“Professors in the Hot Seat,” Novo Nordisk, Medical Education, and Pharma Launches: How the KOL Interview Format Unleashed Repeated Engagement and Education for Novo Nordisk

Bozidar: Hello and welcome to the new episode of the Pharma Launch Secrets podcast. I have the pleasure of being joined today by Jens Olgaard. He is from Denmark. He is head of medical education at Novo Nordisk, which is a well-known global healthcare company. Jens is a medical doctor by training. He has a strong passion for changing the future of people with chronic diseases through his leadership, through his entrepreneurship and his engagement. He has over 15 years of experience in the medical field. He worked across different multidisciplinary teams and in his role in medical affairs, he was responsible for product launches. So I’m really looking forward to the conversation today and dive deep a little bit into the role of medical education content and all those kinds of good things when it comes to pharma launch secrets. So welcome, Jens, pleasure to have you today.

Jens: Thanks a lot, Bozi, and really a pleasure for me as well. I’ve been looking forward to this conversation with you.

Bozidar: Okay, so medical education and pharma. In your view, so let’s say a pharma is preparing product launch. And Novo has a few coming and they seem to be in the news every other day. So medical doctors get their continuous education from various sources. What do you think is the role of pharma? What is pharma doing? Well, and what can pharma do better?

Jens: Well, I think pharma has a very important role in continued medical education across therapy areas, and I think pharma sometimes need to rethink what they are doing. I think one of the most important roles for medical education in pharma is to be paving the road even before or in the very early preparation phases of product launches. One example I’d like to share is that Novo Nordisk is expanding indications and moving into other therapy areas than Novo Nordisk previously has been working within. So the customers, first of all, need to know about those new therapeutic areas because that may be within diseases that are not very well described, known or treated today, but also they need to know that Novo Nordisk is engaged in these therapy areas. So with medical education, without talking specific brands or even compounds, we can actually make very interesting engagements with HCPs, sort of paving the road, gaining insights from the physicians and nurses to bring back to commercial functions and on the other way, making it easier for the product launch team when they ramp up their pace.

Bozidar: Great. So let’s say that there is a company like Novo Nordisk moving into a new indication. So when does that education typically start? Is it a year or two before the launch? Is it more disease related? How much is it give and take? Because what you said, there are two parts. One is, you know, Novo bringing back the insights back to the commercial team. The other one is Novo disseminating information. So how does that work? What’s the balance and what do the channels use for that?

Jens: That’s a very good question. I think content marketing is not a term I’ve heard coined very often in the pharma world, but many other businesses use content marketing very deliberately. And in content marketing, especially if it’s new customer segments or new indications, I would say it’s give, give, give, and then take some back after long period, because you need to establish yourself as a knowing, trustworthy partner that has the right to be in their space. If we are to use a very old expression from, I think it is Plato or Socrates, the old Greek philosopher, that would be eunoia, the opposite of paranoia. So meaning that you want to do something good for them. And also phronesis. So that are the two of the three parts of the ethos in ethos, logos, pathos, that you know how to do stuff. So you have to display that you actually know about the disease, but also their work life. What is it to be treating, let’s say, people with fatty liver disease? What are the patients like? What are their struggles, their needs? So why is there an unmet need within this space? And medical education can help that, I think, better than other activities, because if you work in an unbranded nature, you can get a lot of trust with the customers. They will start perceiving you as sort of a thought leader. Or I try to use the metaphor a lighthouse frequently, and it can gain a very deep relationship with many customers to use this approach. It’s my experience in Denmark. And actually, you can do basically the same thing with marketed products as part of lifecycle management as well by staying relevant, using up to date educational content that fits within HCP’s daily life. I can give you two examples. We’ve had pretty successful webinars, one being before the Ramadan, speaking into how do you manage diabetes during the Ramadan? And the second one being how do you travel with type 2 diabetes? If you need to bring, for example, insulin, there are certain prerequisites you need to meet in order to store the medications correctly. You need certain documents to be able to travel with the medicines as well. So, I mean, that’s not very promotional in its nature, but we establish ourselves as providing valuable content to the customers. So when we then get to the more promotional content, then they are much more open to that.

Bozidar: Got it. What resonated with me was really focused on building trust and education and giving with the mindset of give, give, give, as you said, and starting with education and talking about unmet needs and updates on disease, guidelines, gaps in the guidelines is really the best way to establish their trust. Now things have changed also with COVID. I remember when I was a sales rep 20 years ago, I would organize a small meeting, some would come, there’ll be 20, 30 people. Now a lot of people don’t see, a lot of doctors don’t see reps. And so the question is how much medical can do all of this proactively versus reactive? Because that’s always a question. Sometimes I hear, oh, smaller companies are a little bit more relaxed in that matter, so they can do more proactively, but most companies are reactive. So what’s the role there if you cannot push information?

Jens: Yes, I think so, because in many cases, it’s my experience, customers are more open to engaging in discussions with medical and medical education than with traditional sales rep roles. I think because to be very respectful for sales reps as well, but medical people do have, most frequently, more in-depth disease understanding and knowledge, and thus are able to engage in deep and meaningful conversations with the customers. And also, especially if the MSL or RMA or whatever the role is called has a history within actually being an ACP themselves, being a nurse, being a doctor, then they also know the work context very well and might be better suited for understanding the concrete problems that the customer faces in their clinical life.

