In this episode, we dive into the world of healthcare innovation and how pharmaceutical companies are reimagining their role in promoting better health outcomes. Our guest, Amy West, the Head of US Digital Transformation and Innovation at Novo Nordisk, discusses the pressing need for change in the healthcare industry and how Novo Nordisk is committed to investing in innovation to meet the diverse needs of patients, healthcare providers, and payers.

We explore the shift from a sick care model to a more proactive and preventative approach to healthcare, acknowledging the challenges of the US healthcare system with its complex, multi-payer structure. Amy delves into the rise of consumerism in healthcare, where patients are demanding more control and choice in their healthcare decisions. The episode also touches upon the importance of educating consumers and the unique challenges and opportunities in the pharmaceutical industry.

Join us for a thought-provoking discussion on healthcare, innovation, and the path forward to better patient outcomes.

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[0:00:38] Christopher Habig (CH): Welcome to Healthcare Americana, coming to you from the FreedomDoc Studios. I am your host, Christopher Habig, CEO and Co-Founder of Freedom Healthworks. This is a podcast for the 99% of people who get care in America. We talk to innovative clinicians, policymakers, patients, caregivers, executives, and advocates who are fed up with the status quo and have a desire to change it. We take you behind the scenes with people across America that are putting patients first and restoring trust in American healthcare.


So many of our guests, and so many of our episodes focus on really the Davids and any type of business interaction going up against, what I’m going to call the Goliaths. We do that just to highlight the headlines that you read every single day. It’s not just doom and gloom. There’s a lot of good out there. There’s a lot of people doing the right thing in my world, the Freedom Healthworks and the Direct Primary Care and concierge care. That means that individual doctors, meeting with individual patients and fixing health problems addressing it there, not looking at some type of central planning, or some nameless corporation to come in and save them, usually insurance, or whatever that is.


Today’s guest presents a little bit different take on that. I’m really excited, because it’s an angle that we just don’t get to talk about a lot. That is what I’m going to say and hope she doesn’t come at me for this one, but this is one of the Goliaths out there in the world in the healthcare space, that is looking at entrepreneurship, that is looking at innovation, that is looking at helping more of a boots on the ground type of approach to drive better outcomes in healthcare really across the world. Please, welcome Amy West, Head of US Digital Transformation & Innovation, an internal innovation incubator at Novo Nordisk. Amy, welcome to Healthcare Americana. It is a pleasure to be speaking with you.


[0:02:34] Amy West (AW): Thanks Christopher. I’m thrilled to be talking with you today, and I appreciate the opportunity to be a part of your program. Thank you.


[0:02:42] CH: Hopefully, you don’t have your pitchforks out for my introduction. So many times, big companies, big corporations get things wrong, or they get stuck in their ways. So many people are sitting here saying, “There’s got to be a better way to do this.”


[0:02:58] AW: Yeah. I think that is absolutely true. I know healthcare can be very frustrating for all of us. We all have our stories and our examples that we can share. I work for Novo Nordisk. We are a pharmaceutical manufacturer. We just celebrated 100 years this year. Our primary focus where we started was in a diabetes space. We have since evolved over a 100 years into some other areas, like obesity and cardiovascular disease, and some other areas.


We recognize that the way we have done things for the last 100 years, we’re going to have to – it’s not going to get us to the next 100 years. We’re going to have to make some changes. The company is very committed to looking at how do we invest in innovation to meet the needs of our customers, our patient, patient customers, our provider customers, as well as the payer side.


The company has always been very customer-centric, always really starting with the patient at the center of what we do. Again, things are evolving and changing in how we can reach and connect and deliver. One example of how this company is, I think being really innovative and I could be a little bit biased, but it’s because I’m leading up this digital transformation and innovation organization within our US market. I’m in essence, an innovation incubator. We are focused on the needs of the US market, in particular, starting with our patient customers’ root cause pain points. Really looking at the challenges that we see in healthcare that even sit beyond the cost of drug, which is obviously, top of the news, right?


