Novo Nordisk's first Type 2 product
Launch of Prandin™/NovoNorm®

Financial highlights
Summary of the Group

Financial statement
For the first quarter of 1998

Disease management - the Novo Nordisk way
A new concept in health care

NovoNet™ - the Irish example
The cornerstone of Novo Nordisk's disease management programme

The euro and its consequenses
Pricing and currency exposure are two aspects of the euro issue. The coming of the euro is an opportunity and a challenge

Drug development
A new strategy

Novo Nordisk's first Type 2 product

The premier launch of Prandin™/NovoNorm® (repaglinide), Novo Nordisk's new oral agent for the treatment of Type 2 diabetes, took place in the United States in early April of this year.

Prandin™ has been on the fast track for approvals since August 1997, when the US Food and Drug Administration notified Novo Nordisk that the product had received priority review status.

A recommendation for approval by the FDA Endocrinologic and Metabolic Drugs Advisory Committee in November was followed by FDA approval in December.
This is the first country in which the product is available, and it makes Novo Nordisk the only pharmaceutical company in the US that offers people with diabetes an oral treatment for Type 2 in addition to insulin for those patients in which it is needed. Prandin™/NovoNorm® is the newest addition to the growing portfolio of products that makes Novo Nordisk a truly comprehensive diabetes care provider.

NovoNorm® will be presented in Europe in connection with the EASD to be held in Barcelona in September this year.

Prandin™/ NovoNorm® is the first in a new class of chemically distinct oral antidiabetic agents that helps people manage their Type 2 diabetes. Prandin™/ NovoNorm® is a potent, fast-acting agent that is absorbed rapidly after dosing and cleared quickly from the bloodstream. The product is indicated as an adjunct to diet and exercise to lower the blood glucose in patients with Type 2 diabetes whose hyperglycaemia (high blood glucose level) cannot be controlled satisfactorily by diet and exercise alone. It is also indicated for use in combination with metformin to lower blood glucose in patients whose hyperglycaemia cannot be controlled by exercise, diet or metformin alone.
The Prandin™/NovoNorm® tablet is taken only at mealtime, so if a meal is missed during the day, the tablet for that meal is not taken; if a meal is added, so is another tablet. Dosing connected to meals combined with the knowledge that the product works only when necessary to manage mealtime glucose levels may ultimately help improve compliance with diabetes treatment regimens.
Prandin™ has been priced competitively for the US market. Depending on the dose recommended by physicians, Prandin™ is priced somewhat higher than sulfonylureas, but it is lower than the recently released troglitazone.

Copromotion with Schering-Plough
In January, Novo Nordisk and Schering-Plough Corporation announced plans to comarket Prandin™ along with Novo Nordisk's full range of insulin products and devices in the United States. The multi-year copromotion agreement took effect immediately. It will enable Novo Nordisk to expand its business in the US and increase the ability to access physicians, other health care professionals, patients and other purchasers.

Advertisements are part of the campaign to make American doctors and people with Type 2 diabetes realise the advantage of being able to regulate insulin secretion in relation to food intake.

Novo Nordisk teamed up with Schering-Plough as a copromotion partner in order to have access to the support of a recognisable committed, entrepreneurially focused sales team. It also enhances Novo Nordisk's ability to reach primary care physicians and strengthens and expands Novo Nordisk's position in the US managed care system due to Schering-Plough's particularly strong position in this area. The alliance effectively provides the broadest and most comprehensive collection of diabetes care products and services in the US. Although historically Schering-Plough has not had a presence in US diabetes care, Novo Nordisk believes that Schering-Plough's large sales force and strong overall US presence will mean success for the copromotion agreement. In fact, Schering-Plough's disease management subsidiary, Integrated Therapeutics Group has been named Number 1 in disease management for the third consecutive year by the Health Industries Research Companies Survey of managed care decision makers.
The combination of the companies' field sales representatives will increase dramatically the competitiveness in the US market place, where Novo Nordisk currently has around 200 sales representatives. By comparison, Schering-Plough with approximately 3,000 sales representatives currently employs the fifth largest sales force in the US.
Because this agreement significantly increases the number of sales representatives that will be promoting the company's entire line of diabetes products, Novo Nordisk believes that sales will increase, translating into a positive impact on the bottom line.

Repaglinide is marketed in the US under the trade mark PrandinTM

Repaglinide is marketed in the US under the trade mark Prandin™ while in the rest of the world it will be known as NovoNorm®

Promising launch
Prandin™ was launched during a launch conference with more than 1,000 attendees from both Novo Nordisk and Schering-Plough in early April. On 6 April, sales representatives across the nation began to introduce Prandin™ to their physicians, beginning with a targeted approach to endocrinologists then expanding to primary care physicians. These sales efforts are supported by journal ads and other activities designed to educate physicians about this new class of drug in the treatment of Type 2 diabetes.
Initial physician reaction to Prandin™ has been positive. The key message they are receiving is that the rapid absorption and elimination of Prandin™ provides insulin-releasing power when patients need it, and may pose fewer health risks than drugs whose longer half-lives keep them active in the body longer. Physicians appreciate this physiologic action and consider it a more natural approach to Type 2 treatment.

The market for Type 2 diabetes
Type 2 diabetes is a major and serious health care problem affecting approximately 120 million people worldwide. The number is growing at a rate of 4-6% per year, and it is estimated that by year 2010 approximately 215 million people will suffer from this disease. In 1997 the worldwide market for oral antidiabetic agents was USD 2.4 billion, an increase of 24% compared to 1996. The market for oral antidiabetic agents is expected to grow by 15-20% annually in the coming years.
In the US, an estimated 16 million people suffer from diabetes. According to the American Diabetes Association (ADA), more than 5 million adults in the US have undiagnosed Type 2 diabetes. Of the people treated for diabetes in the US, approximately 50% are treated with oral antidiabetic agents only, 32% are treated with insulin, 8% are treated with a combination of an oral antidiabetic agent and insulin while 10% are on diet and exercise^*). In 1997, the US market for oral antidiabetic agents was USD 1.3 billion, an increase of 51% compared to 1996.

*) Source: Roper Starch: 1997 US Diabetes Study

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