Changing Diabetes

Novo Nordisk's Martin Soeters has a question: How can a nation that leads the world in diabetes research do such a poor job of treating it? He also thinks he has some answers.
Oct 01, 2005

Martin Soeters (pronounced soo't rs) has dedicated a quarter century—almost half his life—to the company at which he's now president of US operations. Novo Nordisk, where Soeters has worked since 1980—in various executive roles and locations, from The Netherlands (his homeland) to Belgium to France—is a leader in diabetes treatment, with the largest portfolio in the industry. That's not good enough for Soeters, though. He admires Americans, but remains unimpressed with what's been done thus far to control the diabetes epidemic in this country. He wants control in the United States to be what it is in Europe and Japan. The recipe? For starters, according to Soeters: better communication, more exercise, and evolved sales infrastructure at pharma companies. The Dutchman is leading the charge—one bike ride and piece of fruit at a time.

Pharm Exec: You've been so intimately involved with diabetes. In what areas is our healthcare system lacking when it comes to this disease?

Soeters: As a foreigner, I have built-in admiration for Americans. But when you see how poorly diabetes is treated here, and what the consequences linked with that are, it doesn't match. Of the top-20 universities in the world, 17 of them are American. When you come here, you expect a sophisticated market. And in many areas it is sophisticated, but not in diabetes.

Martin Soeters
As a result of that poor control—and this is confirmed by the American Diabetes Association and the American Association of Clinical Endocrinologists—more than 200,000 people die every year from diabetes. And sometimes diabetes is diagnosed because of heart disease or a kidney failure. But all of that comes via late complications, as a result of poor control.

So 200,000 people, at least, die from diabetes every year, which means that one person dies every 20 minutes. In addition, more than 100,000 people get amputations, or become blind, or need kidney dialysis because of diabetes complications. So 300,000 people are affected directly, and then the whole environment around those 300,000 is indirectly affected. Not to mention, there are 44 million people who are obese. There is a high likelihood that a number of those people will become diabetic. The inflow of diabetes is going to be substantial. At the same time, if we look at the increase in doctors and specialized doctors, it doesn't match up with the growing patient population. This is going to create a big clash. In all of that, I think there is a mission. There is a challenge. There is an opportunity to do something about it.

Apart from the human drama, there is financial drama. We know that 10 percent of the healthcare budget—about $132 billion dollars annually—is spent on diabetes. Only 6.7 percent of that cost comes from drugs, so it is not the drugs that make diabetes treatment expensive. It is all the other things. In particular, it's the treatment of late complications, which apparently account for more than half of all the cost.

In the United States, the healthcare system is designed for acute care, not chronic care. Secondly, because of the extreme competitive environment between health plans and hospitals, there is not much sharing and communicating happening.

Now compare that with some European countries. There, if someone has a better practice, they stand on their hospital rooftop and shout it out to everyone. That's not necessarily the case here.

At Novo Nordisk, we basically want to be the catalyst in changing diabetes. We are not going to have the solution, but we want to try to bring together all the better practices in the United States and abroad, and make sure that they are disseminated and used across the nation.

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