1. Reinvention for Growth
We came of age, but orking to feel increasingly rejuvenated. We made 2017 a year of reinvention. Our strategy’s starting point was to focus on our really differentiated capabilities. We promoted significant changes and advanced culturally, so that we could increase and qualify our offer of solutions. We aligned structural costs, thus, reorganizing ourselves to grow. During this whole journey of renewal, however, we did not abandon what has been essential to us since 1999: We continued to be people caring for people.
Following this strategy, we created business units, which provided managers with increased responsibility and decision-making autonomy. Internal leadership began to play a significant role, enhancing our potential. Operations moved to higher levels and gained greater visibility, ensuring the best results in our history. EBITDA, for example, grew significantly compared to 2016. We advanced in quality, optimizing costs and concentrating our efforts on our DNA.
But what is our DNA? This reflection was the key to understanding the importance of combining pharmaceutical assistance and population health management. More than established drug benefit management programs (PBM – Pharmacy Benefit Management), based on our Specialty Care unit, we facilitate the access of Brazilians to drugs for rare and complex diseases, strengthening our ties with health maintenance organizations and the pharmaceutical industry.
We get even closer to people, answering questions and promoting changes of habit, opening up a promising field for providing solutions aimed specifically at patients, who should be among the main health system payers in the near future.
On the other hand, we saw a new corporate market perspective towards health, viewing it as added value for employees. This is also a concern for middle-market companies, a segment for which a product was specifically designed – the ePharma Plenus Middle, which is already offered by our PBM unit since the beginning of 2018.
Motivated by technological advances, we began a process of reflection in order to map and anticipate changing habits and cultures. These studies will guide our future steps, moving our actions towards home care assistance and innovations to facilitate our patients’ journey.
It was a year marked by change. We are ready to innovate and help Brazil build a great health access network. The more changes the better!
Luiz Carlos Silveira Monteiro
2. Our Values
Consistent medical advances have become increasingly strategic allies for Brazilian health. The growing range of medicines and treatments available to prevent and fight diseases, however, face barriers difficult to overcome: Access is still a distant reality for a significant part of the population, which continue to pay over half their drug costs – a cost almost totally subsidized in developed countries. Another challenge is patient adherence to therapy, a situation even worse in cases of chronic, rare diseases and high-cost drugs.
For ePharma, a solution will only be achieved through integration of the various links of the pharmacy chain – government, industry, retail, health plans and companies that provide drug benefits to their employees.
With this in mind, we help companies improve health and drug management. We help pharmaceutical companies humanize their relationship with patients, making it possible to provide public health system users with access to complex treatments. We are with HMOs side by side. We operate systems that enable discounts and home drug delivery.
This is how we provide increased healthcare to Brazilians in an efficient, careful and integrated way. This is our commitment.
To develop innovative solutions for pharmaceutical assistance and health promotion, generating knowledge and results.
To help more people improve their health condition through innovation and reliable partnerships.
- Trusting relationships, based on ethics and transparency.
- Respect for life and health.
- Innovation and excellence in performance.
- Pride to be ePharma.
Provide a sustainable return to our shareholders based on the excellence of our services, as well as through the engagement and motivation of our employees.
Main facts in
3. A new look at our business
Reinvention for Growth. This was the motto that guided our organizational restructuring and ensured even greater operational efficiency, with a significant increase in assistance and, above all, in excellence.
Results of transactions
(in R$ thousands)
(in R$ thousands)
Processed Drug Units
Retail Pharmacy Network
Number Accredited by Brazilian Region
Diagnostic Medical Centers and Laboratories
Drug Infusion/ Application
Contact Center Structure
4. Business Units
Solutions for all profiles and demands.
The structural reorganization and the consequent establishment of business units meet the increasing need for products and services that harmonize with pharmaceutical assistance and population health management.
The PBM, Specialty Care and Pro-Health areas address different categories and target audiences, with the support of shared service units. Although associated with independent operations, they act in a synergic way, to offer the market a range of options to encourage access to drugs and adherence to treatment.
The shared service units – Corporate and Information Technology – support the business units. In this way, they contribute to improving the effectiveness of operational processes and controls.
Some of our clients
Incorporated in 2014, In Health gained the status of an ePharma business unit, which together with the already existing Primary Care operation accounted for 64% of revenues in 2017.
