worked in a joint venture between Abbott and Takeda Pharmaceuticals, Japan's largest pharmaceutical company, where she spent 10 years as Takeda's U.S. finance director. She was part of the deal team that acquired Shire, the British company known for its hyperactivity drug Adderall, for £46bn and led its subsequent integration.
It was a “once in a lifetime experience,” she says. “We were acquiring companies the same size as ourselves, and that's where my transformation experience really comes from.”
resume
56 years old
The family is married and has one son.
Education British Chartered Accountants. He holds an MBA from the Kellogg School of Management at Northwestern University in Illinois, USA.
He will pay €4.9m (£4.1m) in 2023.
Our last vacation was a family trip to New York and Mexico.
The best advice she was given was, “Work hard and the rest will take care of itself.”
Biggest Regret “I have no regrets. The twists and turns in life's path, the choices we make, and how we deal with them ultimately make us who we are.”
The phrase she overuses: “Can I double-click?”
How she relaxes: “Running outside is my happy place. I also do power yoga.”
