John Dawber, vice president and general manager of Novo Nordisk Thailand, offers his first impressions of the Thai market since moving from Japan. Dawber explains the current challenges and areas for improvement in diabetes treatment in Thailand, how the most innovative Novo Nordisk products have propelled the affiliate forward in Thailand, and the close collaborations it has in place with local stakeholders.
Every generation of our insulin products is on the market in Thailand, from the oldest to the latest, premium, and innovative products
Having been appointed vice president and general manager of Novo Nordisk Thailand last January, what are your first impressions of the Thai market?
Thailand is a unique and interesting market for Novo Nordisk. We are able to bring the full Novo Nordisk portfolio to the Thai market thanks to the country’s universal healthcare coverage. The Thai government, healthcare institutions and the FDA are doing great work to be able to give access to healthcare to as many people as possible in the country. Every generation of our insulin products is on the market in Thailand, from the oldest to the latest, premium, and innovative products. The Thai market is full of opportunities for us.
You previously worked in the UK, Denmark, and Japan. What have you learned from these experiences and what can be applied to your work Thailand?
All of my previous experience taught me how to navigate within a different culture and part of the world. From the UK, I learned a lot about the regulatory and compliance environment and how to promote medicine appropriately, I can help people here to have a better understanding of what the compliance environment might look like in the future.
In our headquarters in Denmark, I was responsible for the global marketing of our modern insulin products. This gave me an overview of the full life cycle of our products, the development and production processes and of course the global market.
Finally, four years in Japan taught me how to navigate in an Asian country and how to adapt to another culture. After all this international exposure, I hope that I am now more open-minded, can communicate well across cultures, and am a better leader.
What are the key priorities and goals you established for yourself and the affiliate when you accepted this challenge?
We have been working on three major commercial priorities. First, we would like to expand the use of our GLP-1 injectable portfolio. These highly effective treatments for Type 2 Diabetes make up only about 10% of the Diabetes market in Thailand, and there is much more potential for them. We already have one of these available in Thailand, and it is the market leader in the segment, and we are working with the Thai FDA to bring a second GLP-1 as soon as possible. Our second main priority is with our insulin products. We have three different generations of the insulin on the market; we would like to be able to maintain broad access for Thai patients as well as upgrading patients to benefit from the more innovative insulins, and hence have better control of their Diabetes, simpler treatment regimens, improved quality of life, and less hypoglycemia. Finally, we observed, from other Novo Nordisk affiliates, and from the Thai market, a new opportunity in treating obesity. It is a challenging area, the product, for the treatment of obesity, will be launched in August and is a completely new area for us, we must develop and educate the entire market on the importance of treating medical obesity and its links to the prevention of other chronic diseases.
How do you find launching those very innovative products in Thailand?
One of the main challenges we faced in the past, was getting timely Thai FDA approval. Pricing and affordability are also a challenge, as it is around the world. The review time for Thai FDA approval used to be a long process and needed a lot of data from the company. Recently however the Thai FDA has done a wonderful job in expediting their review timelines to be among the most efficient in the world. To further facilitate the process, we try to work with the Thai FDA to create a strong collaboration. For example, by sharing some reviews and approvals done in other countries it may help the Thai FDA further, and we also aim to supply our data quickly and in the best format. It takes work from both sides, and we are lucky to have strong support from our headquarters. The regulatory environment has changed a lot in a positive way, and if we can obtain the right price and approval times for our products, it could be a great opportunity for Novo Nordisk.
Novo Nordisk has been present in Thailand since 1984; what is the importance of Thailand to your regional operations? How has the affiliate been performing under your leadership and what is your growth target?
Novo Nordisk Thailand is part of the Business Area Oceania and South East Asia (BAOS). The headquarters of the regional operations are in Kuala Lumpur. Since we include Australia as part of the region, Thailand is on track to become the second-biggest market in the area in the next few years. The Thailand affiliate has been performing well, in 2018, Novo Nordisk was the third fastest-growing company in the PReMA group and has been growing at between 14-18 percent. Our growth is due, first of all, to our developed portfolio. For example, our GLP1 Victoza® product is still observing 30 percent growth in Thailand, despite being almost 10 years old. Secondly, but absolutely key to our growth, is our strong discipline and passionate workforce. We train people well, give them strong professional development and spend a lot of time focusing on execution. Our Novo Nordisk patient-centred business approach and the passion that comes from this is at the core of what we do.
Maziar Mike Doustdar, Novo’s EVP of international operations told us that a key advantage of Novo Nordisk in emerging countries is “the versatility and multi-dimensionality of its product portfolio”, which includes both high-need products and some of the latest innovations. To what extent does this broad portfolio also stand as a competitive advantage in Thailand?
