Pre-inauguration of Novo Nordisk's new factory in Koriyama, Japan. Roger Moore, president of Novo Nordisk Pharma of Japan, the Danish Crown Prince Frederik, and Mads Øvlisen, president and CEO together with representatives of the Japanese authorities

As of 1 April 1998, Novo Nordisk Health Care in Japan will be taking over from Yamanouchi Pharmaceutical Co, the sales and distribution of its own products. At the same time, a brand new, larger factory will be inaugurated for labelling, packaging and quality assurance.

"Satisfying customers' needs is of paramount importance and in Japan, the customers are extremely demanding," explains Roger Moore. "It is important to get as close to the customer as possible so that we can provide the best possible service." This fact underlies the decision to take over the sales and distribution of Novo Nordisk's pharmaceutical products in Japan as of 1 April 1998. Novo Nordisk has been working together with Yamanouchi, a major Japanese company, on promotion, sales and distribution since the mid-1970s.

"We will sell to about 60 wholesalers, most of which derive from our cooperation with Yamanouchi, so we already know them. Unlike in other countries, where wholesalers usually only handle logistics and distribution, the Japanese wholesalers also support Novo Nordisk's sales force with promotional work targeted at general practitioners and small hospitals," continues Moore.

In order to meet the demands of independence, Novo Nordisk has been hiring 50-60 new sales people every year since 1993. Today the sales force numbers approximately 350, approaching the desired target of next year.

April 1998 is the key month for another important event. On 17 April, a large, new, ultra-modern finished goods factory will be inaugurated in Koriyama, about 200 km north of Tokyo. For several years, Novo Nordisk has been operating at 'maximum capacity' levels at the present factory in Atsugi. The new factory in Koriyama will provide the latest automated technology in packaging and labelling of the products.
"The Japanese inspect all of the products imported from Denmark. They pay a lot of attention to quality and appearance, including how products are packaged and labelled. Therefore, we are delighted to be able to open a factory in Koriyama that will be state-of-the-art (the frontier of what is possible given present technology). Our new factory has plenty of room for expansion and thus will be able to live up to requirements way into the next century," relates Moore.

Increase in Diabetes Care
With the full take-over of promotion, sales and distribution of drugs, and the upgrading and expansion of production capacity, Novo Nordisk Health Care in Japan will be well prepared to handle the increasing demand anticipated in future, including Diabetes Care products.

"We expect that the insulin market generally will increase by 7-8% in the years ahead, and if we manage to maintain our approximately 80% market share, naturally that will mean increased sales and increased earnings," continues Moore. One of the reasons for an increase in insulin sales is that there are still many people with Type 2 diabetes who are not adequately controlled on oral therapy.

Mads Øvlisen, president and CEO, and Roger Moore, president of Novo Nordisk´s Health Care affiliate in Japan, demonstrate Novo Nordisk's pen systems to Crown Prince Frederik.

Moore also has great expectations for NovoNorm®, Novo Nordisk's tablet for people with Type 2 diabetes. Today about 1.7 million Japanese patients take oral hypoglycaemic agents, and the number is expected to increase to 2.6 million by the year 2001, around the time when Novo Nordisk expects to have NovoNorm® tablets on the market in Japan. Furthermore, Novo Nordisk together with LifeScan, introduced a new blood glucose monitor, NovoAssist®, in August last year.
s also enjoying wide success with its sales of glucagon, which is usually used to counteract hypoglycaemia in people with diabetes. However, in Japan, the bulk of the turnover in glucagon derives from sales in conjunction with radiological and endoscopy examinations. Glucagon works as a 'motility inhibitor', causing the smooth muscles in the intestinal walls to stop contracting, which makes it easier to take x-rays of the intestine. X-rays are very common in Japan, where the relative incidence of intestinal cancer is high.

New indication for growth hormone
Novo Nordisk has about 30% of the market for human growth hormone in Japan, and expects a modest increase in sales and earnings in this area in the near future.
"We expect that sales of growth hormone measured in volume will increase by about 5-10% a year, but because health insurance prices have fallen, the earnings increase will be relatively lower," explains Moore. However, Novo Nordisk is the first company in Japan - and the rest of the world - to get approval for a new indication for treatment with growth hormone in Japan, namely achondroplasia, which is the most common form of skeletal dysplasia. Patients with achondroplasia are usually only 1.2-1.3 metres tall, with short limbs and a large head. The disease is due to a receptor defect in a so-called growth factor.

Osteoporosis
Novo Nordisk does not sell any Women's Health Care products on the Japanese market. However, Moore is optimistic for levormeloxifene, a non-steroidal compound that works like an oestrogen on bone without stimulating the uterus and breast tissue. The drug is intended for treatment and prevention of postmenopausal osteoporosis. In Japan, about five million people suffer from osteoporosis. Of this number, about two million are being treated. The market for treating osteoporosis is extremely large in Japan, amounting to about 40% of the total world market. The reason that the disease is so widespread is that dietary intake of calcium in the Japanese diet is not high enough, coupled with the fact that Japanese women enjoy record longevity. Levormeloxifene is, however, not slated for release on the market until a few years into the next century.

The road to success
With a turnover of around DKK 2.5 billion in 1996, Novo Nordisk Health Care in Japan is the heavyweight among Novo Nordisk's health care affiliates worldwide. There are several reasons for the success in Japan: "In addition to our pharmaceutical products, the high quality of our pen systems and needles plays a vital role," says Moore. He also praises the cooperation with Yamanouchi. "We have had very good cooperation from Yamanouchi, particularly over the past seven years. With a sales force of 1,100, Yamanouchi have a very strong promotion and distribution system." A third reason for success is a lot of work on Novo Nordisk Pharma's Vision21 (the company's vision for the 21st century), including participation of all employees. "We have made a major effort to involve employees in formulating Novo Nordisk Pharma's Vision21, our mission, core values, objectives and focus areas. This is very important to ensure a high level of commitment and motivation," says Moore. Finally, as highlighted in the Vision, we must never forget to fulfil the customers' needs and expectations. "The customer is king in many countries, but in Japan the customer is GOD," concludes Roger Moore.