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Sweet taste of victory

Novo Nordisk and Lilly lead the way for diabetes products, according to a survey of diabetologists

Champagne bottle being openedThis analysis is based on research conducted by medeConnect Healthcare Insight, which is part of the group. The questionnaire was conducted online with members.

This survey targeted 75 senior grade diabetologists/endocrinologists (79 per cent male, 21 per cent female) and was conducted in September 2010. This article covers a number of questions and responses in the survey.





Companies you trust

Q1: Please pick the three pharma companies you most trust
Company Position  Most trusted companies Average score 
First Second Third
Novo Nordisk 1 48% 23%  8%  1.97 
Lilly 2 39% 32% 12%  1.92 
sanofi-aventis 3 4% 16% 27%  0.71 
MSD 4 1% 7%  3%  0.20 
Novartis 5 1% 1%  12%  0.19 

Diabetologists were shown a total of 31 pharmaceutical companies from which to choose the most trusted. Looking at the top five contenders, there are two clear leaders that stand out: Novo Nordisk and Lilly. These two companies stand head and shoulders above the rest, with sanofi-aventis coming a respectable third.


Educational materials from pharmaceutical companies 

Q2: Which pharma company offers the most helpful educational materials?
1 Novo Nordisk 44%
2 Lilly 36%
3 MSD 7%
4 Servier 3%
5 Roche / GSK / Takeda 1%

On the question of most helpful educational materials, again the two clear front-runners are Novo Nordisk and Lilly: 44 per cent and 36 per cent of diabetologists selected them as the companies providing the most helpful educational materials, respectively. This is very impressive and reflects a significant investment in specialist support. Interestingly, GSK came joint fifth in this category, despite coming fifteenth in the list of most trusted pharmaceutical companies. The figures could have been negatively affected by the Avandia situation.


Pharmaceutical company recommendation 

Q3: How likely is it that you would recommend each of the following pharma companies to one of your colleagues?
Company Average scores taken from answering 0-10
1 Lilly 7.5
2 Novo Nordisk 6.9
3 sanofi-aventis 6.7
4 Novartis / MSD 5.7
5 Pfizer / AstraZeneca 5.5

The top five are relatively predictable here, all having a strong presence in the diabetes market. Lilly takes pole position in this question, being the diabetologists' favourite company to recommend to colleagues. The second and third slots are very close, with Novo Nordisk and sanofi-aventis on almost equal footing. Novartis and MSD take joint fourth position, with Pfizer and AstraZeneca tying in fifth with an average score of 5.5 each. This is quantitative research, but as a qualitative follow up it would be interesting to know whether this is due to sales representative interaction/support, awareness of the company's products or another factor.


Satisfaction with clinical experience of products 

Q4: Please rate your satisfaction with your clinical experience of the product
Product Mean score based on diabetologist response
1 Glucophage (Merck Serono) 4.7
2 Lantus (sanofi-aventis) / Humalog (Lilly) 4.5
3 NovoRapid prefilled pens (Novo Nordisk) 4.4
4 Byetta (Lilly) / Novomix insulin (Novo Nordisk) / NovoRapid penfill cartridge (Novo Nordisk) / Humalog mix 25/75 (Lilly) / Victoza (Novo Nordisk) / Levemir (Novo Nordisk) 4.3
5 Apidra (sanofi-aventis) 4.2

Twenty-four major diabetes products were included in this question and diabetologists were asked to rate each product. There was an option for them to enter 'not familiar enough to rate this product'. The score was calculated from the doctor responses of: very satisfied (5) through to very dissatisfied (1), with five options in total. Merck Serono's Glucophage occupies top spot, just ahead of Lantus and Humalog. Overall Novo Nordisk again dominates the table, with almost half of the top products. The top five clinical experience scores were all very close, illustrating little difference based on the diabetologists' feedback. Not surprisingly Avandia came last in this category but still garnered a mean score of 2.1.


