Novo Nordisk is one of the few pharmaceutical multinationals focused in one key therapeutic area. Perhaps you could start by telling our readers about how diabetes has evolved in Taiwan over the last few years, and what the situation is like today.
The prevalence of diabetes is increasing as in most developed countries, and the government and the pharmaceutical companies are today paying more attention to the disease. According to the most recent surveys, around 1.3 million people in Taiwan today are suffering from diabetes. An increasingly westernised diet is ensuring that the prevalence rate is increasing.
The average level of Haemoglobin A1c in Taiwan is more than 8%. The TADE say that this figure currently stands at 8.6%, but different associations have different data. Novo Nordisk Taiwan believes that more attention needs to be paid to diabetes care. As a result the company is promoting a concept that we call ‘Are You 7!’ which encourages patients to lower their A1c levels to below 7%, giving better glycemic control. According to the UKPDS, once you reduce your A1c by 1% you can reduce by 14% the chance of macro vascular disease and 37% the chance of micro vascular disease, which is excellent for long-term complication prevention.
The BNHI, the Taiwanese pharmaceutical associations and also the Taiwanese Association of Diabetes Educators (TADE) are all actively involved in promoting diabetes awareness, and improvements are being seen. However, many of the people with diabetes here have a fear of injections. This is why the injection rate in Taiwan is so low compared to western countries. In Taiwan a lot of oral anti-diabetic (OAD) drugs are used as patients are not willing to inject insulin, and A1c will increase after several years of OAD use. Today we are trying to reduce the needle phobia. We need to promote this concept that people with diabetes can reduce their A1c level through insulin injection.
Most doctors here know that A1c should be lower than 7%. However, most patients have higher levels than this because they don’t understand the concept. Taiwan is also a hospital-oriented country, and because they are so busy, doctors often do not have the time to educate patients. This is why Novo Nordisk cooperates with hospitals and elected associations to run awareness programmes, to let patients know that they should have better glycemic control to prevent long-term complications. This cannot happen overnight. It is a long-term project, but hopefully in three to five years we will see some noticeable results.
I imagine that most of the pharma companies that have seen the business advantages of moving into diabetes have done that through oral diabetic treatments. So in a market where the tendency is to go for oral treatments, how does Novo Nordisk stand against its competitors?
Companies that deal with diabetes in Taiwan are today most focused on OADs because patients don’t want to inject insulin. Previously, most doctors would use OAD until the maximal dose. Most patients don’t know this about the advantages of injection until they have OAD failure and start to inject insulin. The attitude to insulin is that it is a last resort, as it is currently only used when this happens. Today, Novo Nordisk is trying to help both doctors and hospitals because whilst the doctors know this concept, they don’t have the time to implement it. Most of the pharmaceutical companies and the associations, even the BNHI know that the long-term complications can bring a large financial burden. So, better glycemic control becomes more important. Most of us know that, and today we are working together to increase public awareness.
What are your expectations for growth? You have been General Manager for a year and a half. How has the company developed since that time when you took over and what are your expectations for it to grow in the future?
The diabetes market is increasing due to the acceptance rate being so low compared to western countries. This gives Novo Nordisk a good chance for growth. Once more and more patients take insulin, patients have better glycemic control. This will be good for people with diabetes and also good for the BNHI. The Diabetes market increasing compared to the total market growth.
On top of this, Novo Nordisk takes social responsibility very seriously. We know that people with diabetes do not have very good control in Taiwan. As a result the company has a responsibility to do more to help the people with diabetes. This will be a win-win situation. Once the people with diabetes inject insulin, they can have better glycemic control, and doctors also can have better reputation with the patient and the patient will have fewer complications, and we will also improve sales. It’s a win-win-win situation.
One interesting thing about this industry is that it’s not just capital intensive, but human resource intensive. You have been in the company for sixteen years: Novo Nordisk seems very good at keeping hold of the best people. For you personally, why have you been here for sixteen years, and what is it that is going to keep you here for longer?