Looking at things like, there are people out there that can’t even get to a doctor to get a diagnosis, to get a prescription and then have the challenge of paying for that prescription. How do we look more holistically at health care at the patient root cause pain points and start to look at how can we leverage innovation to support that in addition to our pharmacotherapeutics and the device, the delivery devices and things like that. Really trying to take a more holistic view of how can we ensure that our medications are getting to the right people at the right time based on what their needs are.


[0:05:32] CH: It’s this departure and what you’re describing from what many people, including yourself, describe as it’s really a sick care model. It’s all reactionary. We’re not going out there and actually teaching people how to be healthier, showing them a good example, educating along the way, because for most business models, that is a disincentive to sell more treatments, sell more medication, sell more visits to your doctor, and all that is built on what you just identified as an incorrect payment structure in the US.


Now being, working for a Danish company, is there any inner office rivalry, where it’s saying like, “Hey, this country’s model over here versus this country’s model”? You guys get in at any type of international health care politics?


[0:06:21] AW: I wouldn’t call it a rivalry. I mean, there’s a recognition that all the markets are different, right? In particular, I think you could argue that the US market is probably one of the most complex, because we have commercial insurers. We have Medicare and Medicaid. We don’t have single payer, which most of the rest of the world is single payer. Because of this multi-payer approach, we have always complexities. We also have a very strong consumer demand going on here. In the United States, pharmaceutical manufacturers are able to speak to our customers through direct-to-consumer advertising. You can’t do that in most other countries around the world.


It speaks to this rise of consumerism in health care, because if you look at most other industries, like financial services, or travel and leisure, or retail, the consumer gets to really call a lot of the shots, as far as when they want to engage, what they want, they have a lot of options and they’ll choose. We’re now seeing this transfer into the health care space. Health care tends to be a laggard with a lot of these innovations.


There’s good reason for that. I mean, there’s a lot of privacy. Health privacy, HIPAA is of utmost importance across the board of any player in the space. That’s why it can be harder to integrate some of these innovations. We’re starting to be able to make some better strides, because we understand it better and there’s better connectivity. This transference of customer control and decision and choice making is really hitting the health care space.


We acknowledge that people are now having – customers are having to pay more out of pocket for their health care. They want to make the decisions that work for them. We want to make sure that we are going to be a choice for them that they want to consider very thoughtfully, because it’s going to be the right thing for them. That is something that, again, is very different from how other countries operate based on the dynamics, the laws, the regulatory environment. It isn’t really a rivalry. It’s just that we have to do things differently.


I think there’s an opportunity, because I actually do get to work with some of my colleagues in our China market, in our international operations market, which is basically, all the other countries, where we share our learnings and our insights. We try to break down these silos, because if you create a digital platform, perhaps, that is designed to help people better understand their medication, or to educate them about a disease state, the modality of it may not necessarily be directly transferable, but it could be adapted for other markets.


It doesn’t have to be just a pickup and a lift and shift. It could be an adjustment. We do try to keep that connected, because a lot of really good learning that is transferable, it just has to be adapted.


[0:09:32] CH: I want to go back to what you said about consumerism in the United States, because most people will say, an educated, well-informed consumer utilizing a free market is going to be better for everybody out there. Suppliers, purchasers, everybody along the way. I started laughing when you said, healthcare seems to be a laggard. I’m like, yes. Yes, it does. We’ve pegged it 20 years. It might be 25, 30 years beyond that, only trailing higher education, I feel like an innovation and just waking up to the actual moment in technology, all that fun stuff.


In healthcare, it’s like, we make it so complex as to cloud the judgment of the consumer, where they just get so frustrated, they throw their hands up and just be like, I don’t know what to do, so I’m just going to just go buy everything I possibly can and see what works. We have that mentality in a lot of exam rooms, where doctors just don’t have time to spend with their patient. You see that on almost every single step along the way of anybody’s healthcare journey. The question for you is, when you talk about consumerism in the US versus international, where do you think that Americans have really either given up the responsibility on educating their consumers? Just to put up an example, I can go read everything I want to about Tide laundry detergent, and they want me to be educated on their competitors, right? We don’t see that in healthcare.