Through this area, we strengthen our condition as a service hub for the healthcare market, both for the pharmaceutical industry and HMOs.
Our deep knowledge of access and adherence, as well as our business experience, allow us to innovate and integrate different essential services and program levels for every stage of the patient’s journey, from prediagnosis to drug dispensation, both in the treatment of high-complexity pathologies and of rare diseases.
Learn about our main customized programs, which have the most complete portfolio of services and strategic support for the pharmaceutical industry.
PHARMACEUTICAL INDUSTRY PORTFOLIO
Relationship programs with patients who need continuous-use drugs for chronic diseases, dispensed in the private pharmacy environment. They provide access to discounts, orientation and monitoring of use, always seeking to maintain therapy and improve patients’ quality of life. Our retail pharmacy network, connected to the authorization system, represents one of ePharma’s major competitive advantages in this segment.
Patient Support Programs: High Complexity
Focused on high-complexity drugs and rare diseases, PSPs develop support strategies for patients in order to increase the level of access and adherence to treatments defined by the medical establishment. Sponsored by client pharmaceutical companies, the High-Complexity PSP includes, among other solutions:
- Support of a multidisciplinary health team created according to the program profile;
- Exclusive Patient Account Management (PAM) concept, through which each group of patients is assisted by the same professional, establishing ties of trust and reception;
- Specialized health provider network to support diagnosis and infusion;
- Programs to screen for diseases in society;
- Awareness campaigns on the pathology;
- Mapping service of protocols and procedures for requesting drugs from the Public Health System (SUS) and health plans;
- Specialized Logistics: Medication dispensation management for programs centered on beginning treatment programs and other strategic inputs for better distance administration and monitoring of patients. We are active in product logistics in dry or cold chain, temperature-sensitive products, service items and hospital products and inputs.
Diagnosis Support Program
We support access to diagnosis, based on our accredited network of clinical image and analysis laboratories for various exams and procedures, homecare companies and accredited nurses for home collection and exams, with specialized logistics in biological sample transportation. We have partnerships with national and international laboratories: MAYO CLINIC (USA) and CENTOGENE (Germany).
Specialized Communications Agency
Establishing communication strategies, which motivate and guide the patient to engage in his/her treatment, is becoming an increasingly key factor for project success. We at ePharma take this very seriously. We have a department and professionals specialized in the subject.
Programs for OTC, Personal Care and Out-of-Pocket
This unit also develops discount and loyalty programs for other products and consumer goods sold in pharmacies, such as the dental line and out-of-pocket consumer articles (nutritional, food supplements and skin-care products).
We support health plan operators’ drug dispensation and administration needs that meet the demands of the ANS (Normative Resolution 338 of the National Health Agency) and of imports. Even further: We developed a base of knowledge, tools and services to create integrated solutions, with specific answers that improve the efficiency of operations, from the initial prescription to final drug disposal, optimizing resources and reducing costs.
Learn about our main solutions offering health plan operators the most complete management and services portfolio.
HEALTH MAINTENANCE ORGANIZATION PORTFOLIO
ANS Roll – Binding Coverages
Partnership advantages include:
- A network of logistic partners and approved suppliers;
- Search for the best conditions for negotiation and form composition;
- Compliance with regulatory agency deadlines and standards;
- We enable dispensation of adjuvants and drugs required for control of adverse effects of antineoplastic treatments by means of simplified payment management – monthly closing, report transmission to the operator and transfer of payments to our pharmacy network.
We take care of the entire importing process with security, guarantee of origin and meeting the deadlines related to lawsuits and regulatory rules, with management and budget forecasts individualized by patient.
Notification of Preliminary Investigation (NIP)
- Deadline controls, indicators and SLAs in all processes, in accordance with ANS rules;
- Operation of national scope, with cutting-edge technology, carried out by a team of health experts and professionals;
- Active management of form prices for national and international suppliers.
Health within the reach of all Brazilians. With our Pharmacy Benefit Management (PBM) programs, companies and organizations can provide their employees with greater access and adherence to drug treatments. Consequently, they enjoy a number of benefits that enable them to have healthier employees, reduce absenteeism rates and optimize health costs.
ePharma handles all operations involving total management of pharmaceutical assistance, such as program modeling and standardization, benefit card issuance, eligibility checks and authorization processing for validating purchases from the accredited network, in addition to preparation of managerial reports, clinical-pharmaceutical studies and a drug preference form.
