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“We have to embrace the new era of diabetes care”

Mads Krogsgaard Thomsen, Executive Vice President and Chief Science Officer at Novo Nordisk, talks about the Danish pharma giant’s drug-development strategy, the new era of diabetes care and his 25 year-long passion for his job.

The changing diabetes market, with increasing competition and high prices for diabetes products in the US, has made the world’s largest insulin maker bring about some fundamental changes. Danish Novo Nordisk is redirecting its R&D strategy, abandoning the development of oral insulin for diabetes and trimming about 1 000 jobs worldwide mainly in staff functions at its headquarters, R&D and US.

Can you tell us more about Novo Nordisk’s changed strategy and new focus?


“There are two sets of factors that have raised the bar for innovation that we need to bring into the lab. One is the success from our own products, both those that are on the market and those that are coming. They have exceeded what we had expected in the targeted profile which meant that we had to raise the innovation profile. The American peers have become very strong and are really trying to drive down the prices, making it difficult to get the innovation premium in the US. To get that premium you really need to have a real differentiation compared to existing product. The decision was to discontinue a number of projects in our pipeline that were not going to be commercially viable. Unfortunately, this meant that we as a company have to say goodbye to number of specialized colleagues in these areas. Even if we do anticipate growth over time, we need to realize that resources have to be allocated that can be outside of Denmark. In some regards in the future we might become even more globalized but at the moment we still remain a huge stakeholder in Denmark. The new strategy is to build a sustainable research portfolio within new areas, focusing on biological medicines for NASH, CVD (cardiovascular disease) and CKD (chronic kidney disease).”

Why did Novo Nordisk decide to drop the company’s oral insulin?

“The discontinuation of oral insulin and combinations involving oral insulin, is a result of the updated R&D strategy. The emergent product profile and the required overall investments have been assessed not to be commercially viable in the increasingly challenging payer environment.”

What do you think will be the future of diabetes care?

“We have a unique situation as we are entering a paradigm shift after the historic one that has lasted for 90 years. The old paradigm was where doctors have mainly treated diabetes patients for symptom relief, whereas the new one is where new products will change the long-term outlook of the patient’s disease and even life expectancy in a way that is safe and effective and improves the quality of life.”

What do you think will be crucial for those companies active in the diabetes field?

“I would say that the era has passed by where it was possible to be successful without innovation. To stay active you will need to bring true innovation. That is a hurdle that has increased in general. I don’t think there will necessarily be as many companies involved in diabetes, rather the focus is finding the key competence to meet the innovation needed.”

Will there be more collaborations do you think?

“Speaking on behalf of Novo Nordisk, we are working more and more towards a multitude of targets like liver, kidney and heart disease. This means we need to shift our resources to collaborate to a greater extent with academic institutions and biotech companies that can come up with these new targets.”

What is Novo Nordisk’s strategy to deal with the competition from the US?

“At this point we have an increasing global market share, which we expect to continue. We have four classes of insulin products. In each case, we have the best in class product fulfilling all needs. I think in terms of competition we should always anticipate competition and embrace it. The more competitive the companies become the more innovation we will see, so Novo Nordisk welcomes competition and doesn’t fear it. Looking ahead I think we will be able to continue to increase our diabetes market share globally. At the same time, we still need to think strategically about what we will bring during the next ten years.”

You are, alongside with other industry professionals, a part of the life science growth team that the Danish government has set up. Can you tell me more about the overall goal of the initiative?

“The main task is to put forward suggestions to boost the Danish life science industry. Together we will come up with recommendations that support excellence in the life science sector, life science education and the ability to internationalize. It is also about attracting talent outside of Denmark and talent that can boost life science in Denmark. These are the things we are looking at so far. We are working on a unified document that will be presented to the ministers.”

What do you think Novo Nordisk, as a leading Danish life science company, can contribute with to boost Danish life science?

