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Posted: June 7th, 2023
The marketing plan on Levemir for the Indian market presents the approach to increase market share of Levemir in basal analogue to 50% and in the basal insulin categories to 30% by 2012. We think that this target is achievable because of improving economy, market growth and our competitive advantage. In doing so we would retard the growth of Lantus and upgrade our existing patients on Insulatard (basal human insulin) to Levemir and would position Levemir – the preferred basal insulin of choice for both type 1 and type 2 diabetes.
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There was no mission statement but Novo Nordisk (NN) had the vision statement as mentioned above. Ideally a mission statement should cover the firm’s priorities in terms of customer focus, value provided, market scope, guiding values and core competencies. The vision statement of NN is fair enough to clarify all these aspects, may be they could have added or modified more about their core competencies.
Information about Indian Pharmaceutical, Diabetes Care and Insulin market is described in the appendix p 24.
The insulin analogue market is growing at 27%, predominantly contributed by the multinational pharmaceutical firms including NN, Eli Lilly and Sanofi-Aventis (fig 1). NN is leading the insulin analogue market with 54% market share followed by Eli Lilly and Sanofi-Aventis (fig 2).
Figure 1: Insulin Analogue Market Growth
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Figure 2: Insulin Analogue Market Share
Basal Insulin market can be categorised as animal, human and analogues and it offers a total market of Rs.58 crores and growing at 57%. In terms of volumes the total basal market is 810.4 million units (MU) and NN is the market leader in this segment with 46% market share. However, this share is largely because of high contributions coming from human basal. In the category of basal analogue, Sanofi-Aventis is a clear leader with ~77% market share and NN with 23% market share (fig 3). The key market insights from the basal analogue segment are as follows:
The total basal analogue is worth Rs. 58 crores
Lantus has ~77% market share and Levemir has 23% market share.
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Figure 3: Basal Insulin Analogue Value Market Share
Total sales in 2007 and 2008 were Rs. 309 crs (23.6% growth) and Rs. 363 crs (17.5% growth) respectively. With respect to Levemir, sales were Rs. 8.88 crs (94% growth) and Rs. 16 crs (81%) in 2007 and 2008 respectively. The sale of Levemir until YTD November 2009 is 28 crores. The planned growth for Levemir next year (2010) would be 70%. Introduction of Levemir PenFill will further strengthen Levemir’s stand against Lantus.
India is a growing economy with a stable government and Indian Pharmaceutical Market is also growing rapidly at 15%. Moreover, India has the highest number of diabetes population (51 million) in the world and is growing with westernization. Hence, it’s a dream of every Pharmaceutical company with diabetes products to be present in India. High market attractiveness and no barriers to entry so number of players in diabetes and insulin are growing. NN is focussed in shifting the patients to insulin analogues from human insulins as the analogue market has barriers to entry due to patents in place, less competition, no price war and has high profit margin. It is discussed in detail in the appendix p 27.
India has the world’s largest population of people with diabetes, with an estimated 51 million people suffering from the disease. According to the International Diabetes Federation (IDF), India is expected to have 87 million people ailing from diabetes by 2030. India is considered as the diabetes capital of the world with a patient population of more than 50 million. Diabetes strikes the Indian population a decade earlier than the west. The reasons for the pandemic are attributed to genetic predisposition, changing lifestyle and urbanization.
Treatment data (Table 1) suggests that out of 51 million, only 13 million people are diagnosed with diabetes but only:
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The main competitors for NN India are:
Table 4: NN in the insulin market
As per the Ansoff’s matrix, NN is developing a new market for analogues. Hence, it is in the market development phase. As the human insulin market is crowded by generic players and more local players are entering due to market attractiveness and no barriers to entry, NN is focussing on creating and developing a new insulin analogue market so that the patients can be shifted to insulin analogues. The model is depicted pictorially in the appendix p34.
Among the various diabetes care products, the insulin analogues including NovoMix, Levemir and NovoRapid are growing very fast and star as per the matrix. The human insulins (Mixtard, Actrapid & Insulatard) are cash cows. The only OAD of NN is in the Dog stage and this maybe due to that we are not focusing in this product as we want to grow the insulin analogue market. As per NN strategy, we want to develop the analogue market, hence heavy investment and more noise level would be the key to our success.
The complete range of insulin analogues, along with various delivery devices, in the Indian diabetes care market will be available only from NN. With NovoMix we will drive the analogue category in India which is predominantly a premix market (~80%). Levemir will be a part of this intensive offering, to shake up the market share occupied by Lantus. Being the only company with a full analogue portfolio, gives us the ability to initiate people with diabetes on a full analogue basal oral regimen.
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Levemir would be placed in the minds of the customers as the basal insulin of choice for intensive treatment for type 1 and type 2 diabetes. In both type 1 and type 2 patients, Levemir will be a once daily dose available in FlexPen.
Prescribing doctors were divided into different categories on the basis of their prescription behaviour, qualification and influence on other peers, society or key decision maker in large institutions of repute (table 6). Prescription pattern was found out by market research (external agency) and internal data obtained from the sales team.