I must admit that it is a very strong competitive advantage to have a broad portfolio in the therapy areas where we work, and it gives us the versatility to include both high-need and innovative products. With this comes some flexibility on the price and hence the opportunity to have both 40-year-old products and the latest innovative products on the same market at the same time. Novo Nordisk is pretty much a diabetes company, even if we are now focusing on other areas, we understand the diabetes market deeply and can utilize our rich portfolio to treat as many people as possible, with the right medicine for them
Dr Suwapadee from the Sirajaj Center of Excellence for Diabetes and Obesity and Dr Wannee from the Diabetes Association of Thailand both highlighted the urgent need for multi-stakeholder collaboration in regard to diabetes awareness, prevention, and disease management. How is Thailand benefiting from the knowledge and the expertise of Novo Nordisk, beyond the product?
Without taking into account the commercial activity of Novo Nordisk, the company has a role to play in supporting the associations, organizations and foundations. One example of this is Novo Nordisk’s support of the World Diabetes Foundation. The WDF independently undertake great work in emerging markets like Thailand to improve Diabetes care. We are increasing the number of collaborations we undertake with hospitals and key opinion leaders in order to be able to support diabetes clinics and doctor’s education in the countryside outside of Bangkok. In Thailand, the World Diabetes Foundation is beginning a collaboration with academia to train doctors on how to treat diabetic patients properly. We are convinced that it is our responsibility beyond the product to educate doctors, and HCP’s across many disciplines in order that patients get the best care.
While I was in Denmark, I was involved in setting up the sponsorship of Team Novo Nordisk, a global professional cycling team with only Type 1 diabetes patients within the team. The purpose of this project was to allow these cyclists to educate, empower and inspire patients and doctors around the world about living with diabetes. Living with Diabetes does not need to hold anyone back in the achievement of your dreams, in fact it can be a facilitator and motivator to achieving your dreams. This is something that we are really proud of and would like to bring this inspiration to Thailand too.
While in Japan, you were closely involved in collaboration with some digital healthcare startups specialized in diabetes management such as Health2Sync. What has been the impact of these partnerships and do you have the potential to replicate this approach in Thailand?
I would like to bring these kinds of collaboration to Thailand, even if the business model may be slightly different. Health2Sync seem to have a unique and innovative business model, the diabetes patient can interact with their doctor at any time of day, in real-time, and they can track and monitor their results. These kinds of innovation have several benefits such as improved clinical and patient management and education. It really could be a win-win situation, and a good payoff for Novo Nordisk in term of reputation, through investing in the country and engaging in the digital industry, for the patient who will get better treatment, for the doctor because it will make their life easier, and for the hospital because they will differentiate themselves with the collaboration.
Thailand is aiming to become a clinical trials hub in the region. What is Novo Nordisk’s approach to clinical trials in Thailand?
Novo Nordisk is lucky that both Thai doctors and university hospitals are very highly respected around the world, particularly on their knowledge of Diabetes and their strong execution and quality of clinical trials. This means that through our clinical team and our clinical research associates in Thailand we are very active in engaging Thai doctors and patients in benefiting from involvement in clinical trials. This, of course, brings resources, enhances expertise and allows patients to benefit from brand new innovation. The country has been and will continue to be part of the clinical research programmes for all Novo Nordisk’s new medicines.
After more than ten years at Novo Nordisk, what does the ‘Novo Nordisk way’ mean to you?
There are ten essentials or guiding principles to the ‘Novo Nordisk Way’. All of us around the world try to live and do our work every day according to these essentials. Three of the ten essentials are at the front of my mind on a daily basis, and very much shape my decisions. The first one is about delivering innovation to the stakeholders, this is my responsibility. The second one is about our patient-centric business approach. Patients are part of our DNA and should drive our business decisions. The last one, and a critical one for this part of the world is to never ever compromise on quality and business ethics.
What drives you personally and what keeps you fighting to bring innovative products to market? What is your vision for Novo Nordisk Thailand in the next 5 years?
My main motivation would be to keep delivering results for the patient. Although this is easy to say, it is not an easy task, especially within this market. If you go to a university hospital or a diabetes clinic here in Bangkok, you will see a huge opportunity for high-value products and if we reach our targets, the patient will be treated brilliantly. On the other hand, if you go outside of Bangkok, you will realize that the patient there does not always have the same opportunities. We can be focused on the patient in Bangkok but also must make sure that people in rural areas have access to high-quality human insulin, or modern insulin, good delivery devices and great access to our products. I really want to be able to work on both sides. Within the next five years, I would like to carry on delivering all of our current strategies to continue to improve the position of Novo Nordisk in South East Asia and in doing so, Change Diabetes.