All these tasks are facilitated by a mobile app, made available to beneficiaries, which expedites the search for drugs and pharmacies in the nearby area, in addition to allowing storage of the historical background of medical prescriptions.
Learn about the drug plans offered by the ePharma PBM unit.
The partnership with companies and pharmacy networks makes it possible to offer employees drugs at special prices. In this fashion, the employer subsidizes a portion of the cost and the beneficiary can purchase the drug without having to pay immediately, since the cost will be deducted from his/her paycheck.
In this case, the company does not participate in the payment. The beneficiary has the right to a 10%-to-60% discount on a broad range of drugs available through the associated network.
Aimed at companies with at least one thousand employees, ePharma Plenus is the most complete prepaid benefit plan on the market, establishing monthly fixed amounts for the coverage of drugs prescribed for employees and their dependents, covering 98% of pathologies treatable in clinics. It also enables the company to have a budget forecast and even reduce overall healthcare costs.
The success of this plan inspired creation of ePharma Plenus Middle, custom designed for middle market companies with 100-to-1,000 lives. With this solution, the SME segment can provide employees with pharmacy benefits in an easier way and with the same ePharma Plenus advantages.
ePharma Plenus Benefits
Greater access to treatment, lower healthcare costs;
Assistance by a wide network of accredited pharmacies;
It enables the company to prepare a Budget Forecast;
Plan extended to employee family members;
Mobile App for beneficiaries;
Quick and easy implementation.
Aqui tem Farmácia Popular
ePharma contributes to providing healthcare to close to 8 million people in Brazil by means of a partnership with the AQUI TEM FARMÁCIA POPULAR program. The initiative, launched by the federal government in 2006, extended its services to establishments in the private network, with discounts of up to 90% authorized by our system. In 2017, more than 17.8 million units were dispensed, substantially expanding public access to drugs.
Sharecare is a platform that offers technological solutions for healthcare. Promoting the quality of life and well-being and providing each person with control and personalized monitoring in a dynamic and easy way.
ePharma is the company chosen by Sharecare in Brazil as its official partner to manage the drug distribution to its more than 38 million users.
A union that fills us with pride. Not only due to the opportunity to share our expertise in drug access and adherence with Sharecare, but primarily to the ability to contribute to the well-being and health of so many people.
More than just ensuring quick drug access to, it is necessary to promote good health practices. With this in mind, the group’s business unit combines services to encourage awareness and public action to promote self-care and risk prevention. Empowerment and information for patients and reduction of avoidable costs for healthcare managers.
Health Risk Management (GRS)
By means of an Electronic Clinical Protocol Manager, information is provided on the risks of the analyzed population, thus improving management of beneficiaries with eligible chronic diseases and health conditions.
Health and Well-Being Concierge
A receptive service center answers beneficiary questions and offers guidance related to drug interaction, nutritional habits and physical activities, as well as psychological and stress-relief counseling. Staff is supported by a network of clinical analysis and diagnostic laboratories to monitor the examination process, in order to detect risks or diseases still in the asymptomatic phase.
This business intelligence platform reviews data collected by ePharma on the population. Based on this stratification, the company generates reports with graphics, tables and clinical analyses, which allow identification of the most appropriate actions for patients in accordance with profile, risk and seriousness.
A health promotion solution whose purpose is to detect risks or diseases of the main company executives and managers while still in the asymptomatic phase. This guarantees maintenance or improvement of executives’ health after their check-ups. After the medical evaluation, they are monitored over 12 months by the ePharma multidisciplinary team.
5. Our Pillars
Technological innovations, a consolidated relationship with the network of accredited pharmacies, the well-established partnership with the pharmaceutical industry and an organizational culture based on the generation and retention of talent are what constitute our DNA.
Information technology represents the heart of the ePharma restructuring process. In 2017, it became an independent unit in the organizational structure and was responsible for a number of innovations that expanded access to quality information on pharmacy assistance plans.
The knowledge stored in company data centers, following market trends, migrated to the cloud, with the support of high-performance Oracle Cloud and Microsoft Azure solutions.
