With the rapidly growing interest in obesity diseases and treatments worldwide, Novo Nordisk, which owns an obesity treatment Wegovy (semaglutide), has drawn much attention on how it would address the global supply shortage. 

Despite receiving approval from the Ministry of Food and Drug Safety in April, Wegovy has not been released in Korea.

Moreover, 2023 marked a significant juncture for Novo Nordisk as the company celebrated its 100th anniversary and 30th anniversary in Korea, prompting reflections on its role in the next 100 years.

This year also signifies one year since Sasha Semienchuk assumed the position of General Manager for Novo Nordisk Korea.

Korea Biomedical Review sat down with Semienchuk to gain insights into the past year in Korea, along with Novo Nordisk's strategies for Wegovy and the future trajectory of the business.

Question: This year, you celebrated your first anniversary as general manager of Novo Nordisk Korea. Could you tell us about your experience so far?

Answer: First of all, thank you for your interest in Novo Nordisk Korea. Since joining Novo Nordisk, I have lived in seven countries and taken care of more than 40 countries, and I think Korea is one of the fastest-changing and most dynamic countries. Not only society in general, but also the pharmaceutical, digital, and startup environments, as well as the innovation in R&D, are rapidly changing and dynamic, making it a great place for Novo Nordisk to do business and engage with patients. In our experience, Korea has sustained strong innovation because of its talented workforce. The Korean people's passion for research, education, and innovation drives the innovation we are seeing in Korea.

Q: At the last Novo Nordisk 100th anniversary press conference, you mentioned that over the past five years, Novo Nordisk's clinical trials in Korea have increased fivefold. In terms of research, the number of Korean-related studies has more than doubled. What has been your main focus in business operations over the past year? The increase in research in Korea can also be seen as a reflection of the company's interest in the Korean market at the headquarters level, how do you assess this?

A: Novo Nordisk is very interested in the Korean market, and we already know that the level of science and research in Korea is very high, so we understand that they also recognize the importance of working with Korean researchers on projects for Korean patients.

When I joined Novo Nordisk in Korea a year ago, I realized that the country was facing a significant chronic disease burden due to an aging population. Currently, Korea has 15 million people with obesity, 5 million with diabetes, 15 million with pre-diabetes, and 1.8 million with heart disease. As you know, Novo Nordisk specializes in chronic diseases. Under these circumstances, Novo Nordisk needs to create solutions for patients with chronic diseases in Korea by promoting various collaborations through partnerships with domestic companies and stakeholders.

In this context, our partnership with Kakao Healthcare, which is a leader in AI in Korea, and our collaboration with the Seoul Metropolitan Government on diabetes are very inspiring and we are very proud of them. Through the Cities Changing Diabetes (CCD) project, we are exploring ways to provide more effective support and assistance to patients in the community, not just medical treatment. We are also collaborating with various disease-related societies such as the Korean Diabetes Association and the Korean Society for the Study of Obesity (KSSO) to provide better solutions for Korean patients and contribute to the accelerated growth of the Korean pharmaceutical market.

Q: Based on your experience working in various countries, can you tell us about the unique characteristics of the Korean pharmaceutical market? In particular, there are opinions that it is relatively difficult to get a new drug approved or reimbursed in Korea, and issues such as "Korea passing" are constantly raised.

A: According to the Global Access to New Medicines Report released by the Korean Research-based Pharmaceutical Industry Association (KRPIA), Korea is known to take more than two years (28 months) for a new drug to be introduced in Korea after its global launch, which is longer than the average for OECD countries (21 months).

South Korea has a very good, advanced, and top-notch healthcare system, with national screening for chronic diseases for all citizens and reimbursement for tests such as blood sugar, BMI, and inflammatory biomarkers. On the other hand, it is unfortunate that access to new drugs is somewhat low, with an average of 28 months for new drugs to be introduced in Korea, which is more than two years.

However, the Korean government and industry are making a lot of efforts, and we expect the innovation of the Korean pharmaceutical system to accelerate in the future. We hope that Novo Nordisk Korea will be able to contribute to these developments and provide better solutions for Korean patients. As a pharmaceutical company, Novo Nordisk Korea is committed to working with the government to not only develop excellent treatments but also to improve access to new medicines for Korean patients as quickly as possible. In a country with a rapidly aging population, increasing healthcare spending is a major challenge, and we look forward to working with the government and other stakeholders to find the best solutions to ensure that the best innovative solutions are adopted in Korea.

Q: Wegovy, which was approved in Korea in April, has not yet been released in Korea. What are the specific launch plans? There are concerns that there may be supply issues due to the high demand worldwide, please explain.

A: As I mentioned earlier, obesity is a major social issue in Korea. It is estimated that there are about 15 million obese people in Korea, and the KSSO is one of the most important contributors to the topic of obesity in Korea, Asia, and globally.

