Novo Nordisk manufactures and markets pharmaceutical products and services, and is a pioneer in the treatment of diabetes.

In the first of a two-part series, host of the Citi Breakfast Show, Bernard Avle, speaks  to CEO of the company,  Lars Fruergaard Jørgensen, on the company’s work in the treatment of diabetes and obesity, and their contributions to healthcare delivery in Ghana.

Ben: You are the new CEO of Novo Nordisk. It’s a huge company, tell us what is it like to be running an organisation of that size and how you do it? 

Lars: It’s a great privilege to have that role. I’ve been with the company for 26 years. When you’ve spent your whole working life in the company, to become CEO one day is fantastic. It’s a special pleasure because it’s a company where, as a CEO, I need to satisfy my shareholders but we run our business based on what we call a triple bottom line principle. So I have to be accountable for the financial resources and also environmental impact and social responsibility. Being here in Ghana is part of that because we think we have a special responsibility for both employees of the company and also the patients we serve. Helping people with diabetes is basically what we do both from a business point of view but also from a socially responsible way of conducting business.

Ben: Your company is a massive and impressive organisation and you are a global player. Africa has some of  the diabetes burden but in terms of economic power, Ghana is a small player. Why would a global CEO of a multinational company like yours be so interested in Ghana to the extent of signing MoUs and coming here yourself?

Lars: We are committed to people with diabetes all over the world including in Africa and Ghana. You’re right that this is a very small business for us, but in Ghana we have as many people – around 8% – living with diabetes. Many of them, more than 70% are not diagnosed and do not know they have it. We feel a responsibility for going into partnerships with local faith-based groups, the Catholic church and the Ministry of Health to help people do screenings and ultimately make sure that you get to know early on if you have diabetes. Because if you get treated early, you can live a much better life, free of complications. If you walk around with the condition for a long time and discover it late, it will have a more devastating impact on your life and on the health system that has to treat it.

Lars: The number of people with diabetes is expected to almost double over the next 30 years but we also know that we have a lot of products that can treat diabetes. Actually, a leading cause of developing Type 2 diabetes is obesity. We believe that instead of treating diabetes when you get it, if you can actually address the obesity and prevent people from getting diabetes that is the right way to go.  Obesity is a very complex disease; it’s lifetime related but there’s also physiology linked to it. So we believe that focusing on both lifestyle and medication can reverse the trend in obesity. Looking at the model, if you can reduce the number of people that are obese by 25%, you can reverse the growth in diabetes. If we bring down the number of people with obesity by 25% we can reduce 100 million diabetics on a global basis. We are in the business of selling products but we’re also in the business of making sure that the health systems of the countries we operate in are sustainable from a disease burden point of view.  Unless we do something together with the local health agencies, the burden of obesity and diabetes will just continue and will be too big for most countries to deal with.

Ben: How far are you in your research for obesity? Within Ghana’s middle class, you see a lot of people trying to lose weight; some are exercising, some are taking all kinds of concoctions and a few of them also do surgeries. From a Novo Nordisk point of view, what are some of the prognosis in terms of what you’ll be offering when you fully enter the obesity market?

Lars: We have a product class called GLP-1; we have launched GLP-1 in Ghana called Victoza. It has a good side-effect that makes people lose weight. We have also developed a version of the molecule into a dedicated obesity product. A third of the patients using this product lose more than 10% weight. We have the next generation GLP-1 product under development where people will lose weight similar to what you lose when you have surgery. We believe there is an opportunity to significantly reduce weight based on medical intervention but it’s really important that you do it together with lifestyle change, diet, exercise, and that takes a lot of coaching and education in what is the right food to eat. When I visited the diabetes center, it was interesting to listen to those who come there that are getting education on the right foods to eat when you have diabetes. It is possible to do, but it takes a big effort.

Ben: Your company is a pioneer in the injection for diabetes and a few months ago you launched in Ghana, your Human Flexpen insulin. Talk to us about how proud you are of these products and how they will change the management of diabetes for people who have the condition.

Lars: Today, most diabetics in Ghana have to pull up insulin in syringes from vials and inject themselves. We just launched in Ghana, insulin in a pre-filled pen so you put on a very small needle that you hardly feel when you penetrate your skin. You have a pen system that you can wear and bring. It’s a very convenient way of treating yourself and takes some of the concerns that diabetics have in terms of handling the injection. So these pens are now available in Ghana.

Lars: Yes, they are. Actually, in Ghana, there’s a social security system that provides access to insulin. The insulins we provide here are quite affordable. We have a pricing policy so the least developed countries that can buy products at a low cost. We also have programmes where children with diabetes get access to free insulin. In Ghana, there is access to insulin so what we are focusing on, together with the Ministry of Health and the Catholic Church is to make sure that it gets to the patients and that it’s accessible. We invest in these diabetes clinics where patients can come and get all their care in one place.  We are committed to making products available. If you get insulin in a sophisticated device, it’s more expensive and that is not available for everyone.

Ben: How does the model work in Ghana? Do you partner with Government to make the drugs available and the government resells? Or can I go to a normal hospital or drug store and ask for your Insulin pen?

Lars: When you go to the hospital, there is access to our drug. In the clinic I visited, there’s both a screening function where people are screened for diabetes to see whether there are any complications. You’ll get your laboratory work done, measure your glucose level and get a prescription of insulin and there’s actually an in-clinic pharmacy where you pick up your product.  So it’s all in one place which makes it easy for patients.

Ben: And you’re saying you price differently so the cost at which I’ll get the insulin pen in Accra is different from what I’ll get it at in New York. By what percentage is it lower?

Lars: We have different generations of products. If you are an American and you have a job in a big company, typically you have a very rich health insurance plan and you’ll get access and reimbursement to the latest medication so you have latest generation insulin and devices. If you are an America without Health Insurance, you’ll probably get the same insulin as they get here in Ghana. In the US, it’s also very cheap but it’s still more expensive than it is here.

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By: citifmonline.com/Ghana

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