Spotlight Interview: Simon Estcourt, Managing Director, Aposave

About Simon Estcourt

With over 25 years of experience in the pharmaceutical and pharma/healthcare services industries Simon joined Aposave in November 2018.

Starting as a graduate at Servier, Simon moved quickly into management positions before joining Quintiles in global operations.  He worked with many of the leading pharmaceutical manufacturers and

pioneered the development of innovative access programs.  He further developed his vision when invited to join the leadership team at Idis. 

A series of executive positions saw Simon and his teams develop the new category of pharmaceutical service that has now become known as Managed Access Programs.  These benefitted thousands of patients globally who were able to access previously unavailable medicines.

The success of Idis lead to an acquisition by Clinigen, where Simon continued as Chief Operating Officer and Chief Strategy Officer.

About Aposave

Aposave is the pharmaceutical services arm of the Abacus Medicine Group. Abacus Medicine was founded in 2004 by CEO Flemming Wagner to provide access to original prescription medicines throughout Europe, driven by the vision of providing better access to medicines which supports better healthcare for patients. The Group has enjoyed rapid growth and now employs over 800 people across 12 locations.

Being a part of the Abacus Medicine Group allows Aposave to have one of the strongest supply networks in the world, containing more than 260 active QA-approved EU and US suppliers. We understand what it takes to get medicines into the hands of healthcare professionals and have an unwavering commitment to deliver the highest levels of service to all our customers and partners. Visit

Medical Travel Today (MTT): Provide our readers with some background information about your company.

Simon Estcourt (SE):
Aposave is part of the Abacus Medicine Group, a Danish company that focuses on providing access to commercially available products throughout Europe that typically works with wholesalers. Aposave is the pharmaceutical services arm of Abacus Medicine. After several years of market testing and a year developing the foundations of the company, Aposave is now set for rapid global growth. 

Aposave is particularly focused on helping patients and healthcare professionals get access to medicines that aren’t available in the country where they live. Sometimes we do that directly in response to a pharmacist getting in contact with us, and sometimes we work directly with the pharmaceutical company and offer it as an outsourced service on their behalf.  In that instance, we provide these services to access medicines all around the world and wherever that patient or healthcare professional happens to be.

MTT: First of all, what kinds of medicines are most requested and what parts of the world need the most access?

SE: These days, global launches of medicines don’t exist.

You may read about the global launch of a medicine, but even after the medicine has been launched for three or four years, only 40 to 50 countries will have access to that medicine. This means that most countries, and therefore patients, don’t have commercial access to medicines.

In countries where medicines are launched, it can still take up to three or four years for them to be available. For many patients the only way to access a medicine that is not available where they live is through an access program, or a company like Aposave that finds a source of the medicine for them.

The process for doing this is the patient needs to first go through their healthcare professional, who must determine that the patient has an unmet medical need that can’t be addressed by the medicines that are commercially available. And then they come to us or a company like us asking for help to access the medicine.

We find a source for that medicine and handle all the regulations and logistics involved in moving an unlicensed medicine from one country to another so that it gets there in time to treat the patient.

Because we’re dealing in areas of unmet medical need, the type of disease areas and therapy areas that we’re working in most are oncology, infectious diseases, central nervous system, neurology and so forth. We also work with a lot of medicines for orphan and rare diseases.

MTT: Your service negates the need for people to travel to other countries to get their medications, correct?

SE: Itdepends on the treatment. What we provide is access to the drug.

A patient may wish to travel to a country where the drug is commercially available because the treatment they require is more than simply just taking the drug.

Clearly, if they just need access to the drug, the simplest way to do that is to get the health care professional to contact us, order it from us, and have us ship it directly to them.
It’s a need that isn’t going to go away because around the world it has become more difficult to get your drug registered and for health care economies to find it worth paying for, even if tens of thousands of patients would benefit from getting the drugs.

MTT: What parts of the world do you find are the neediest?

SE: They are typically outside the United States because most drugs do get launched in the United States first. But even throughout Europe, there is no equal access to new drugs.

The European Pharmaceutical Association looked at products that had been launched over a five-year period and did an audit that found that out of 260 new products that had been launched, in some countries 85% were available. However, in others it was as low as 15%, even in France, with only 50% of those new medicines available during that five-year period.

The discrepancy in availability of drugs occurs all over the world.