The change even further facilitated customization of programs to the needs of each drug user. The adoption of Power BI as a business intelligence platform also improved business analysis – turning data into insights, it allows health operators, companies and pharmacy retailers to build models in order to make the best decisions.
In addition, new versions of apps were developed, which empower beneficiaries with guidance on their health. Available 24 hours per day and seven days per week, the IT systems ensure authorization to purchase drugs in pharmacies within three seconds and define eligibility rules appropriate for each population, among other advantages.
How IT streamlines the operational steps
Pharmacy Claims Processing Workflow
Providers Claims Processing Workflow
Retail Pharmacy Network
New projects for 2018
As the axis that connects all the company’s business units, the retail pharmacy network is one of the ePharma pillars and it includes 26,159 points of sale throughout Brazil. It is the direct partnership in all PBM unit programs, as well as in the Specialty Care unit programs focused on the pharmaceutical industry. In addition, close to 130 distribution centers (deliveries) are included in the system.
For 2018, the goal is to make this partnership even more modern and dynamic. For this, we are developing a web authorizer that will make tasks such as system updating quicker and easier. In the first half of the year, we will launch an exclusive website for the retail pharmacy network, with direct access to information and focused on operational transparency. An e-commerce platform for the associated pharmacies, which already includes the ePharma authorizer, is also in development.
Some of our Retail Pharmacy Network partners
Some of our Clinical and Laboratory Network partners
ePharma also has the broad support of a qualified network of clinical image and analysis laboratories, infusion and vaccination clinics for exams and various procedures; home care companies and accredited nurses, which allow home collections and exams. Two international laboratories – Centogene (Germany) and the Mayo Clinic (United States) – are also among our partners.
Partnership with The Pharmaceutical Industry
The best purchase conditions
The purchase of medicines always was and will be one of the main benefits managed by ePharma. With the creation of new business units, the company has the pharmaceutical industry as an increasingly important ally. The largest laboratories operating in Brazil are included in this partnership, with the purpose of offering their clients special purchase prices and conditions. The pharmaceutical laboratories, on the other hand, also have an important channel for offering their support programs to chronic patients.
This relationship also has another important function: to establish a list of medicines covered by the benefit by means of the so-called ePharma Preferential Form. The main purpose of this document is to encourage the safe and effective use of medicines.
ePharma Preferential Form
People make the difference
The ePharma multidisciplinary team is one of the pillars of our business. The specialized team includes professionals in the areas of technology, management and health – doctors, nurses, nutritionists and pharmacists – who offer personalized guidance based on the specific needs of each client.
We regularly invest in the professional development of our employees in order to enhance and expand skills, knowledge and attitudes in a systematic and consistent manner, through training and subsidies. ePharma commits to supporting and encouraging its professionals to seek the development necessary to perform activities with excellence, allowing all learning to be in line with company strategies.
In keeping with market practices, we invest in benefits in a planned way, in order to ensure the comfort and, consequently, retention of our talent.
In 2017, the area of people management was also subject to change, with the goal of increasing response capacity focused on the ePharma business model. The area was reorganized into three specialist sectors: Remuneration and Benefits; Training and Development; and Talent Acquisition. This new structure provided support for the business strategy. Thus, we became better prepared to find the “right person,” identify and develop potential employees and retain our talent.
Number of employees is constantly changing
6. Enhanced planning and control
The basic principles guiding the company over these 18 years remain unchanged. ePharma has always been based on ethical values and legal compliance. We respect the principle of equal treatment of shareholders and ensure transparency and accuracy in our financial statements, which are externally audited every year.
Structure of corporate governance
The Board of Directors is responsible for long-term strategy and formulation of company business policy. Among its statutory responsibilities, appointment of the executive body and monitoring of its management stand out. On December 31, 2017, the board was composed of five members representing shareholders, including president Luiz Carlos Silveira Monteiro.
Composition of the Governing Council
CEO of the Pague Menos Group, created 37 years ago. The company is the third largest pharmaceutical group in Brazil in revenue and number of stores. With a degree in Business Administration from the University of Fortaleza (UNIFOR), he has gained experience through various management and administrative positions at Farmácias Pague Menos, as well as worked in another group company – PAX Corretora de Valores e Câmbio Ltda.
