In conversation with Vikrant Shrotriya, Managing Director & Corporate Vice President, Novo Nordisk India

1. Please highlight the work of Novo Nordisk in India during the ongoing COVID-19 pandemic? How has it maintained the supply of insulin during the lockdown?

We take pride in the fact that more than half the number of people with diabetes who require insulin depend on us. Hence, during the COVID-19 pandemic, our entire logistics team worked overnight with our partners to ensure that our life saving medicines were available to people with diabetes across the country. We faced some disruption and logistics issues initially, but with the support of the government, our partner Abbott, and local authorities, we were able to overcome all the challenges we faced together.

Apart from ensuring the uninterrupted supply of insulin, we also participated in the cause of supporting the Karnataka Government and Police Department by offering them free insulin and protective gear for INR one crore.

While doctors across India have been active in providing their services during these unprecedented times, we also feel responsible as a partner to offer an uninterrupted supply of medicine and departing the right medical information. Thus, we started various digital connect initiatives to impart the right knowledge and information to doctors across the country.

2. Can you shed some light on the uptake of Insulin in the Indian market?

India is considered the diabetes capital of the world with approximately 77 million people living with diabetes, of which only ~5 million people are on insulin. Currently, people living with diabetes avoid injectables till it becomes unavoidable.

In that light, our efforts are focused on increasing knowledge and advocating the importance of early and optimum use of insulin therapy to people who need it. We have been running various effective diabetes management education programs throughout the years to create awareness on the importance of early diagnosis and treatment.

While we have seen acceleration in insulin therapy over the years, there is still a long way to go. We believe there is a high potential to upgrade people with diabetes to the next level of therapy and newer insulins, which are already available in the market. We have a wide portfolio of products under our promise - ‘An insulin for every Indian’ who needs it, which includes Human Insulin, Modern Insulin, New Generation Insulin Insulin (NGI) and GLP-1 products.

3. Since its discovery 99 years back, innovation in Insulin use has seen steady progress. Can you share the current trends in Insulin and what we can look forward to from Novo Nordisk on this?

Since the advent of insulin, we have been striving to ensure the accessibility of the product across the market for every person who needs it. Through constant pushing and continuous innovation, we have led the transition from Animal Insulins to Human Insulins, to Modern Insulins to New Generation Insulin. While human insulins are still a gold standard in India, we believe that newer insulin therapies would be a game changer for people with diabetes, as they offer better glycemic control.

Continuous innovation of insulin is not enough for us. We believe that our real competition is the lack of awareness, uncontrolled diabetes in India, and challenges regarding access of products. Hence, we are making sure through our various programs that we raise awareness around the acceptability of insulin and make it more reachable for people with diabetes across every corner of India.

Novo Nordisk insulins have been present in India from 1935, marking more than 80 years of uninterrupted supply in the country. The India arm started operations in 1992 with its headquarters in Bengaluru and just 26 employees. Since then, the company has grown to over ~1300 employees, becoming one of fastest growing pharmaceutical MNCs in India. Novo Nordisk India’s portfolio of products addresses diabetes, human growth hormone and haemostasis management.

4. As the market leader of insulin in India, what are your top priorities for the business?

We believe that our real competition is the uncontrolled growth in diabetes, lack of awareness, and restricted access to products, so we will continue partnering with stakeholders including HCPs, doctor associations, and government bodies to overcome these. While diabetes treatment remains primarily in the domain of doctors and healthcare providers in India, there are a variety of attempts to bring integrated solutions to the patients. We learn and embrace technology as much as possible and we have taken big steps in various therapy areas globally and locally.

While we do have a full portfolio of products under our promise of “An insulin for every Indian” at all stages of therapy, there is still a great potential to upgrade our patients to the next level of therapy and newer insulins in the market. We also see a potential for growth in incretin and GLP-1 therapy in India. There are several products in the pipeline which should see access to the Indian market in the near future.

Novo Nordisk India partnered with Novo Nordisk Education Foundation and launched the 'Impact India: 1000-Day Challenge' programme in 2018 with the aim to reduce the national average of HbA1c by 1%, as it can help reduce the risk of diabetes-related complications significantly in India. Based on data analytics, iDCI® has been providing a real-time view of the average HbA1c in India across several cities. Under this programme, digital platforms are being leveraged to partner with healthcare practitioners to evolve and implement an approach for diabetes care in India. iDCI® is a dynamic tool that not only tracks the status of diabetes care but also helps to increase awareness, motivate and sensitize the healthcare professionals (HCPs) and society.

5. With the world's second-largest population of diabetics, what are the measures that can prevent a further escalation?

In India, there is a genetic predisposition towards diabetes, making Indians highly susceptible to Type 2 diabetes. While incorporation of proper diet and exercise can go a long way in controlling the disease, it is important to also keep a check and monitor diabetes regularly. We strongly believe that if the disease is diagnosed in its early stages and the right treatment is initiated, we can go a long way in controlling the disease and its effects.