Interview

“Our commitments for the patients living with diabetes will be continued"

Sebnem Avsar Tuna

Corporate Vice President

Novo Nordisk Pharma Operations (BASEA)

 

What is the key contribution of Novo Nordisk for the patients living with diabetes?

We are in Bangladesh and Novo Nordisk is working as a leader in diabetics for about 60 years now. Hopefully, we will continue to be here and our contribution to people who live with diabetes here can be a different topic. We are developing research and manufacturing insulin and other diabetic products. So, we are providing our products, we are not only supplying products we are also manufacturing the products here with our local manufacturing partner Eskayef and today 80% of patient are using Novo Nordisk product, which are locally produced in Bangladesh. Another commitment and contribution we can say Novo Nordisk is doing the training and educational activities related to diabetes. Our key contribution is to discover and develop better biological medicines, manufacture them to meet increasing global demand and make them accessible wherever they are needed.

In Bangladesh ~400 hundred thousand patients depend on Novo Nordisk insulins; every second patient is taking Novo Nordisk’s insulin. Novo Nordisk is the market leader within insulin and GLP-1, and is the world's largest producer of insulin. In Bangladesh we have introduced entire range of products starting from HI, MI, NGIs and GLP-1, which meet the needs of all type of patients’ requirement.

We know that there are 7 million diabetic patients living in Bangladesh. Only 50% of them know that rest of the 50% have not been diagnose yet. Only 50% are getting treatment. Diagnose or no diagnose, lots of complication are still there and a lot to do with contribution and we would like to move.

Would you please tell us about the diabetes challenges globally and locally?

I think diabetes is a big challenge globally. We call it’s a kind of a slow motion epidemic. It is communicable and non-communicable because of the number of the patients. The size of the diabetic population is big and huge. It is a burden to the public. Being working and partnering together, how we can find a sustainable situation for the diabetic patient to get to reach to treatment option and care, I think it’s the biggest challenge for any kind of nation. But, Novo Nordisk treating diabetes is not so expensive. But, “Not Treating” diabetes is progressive thesis, goes with complications. In terms, if you don’t get a random treatment on time, you can get blind, your kidney may doesn’t work, can affect your food habit and heart also. Treating these complications are much more expensive than treating diabetes than having once or twice having insulin daily. For any research on the total cost of diabetes only 7% is for drugs and other 93% cost for the complications.

According to IDF data:

Diabetes affects 415 million people worldwide and the number is expected to increase to 642 million by 2040. Two-thirds of all people with diabetes live in urban areas. In Bangladesh 7.1 million people living with diabetes in 2015 putting it among top 10 countries in the world and it will hit 13.6 million by 2040. The prevalence of diabetes in Bangladesh is 7.4 percent.  ~129, 313 people died in Bangladesh due to diabetes.

What does “Changing Diabetes” means to Novo Nordisk?

It’s a good question. All we say it’s a lifelong disease that the patient need to cooperate and it’s a progressive disease. In different term it needs to get different treatment and the extreme term you need to get insulin by injections which is not certainly easy. We are trying to change the quality of life by our ‘Changing Diabetes’ activities. Either giving better treatment and giving better opportunities, education to cope with these diseases or some inspirations of diabetic appears, to see some wrong models who has been living, shows them that can lead a healthy life.

We can change its trajectory – and we must act now. We are working for changing diabetes. We must ensure that people are diagnosed earlier, improve diabetes care and tackle the rise of the diabetes in cities.

In a country like Bangladesh can our poor people afford your products?

I think they can! Because the level of the price we are providing is not so much. It is less than a cup of coffee. We are the only company who has entire range of products starting from HI, MI, NGIs and GLP-1, which meet the needs of all type of patients’ requirements based on affordability.

What is your triple bottom line?

Triple bottom line means the 3 components of it and the 1st component is the financially being responsible, 2nd one is environmentally being responsible and 3rd one is socially being responsible. Financial being responsible, we are aware of our responsibility in terms we are providing and supplying the demand globally the insulin which is a lifesaving product. If we do continue this, we sustain, we need to have financial support, and we organized company so that we can continue our research and manufacture and sell those products. Environmental responsibility, we are already manufacturing huge products, so we have a huge plan. We want to be a part of this society, we don’t get it direct because of our production. In our green field we only use green energy, wind energy. We have some commitment. Novo Nordisk is doing business in a responsible and sustainable way, with a focus on improving public health, benefits patients, society and shareholders. We believe that a healthy economy, environment and society are fundamental to long-term business success.

Socially being responsible we want to be a part of this society. If there is flooding we have to make sure that our insulin are there. We have distribution partner.  We are ready to face some challenges. We are also working for children.

What is in your pipeline?

