The mass consumption approach
This is why the appointment of Poul Weihrauch, CEO of Mars, as an observer on the Novo Nordisk board – announced at the annual general meeting a couple of months ago, with a view to his formal appointment as a board member in 2027 – is a first attempt at a response. It is a sign that the group, which has built its reputation on insulin, metabolic research and Nordic rigour, has decided to seek help from those with a background in mass-market consumer goods. Chairman Lars Rebien Sørensen put it in no uncertain terms: “We must start viewing our community more as customers than as patients”. A statement that, five years ago, would have been unthinkable at a board meeting of a European pharmaceutical company.
Novo Nordisk is experiencing first-hand what many European companies still struggle to admit: in the new healthcare landscape, scientific research contributes to, but does not exhaust, the process of shaping the supply. Now more than ever, demand must be managed. The American market knows full well how to reach consumers, reduce barriers to purchase and expand distribution channels. It is clear, however, that applying this approach to healthcare has meant lowering barriers of caution – which did not arise by chance – whilst increasing the pace, commercial pressure and the demands of consumerism.
Novo Nordisk’s dilemmas thus become a testing ground involving the management of major healthcare players and the regulatory authorities themselves, from the EMA to the FDA, right through to Italy’s AIFA. They, too, are called upon to rewrite part of the rules governing medicines: to understand where to allow commercial innovation, where to accept new channels of engagement with patients, and where, on the other hand, to stand firm. Because there is only one decisive question: what will be the non-negotiable boundary between science and marketing in 2026?
Here, paradoxically, Europe has something to teach us. It is precisely the constraint that today appears to be a competitive disadvantage – mediation, regulatory prudence – that is the repository of a historical stratification which America has not experienced. Four centuries in which the relationship between healthcare, authority and the body has been conceived as a public matter rather than a transaction: from the earliest health regulations of the Italian city-states through to twentieth-century welfare, via the notion that illness is not a private matter for the individual but a matter of public concern. It is an institutional awareness that has become ingrained in regulatory agencies, in the detail of package leaflets, in the role of the doctor, and in the scepticism towards pharmaceutical advertising.
The challenge over the coming years will be to see how Novo Nordisk and the major European groups manage to update their business models whilst maintaining this boundary. With a bit of courage, Europe could make an unexpected statement, finding a new way of addressing the market without selling its soul to the marketing department.