Novo Nordisk is like a family. As a Taiwanese national, it is important for me that Novo Nordisk isn’t simply focused on growing its business here but showing a sense of social responsibility in what it does. One of the ways that the company does this for example is in encouraging its staff to engage in socially responsible activities during their weekends.
Novo Nordisk’s ambitions are much larger than simply achieving short-term goals. To change the outlook and mindset of a whole country about diabetes is a long-term ambition. Novo Nordisk is willing to invest in these long-term goals. My CEO, his ambition is that during his lifetime he hoped that diabetes can be cured. If this were to happen, the company that exists today would have no market left, and yet finding a cure for diabetes is the company’s goal. It is Novo Nordisk’s responsibility and ambition. For this reason, I love this company very much.
One of the things that our readers are always really interested in knows the particular management style that it takes to be a successful manager in a particular country. A lot of our readers don’t know much about Taiwan. You were born here and have lived here for a long time, so perhaps you could tell our readers a little about what it takes to be a good manager here.
The turnover rate at Novo Nordisk Taiwan is very low. When I joined, the company only had three employees, and now we have 75. It’s still not a large affiliate, but most of us are like family because we have the same ambition, and we know that we should work better to help people with diabetes have better glycemic control. We have the same ambition and so everybody works together to achieve this. It’s not like a business. Sometimes we face problems and challenges, but everyone knows that we are all in the same boat. Everyone is very happy about that. Once we meet with problems we can work together, and because we are small company, we don’t have a lot of bureaucracy. My door is always open. Even the sales reps can come to my office and we can talk together. My position may be the general manager, but the reality is that I am much closer to my team than the title would suggest.
Novo Nordisk’s corporate culture at the headquarters in Denmark is to treat everyone as equals, even though their jobs are different. Because everyone in this company has a different function and position, everyone can contribute to the whole and work together to build a stronger company.
Novo Nordisk Taiwan has experienced slightly higher turnover over the last two years than in the years previously. These last two years it has been because the market is challenging and some sales reps have gone to other companies due to their good experience in the diabetes market and our competitors are willing to pay more to lure our people. However, I am never too sad when people move on from Novo Nordisk, as they take with them our company’s philanthropic spirit, which can only be a good thing.
Why did you join Novo Nordisk in the first place? Were you attracted by the company culture or was it something else?
When I joined Novo Nordisk it was not because of corporate culture, which I wasn’t aware of at the time. As well as wanting to take on the challenge of coming to work for a company that was essentially in its start up phase at that time, I was also attracted to the position because Novo Nordisk had shown the faith to offer me the next step up in my career. After I joined Novo and got to know the culture, I found I could contribute more and this is why I stayed ten more years. Most of my management group here in Taiwan joined the company before the year 2000, and they have all stayed.
Novo Nordisk has a very European culture. Was it hard for you as a General Manager to adapt that European style to the way that you do business?
It was initially a challenge, because the company has such a unique view on the best way to do business, but I have come to see that such an attitude to the market is actually very positive. Today for example, Novo Nordisk Taiwan is the market leader for insulin. My main objective currently is to increase Taiwan’s market size. Other companies in our position would not do the same thing, as it also allows our competitors increased access to the market, but for Novo Nordisk this is a matter of social responsibility. This is good for both the company’s reputation and for its long-term finances.
Most expat general managers would be very unhappy to pursue a long-term market strategy that was not focused on short-term performance. I want to stay here for longer, and pass on this sense of responsibility to my staff.
What is your plan for the next five years with Novo Nordisk Taiwan?
My medium term goal is to promote ‘Are You 7!’ campaign. I hope that A1c control in Taiwan will improve as a result. But it is very difficult: no country has achieved this goal before. We want to be the first. In five years from now we might only get as far as 7.4 or 7.5, but it means that we can reduce the number of diabetes patients facing complications, which is great for Taiwan, and also good for my business. In order to do this, we will have to do a lot of public awareness and also direct patient awareness programmes.