Founder and CEO of Distrifar, a pharmaceutical distribution company, he was partner-owner and executive director of Drogasmil until its sale in 2009. Previously, he worked as partner-owner of Distribuidora Faria and Intermed for 18 years. He has a Bachelor’s degree in Information Technology from the Pontifical Catholic University of Rio de Janeiro (PUC-RJ) and an MBA from the Federal University of Rio de Janeiro (UFRJ).
Founder and CEO of Drogaria Araujo, the largest pharmacy network in Minas Gerais in revenue and number of stores, with more than 170 points of sale. With a Bachelor’s degree in Business Administration from FUMEC University in Minas Gerais, he studied for an MBA at the UNA University Center, also in Minas Gerais.
One of the founding partners of Valiant Partners, a U.S. investment fund created in 2008. Previously, he worked as a financial analyst for 3G Capital for five years. An economist with a degree from PUC-RJ, he has a Master’s degree in Finance from the London School of Economics.
The directors of ePharma are its legal representatives, chosen by the board and responsible for managing the business and implementing general company policies and guidelines.
Luiz Carlos Silveira Monteiro
President and founder of ePharma, created in 1999, a physician and health manager, he was president of the Pediatrics Surgery Association of São Paulo and director of the Brazilian Medical Association. Advisor of the Corporate Governance Brazilian Institute (IBGC) and founder and advisor of the Population Health Alliance (ASAP).
Director of Finance & Administration, he worked as a planning manager for Carrefour, as well as for Monsanto, Chase and Andersen. Holding degrees in Business Administration from the Pontifical Catholic University of São Paulo (PUC-SP) and Accounting from Paulista University (UNIP) in São Paulo, he also has an MBA from IBMEC-SP and a Master’s degree in Business Administration from PUC-SP. He also took specialization courses at the NYU Stern School of Business, the Kellog School of Management and Harvard Business School.
Director of PBM and Pro-Health units, he worked as Business Manager at Searle do Brasil for fifteen years and Sales Director at Coloplast do Brasil for seven years. He holds a degree in Business Administration from the Faculty of Philosophy, Letters and Human Sciences of Rio de Janeiro (FFCL-RJ), a graduate degree in Health Management from the National Service for Commercial Apprenticeship (SENAC) and an MBA from the School of Higher Education in Advertising and Marketing (ESPM), both in São Paulo.
Bruna De Vivo
A pharmaceutical senior manager at ePharma since 2002, with experience in the PBM market since 1999, she is a member of the São Paulo Pharmacy Council. She has a degree from the Catholic University of Santos School of Pharmacy and Biochemistry (UNISANTOS) and an MBA from the Dom Cabral Foundation, in addition to health specialization at PUC-SP.
Carlos Pappini Jr.
Director of the Specialty Care unit, he has more than 20 years of experience in the health area, having worked at health operators (Amil) and in the pharmaceutical industry (Merck Sharp Dohme, Baxter, Cristália and Bayer). An administrator with graduate studies in Marketing, an MBA in Health Economics from the Federal University of São Paulo (UNIFESP) and a Master’s degree in Management from PUC-SP.
IT Director, he worked as IT director in an Electronic Medical Records company, with a focus on Big Data, as well as in the consulting area of Microsoft Brasil. With a Bachelor’s degree in Computer Science, he has graduate studies in Project and Portfolio Management, and also received the Microsoft Most Valuable Professional (MVP) award seven times.
Regulations and Controls
The existence of a number of codes and policies strengthens the ePharma commitment to ethics and transparency in its activities. In 2017, in addition to reviewing two protocols, another four were prepared and implemented.
Supplier Code of Conduct
Presents the guidelines for company relationships with its suppliers, detailing the standards that should be established in all contracts, and commercial and institutional partnerships. ePharma believes that its reputation is a result of a collective process that should involve the entire direct and indirect value chain related to its activities.
Employee Code of Conduct
This document contains ethical principles and extensive rules for all employees, whether acting exclusively in the name of the company or in the name of clients, governing how they work with associates, partners, suppliers, service providers or consultants.
Intermediary Contracting Policy
Establishes rules that define the process for contracting intermediary third parties responsible for conducting business on behalf of ePharma. The objective is to prevent risks resulting from violation of anticorruption laws in Brazil and abroad, capable of compromising the company assets and image.