We don’t see United saying, “This is why you should pick us, versus this one over here. Then, this why you should go to this hospital, not this hospital over here.” There’s no competition, even in a friendly standpoint to really foster that educational incentive on consumers. I’m really curious, where you see it from your side of how do you educate a market that’s actually going to sink in and not just create more robots, I guess? I don’t know what else to say from a consumerism standpoint, but how do you guys go about creating and getting enough information to a consumer, so that they’re like, “Yes, this is my well-informed decision. I need to go learn more about this?”


[0:11:44] AW: Well, you’re speaking from the pharmaceutical industry standpoint. You could almost argue, maybe there’s a little bit too much information out there. If you’re watching television, and there’s – we see a lot of pharmaceutical advertisements, and it can get a little confusing. There’s a lot of noise out there. That can almost get people to shut down to a degree. Also, the advertisements that you see in the market are intended for the person to get the attention of somebody who may have the condition and to encourage them to talk to their doctor about it, do a little bit more research and determine, is this the right thing to do? In talking with their doctor, have the conversation around, what are my options? What’s going to be right for me?


I think there’s an appreciation by the provider world, because in light of the time challenges that we have, to have that educated consumer come in and have those conversations. Again, it can also get confusing, because there is so much out there. That is the intent of these direct-to-consumer television commercials, the things that you see online, any promotion, it’s about, here’s some information for you. You need to talk with your treatment team, your doctor to determine what are your options and what’s going to be the best thing for you. It can be a lot of information at times. It can be a little overwhelming.


[0:13:17] CH: It can be. We’re talking with Amy West, the Head of US Digital Transformation and Innovation, Novo Nordisk. Amy, you talked about an internal innovation incubator and this is fascinating. My life has been in the startup world. That’s entrepreneurism, startup over the past decade or so of my career, and bootstraps, funded, all that fun stuff. The concept that a company like Novo Nordisk and then your talents are coming in from an internal innovation standpoint. Give us an idea of what that looks like within a company, versus what a lot of our listeners are going to say, “Well, I’m an entrepreneur. I set up medical clinics.” Or, “I’m a small business owner.” Give us just a little glimpse into the life of an internal incubator.


[0:14:04] AW: Sure. Yeah. Just for the record, innovation – at Novo Nordisk, innovation is everybody’s responsibility and everybody’s job. There are different capacities and scopes and focuses based on where you sit. What’s really interesting, I think, for what I’m leading up is this is a very unusual type of operating model, or construct in the world of pharmaceutical manufacturing and that we have an internal innovation incubator. We have a lab framework that we developed, that is fit for our purposes to help us discover the root cause pain points of our patient customer.


We start with our patient customer first. What is the root cause pain point? Again, going beyond even getting access to the drug. What is preventing you from having a good health outcome and a good quality of life? Being that educated healthcare consumer. We start there. Then through our process, we apply these innovation methodologies, which haven’t traditionally been used in the pharma space. Things like, agile, lean, design thinking to advance opportunities through the different phases of ideation, test and learn experimentation, experimentation to minimum viable product, market pilot validation, and then potentially, to scale.


Again, the concept of all of this is we want to take a problem, starting with our customers’ problem. What’s important to really, I think, call out there is that in any business, including a pharma, a lot of times when you’re talking with folks in the organization, they’re looking to solve a problem, it’s a business problem. We’re looking to start with the patient’s problem. Not that we’re not always looking to try to do what’s best for our customer, but I think sometimes you can get a little lost in that, okay, this is a business problem you’re really trying to solve. How do we really get to the root cause of the patient value in each side? That’s where we start.


