Novo Nordisk’s Steve Profit outlines the progression of the group’s strategy in Taiwan, how the affiliate works with the Taiwanese healthcare system and physicians on diabetes and obesity, the changes that were needed to adapt to the COVID-19 pandemic, and new product launches he is particularly excited about.
Can you begin by introducing yourself and your role at Novo Nordisk Taiwan?
I joined Novo Nordisk headquarters in Denmark in 2013, as a global director of sales and marketing. Having gained a lot from the great training and experience, I was delighted to have the opportunity to join the Taiwan affiliate as general manager early in 2019.
I am very lucky to work within the welcoming and well-established Novo Nordisk Taiwanese team, which has recently celebrated 30 years in Taiwan. We work in collaboration with the Taiwanese National Health Insurance (NHI), offering a high level of care to a large local patient population, including many with diabetes. Taiwan is no exception to the global trend over the past decades, in seeing an increase in the number of patients with diabetes; current International Diabetes Federation data estimates that approximately 1.2 million out of the population 18.5 million (aged 20-79 years) are impacted by diabetes. Novo Nordisk has the responsibility to patients at the heart of our business and Taiwan is an important market in regional growth.
What strategy did you lay out upon arrival in Taiwan in the midst of a period when Novo Nordisk itself was under transformation?
One of our aims is to go for ‘moon shots’, focusing on speeding up the time it takes to bring products to market here
When Lars Fruergaard Jørgensen became Global CEO in 2017, he established listening as a key focus, so I took the same approach with me to Taiwan. I spent my first months listening and observing, before developing a specific approach for Taiwan. I incorporated important cultural aspects into the five-year strategy and have ensured that the relevant management teams are on board and updated regularly regarding the strategy and progress, and that it is aligned with corporate headquarters.
One of our aims is to go for ‘moon shots’, focusing on speeding up the time it takes to bring products to market here. We continue to make excellent progress and are seeing the impacts. We are bringing true agility into the organisation though empowering people to question how they work and execute on what can be improved.
How have you progressed this strategy over the past two years?
I have continued to listen and refine the strategy, based on input and observations and with a strong people-focus, including training and development to drive the organisation forward.
I have ensured that the team are focused and invested in preparation. Without preparation the full potential and the “moon shots” would remain out of reach.
After this, it is all about the vision of what you want to be and importantly where you are going. All of the directors work closely together; there is no point in a sales director having one ambition of where to go and a marketing director having another. Simplification, communication, and alignment have been the order of the day, backed up by Novo Nordisk’s ‘lean approach’. As the world’s biggest supplier of insulin, we have lean process worthy of this achievement.
“Simple” is often more complex than it first seems, and a lot of work goes into the back end to make things at the front simple. We have reaped the rewards of this approach, having been able to launch three new products during the COVID-19 period. This marks an outstanding performance by the Taiwanese affiliate. Focused, fast delivery of outcome-improving treatments for patients.
Especially during COVID-19, we have been highly vigilant on this, because the safety of my staff, their families, and patients is paramount. I am extremely proud of how we have worked together with other stakeholders, to keep patients and staff safe as our number one priority throughout 2020.
Given the hurdles that 2020 has thrown up, what have you learned or relearned about product launches?
The biggest reminder for me is to expect the unexpected! There is no classic rulebook for a launch. Restrictions around physical meetings have created opportunities to innovate ways to bring in guest speakers from the US or Denmark to communicate with our physicians and KOLs here and get feedback.
The biggest reminder for me is to expect the unexpected! There is no classic rulebook for a launch
This new approach allowed internal and external stakeholders to think about product launches in a more structured and focused way. When people have to think more about something, they get more out of interactions. We have been very happy with the approach and the outputs and take this forward.
Globally, Novo Nordisk’s goal is to eradicate diabetes. How far towards this ambitious aim is the company in Taiwan and how have your GLP-1 products been received by stakeholders?
We have brought GLP-1 products onto the market in Taiwan.
We have had fabulous post-launch feedback from both patients and physicians on this game-changing product, since local adherence to daily injections has historically been <20% and one of the lowest in the world, therefore, a once weekly injection provides an opportunity for better adherence and patient outcomes.
How would you characterise the way the Taiwanese healthcare system and Taiwanese physicians work to treat diabetes and obesity?
Taiwanese physicians are truly impressive! Visitors are frequently astounded at Taiwanese physicians’ ability to see over 100 patients in one day. The NHI card allows patients to check in, see the doctor efficiently, and get their prescription incredibly quickly.