“The Novo Nordisk foundation is in terms of donations contributing to research and life science in various areas. We bond a lot with the Danish research society and offer research scholarships. In that way, we are offering something back to the Danish society but also to ourselves by creating a pool of the best scientists that could become future employees at Novo Nordisk one day.”

What do you think about the politics so far when it comes to Danish life science?

“If Denmark wants to continue to be a leading country in research-based innovation, then the decline of research funding that has been going on for the last couple years needs to stop. That is one vital issue. But I have faith in the commitment of the Ministry of Business and Growth and the Ministry of Health and that they can put some action into play from our recommendation.”

Lars Rebien Sørensen, Novo Nordisk’s retiring CEO, has been named the world’s best CEO twice, in 2015 and 2016. What would you say have been some of his important qualities as a CEO and what has this meant for the success of Novo Nordisk?

“Lars has been my boss for the last 18 years. During this period I have seen closely that he is a leader who can inspire an entire organization to go in the same direction and at the same time create a team of executives that have had such impeccable collaboration under his leadership. He really has the ability to see people for their unique and complementary skills and mindsets.”

You are celebrating 25 years at Novo Nordisk this year. What have these two and a half decades been like?

“In my eyes I have had two families. My own but also my colleagues at Novo Nordisk. I have been working as head of Diabetes R&D since 1994. So everything that has happened since then and is happening has been brought to birth in a time when I have been pretty much involved, while many projects have also been put into the grave. These past 25 years have been an extremely rewarding time. It has also been very interesting to witness how diabetes as a disease has developed and the new knowledge we have gained about it, which also helps us see the needs for the medicines that will emerge. Working within the diabetes industry is not like being in any other business. It is a very rewarding feeling to know that you are actually doing something for other people.”

What are your thoughts about the company’s future and further development? Where do you see Novo Nordisk in another twenty years?

“We will continue on the path of innovation to fulfil unmet needs for patients. On the one hand we have the technology development and on the other hand the disease therapy that I think will go way beyond drug and pharma intervention. In the new era of diabetes care digital health and a more holistic approach will play a much larger role. Novo Nordisk will have to embrace that development, either internally or in collaboration with others in a way that can help patient outcome.”

In your role at Novo Nordisk you are responsible for global drug and device research, development and regulatory affairs. How do you manage to keep a balance between the different areas?

“I have always seen my job as a hobby and I like having these different and varying roles. Whether it revolves around early basic research, medical affairs or drug labels I consider my work as extremely rewarding.”

You have DVM from the Royal Veterinary and Agricultural University. How did you go from veterinary science to pharmacology?

“When I was in my early twenties and studied veterinary science I started studying pharmacology. I immediately became very interested and I have been interested in pharmacology ever since. When I did my PhD I spent a couple of months working at a veterinary clinic. I must admit it was exiting but overall I felt that each day was kind of similar to the other. I felt that I needed the constant challenge you get when one day is not like any other, which I have experienced during my 25 years at Novo Nordisk.”



Mads Krogsgaard Thomsen

Born: December 1960

Family: Married to Birgitta Krogsgaard Gudnason, three children (14 year old twins and one adult son, working as researcher at the University of Oxford)

Position: Executive Vice President and Chief Science Officer at Novo Nordisk

Career: DVM (1986), PhD (1989), DSc (1991) and adjunct professor of pharmacology (since 2000) from the Royal Veterinary and Agricultural University in Denmark. Joined Novo Nordisk 1991 as head of Growth Hormone Research, and then as Director of Diabetes R&D and Global Drug Discovery. In November 2000, he was appointed Executive Vice President and Chief Science Officer. He has chaired Danish Research Council programmes within endocrinology and has been President of the National Academy of Technical Sciences in Denmark. Today, he serves as vice chairman of the board of the University of Copenhagen. He is a member of the editorial boards of international, peer-reviewed journals.

Interests: Working at our farm in Græsted where we have around 20 Icelandic horses and a dog.