We would continue to bring newer insulin and we are now also producing fortunately in this country a lot GRP-I. It’s a daily injected product, or can be weekly. We are also working on drug abuse. Hopefully we will have a ruling at the end of the year. That data is very robust, it really will indicate to most that looks at the data, that it is the best GLP-1 data that has been seen.

When you talk about the excitement of being able to reproduce that kind of data and take a once-a-day pill, I think that’s exciting. That’s in the relatively manageable 3- to 5-year timeframe. We are still exploring things like a weekly insulin injection or combining a weekly insulin injection with a weekly GLP, things like that, but that’s further down the pipeline. In Bangladesh we will launch Fast Acting Insulin as part in 2018 for the benefit of patients. Hope these can be valuable for Bangladesh.

It takes more than medicine to defeat diabetes. Please elaborate?

As I said earlier that as it is a lifelong disease and should take treatment on time and be aware about drugs and need to know how to cope with that, it requires lot of services. To be professional as well as the patients in terms of education and to learn how to cope with this non-communicable disease. It’s a part of our “Changing Diabetes” and we committed to our educational activities and get more physicians to increase our diagnosis rate at the diabetic related complication, we are working to keep it less.

However, to defeat a serious chronic condition, we need to do more than supply the right medicine. This is why we work in partnership with patients, policymakers, healthcare professionals and non-governmental organisations to raise awareness, improve prevention, promote earlier diagnosis and expand access to care.

In Bangladesh, we have launched changing diabetes® in children (CDiC) programme in partnership with DAB and World Diabetes Foundation (WDF) to increase access to diabetes care for children with type 1 diabetes so that they can live better lives.

Globally, Novo Nordisk has launched Cities Changing Diabetes® – a cross-disciplinary and cross-sector partnership programme to identify and address the root causes of the rise in type 2 diabetes in urban areas and we want to introduce the same project in Dhaka.

Team Novo Nordisk, a global all-diabetes sports team, spearheaded by a professional cycling team, works to inspire, educate and empower people affected by diabetes.

Would you please enlighten me on your activities for changing diabetes?

We are doing many activities with the partnership of Diabetic Association of Bangladesh (DAB). We have supported DAB to initiate Distance Learning Programme (DLP) in 2003 to create trained diabetologist  with a view to ensuring better access to care the people living with diabetes. DLP is now a self-sustainable programme and now developing skilled doctors to treat diabetes better. It has already trained more than 12,000 doctors.

Recently, National Cricket Captain Mashrafe Bin Mortaza has joined with Novo Nordisk as brand ambassador to fight against diabetes. He is working as a “Changing Diabetes® Brand Ambassador” to create awareness on the prevention, detection, management and control of diabetes. He is also focusing on the benefit of healthy lifestyle and diet to prevent diabetes.

In addition to that we have trained 55 journalists on non-communicable disease and sustainable development goals.

We have organised more than 100 awareness campaigns on World Diabetes Day last year and Novo Nordisk Half Marathon- run for changing diabetes to motivate on healthy lifestyle and diet. 

How Novo Nordisk is helping people living with diabetes to live a better life?

 Taking a patient-centred approach, Novo Nordisk focus on continuous innovation and therefore proving an access to newer treatment options. We have the entire range of insulins e.g. human insulin, modern insulin and next generation insulin and GLP-1 Analogue for people living with diabetes.

We are introducing innovative and simpler devices with benefits like simplifying the self-injection of insulin compared with durable pens. As part of our continuous innovation, Novo Nordisk has introduced world class Human Insulin FlexPen® devices in Bangladesh to ensure more benefits and safety for patients.

In addition to that, as part of our long-term commitments, Novo Nordisk has transferred state-of-the-art technology from Denmark to produce Human Insulin vials in partnership with Eskayef since 2012. Transcom Distribution Company Limited (TDCL) is our partner in insulin distribution to reach within 2 hours to any corner of the country maintaining strict cold chain.

What is a cold chain (supply chain) and how do drug supply chains break?

Insulin is one of the many life-saving drugs that can get denatured if not stored in proper temperatures. When we import our insulin from Europe, with each box is attached a thermostat that logs the temperature during transportation from the point of exit to the final destination.  When the shipment arrives to the warehouse in Bangladesh, quality control personnel check the temperature log of each box, and report it back to the exporting country.

The shipment is authorised for distribution only after the headquarters have confirmed that the temperature has remained consistent. If there is deviation from the given temperature range at any point during transportation if the insulin's quality is jeopardised, the shipment is destroyed.

The drug-carrying coolers are sent to many branches of our distribution centres in authorised cold chain vans that maintain a temperature of 2–8 degree Celsius. The distribution centres than deliver the coolers to pharmacies, who are ideally supposed to take them out and store them in proper conditions until purchased.

A cold chain breaks when one actor does not maintain proper storage temperatures. This can happen at the supplier's warehouse, or it can happen in pharmacy retailers

  Dhaka -

Friday 15 Dec 2017

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