The number of sales call, expenditure on the Dr for research purpose, international sponsorships, exposure to international forums and advisory board membership would vary for each category of physician.
Levemir prescription would be generated primarily from the ‘A’ and ‘B’ class doctor. Hence, segmentation will help the sales force to focus better on the key customers and less cannibalisation into premix analogue segment.
Patients: Levemir will be targeted at the following categories of patients:
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The main patient benefit will be improved control and safety coupled with no undesirable weight gain compared to Insulatard and Lantus. These benefits will be offered together with a far superior delivery device – the FlexPen.
Majority of the patients will come from basal-bolus to Levemir. As can be seen from the figure 5, 40% of the patients will come from basal-bolus therapy followed by basal only (20%). It will be important to focus on these two segments to ensure rapid market penetration.
Prescribers: Levemir will be targeted at the following categories of doctors and prescribers (table 7):
The target doctors for Levemir will be Diabetologists, Endocrinologists, Cardiologists and Physicians particularly Lantus prescribers. Key customers are described in detail in appendix p32.
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The product proposition or the key to owning the positioning in the doctor’s mind is based on better glycaemic control and positive differentiation of Levemir over both Insulatard and Lantus. The positioning line for Levemir in India will be as follows:
“Add Levemir once-daily, reduce weight gain”
Weight neutrality assists the physician to achieve optimal control – with fewer hypoglycaemic episodes and no undesirable weight gain. Levemir once-daily with OAD’s has to be ingrained in the doctor’s mind.
Key messages: The key messages will aim to reinforce good glycaemic control and weight neutrality would be the key differentiator from Lantus:
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Key Messages are described in detail in the appendix p 35.
Levemir is a solution for injection that contains the active substance insulin detemir. It is available in pre-filled pens (FlexPen). Levemir is used to treat adults, adolescents and children over the age of six years who have diabetes. The medicine can only be obtained with a prescription. Levemir is imported to India from the manufacturing plant in Copenhagen (Denmark).
Levemir is an insulin analogue prescribed to patients with diabetes for meeting the basal insulin requirement. Other insulin analogues of NN are NovoRapid and NovoMix 30. All the insulin analogues including Levemir are patented product of NN.
Source: mbarreiro.wordpress.com/
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Levemir was launched in May 2006 in the Indian market. Levemir was second to Lantus in basal insulin analogue category in India. Although Levemir is 3 years old in Indian market, still it has not grown as expected compared to the global market. As per the product life cycle graph, Levemir is in the initial part of growth phase, needs more attention and intensive promotion to reach the peak.
Hence the focus will be on the single biggest benefit of Levemir i.e. “Less undesired weight gain” and “Once-daily” therapy with OADs in all our communications. This will ensure that Levemir’s key differentiator of “Weight Advantage” is completely understood and appreciated by the prescriber base. The integration of Levemir with NovoRapid will be extremely important to establish Levemir as the key part of basal-bolus therapy. This will be achieved with joint promotion and communication activities with NovoRapid with the key objective being the importance of basal-bolus therapy in the proper treatment of diabetes.
Strong brand showcasing in all reputed diabetes journals, conferences and meetings with leading Key Opinion Leaders endorsements will be the key to success of Levemir so that Levemir reaches the peak of growth phase.
Pricing in India has to be extremely competitive as it is a very price sensitive market. Pricing here follows certain regulatory procedures. Since insulin falls under the price controlled drugs and pharmaceutical products category there is a maximum selling price which needs to be approved from the pricing authority NPPA (National Pharmaceutical Pricing Authority). They would evaluate the recommendation on the following parameters:
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Post this NPPA gives clear approval based on which a license to market is procured. The following price was approved by NPPA after our recommendation.
Levemir FlexPen 988
NN is a market leader in diabetes market globally including India and is known for its strong research and development activities. Levemir is an innovative patented product; the pricing is based on the value perceived by the customers (doctors). The pricing decision has also been done taking into account on the price of the competitor that existed during launch, Lantus Optiset Pen (MRP = Rs 801).
NN would adopt both Push strategy and Pull strategy as promotional tools. The Push strategy would be through promotional activities target at the prescribers (doctors), whereas the Pull strategy would be through increasing awareness of the end consumer (diabetic patients) about good glycaemic control, less undesired weight gain, less hypoglycaemia and easy to use insulin pens.
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The promotional tools are described in detail in the appendix p35.
Distribution channel structure: Levemir will be distributed via wholesalers through our channel partner M/S. Abbott India Limited. There will be no change in the distribution channel for Levemir. We will focus on Metros and larger cities to gain market volumes. Levemir will be made available in select retail outlets.
The pharmaceutical distribution channel in India is described pictorially in figure 7.
Figure 7: The Pharmaceutical Distribution Channel in India
Note – Figures in %age indicate %age of medicines supplied to the entity
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Acknowledgement: I am grateful to Mr Devdutt Dash, Senior Product Manager Levemir, Novo Nordisk India for providing the market data on Indian Pharmaceutical Industry, Diabetes Care, Insulin & Insulin analogues and internal sales data of NN, Levemir and Lantus.
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6. www.financialexpress.com/…/indias-gdp…200910…/435703/
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