The World Is His Oyster (Less N. America) – Novo Nordisk's Mike Doustdar

Maziar Mike Doustdar faces a big task implementing a new commercial approach under Novo Nordisk AS's new CEO Lars Fruergaard Jørgensen that will give regional centers more business autonomy in effort to remove bureaucracy and centralized rigidities while boosting sales.

Mike Doustdar will be overseeing much of that transition as head of international operations outside North America. The new strategy came in along with Novo Nordisk's new CEO in January this year.

"I think it's fair to say it's still a gradual change to a true portfolio approach, where we kind of adapt more the portfolio locally to see what plays out, so it's not like one big global thing that we're now launching with a big bang strategy. It's becoming more targeted to each individual market," Doustdar told Scrip in an interview at Novo Nordisk's headquarters outside Copenhagen.

Reflects Company's Evolution

He said the company's own success of becoming the world's biggest insulin maker has made the change necessary.

"Ten, fifteen years ago, Novo Nordisk's approach was to introduce one drug to the market at a time; and often we didn’t have enough production capacity, so we had to choose which region and country would be in the first roll-out wave, which in wave two, and those in wave three; Then three or four years later we introduced the next product; for example, NovoRapid (insulin aspart) I believe was introduced in 1999, then in 2002 or 2003 NovoMix was introduced, and in 2004 Levemir (insulin detemir) was introduced. So, we came from a background where we had one thing at one time. This then translated into, more or less, a one-size strategy," Doustdar explained.

"Fast-forward to today, where we are getting four or five products ready to go – we have Tresiba (insulin degludec), we have Ryzodeg (insulin degludec/insulin aspart), we have Xultophy (insulin degludec/liraglutide); we have a number of products in the biopharma area like Novoeight, Novonine and so on; and we today have enough capacity because we learnt from our past, and they built a load of capacity to go very fast with all of these products," he added.

Two-Way Dialogue Key

So, the new market approach will be built on dialogue between HQ and the individual regional affiliates. But the process will be incremental and targeted.

"If then we tell everyone in the world you can have all of it – and you can you have it tomorrow – something will possibly go wrong, so the best way to attack that is to go to a particular market like Germany or Albania, Columbia or Vietnam, and say to our people there, what does your market look like? Who are your competitors? Where are we strong right now? Where do we need the extra push? And then pick and choose as we wish and fit it into that market," he said.

"If you're sitting in Vietnam, Columbia, Albania or Germany, you are very happy with that new approach because you have options and choices, and you really can through that dialogue find the best fit. So we have places where Tresiba is the flagship of our products, in a number of European markets.

"We have places where we [are] right now in the midst of introducing Fiasp (faster-acting insulin aspart) in Germany – which we were not able to keep supplied with Tresiba due to access issues – we have all focus on Fiasp; then go down the road to France, and Xultophy is where we are putting all our efforts, so that notion of three European markets with three different flagship products on this day is somewhat unique. That's how we are managing our so-called market fit strategy and approach."

But the strategy will still involve a coherent standardized commercial framework.

"It's not that the Columbians have to come up with how to launch it the Columbian way and that would be very, very different than the Vietnamese way, because it's the same product. We want to make sure that globally we create a sense of what this product is and what it's not; and from a compliance point of view also, that we have some bit of control over the various different launches. But what to launch, how much money we put behind it, what goes first and second, what key messages works or doesn’t work in that market, all of those are a dialogue that has already started taking place and that is somewhat new over the last I would say six to nine months, compared to five years ago."

Moving Fully Into Obesity

Doustdar said the nature of Novo Nordisk's business and the inter-relationships shared by type 2 diabetes and obesity are compelling the group to trial novel new drugs for treating people who are abnormally overweight even though commercial prospects for such therapies are unclear.

"We are moving full-fledged into obesity, not because there is a business right now there, there is none … But we know that the patients are there." – Novo Nordisk's International Operations Head Maziar Mike Doustdar

"We are moving full-fledged into obesity, not because there is a business right now there – there is none. If you take a look at the anti-obesity medication financials, it's not giving you any return of investments that justifies what we're about to embark ourselves in. But we know that the patients are there. The good news with obesity is you don’t need a market research company to tell you that many people are obese, you can figure that out on your way to work and make your own statistics."

Asked about the importance of prevention and whether the food industry will eventually join the collaboration, he replied: "We are at the early stages of some of those discussions. I think that society is moving more and more towards prevention rather than just treating diseases, because they realize that unless you really tackle the root cause of type 2 diabetes you could forever run after treating it and you will never get anywhere. "

"Ninety years after [Novo Nordisk's] creation we're only selling products to 25 million people out of 450 million diabetics, and we are the world’s largest diabetes company and call ourselves very successful.

"In some ways we have all failed, including us, because 94% of the population is in bad shape and only 6% is today living a normal healthy life without complications. So, slowly, people are getting there, but we need to do more of it."