Treatment starts early here, as the heath service invests significantly in screening. Signs of early onset disease, are checked and treated quickly, which is especially relevant for Novo Nordisk, given our focus on diabetes and obesity. There are over three million people living with obesity here in Taiwan and it is a growing epidemic. Although still not fully recognized as a disease by the NHI, obesity has further ramifications such as diabetes, cancer and heart disease If we can treat patients well for obesity, then they will not progress to have diabetes.
Taiwan had been selected as one of Novo Nordisk’s preferred regions for haemophilia clinical trials for a couple of years. What is the expectation around clinical trials in Taiwan?
With a large talent pool of well-trained clinical practitioners, a well-established review system and government-supported world-class infrastructures, Novo Nordisk has identified Taiwan as a regional centre of excellence for conducting clinical trials in Region China. This year we have 11 ongoing trials, and we will have more clinical trial activities in the fields of haemophilia, diabetes, obesity, non-alcoholic steatohepatitis (NASH), Alzheimer’s disease.
With a large talent pool of well-trained clinical practitioners, a well-established review system and government-supported world-class infrastructures, Novo Nordisk has identified Taiwan as a regional centre of excellence for conducting clinical trials in Region China
Taiwan has been able to carry on with clinical trials throughout 2020, since there hasn’t been a high impact of COVID-19 locally.
How can greater numbers of Asian patients being included in clinical trials help create better data and ultimately better outcomes?
In the past, many companies’ clinical trials have been US-centric, without global representation.
The clinical work in Taiwan ensures relevant data for global treatments.
Globally, it has been difficult to move the conversation around obesity from the aesthetic to the clinical setting. To what extent has this been the case in Taiwan?
I attended some of these obesity clinics myself as a patient, to better understand the patient experience. This was a real eye opener, as obesity clinics differ greatly from diabetes or haemophilia clinics. They require a different mind-set to match the businesses approach of running them.
Obesity treatment also encompasses the complexities by addressing emotional and psychological factors. A multitude of obesity products have been developed in the past, but very few have been FDA approved.
We have also introduced a patient support programme. Obesity is not a disease that can be solved in a couple of weeks. It can take a lifetime. Novo Nordisk is prepared to accompany patients along this journey to ensure that they get treated for obesity, ideally early on, and that they can look forward to a healthier future for themselves with their families.
How will running an obesity franchise differ from running a diabetes franchise in terms of sales force organisation and stakeholder relations?
It will not be the same, but there are some similarities. Novo Nordisk never compromises on business ethics and this remains consistent in all areas of our work. It is always patient first. For example, our five-year strategy is based on patient numbers, not on revenue. It is important to bring this mind-set from a business-to-consumer (B2C) model, like diabetes, into a business-to-business (B2B) model, like obesity.
Moving into obesity also necessitates finding B2B experts and driving the business forward; there are a lot of negotiations on contracts and ordering which is more like a consumer product than a medicine. It is exciting new ground: in diabetes we have experience gained over 100 years in the market and this is something different.
What work will need to be done with KOLs and patient groups to create more awareness of obesity as a disease?
There is a journey ahead for obesity being recognised as a disease. This is a health issue and we will need to continue to increase awareness and provide supporting scientific data to enable evidence-based medical practice. If treated early, patients will be less likely to develop heart disease, diabetes and other associated illnesses.
What are your thoughts on how Taiwan has adapted to control the COVID-19 pandemic?
I am impressed by the preparations that enabled the quick actions of Minister of Health & Welfare, Chen Shih-Chung and the NHI, to effectively safeguard people in Taiwan. The implementation of effective quarantining and daily measures taken by the population has contributed to Taiwan’s successful approach.
The numbers of imported and local cases in Taiwan are very low compared to the rest of the world, to date.
As a UK citizen, I know that in other countries many do not like wearing masks. However, in Taiwan the mask is ordinarily used to protect others. Today, we wear masks in crowded places and in adherence with local guidelines. The control system in Taiwan is one other countries could learn from.
Novo Nordisk set out an ambitious strategy to grow between six and ten per cent in its most recent annual report – is that ambition matched by the Taiwan organisation?
Very simply, yes. We will be playing our part in contributing towards this with a patients first approach.
What can the world learn from Taiwan?
Planning and preparation! If you plan well, you put yourself in a strong position. Business in Taiwan is also agile and ready to grow.