Then, this is giving us some unique insights and opportunities to then really check the box on what do our customers really want when it comes to their health and wellness? Then, is there an innovative modality out there that we can bring that to life? For the person who doesn’t, as an example, the person who – say, the single mother with three kids who’s working two jobs, her car just broke down, she can’t get to the doctor’s office. She’s not prioritizing her health, because of all these other really important things, like keeping a roof over her kids’ head and keeping food in their bellies.


How do we shift the paradigm of control from the clinic? “I can’t get to the clinic, because my car broke down,” to, well, we’re going to bring it to you? That can be through a smart home environment. That could be through a low-tech mobile healthcare unit that comes to your house. Again, exploring these different ways to make it easier for this mom to take care of her health, so that she can take care of her family. If you have a concept like that, we try many different ways to solve for that. You could say a 100 different things. Then as you test them down through the funnel of the experimentation model, applying these innovation methodologies, you hopefully come up with one or two viable options that will, number one, meet the need and desirability of the customer. Check the box on the feasibility that you can actually do this. There’s a technology, or a methodology, or a vehicle to do this.


Then thirdly, it has to be business viable. There has to be that shared value for us to be able to invest in something like that. That shared value does not have to be money. It doesn’t have to be an ROI, or revenue. It can be a new business model. It can be greater insight around our at-risk patients. It doesn’t have to be a dollar figure. But it has to be something that is going to better inform the organization, so that we can continue to invest in our R&D efforts and our innovation, so again, we can deliver the best solution for our customers.


[0:18:18] CH: I like the mentality that you bring to it, right? It’s not just saying, “All right, what’s the business problem?” But what’s happening in real life? Going back to the introduction, that’s what is remarkable, because so many big companies say, “Look, I built this great hammer. Let’s go find a bunch of nails.” Or try to turn things into nails. Again, you’ve flipped the script and you’re saying, “All right, how do we actually help out people?”


What is your response when somebody’s looking at this and saying, “Well, you guys are a pharmaceutical company, so you make money, the more pharmaceuticals you sell.” If you now embark on a mission to emphasize prevention, emphasize people actually becoming healthier, curing potentially chronic diseases. Doesn’t that cut into your top line?


[0:19:05] AW: Well, I mean, first of all, pharmaceutical manufacturers – we are not nonprofits, right? We are there to generate a revenue and profitability. The important thing is that profitability also enables us to invest in future innovation. That is so much of what we’re looking to do. We have to continuously improve, and you have to invest in order to do that. We know, in pharma, right now the average time to market for an early discovery molecule is 10 years on average, and it could be even longer than that. It’s hundreds of millions of dollars. Many of those things never even get to markets. They fail, or they’re not going to work, or whatever.


It’s important to know that the revenues that are generated are put back into the early R&D and innovation spaces. I think, there’s also a times depending on the innovation space that you’re working in, for example, the work that my team does, it’s a very efficient, lean, agile way of advancing opportunities. It doesn’t require a 50-million-dollar investment. It can be a very, very efficient way to test and advance things very, very quickly, without having to invest a lot of money that could have been – the trade-off could have been somewhere else.


We’re very careful about how we think about where we want to invest in innovation, because we obviously want to get the most benefit out of it, but innovation doesn’t have to be a huge, huge investment. Now, if you’re playing in the molecule space and more of the heavy science area, it could be a different story, because a lot that goes into it. That’s definitely outside of my area of responsibility and insight. I think, it’s a mistake sometimes to think that innovation has to be some huge, huge investment, because it doesn’t have to be.


[0:21:06] CH: I totally hear you. My background is more real estate investment. We started looking at that, just the cash-intensive nature of that, saying, “Wow, we could invest in this house, or we could go fund the business that has a potential to change the world for a couple of years here.” Again, it was echoing, reflecting that mentality that you have there.


We’ve had some people in the pharmaceutical world who has been on the show, and it is really staggering the amount of money and amount of time that goes into it. I get it, you want to know it’s safe, you want to know if it’s effective. Again, the rest of the world is looking at us and saying, “Well, what is the US going to do next? Where are the US companies? How are they going to innovate and create new drugs, new technologies, all that fun stuff?”


