Smart insulin is the future: Vikrant Shrotriya of Novo Nordisk

Novo Nordisk has a strong foothold in India… In fact, in my team, over 100 people are dedicated to making clinical trials happen in India. We have about 200 centres, be it trials in diabetes, semaglutide or the rare disease segment. India is a very strong partner, which contributes towards clinical trials globally.

We have done something very interesting recently, in terms of launching oral semaglutide. Semaglutide works by helping the pancreas to release the right amount of insulin when blood sugar levels are high. Semaglutide was available only as an injection and we have been able to replace that injection with a tablet. India is now the sixth country to have this drug in the form of a tablet. This is a pioneering move in the treatment of type 2 diabetes in India.

Novo Nordisk is also conducting clinical trials for once-weekly insulin icodec.

Can you elaborate more on this?

The future lies in the slew of products for diabetes control. Having an injection every day is very difficult for a patient. That is probably one of the reasons why patients don’t take injections and having a once-a-week injection will be more acceptable. The future is about smart insulin. We are also working on obesity – half of the people with diabetes are obese.

When can we expect this product to be available in India after it gets regulatory approval?

We are committed to releasing the drug in the shortest time in India, within six months to one year after the US or the country of origin. We are really hoping that with good clinical trial results, maybe by the end of 2025 or 2026, you would get icodec in the Indian market, which needs to be administered just once in a week. It depends on how fast it gets approved in the US or Europe. As soon as it gets approved in the US or Europe, India should get access at the earliest.

What is the company planning for rare diseases in India?

We are working on futuristic clinical trials. We are interested in sickle cell anaemia. Haemophilia is another strong area for us and the government has also done a commendable job in this regard. For rare diseases, we are partnering with a lot of state governments in terms of creating platforms for awareness, working with patient bodies for haemophilia.

Novo Nordisk is among the top three insulin companies in India. What is the growth you expect in India?

The Indian market has a large and fragmented demography. It’s a market where the majority of the patients pay out of their pocket. In other markets, the government procures and disburses the product. The government is now trying these with Ayushman Bharat and wellness clinics.

The numbers are huge – 77 million people in India are diabetic, but very few of them are taking insulin. There is a substantial need but not demand for insulin by diabetic patients in India. From the demand perspective, 7 to 8 percent volume growth is normal every year and we expect this to continue.

You spoke about the large number of diabetic cases in India. What is the scope for potential business growth that you are looking at?

In the Indian market right now, people are more aware of their health – they are taking vaccines, they are going to the doctors for lifestyle diseases and more awareness of diabetes is leading to acceptability of insulin and semaglutide. IQVIA data suggests that 10 percent is the future growth that we would see.