Novo Nordisk aims to provide innovative solutions to patients across all therapeutic areas in a balanced and responsible manner that does not impact the supply chain of products currently used by patients. Novo Nordisk is continuously monitoring the volume situation in the market to ensure that patients receiving treatment with our products can continue to do so. We regret that we are unable to provide a specific date for the launch of Wegovy in Korea as it has not yet been finalized. Novo Nordisk Korea is working to ensure that Wegovy is available in Korea as soon as possible.

Q: Novo Nordisk already has a blockbuster Glucagon-like peptide (GLP)-1 analogue-based drug called Saxenda. If Wegovy is launched in the future, will there be a change in marketing strategy for existing GLP-1 analogs?

A: The management and treatment of obesity varies widely depending on the patient's situation. Pharmacotherapy is one of the options. It is important to use the appropriate medication according to the individual needs and preferences based on the patient's weight loss efforts, under the precise guidance of a healthcare provider. In other words, there should be a full consultation between the patient and the healthcare provider to choose the most appropriate obesity medication for the patient.

Q: I have heard of other companies developing oral obesity treatments that have been discontinued due to adverse events. What are Novo Nordisk's plans for developing an oral obesity drug?

A: Novo Nordisk already has liraglutide 3.0 mg and semaglutide 2.4 mg in the obesity space, and will continue to expand its portfolio of obesity therapies to offer patients and healthcare providers greater flexibility in choosing treatment options.

Novo Nordisk has a strong leadership position in the treatment of diabetes and obesity with semaglutide, but we also recognize the market need for an oral formulation. To meet the current high demand for semaglutide in as many patients as possible, the company will initially focus on manufacturing its semaglutide portfolio in injectable form and may consider launching oral semaglutide for the treatment of obesity in the future, depending on manufacturing capacity. Novo Nordisk continues to build on its longstanding experience in the GLP-1 analog market to provide optimal solutions.

Q: Many Korean pharmaceutical companies are currently working on obesity treatments and are aiming to develop treatments optimized for Koreans. What do you think Novo Nordisk's comparative advantage is in this regard?

A: It is very encouraging to see that many pharmaceutical companies in Korea are conducting intense R&D and investment in obesity. This is great for patients as well as for research data on obesity. Novo Nordisk also has a goal to ultimately help patients, so I think it couldn't be a better situation.

Novo Nordisk has data on our product semaglutide in Korean and Japanese patients, and we have seen very good results, so we are confident that Wegovy is a treatment that can help Korean patients, and we are excited to bring it directly to Korea.

Novo Nordisk's differentiator in the obesity market is its patient-centered research and development capabilities. Novo Nordisk has already been conducting research and development in the field of obesity for more than 20 years, has a good understanding of the physiology of obesity, and has developed and introduced excellent compounds such as liraglutide and semaglutide. In addition, Novo Nordisk has been conducting research and development in the field of diabetes for more than 100 years and has developed several treatments, so we believe that the commitment and capabilities are already in our DNA.

Q: As there are supply issues for Novo Nordisk's new drugs, are there any domestic supply issues for existing treatments such as Xultophy? If such supply issues persist, are you willing to collaborate with related societies such as the Korean Diabetes Association if they request supply from the company?

A: As I mentioned earlier, we are currently experiencing significantly higher-than-expected global demand for all Novo Nordisk products, which has led to supply and capacity constraints across our product portfolio.

Novo Nordisk operates its production facilities 24 hours a day, seven days a week, and has invested approximately $11 billion in production facilities in the last six months alone. However, the company will need time to ensure site safety and quality, and will not compromise on quality to speed up production.

Nevertheless, this year alone, 310,000 Korean patients have used Novo Nordisk products, up 40,000 from the previous year, and Novo Nordisk supplies more than half of the insulin used in Korea.

Novo Nordisk recognizes the importance of ensuring continuity of patient care and is committed to ensuring a stable supply of medicines. In the case of diabetes medicines, we are monitoring the domestic supply situation in close collaboration with the Korean Diabetes Association.

Q: Based on the overseas experience with the launch of Wegovy, there is an expectation that the price of the drug will be high in Korea as well. In this case, there is a concern that the treatment will be less accessible to the next tier of obese patients who need treatment, do you have a solution for this?

A: Globally, the prevalence of obesity in low-income populations is rising and the number of patients suffering from this condition is increasing, and unfortunately, Korea is no different. Novo Nordisk is looking at various options to address these issues and is exploring solutions to increase patient access to treatment, such as reimbursement.

Obesity and diabetes share many of the same patient demographics. Just as diabetes is recognized as a chronic disease in society and is treated consistently, obesity needs to be recognized as a disease that requires long-term management. Collaboration between companies, local governments, and academia is crucial to this end. Novo Nordisk's Collaborating to Reduce Diabetes in Cities (CCD) project with the Seoul Metropolitan Government was also inspired by the serious problem of poor access to diabetes treatment and prognosis among low-income people compared to high-income people.