Amy, we’re going to take a quick break. We’re going to hear back from our fantastic sponsor, FreedomDoc. Then we’ll come back, and I know, I’ve got a lot more questions for you. I definitely want to dive into where you guys are seeing investment going here, and how that affects potential groups of people that potentially didn’t have the best education, best access to health care, and really, the initiatives that you’re helping drive that forward. We’ll be back with Amy West right after this message.




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[0:22:55] CH: Once again, we are returning back to our regular scheduled programming with Amy West, the Head of US Digital Transformation and Innovation at Novo Nordisk. Amy, we spent the first part of this episode really talking about large companies, how they can still innovate, and some problems and opportunities we see within American healthcare. I’m curious, you run an internal innovation incubator. Where are you seeing investment dollars being pushed towards?


[0:23:24] AW: I think, across health care in general, it’s obvious that there’s this huge rush to digitization, which I think is great in a lot of ways, because obviously, this can create so many efficiencies and help us accelerate drug discovery, improve workflows, create less discrepancy in data, and create connectivity across health data and things like that. There’s obviously a huge investment in the space.


Obviously, challenges still exist as it relates to data privacy, making sure that everything is secure, which is of utmost importance across the board. Again, I think it’s great. This has the promise to really help us leapfrog into some new areas of innovation that I think can really improve and help change, help people have better lives, but also, improve the overall healthcare experience.


The one thing that I would caution, though, from what I see, and I’m speaking more broadly about this, that as healthcare stakeholders, we don’t want to jump on shiny objects. We want to leverage the digital, the technology, as long as it is doing the job for the customers, going to meet their needs, we don’t want to just be playing with things, because we can do it and make something happen. Because at the end of the day, if it doesn’t get used by the end user, whether it’s a patient, or a physician, it isn’t going to have the value that we’re hoping it will have. We can’t get distracted by the shiny objects. We have to become enamored of the problem first and is the digital, the technology, is that the right solution? That’s how you need to be thinking about it.


[0:25:06] CH: I’m right there with you. I’m curious in your thoughts, during COVID, when you saw this rush to virtual care, were you one of those saying, “Hey, this is the wave of the future. This is going to revolutionize physician visits across the board”?


[0:25:21] AW: Well, personally, I think, I’ve always felt that way. I think that the industry as a whole was resistant to it, because it just isn’t a space we’re comfortable with. I think everyone is well-intended, but I think there’s a huge concern about the data. We have to protect people’s data. It wasn’t a familiar area. I think it was slow, slow growing. It was moving in that direction, but then, COVID just accelerated all that. We didn’t have a choice. The only way they could see their doctor was through a telehealth visit.


That, as well as starting to see the remote patient monitoring aspects really take hold. It really started to push us all forward to realize, “Okay, we can do this. We can figure this out. But we have to really start to invest heavily in it.” That’s where, I think, we’re starting to see a lot of shifting dollars into this digital transformation space. Because maybe in some ways, COVID was the push that we needed in the healthcare industry to really start to get people serious about investing in it.


[0:26:24] CH: I think there was a little bit of an over-correction, as far as to see that come back, because how many people thought, well, this is a replacement, right? This is going to replace that humanistic aspect of – a fifth of our economy revolves around the interaction between a patient and a doctor. Virtual aspects are a great supplement in my mind. But for those people who are looking at and saying, “This is going to replace that humanistic, like face-to-face,” again, this rushed digitization, which I’m very much pro for, but in my mind, it leaves a lot of people – it leaves all the big people behind. I will say that. The people at the margins, those margins just shrink. People who might not be familiar with the digital products, who hardly operate their iPhone, right, or whatever smartphone they have, people have flip phones.


There’s a lot of people that I feel will be left behind in the wake, because everybody’s plowing it to digitization. For me, going back and building a company that uses an old school approach to medicine of longer visits, more face time, actually interacting higher access with your doctor, I’m sitting here saying, “Wow, there’s two competing schools of thoughts here.” Curious on your thoughts there. But I guess to summarize my point here, digitization is absolutely necessary, but we risk leaving so many more people behind when we already have so many disaffected Americans already.


