According to latest estimates, a whopping 537 million adults or 1 in 10 people are living with diabetes globally. India is home to the world’s second-largest population of people living with diabetes at 74.2 million. While Type 2 diabetes (T2D), the most prevalent form of diabetes, is a common health problem today, we often fail to take into consideration the seriousness of the disease. Compared to those without diabetes, people with diabetes are at a higher risk of developing several disabling and life-threatening health problems.
Novo Nordisk India launched the world’s first and only oral GLP-1 Receptor Agonist (GLP-1 RA), Oral Semaglutide, which is claimed to be a game changer in diabetes management in January 2022. Clinical studies have shown that it is a safe and effective treatment option for patients with type 2 diabetes with benefits beyond maintaining glycemic goals. It is claimed that it also demonstrates unsurpassed weight loss, consistent cardiovascular safety, and a reduction in cardio-metabolic risk factors with almost no risk of hypoglycaemia, thus hitting multiple targets at once. FinancialExpress.com caught up with Sebnem Avsar Tuna, Senior Vice President, Region APAC, Novo Nordisk and Vikrant Shrotriya, Corporate Vice President, and Managing Director, Novo Nordisk India to know more about this development. Excerpts:
What is the presupposition of the global market now which was moved from insulin to Oral Semaglutide?
Sebnem Avsar Tuna: We have to note that insulin continues to be a very important treatment for people with Type 1 and Type 2 diabetes. Oral Semaglutide is approved only for people with Type 2 diabetes, the management of which is still dominated by the Modern Oral Anti-Diabetic Drugs (MOADs). Taking into consideration its benefits in providing unsurpassed weight loss and proven cardiovascular safety in addition to robust glycemic control, Oral Semaglutide has a high chance of disrupting this MOAD market. The medication can be administered at any stage of the Type 2 diabetes care lifecycle, but its benefits may be best accrued when given earlier.
For multinational companies like yours, what role does India play in diabetes care?
Sebnem Avsar Tuna: India is one of the most important markets for Novo Nordisk in the Asia Pacific (APAC) region and globally. In India, many people with diabetes need quality care and medicines, but do not necessarily receive it. The rule of halves helps us understand this better. It is estimated that out of all the millions of people with diabetes, only about 50% are successfully diagnosed. In other words, half of the diabetic population is not even aware that they have diabetes and do not see the need to seek treatment. Of the half who do receive treatment, only 50% reach treatment targets, and of them only about 50% achieve desired outcomes1. Our aim is to bridge this gap steadily in collaboration with the government, healthcare providers, and communities.
We continue to work with solid resolve towards providing patients better access to diabetes care. Novo Nordisk insulins have been supplied uninterruptedly in India for more than 80 years, with every second person taking insulin using a Novo Nordisk product. We will continue in our efforts to ensure people achieve good control of their diabetes and improved quality of life.
Novo Nordisk has made a drastic shift to oral diabetic formulations. How has the company been able to make this transition?
Vikran Shrotriya: At Novo Nordisk, we are committed to exploring innovative treatment options and securing more advanced care for people living with diabetes. We have consistently done this through our insulins and state-of-the-art insulin pens. Our resolve to discover novel solutions in diabetes care takes a step forward with Oral Semaglutide, the world’s first oral GLP-1 Receptor Agonist (GLP-1 RA), the “peptide in a pill”. This tablet was the result of an ambitious 15-year journey of meticulous research. So far, the GLP-1 RAs, an efficacious class of drugs with tangible benefits for people with diabetes, was available in the injectable form only and not enough patients were receiving its benefits.
For the first time ever, we successfully delivered clinically adequate levels of the GLP-1 RA, Semaglutide, in a pill formulation with the help of an absorption enhancer called Sodium N-hydroxybenzoyl Amino Caprylate (SNAC), which protects Semaglutide from breaking down in the stomach. Our strong conviction, research collaborations and the persistent dedication of our scientists were instrumental in developing GLP-1 RA into an oral medicine.
Do Indian markets differ from other regions in terms of complexity?
Vikran Shrotriya: India is a highly fragmented, branded generics market where customers tend to have a wide variety of options of the same molecule across brands and price segments. Further, for many countries in the Asia-Pacific (APAC) region, healthcare costs are either reimbursed or healthcare is provided by the government. In India, these costs are paid out of pocket.
There is also less awareness about diabetes in India with many patients getting diagnosed late. Restricted access to appropriate diabetes treatment may also make it challenging for people with diabetes to achieve the required glycemic control and this could lead to the development of complications. On the other hand, Indian healthcare providers and patients welcome innovation and adopt it early.
How do you envision the growth potential of Semaglutide?
Vikran Shrotriya: Due to its tangible benefits beyond glycaemic control, GLP-1 based treatment is becoming an important armamentarium of type 2 diabetes management. Many Indians also prefer tablets over injectables and therefore we believe many patients will find the molecule to be a convenient and effective treatment option that does not only achieve glycemic goals but also targets other important factors like weight and cardiovascular risk factors.
Rigorous clinical studies have shown Oral Semaglutide to be an effective treatment option for patients with Type 2 diabetes providing unparalleled glycemic control, unsurpassed weight loss, and consistent cardiovascular safety. We believe that it has excellent growth prospects. We have already seen strong adoption in India just within two months of launch and believe it will be a game changer in diabetes management.