We get demand worldwide and do a lot of work in the Asia Pacific region, Latin America and some African countries. In Africa they require access to some basic medicines that improve the general health of the population.

MTT: Are the medicationsgenerics, and how are they packaged?

SE: No, the drugs are all original products that we either get directly from the manufacturer, or from our audited suppliers around the world.

For example, if a drug is launched in the UK, but not in France, we can access the drug from the supply chain in the UK and then transport it to France, under the regulations that allow the transportation and use of unlicensed medicines.

MTT: How did you get involved with this?

SE: I spent over 20 years working in both the pharmaceutical industry and the pharmacy service.

About 12 years ago or so, I joined a small company in the UK that was starting to provide medicines on an unlicensed basis around the world. I recognized the opportunity to grow that business significantly and came up with the concept of what we now call a managed access program, or an Aposave Access Program.

Rather than trying to source the products from somewhere in the supply chain, we proactively went to the manufacturer and told them their drugs could address an unmet medical need. We could connect their drugs with patients who needed them now, and not two- or three-years’ time.

These programs are now routinely run by pharmaceutical companies all around the world and they’re known by different names. In the US they are called Expanded Access Programs and in Europe they are called Early Access, Compassionate Use, or Named Patient Programs.

There are different terminologies and that’s why we came up with the term of Managed Access Program because it encompasses all the different terminologies from every part of the globe. Within Aposave we have created the term Aposave Access Programs.

By working directly with a manufacturer, it enables us to respond very quickly to patients because we can hold stock of products in our warehouse and we can get the product where it needs to be anywhere in the world within a short time.

Pharmaceutical companies are not set up to do this. They are very well equipped to ship pallet loads of products to a wholesaler who then distributes for them.

What they’re not very good at doing is sending a smaller volume of drugs to individual patients anywhere in the world. That’s why they outsource it.

MTT: Do you work with a lot of specialty drugs?

SE: It’s predominantly specialty drugs, yes.

MTT: How do you charge for the service?

SE: If we were running the program on behalf of a pharmaceutical company, then we charge fees to the company. In some cases, the pharmaceutical company may decide to make the products available free of charge, pending where it is in its life cycle. We run several programs where the product hasn’t been commercialized anywhere in the world yet, so there is no set price for the medicine. As it progresses through the life cycle and starts to be launched there is a commercial price available and therefore the pharmaceutical company is more likely to start charging for the medicine.

Where we don’t get the product directly from the manufacturer, we must go to the supply chain in a market where it is available and find a source from our supplier base. We then manage all the regulatory requirements and appropriate quality checks. In this scenario we have a buy and sell model.

We mark the products up to cover the cost of doing our work plus a small margin. We’re not one of these companies that are looking to exploit the situation, we want to cover our costs and then make a small margin.

MTT: Do you have any competitors?

SE: There are a few companies that do this but very few that do this on an international scale. In individual countries, there are businesses that will import unlicensed medicines into the country where they are, but that is a small part of a much bigger business.

There are maybe only two or three companies that do this on an international scale.

Because we are part of a larger group that has access to thousands of lines of products, we are able to hold a stock of products in our warehouse and can respond immediately to requests as they come in.

MTT: For our readers, if they have a patient that they think needs a special drug, how do they contact you?

SE: Theycan access all our contact information via our website –

All they need to do is get in contact with our customer services team. They will take their inquiry, let them know whether the product’s available in stock, or if we need to source the product. They’ll then let them know how long it may take and the cost.

We deal with many requests every day and have a very effective inquiry handling process.

MTT: You’re based in the U.K.?

SE: Our commercial headquarters for Aposave are in the UK.  Our parent company is headquartered in Copenhagen, Denmark, and we have a small team in Hong Kong and the United States.

We’re starting to grow more of an international footprint and that’s simply so that we can provide a faster service. For us it’s more about having regional presence around the globe.

Ultimately, our intent is to be a 24/7 business. Because we can distribute centrally from just one or two distribution hubs, we don’t need to be present in all the countries that we service.

MTT: How hasthe coronavirus pandemic impacted orders?

SE: We’ve seen some requests for general antivirals, which may have some beneficial effects.

I hope that within the next six to twelve months there will be a viable vaccine. Once identified it will be a case of how quickly we can get through the appropriate clinical testing phase so that the large-scale vaccination programs can start.

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