Satisfaction with representatives 

Q5: Please rate your satisfaction with the product representatives of each of the following products
Product Mean score based on diabetologist response
1 Byetta (Lilly) 4.7
2 Humalog (Lilly) / Humalog mix 50/50 (Lilly) / Lantus (sanofi-aventis) 4.5
3 Victoza (Novo Nordisk) / NovoRapid penfill cartridge (Novo Nordisk) / Humalog mix 25/75 (Lilly) / Novomix insulin (Novo Nordisk) / Januvia (MSD) 4.4
4 NovoRapid prefilled pens (Novo Nordisk) / Levemir (Novo Nordisk) / Janumet (MSD) / Apidra (sanofi-aventis) 4.3
5 Onglyza (BMS/AZ) / Glucophage (Merck Serono) 4.2

Again the top five are very close, with Byetta (Lilly) just edging out in front. Onglyza (BMS/AZ) storms in at number five, tying with Glucophage (Merck Serono), in its first year of launch, showing that BMS and AZ's collaborative approach is paying dividends. The closeness of the scores show little differentiation among product representatives judged on 'overall satisfaction'. It's no surprise to see that Lilly and Novo Nordisk continue to dominate with their sales force activity. Interestingly, when asked how long on average they saw the reps, 44 per cent of all calls lasted 1–5 minutes, 28 per cent lasted 6–10 minutes, 17 per cent between 11 and 15 minutes, 7 per cent between 16 and 20 minutes and only 4 per cent over 20 minutes, according to diabetologists.


Representatives with the best clinical understanding

Q6: Which representatives have the best clinical understanding?
Product Position  Reps have the best clinical understanding Mean score based on diabetologist response
First Second Third
Byetta (Lilly) 1 20% 17% 8%  1.03 
Victoza(Novo Nordisk) 2 11% 13% 12%  0.71 
Lantus (sanofi- aventis) 3 8% 15% 7%  0.60 
Onglyza(BMS/AZ) 4 3% 11% 3%  0.32 
Humalog mix 50/50 (Lilly) 5 8% 1% 4%  0.31 
Januvia (MSD) 5 4% 4% 11% 0.31
Novomix insulin (Novo Nordisk) 5 8% 3% 1%  0.31

In response to the question 'Which representatives have the best clinical understanding?', diabetologists were asked to rank their top three choices from the list of 24 products, so that a product chosen first scores three, and if chosen second scores two, and so on. The scores are then calculated based on the sum of the scores for each product divided by the entire base of respondents. This ensures that the mean scores do not over-value products whose representatives are highly rated only by a very small number of doctors. Byetta (Lilly) is the clear leader and Victoza (Novo Nordisk) secures second place. Interestingly, although the top three are quite close, there is a significant gap between positions three and four and the drop off after position five is also significant.


Likelihood to attend company sponsored meetings 

Q7: If you were going to attend a product meeting, which, if any, of the products listed would it be?
Product Score based on diabetologist response
1 Victoza (Novo Nordisk) 51%
2 Byetta (Lilly) 15%
3 Januvia (MSD) / Onglyza (BMS/AZ) 3%
4 Avandia (GSK) / Humalog mix 50/50 (Lilly) / Humalog mix 25/75 (Lilly) / Lantus (sanofi-aventis) / Novomix insulin (Novo Nordisk) 1%

This question provoked a strong reaction from the diabetologists and they certainly voted with their feet. Over half of all respondents would attend a Victoza meeting, placing Novo Nordisk's product way out in front. There is also significant interest in Byetta (Lilly). Perhaps surprisingly, diabetologists would still like to attend meetings about Avandia (GSK), which may indicate an educational need. Not surprisingly, it is the newer molecules generating the most interest in diabetes. Apart from those products listed in the table no other brands were selected by the diabetologists, hence this question only has a top four, not a top five.


Overall summary
Novo Nordisk and Lilly are clearly providing quality materials and support for diabetologists and this is reflected in the market research overall. However, sanofi-aventis, MSD, Novartis and Merck Serono are also strong contenders. Educational resources and meetings are making a difference and can clearly change the perception of a brand and company. The research also shows that, with diabetologists at least, it is not the length of the rep call that is important, but the quality of the information and the clinical knowledge of the rep that counts. It will be interesting to see how the newly-launched and pipeline products change the diabetes landscape in the future.

The Author
If you would like more information on this survey or on please contact Marie Pickford, client service director,

E-mail: or call: +44 (0)7824 412 539.

To comment on this article, email

7th December 2010


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