[0:27:49] AW: Yeah. I mean, you raised a number of really important points, and a couple of things that I think about a lot. One in particular is this human component. We cannot afford to lose the human connection. I think we’re struggling with that. I mean, I think about that, too, as we’re starting to see this significant rise in AI, like what are the implications of that? We still don’t even know yet. But there are a lot of problems that we’re being hit with. I mean, we have a shortage of healthcare professionals and COVID just made that worse, because so many people got – so many of them got burned out during that whole process. I have family members that are included in that, and it’s really heartbreaking in a lot of ways.


That’s been hard for them. It’s been hard for patients. It’s been hard for people, because you’re not getting that connectivity that you want. It’s getting harder and harder to get in and make an appointment to do something. That’s a real challenge. I think that we have to – again, as we are applying these technologies, we cannot lose sight of the human aspect. Again, as we are rushing and racing to try to leverage the opportunity that we have with these innovations, we just cannot lose sight of that human connection.


You raise a good point about this disparity. It gets even into the health equity piece. There are many, many people out there who are not connected. They don’t have mobile phones. They don’t have smart phones. They could be elderly and they don’t understand how to use these types of things. I do think over time, this is somewhat generational, though, too, because the generations that are coming up, they’ve been raised on keyboards and screens. Quite frankly, having relationships through a screen, versus real, live and in person.


It’ll be interesting to see over time, and who knows if we’ll all be there then, but what those expectations are going to be. Because when you’re used to just like, “Hey, I don’t need to go talk to somebody in a room and naturally see them. I’m used to just having this screen conversation.” They might be fine with that. Right now, we still have a lot of people – I mean, it wasn’t that long ago, when you think about pre-COVID that it was still like, go to the doctor and see your doctor and sit down with them. I think, some of these are going to play out in awash.


I think, again, we have to be sensitive as we are introducing these new capabilities and technologies that they are equitable and accessible by all. Those are things that we have to seriously take into – we have to think about, because it could further create the disparity if we’re not careful, or exacerbate the disparity.


[0:30:47] CH: Yeah. In your work, Amy, how big of a barrier is the payment structure? The current payment model that is dominated by third-party payers, how big of a barrier is that into innovation and your daily job?


[0:31:03] AW: Well, I’ll be honest with you, my daily job, I’m actually – I’m in a really fortunate space, because the way to really drive through innovation, you can’t have the constraints in there on day one. You’ve got to have a green field. You’ve got to be able to blue sky. Then, you test further down, you start to bring in some of the – it’s one of the – I don’t want to call them gate keepers, but the people that are doing their job to ensure efficacy, safety, regulatory, legal compliance.


Where my team starts is we don’t have to deal with any of that. It’s almost like, God, in a perfect world, what if we could do this? Then you start to test different ways to do that. Then further down the funnel is where you can start to, you need to start to bring in, okay, what are the parameters of what we can and can’t do? In my team, we take an opportunity, we look to experiment and get to a validated opportunity that then gets picked up by an area of the organization that can actually build it out and scale it.


In some ways, it’s going to be on them to really make sure that it’s complying with all the rules and regulations. Then if there’s a payment component to it, they’d have to work on what does that look like? That sits outside my world. Again, they really want us to be able to move forward a pure innovation mindset and not be constrained by the things that have traditionally, I think, held pharma back from really coming up with these disruptive opportunities. Because oftentimes, there’s a way to make it work. It’s just, our starting point, if you start from a place of constraint, you’re not going to get to that disruptive space.