However, chronic diseases such as diabetes and obesity cannot be solved with medicines alone, so Novo Nordisk is committed to contributing not only to the supply of medicines but also to the establishment and improvement of social systems that help patients achieve the best possible treatment outcomes by ensuring proper management of their diseases through collaboration with local governments and academic institutions.

Q: In Korea, Novo Nordisk recently signed a business agreement with Kakao Healthcare to provide chronic disease management services. When do you think patients in Korea will be able to benefit from the technology, and what are Novo Nordisk's long-term plans for digital transformation?

A: I think it would be more appropriate for Kakao Healthcare, not Novo Nordisk, to answer about the specific launch time of the program we are preparing with Kakao Healthcare. However, it is expected to be launched shortly, and Novo Nordisk is looking forward to it.

I know there is a lot of interest in digital healthcare in Korea, and I believe that digital is the future of healthcare. Korea has world-class capabilities and technical expertise in digital and AI. Korea was ranked 6th in digital technology adaptability in the 2023 Global Digital Competitiveness Assessment released by the Swiss International Management School (IMD) in November this year, and 6th globally and 1st in Southeast Asia, East Asia, and Oceania in the Global Innovation Index (GII) released by the World Intellectual Property Organization (WIPO), a United Nations organization, in 2022. Several Korean bio companies and venture startups have already made their mark in AI and digital healthcare.

Novo Nordisk's focus on chronic diseases requires an individualized, differentiated, and tailored treatment approach for each patient, as patients show different disease patterns depending on their age, gender, and lifestyle. In this context, digital healthcare can help patients with chronic diseases and their families manage their conditions daily. In fact, in a forum last month, I came across a post about a diabetic patient with Alzheimer's and his family. The family was very concerned about the patient's inability to administer insulin at the right time due to Alzheimer's disease. If digital healthcare is applied to these families, it will help them to efficiently check the patient's insulin dosage and overall health status.

Digital healthcare is expected to become increasingly important for many patients, especially as the world enters an aging society, and Novo Nordisk Korea will also introduce a digital pen connection technology called Mallya. When connected to a pen-type self-injection device used by patients with chronic diseases, such as an insulin pen, Mallya allows patients to view their medication and dosage data through an app. In Korea, almost all citizens already use smartphones in their daily lives, so we expect that the introduction of digital healthcare will be more likely to be utilized at the point of care.

Q: Novo Nordisk Korea operates the Short-Term Assignment (STA) program to enhance employees' capabilities. Please describe the program's operation, plans, and employee satisfaction.

A: I believe that the success of a company is based on the success of its employees. We have a lot of talented people working at Novo Nordisk Korea, and because of that, we have a lot of potential. No matter what kind of success we aim for in the future, we will have talented people at the core of it, so we are putting a lot of effort into focusing on talent development.

Korea is a relatively small country with few natural resources compared to my home country of Canada. Nevertheless, Korea has been able to grow into one of the most globally recognized R&D-based countries due to its rich human capital. Novo Nordisk continues to support the growth of this great talent.

We, therefore, strive to provide our employees with as many opportunities as possible to fulfill their personal development needs and actively support them in gaining work experience in other departments if necessary. For example, we offer employees who have worked in sales the opportunity to work in marketing or medicine, or we support employees in our Korean branch to work in our Danish headquarters or neighboring Southeast Asian countries. This allows us to showcase Korean talent to other countries, while also developing these great employees into global talent with experience at our headquarters or abroad.

In addition to the STA program, Novo Nordisk Korea also operates the Long-Term Assignment program, which is conducted over a longer period, and we are implementing various efforts to develop human resources as the importance of human resources is increasing globally.

Q: Ahead of Wegovy, Ozempic, another semaglutide, is also experiencing supply issues, so how do you prioritize between the two treatments?

A: Novo Nordisk is prioritizing both Ozempic and Wegovy, and is producing record volumes for each treatment.

Although both Wegovy and Ozempic are based on semaglutide, they are different products with different dosages and conditions of administration. They are not interchangeable, have different packaging, and are licensed under different conditions. Wegovy is licensed for use in patients with obesity and Ozempic is licensed for use in patients with type 2 diabetes.

Q: Finally, please tell us about Novo Nordisk's business plans for the coming year and beyond.

A: I have a very deep passion for Korea and am excited about its potential. Also, Novo Nordisk Korea's goal of providing optimized solutions for patients with chronic diseases will not change. We look forward to building stronger and closer collaborations with stakeholders such as Korean companies and academic institutions to achieve this goal. Through these collaborations, we hope to contribute to the growth of Korean companies.

Novo Nordisk is also actively researching obesity, diabetes, and rare diseases. We look forward to introducing more innovations for Korean patients in the future, not only for chronic diseases, but also for heart disease, and brain diseases such as Alzheimer's, liver disease, and kidney disease. Ultimately, Novo Nordisk strives to be a company that provides integrated solutions that make a real difference to patients, not just treatments.