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Novo Nordisk has launched its anti-diabetes drug Victoza in India barely months after its launch in the US earlier this year.

This may be the shortest time taken for introduction of any drug in the country. In fact, the tiny subcutaneous injectable drug, which is a second brand from the class of GLP-1 molecules (the first was Byetta from Eli Lilly), has been launched here even before its launch in Japan, the world’s second-largest pharmaceutical market.

Novo Nordisk, known in the industry as the diabetes company, has identified India as a primary market, given the nearly 50 million patients in the country and the fact that the anti-diabetes drugs market here has been growing at 18-20% per annum.

By growing deep roots in the area of diabetes over the past many years, Novo Nordisk has no doubt created a strong reputation among Indian doctors.

It is also regarded highly for building a sizeable database on diabetes prevalence in India and in other parts of the world.
A noticeable point was its efforts to quantify the prevalence of diabetes among younger patients in India. DAWN, as the study was named, showed in the preliminary stages that a large portion of young children who had diabetes didn’t manage their condition properly. Such data helps doctors keep a close check on their patients and that personal monitoring helps in better compliance for debilitating conditions stemming from diabetes.

Novo’s Victoza could be another weapon for control of diabetes, but given the US FDA’s additional scrutiny on diabetes compounds, the way the drug works will be watched over many years. Victoza is not one of the conventional diabetes molecules; it comes to the patient as an injectable and the vital ingredient of the compound works only when there is a requirement for release of additional insulin. Also, unlike its rival Byetta, Victoza can be taken at any time of the day irrespective of the food intake.

These benefits could score some strong points for the drug, but Indian specialists are known to be very careful on prescribing new medicines. One, they tend to be sure about how the drugs impact their patients’ health and also see if the products suits the individual’s pocket. Again, very cautiously, the regulators have emphasised that Victoza is not prescribed as the first line of treatment. That means the diabetologists have to be very choosy about who can be put on the new product. Obviously, the more chronic diabetics will have to be identified.

Being a new generation molecule, Novo may have priced Victoza at a premium over its peer compounds in India and may strategically want to tap the urban market first. It will be interesting to see how the new drug clocks in the first few months and then check if Novo Nordisk intends to go deeper down into other cities. Clearly, pricing will play a major role in the drug’s success, besides the acceptability of a daily injectable. For many type 1 diabetics, it is well known that the daily insulin shots are an unavoidable hassle.

Novo Nordisk, like other MNCs such as Eli Lilly and Sanofi Aventis, was pushed to reduce the prices of insulin drugs after a slew of insulins were put into the Indian market by companies such as Wockhardt and Biocon. The product became affordable overnight and patients heaved a sigh of relief. Besides, seeing unfair pricing, the Indian government’s drug pricing watchdog National Pharmaceutical Pricing Authority clamped controls over various brands.

The government’s move was commendable and though the industry may criticise the price controls over medicines, in many cases it is found that the authorities have acted far more responsibly than the corporates ought to.

Victoza has all the settings of becoming a big product for Novo Nordisk, judging by its international performance, but pricing will be an important factor for its success in India. If Novo Nordisk is serious about growing further in the market and cares for the patients here, it will take into account the affordability factor of the Indian patient while introducing its researched products.

Pillman is an executive closely linked to the global pharma industry.