Changing Diabetes - Pharmaceutical Executive


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

I ask for feedback—What should we be doing better as a company? What should we do with our customers, doctors, and patients? They give me direct feedback, and I make note of it. We take their feedback very seriously, and that creates engagement in the company. When your employees are happy with their jobs, you can do things well for people with diabetes. You are successful from a business perspective.

What do payers think of what you're doing?

Eighty-five percent of our products are reimbursed. Financially, we have a good relationship. Payers clearly see the interest, even though five years ago they thought, "Why would I invest in diabetes?" That attitude has changed drastically.

First of all, there is competition—strong competition—between the health plans. There is an awareness that increased treatment and quality of control will make costs go down. And there also is a realization that if you have 20-percent turnover, then after five years, you get the same patients back again, the most expensive patients. So we're seeing a much nicer reaction to people with diabetes. It's still not sold, but there's a clear change in attitude about the importance of good control and how to accomplish good control with people with diabetes. I think the health plans are much more in favor.

And I also see an increased interest on the part of employers. They also see an interest in improving diabetes control because they see that the normal productivity of those individuals, when they are well-controlled, is good for the economy. If a person with diabetes stays in the labor process and pays taxes, that's better than if they depend on social security. That's good for all of us. It's a win-win for everyone.

Speaking of win-wins, you are an advocate for linking sales-representative compensation with patient outcomes. How close are you to being able to do something like that?

That vision is for a few years down the road. At this point in time, we clearly don't have the data, although there are more and more regional data becoming available. We are first trying to get the national data more validated—that is the first step. Getting everyone hooked up and getting electronic medical records has to be done. That's one of our activities that we would like to get attention for in Washington, DC.

In France, when the government offered the whole medical profession special tax incentives to hook up electronic medical records, you saw an extreme, fast takeoff. Once we have established electronic medical records, we should be able to get regional and territory data.

I think we should put money on the table for our reps when they are successful in terms of market share. But that should not be the only objective they look at. Fifty percent of their focus should be on financial accomplishments, and the other 50 percent on accomplishing an improvement in glycemia and diabetes control.

If you can get to the point where your compensation plan is not based on prescription volume but on a combination of share and patient outcome, it becomes very transparent and very inoffensive to the government, to people, and to doctors.

Exactly. Everyone will see that as a very positive signal. The pharmaceutical industry has been doing many great things as an industry, but we have not been able to communicate our accomplishments to society.

What does Novo Nordisk have going on in areas other than diabetes?

We are becoming more and more active in the area of hemostasis. That started because a Swedish professor who joined our company brought in a recombinant factor VIIa, which is given to hemophilia patients with inhibitors. That was a real breakthrough. And even though it's for a small patient population, it is still very important.


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