[0:32:52] CH: Well, it’s a lot of this legacy thinking that you’ve identified as, hey, this is a serious problem in our industry. It is the status quo and we’re kind of a slave to the status quo. This is how we always did think, so we’re going to continue doing it this way, right? Things come to mind when we’re talking about the technology coming in and the digital aspect of it. In my opinion, we weren’t able to really service a lot of the virtual visit demand during COVID, because there was no reimbursement code for it. The technology existed for 30 years. People have been skyping across the Atlantic for decades. Yet, if I can’t get reimbursed for it, I’m not going to do it, right? There’s no payment incentive to go out there and actually say this.


That’s where I’m thinking like, how big of a barrier to these things is not just insurance, but regulations in general? We thought, digitizing EMRs were going to be the savior of US healthcare, and that it, two and a half decades later has –


[0:33:46] AW: Yeah. We got bigger problems than –


[0:33:48] CH: – still created just massive problems. I joke over a cocktail every once in a while. I’m like, you know, paper and pencil was a form of technology one time. That was an innovation. Not saying we should go back to it. I think, people are saying like, “Oh, technology can save us. Technology can save us.” But yet, we have the technology tools right there, but there’s so much stuff in the middle of it that clouds judgment. It inhibits innovation, people going out and saying, “Hey, it’d be great if I could go invent this thing and discover this thing over here.” But then, how we’re going to actually get paid for it by the big three, big four insurers, or by CMS? They’re always behind the eight ball there.


I guess, less of a question, more of a comment for you, Amy, there, that in my mind, when I asked you, what kind of barriers are you seeing right there? I don’t want to stir up any bad blood, or have anybody pointing fingers at you, or anything like that. To me, as running an incubator, you’re like, there’s so many cool things we could do, but the payment model is just so antiquated and we have to be bound by those rules.


[0:34:53] AW: Yeah. I mean, I think, again, that is a very complex, involved challenge. I mean, I think that’s when you start to get into federal and state regulation and politics, all these kinds of things that we don’t want to necessarily get into. From where I sit, I think the important thing is to get coverage, to get reimbursement, you want to – your product has to be safe and efficacious. If there is a way that you can – and honestly, when you look at pharma in general, if you take the diabetes space, we’ve had medications around for decades, and starting with insulin. The medications we have for that drug and beyond my own company really, really, really good that work really, really well if you take it the way you’re supposed to.


The challenge has been that our adherence and compliance rates are not great. They are, I think the only 20% to 30% of prescriptions for chronic medication, chronic disease medications are filled. Of the ones that are filled, only half of them are used optimally. You’re not getting the desired outcome that we want. We’ve said, like in our clinical trials, this is what we can do. We are trying to find – the medication works, but if you don’t take it the way you’re supposed to, you’re not going to have that optimal outcome.


As we think about innovation, maybe we should be looking at the human behavior side of things. Maybe we should be looking at the social determinants of health, the socioeconomic implications and influences that are playing a huge role in a person’s ability to be adherent and compliant. If we can solve for some of those things through technology and innovation, perhaps that helps out the real-world evidence and value of our medication stronger, better to ensure that these should be reimbursed, because they do work really well. That’s how I think about it.


It doesn’t necessarily have to be about just paying for a drug. It can be, well, how are we helping people adhere to these drugs better? How to make it easier for them to get it and engage with it better? How do we help keep them to be better educated patients, or people? I always hate to say patients, because they’re people. How do we ensure that? Because the reality is at the end of the day, if you’re somebody that has chronic health issues, you’re going to see your doctor once, twice, maybe three times a year. You have to manage your disease state on your own for the most part. That’s the reality. How can we make it easier better for you to do that?


I think that’s where there’s a huge benefit that that doesn’t get looked at as part of the payment model either. Maybe we should be thinking about that a little bit differently. Again, maybe shifting to that well care prevention model a bit more.


[0:38:08] CH: Well, I have a couple ideas, right? I love the well-care side of it, because that’s what we’re doing. Just to give a glimpse into our world, when we have an office dispensing for medications, you go see the doctor, you walk out with your medications, guess what that does to compliance rights? They skyrocket. But you don’t have another trip and you don’t have to go without and pull out a coupon card, or just roll the dice on what you’re going to be charged there. There are models where it’s like, okay, just gives cash prize. We’ll let the consumer go out and make their own judgment on it.


