Araceli Enriquez – Takeda

When the Doctor Vagón health train started rolling into marginalized villages across the Mexican countryside this year, the medical team aboard was delivering a message of hope and information to hundreds of people suffering from one of the country’s biggest killers: diabetes.

The Vagón train and a cancer patient assistance program to help those who cannot afford life-saving medicine, are just two of the community health care initiatives Araceli Enriquez is supporting via Takeda, the largest pharmaceutical company in Japan.

Serving as lead counsel for the company in Mexico and Central America, Enriquez has been instrumental in launching the programs. The first, a patient assistance program launched in 2018 focuses on supporting 100 patients who suffer from Hodgkin lymphoma and do not have health insurance nor a way to pay for a doctor. The second program, the train, offers various health services from different companies, one of them offered by Takeda for diagnosing diabetes and heart disease.

“My favorite part of my job is helping patients. By doing my legal work minimizing legal risks and working a number of agreements, we help secure better treatment for patients,” Enriquez says.

Vials of life

Lymphoma is a general term for a group of cancers that originate in the lymphatic system. There are two major categories of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma is distinguished from other types by the presence of the Reed-Sternberg cell, expressed as CD30.

According to the Lymphoma Coalition, approximately 67,000 people worldwide are diagnosed with Hodgkin lymphoma each year and more than 25,000 people die each year from this cancer.

As Enriquez explained, Takeda has access programs for medicines in Latin America, South Asia and Africa for people who cannot afford payment for medicines to treat their disease. The company guarantees access to complete treatment with affordable prices, or free of charge, to save lives.

In Mexico, Takeda developed its pilot program last December at two hospitals in Mexico City—the Instituto Nacional de Cancerología and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán—to help patients without health insurance or access to health care. While Takeda works with different companies to help get the medication to the hospital, a third-party organization helps determine financial need.

Enriquez comes into the picture with contracts to organize it all and protect the personal data of the patients by developing a contract process; overseeing distribution and delivery of the medications; and following-up with the patients with the support of a third party that may not share any personal data of patients with Takeda. Treatment is based on a person’s body weight and can range from eight to 16 vials of medication—something poor sick people can’t afford.

“To date we’ve helped 107 patients. The program is growing, and we will be branching out to 13 other hospitals nationwide,” Enriquez says.

The course of the project is complicated, she says, with a lot of analysis to protect the patients and the company while overseeing the details of administering the programs so that they support the patients.

“You have to follow through and coordinate a lot of areas from medical to finance,” she says. “Takeda invests a lot of money and doesn’t expect to receive anything back, knowing the project has such a huge impact on patients, and this is why we see a huge value in doing the program.”

All aboard

If the cancer treatment project targets the cities, the inaugural diabetic patient clinic on the Dr. Vagón health train raised awareness for hundreds of people suffering and dying from diabetes.

Working with Takeda over the course of a two-year contract is the Fundación Grupo Mexico, a foundation that supports social, environmental and cultural programs and the health train. A total of 3,609 people were impacted on the four routes covered.

According to the Institute for Health Metrics and Evaluation (IHME), an independent global health research center at the University of Washington, diabetes was the third leading cause of death and the health problem that caused the most disability in Mexico from 2007 to 2017.

Through this project, Takeda wants to impact those diabetic patients who do not know the complications of this condition, Enriquez said. The Integral Clinic of the Diabetic Patient aims to impact more than 9,000 patients throughout the Mexican Republic.

The train has a team of doctors and nurses on board who conduct testing to measure blood biometrics and lipid profiles. The staff is assisted by a podiatrist and diabetologist to care for and educate patients to improve health and avoid complications such as diabetic foot, diabetic nephropathy, diabetic retinopathy and microvascular/macrovascular disease. A traveling pharmacy is also onboard to assist people once they are diagnosed.

“The program is making a big impact. Many of these people had no knowledge of diabetes and the many different afflictions affecting them, such as problems with the heart, like hypertension, which was really high,” Enriquez says. “The people in these communities have some bad habits and eat poorly, not understanding what is good for their bodies. This project definitely helps to save lives.”

Broadening the service horizon

By acquiring Shire, another pharmaceutical company, in January, Takeda expanded its geographic footprint to bring more innovative medicines to approximately 80 countries.

Focusing its research and development efforts on key therapeutic areas—such as oncology, gastroenterology, neuroscience, rare diseases and plasma-derived therapies—Shire was seen as a key component in building up the portfolio in the area of vaccines, oncology and rare diseases. The companies—with a combined annual revenue exceeding $30 billion—are in the process of integrating operations.

Assisting in the acquisition is Baker McKenzie Abogados S.C. of Mexico, led by Project Lead and Coordinator José Antonio Ambrosi on the commercial end; Alejandro Perez Serrano Flores, partner and senior associate; Jorge Alberto Ledesma Garcia who worked on corporate matters and mergers and acquisitions; partner Christian Lopez on regulatory issues; partners Manuel Limon and senior associate Liliana Hernandez who advised on labor and employment matters; and partner Luis Adrian Jimenez, an advisor on tax matters.

“It is the kind of project that showcases our strengths,” Ambrosi says, commenting the firm is ranked number one in life sciences in Mexico by Chambers and Partners, a global firm that recognizes the best law firms. It described the firm as “a pre-eminent team acting for leading players across the life sciences sector that knows the law and the key people in the life sciences industry.”

Ambrosi added, “We take time to understand the clients’ needs and know how to respond to them and offer the best service to get results.”

In the wake of the transaction, Ambrosi says the firm is working with Takeda on post-acquisition integrations. Part of that process is evaluating which companies are no longer needed; merging viable entities; transferring employees; and updating registrations and procedures to keep operations running.

Forward and fair

As a child Enriquez was fascinated by the concept of “fairness,” and as a student later in life she was motivated to earn a trifecta of law degrees from Instituto Tecnológico y de Estudios Superiores de Monterrey between 2004 and 2012, including a bachelor’s degree in law and two master’s degrees, one in international law and another in corporate law.

Her education set her on a career path in corporate and international law, working first as a labor lawyer for Marvan Gonzalez Graf y Gonzalez Larrazolo S.C. in Mexico City in 2008, and then as a legal corporate chief at Danone for two years before joining Takeda as lead counsel in Mexico and Central America beginning in 2013.

“Since the beginning of my legal career, all of my work experiences helped me learn the basic skills and how the law works. I also learned how to relate with stakeholders and the manufacturing side of companies before moving to pharma,” Enriquez says. “It’s interesting because now I can work for improving patients’ lives. It’s hard and a lot of work, but I know it’s worthwhile and, in the end, will help improve—if not save—a person’s life.”