Requires internal and external employees to comply with Law No. 12.259/2011, which governs the operation of the Brazilian Competition Defense System (CADE). The objective is to avoid inappropriate acts and practices with competing companies and professionals working for them.
Since 2013, ePharma has had a specific document to fight corruption and money laundering practices. In addition to the compliance tools already established, the measures included creation of an Employee Council and a training program for all parties involved.
Policy for receiving and offering gifts, presents, entertainment and hospitality
This establishes principles and guidelines that limit the offer and acceptance of gifts, presents, invitations to entertainment and hospitality activities, including participation in events. It functions as a guide for preserving the integrity of the company and its employees.
Composed of a collegiate body that includes two directors, two managers and one employee of the operational staff, its function is to handle issues addressed by the code. It also acts as a channel to receive complaints and denunciations. All information is treated confidentially and there is a specific commitment to the integrity of the communication author. Denunciations, identified or anonymous, have two channels for accessing the Ethics Committee: through the internet or by exclusive email address.
ePharma is engaged in developing sectors that act and work actively to improve market practices, considering society’s well-being. By means of its managers, it maintains frequent and transparent relations with representatives of regulatory agencies and contributes to development and improvement of public health policies. The company is a member of the Brazilian Association of PBM Operators (PBMA) and the Population Health Alliance (ASAP). President Luiz Carlos Silveira Monteiro is the current PBMA president.
7. Promoting health and sustainability
Always focused on adopting actions that cooperate to improving the quality of life of people and seeking solutions for a better country, ePharma maintains two initiatives in 2017 that promote reduction of the environmental impact of its actions and health.
Expedicionários da Saúde (Health Expeditionaries)
Since 2015, ePharma has contributed financially to the Expedicionários da Saúde (EDS) non-governmental organization, which provides health access to the Brazilian indigenous population. In 2017, two missions benefited communities in the Amazon region.
The project’s 38th expedition, in the first half of the year, involved the Yauratê and Pari-Cachoeira Indians in the Amazon. Pharmacists Bruna De Vivo and Giuliana Taquemoto handled drug dispensing, both for the general surgery center and the ophthalmological center. In addition, they were responsible for providing drugs to patients. In all, 364 surgeries were performed along with 2,963 medical and dental consultations and 5,455 exams and procedures.
At the end of the year, it was the turn of fellow pharmacists Suelen da Silva and Marly Santos to represent the company on the 39th expedition. This time, 400 surgeries, 4,451 medical and dental consultations and 5,699 exams and procedures were performed. In addition, 706 pairs of glasses were donated, benefiting the populations of Alto Rio Juruá, in the state of Acre – living in an area of 82,000 km² occupied by 18,000 inhabitants.
The ePharma Ecoa program was created for the purpose of establishing an Environmental Management system. With the support of all employees, the goal is to obtain market recognition as an environmentally responsible company, with ISO 14.001 certification.
For this, ePharma has committed to complying with a number of targets to help the environment:
Reduce sulphite paper consumption by 20% and paper towel consumption by 80%
Avoid wasting water in all environments
Reduce electrical energy consumption by 10%
Reduce plastic cup consumption by 20%
Recycle 100% of waste
8. Financial Results
Concentrating efforts on what makes it different has provided ePharma with a much more accurate analysis of the cost-effectiveness of its programs. The result has been quickly reflected in the numbers. In one year, EBITDA rose from R$ 6.7 million to R$ 11.8 million, a gain of 75%. A negative net profit of R$ 10.2 million became positive and reached R$ 4.8 million. Another significant indicator: R$ 5.2 million of free cash flow, allowing room to continue our investment and expansion policy.
Financial Results (in thousands of R$)
Return on Capital
Free Cash Flow
Consolidated Summary (in thousands of R$, unless otherwise stated)
(in thousands of R$, unless otherwise stated)
|EBITDA Margin (Mg%)||21,4%||9,2%||7,3%|
|Net Income Margin (Mg%)||8.7%||-13,9%||3,3%|
|Earnings per Share (in R$)||1.7||-4.0||1.7|
|Cash and Cash Equivalents
and Marketable Securities
|Claims (in thousands of transactions)||12,529.3||12,141.3||13,018.5|
|Processed Units (in thousands of drugs)||26,431.8||24,524.9||25,426.6|
|Covered Lives (in thousands of lives)||27,184.6||43,937||37,032.2|