We are emphasizing, doctors want to do right and that’s where we’re emphasizing the fact that that relationship is very, very positive when it comes to compliance rates. One of the things I rail against is value-based care and bundled payments and that kind of stuff. It’s like, well, if a person doesn’t want to go out and lose weight, or be healthier, or stop smoking, how are you going to penalize the physicians? How are you going to penalize the hospitals? It’s just one of those things that makes me scratch my head. That goes back to the policy aspect of it that you’re talking.


It’s funny. I love this conversation, because there’s so many points where like, we’re yes, wouldn’t it be great if this, this, and this came out and happened? One thing I was thinking when you’re talking, when you mentioned that maybe somebody with chronic disease sees their doctor one, two, three times a year, I’ve always been really jealous of dentists being in primary care right now, because for some reason, when we’re ingrained, when we’re born, we’re ingrained that we got to go see a dentist every six months. I actually spent some time trying to look that up. Why is that?


I figured that the American Dental Association, I put this in, and it wasn’t. It was a marketing ploy by some early toothpaste company. I don’t know, maybe, Amy, there’s maybe our solution here is we’ll get a joint advertising campaign now here that says, you need to go see your doctor, at least talk to them every two months. I think, we could change a lot of behaviors if we did something like that.


[0:40:11] AW: I mean, I wish it were that simple, but honestly, my heart does go out to the providers that we don’t have enough, and they’re overworked. I just got my flu shot last night at a pharmacy. A couple weeks before, I got my COVID shot. I make sure that I thank them every single time for what they’re doing, because it’s not easy. A lot of those folks in the pharmacies, they were never set up to be doing vaccines.


I think they’re really trying to pull their weight really, really hard and it’s tough and it’s hard. Unfortunately, we have a lot of people in this country and around the world and we have health issues and we need talented, caring, empathetic providers and healthcare practitioners to be there for us. It’s tough. I wish we could have a campaign where, yeah, go see your doctor every six months, but we just don’t have the capacity for that.


[0:41:07] CH: Amy, last question for you. Because you do integrate and work with so many different international initiatives, I would say, underneath one roof, give us your 30,000-foot view. What are the next couple of steps we can take to help make the US healthcare industry better?


[0:41:26] AW: Well, a couple things. I mean, I love big picture, this idea of moving from the sick care model to well care model, and incentivizing preventive measures. That’s big picture. I think, when we think about innovation from a technology and digital standpoint, how do we shift the paradigm of healthcare control from the clinic to the individual? How do we build smart cities, smart homes, accelerate that, so that you put the access control into the hands of the individual and make it easier for them to take care of their own health and wellness? Because they don’t have to think about it so much as embedded in their environment. That information can be shared with their healthcare team, with their loved ones.


It creates just a more seamless, convenient way to engage in your health and wellness. I think that would be a really interesting way to think about accelerating better health and wellness for everybody. Then you potentially changing the incentives to that well care model.


[0:42:34] CH: Amy West, Head of US Digital Transformation and Innovation at Novo Nordisk. Amy, thanks for joining us here on Healthcare Americana. It has been a pleasure.


[0:42:43] AW: Thank you so much. It’s been a lot of fun and I appreciate the conversation. Thanks, Christopher.


[0:42:47] CH: That’s going to do it for this episode of Healthcare Americana. If you haven’t yet, be sure to subscribe to the show in your favorite podcast platform. Check us out online at to catch previous episodes. Subscribe to our mailing list and visit our online store. Once again, I am your host, Christopher Habig. Thanks for listening.




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[0:44:08] Christopher Habig: Hi, again, everyone. This is Chris. On Healthcare Americana, we’re always on the lookout for great stories to tell in the healthcare industry. We’d like to hear yours. Check out, and send us your ideas for episodes or if you’d like to be a guest. Thanks again for listening. Hope you enjoy it.