Changing Diabetes - Pharmaceutical Executive

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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.


Pharmaceutical Executive


One theory is that with the diabetes market, because there's so much available that is low-cost and can be effective, it's more important than in some other fields to come in with an innovative product if you want to sustain your business. In other words, because there are numerous alternatives available to patients, when you come in with a new drug—especially one that's going to cost more to the patient—it had better be innovative because there's plenty out there already. Do you agree with that?

That is true. We have several products that focus on the beta cell, and some that focus on the insulin receptor. There are many of them on the market and there will be more coming. With insulin, we have short-acting insulin analogs and long-acting analogs; we also have mixture analogs. We are the only company that has all three. With those three different analogs, we should be able to treat everyone well.

But as I said, the doctor has to be committed—and well-educated—with the infrastructure around him to do the right job. And patients have to be aware, first. Secondly, they have to be motivated, they have to be empowered, and they have to be compliant with the treatment. We have the right products. It's just getting the process right.

In some fields, if a patient's falling behind on treatment, you say, "Well the trouble is we don't have the right kind of drugs to treat these patients." With diabetes, we already have both the drugs and the delivery systems to do a very good job with most patients. And yet we don't. So it's not a failure of the drugs, it's a failure of the system.

Yes. If you look at the fact that only 6.7 percent of the total treatment costs come from drugs, it cannot be blamed on that. Let's assume we doubled the price of the drugs, to something like 12 or 13 percent. We won't do that, but it makes the point that the cost of the drug is kind of irrelevant in the whole thing. It is the system, the infrastructure, that is the problem.

Given all the companies out there with diabetes drugs, is it enough to change the way physicians actually think about and treat patients?

I think that if you believe in something, then there is a high likelihood that you will succeed. And we have been able to do major initiatives in other countries where we really have changed the culture and have created an environment that's very positive, that's drawn a lot of attention to diabetes.

Can you give an example?

In Europe, and also in Japan, our company has been very instrumental in getting diabetes well-controlled. In Europe, if you take my home country, The Netherlands, we have 91 percent of the insulin market share. In Japan, we have about 80 percent. There, again, we have not just been selling the product. We want to make sure that people with diabetes are well-controlled. That creates not only customer satisfaction, but also customer loyalty, where our customers are our advocates. They talk about us in a very positive way. If you took a sample of endocrinologists, they would all tell you that we are a very decent company and that we do our jobs in a very responsible way. That's the way we want to be recognized.

If all you have to do is sell insulin, it is difficult to keep being engaged and motivated. But we have so many examples of patients that improve and live normal lives with diabetes. If you combine that with selling a product, then suddenly you have job satisfaction. That attracts people to our company. When people join Novo Nordisk, they usually stay with us. We have many people with high seniority. And even though we are growing, every month I have a huge breakfast with about 500 employees to tell them about what's going on. Once a quarter, we ask our sales reps to sign into those meetings via webcam. Once a month, I hold a birthday lunch for all employees with birthdays in that month.


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