Bozidar: Yeah, clear. All right. So let’s talk a little bit about channels. COVID has shifted a lot how doctors consume content, how they want to engage face to face versus not face to face. What are you currently seeing in terms of how that education is delivered?

Jens: I think many customers still prefer face to face, but I think COVID really moved the needle towards being more accepting of virtual or on-demand content, using that as an alternative or a supplement to face to face meetings. I think if we had suggested before COVID to make a one hour webinar of a talk show format for some disease area discussion, most people would have said, what are you thinking about? I mean, nobody wants to do that. Then COVID came. Basically, during the first half year of COVID, people still said that because, to be honest, most of the content delivered was horrible. I mean, the most frequently used expression was Zoom fatigue or Teams fatigue or something similar. And I don’t believe in that term because it’s not a problem with the channel. It’s a problem with the content. One of my mantras is there’s no such thing as Zoom fatigue, but there is bad content. But if you produce good content, people like to see it. Think of people sitting in front of their television every night. I mean, nobody complains about watching 60 minutes or similar talk show because it’s very good content tailored to the format. But you need to acknowledge that it’s a completely different discipline to conduct virtual meetings than face to face meetings. TV news wouldn’t work very well if it was the anchor reading aloud today’s newspaper. Nobody would watch it. It would be horrible. But that was how we conducted virtual meetings when we started out after COVID. And then we got wiser. I’d say I think there are many businesses that helped us. I think you were among those, Bozi. And thanks for that because you’ve been very inspiring also to us to produce good content. And now I think we at least have gained traction. We have a monthly recurrent education concept that’s virtual, which is called Professors in the Hot Seat, which is very much inspired by a television talk show format. And we have very good traction on that. We’re very satisfied with our numbers, but it is a difficult discipline and it takes completely different knowledge than traditional channels. You need to be respectful of that.

Bozidar: Oh, I love what you said and I like the use of the word discipline because I see sometimes talking to pharma executives, it’s almost like I am a person who doesn’t agree that pharma needs to produce more content in the future because every other industry has gone through that simply because the buyer journey or prescriber journey starts with some sort of search online, some sort of content, third party reviews, then first party go to website of the manufacturer and then the human being. So it’s really aligning with the new way that people buy stuff or prescribe stuff. And so I haven’t really crossed anyone that says, oh, we need less content. People agree on that. And I think that usually I hear what stands on the way is MLR review is difficult. We’re not set up. We don’t have enough people. It’s not clear. Get back and forth, back and forth. It takes three to six months to get one piece of content out. Fair. I mean, I don’t think it’s unsolvable. It exists in other industries in finance and so on. And so it’s just really a tutorial kind of review process. It’s not the rocket science. And then the other one is cost that I hear. It’s costly. Marketing agency tells me that it cost me 50K to five minutes of video. And one thing that I rarely hear, and I think you pointed it out, it’s a different discipline. It requires a different skill set and requires different knowledge. And so sometimes pharma executives I talk to feel like overwhelmed just thinking how much content, how many pieces of content, what should the content be about? How do I know it should be about? How long it should be? Should it be video? And so have you seen in your experience dealing with that content discipline, especially since you have Professors in the Hot Seat, which I will definitely ask you more about that. How do you manage to overcome that through learning, bringing folks from other industries, bringing consultants as well?

Jens: Well, actually, we’ve been working with companies that are outside pharma, but working with learning management in different industries to be inspired by those. And I think one of the key insights that we have gained over maybe the past year or so is that when you start producing content that’s video based, you move to a different sort of competition for attention because most HCPs, when they are in their clinical office, they will not be watching the content while at work. So that will mainly be in their spare time. They will do that. So when you produce content that’s video, then in my view, you move out of their working context zone and actually your competition is with Netflix or Instagram or even TikTok because it’s the same format. And it has taken me quite a while to come to that conclusion. But when you start moving in that direction, you will also see the needle moving into more engagement. And I’m not saying that you need to do medical education that is a TikTok dance or something stupid or cringy. You can do very good content that is short and bite sized and broken down. And that is actually also a point I’d like to make in terms of MLR review, because we tend to do very long bits of content and that takes forever to get through MLR review. But if you can ask a KOL, we do that after our Professors in the Hot Seat sessions, which are live. And we know that we are not able always to make them available on demand afterwards because of MLR review. Then we put the KOL in front of the camera and then we ask them some very short questions they are able to answer very briefly and very concretely. That would be, how do you go about initiating insulin treatment for a patient with type 2 diabetes? And then they provide a very short answer. And beforehand, you had agreed that certain terms would be difficult in an MLR setting, for example, if they mentioned product names, that would be a no-go. Then you will get content that’s much easier to get through an MLR review, because you have basically agreed on what will be said. And it’s very short. You can do a second take if you need that. So it can be difficult to extract content bits from a live conversation in a talk show format. I guess you have the same experience as well, because it’s difficult to do the cutting, etc., without it being unnatural. But if you afterwards try to distillize the main points of the conversation into very brief questions that the customers will engage with afterwards, because it’s only maybe two minutes the video, and then you can put it into a format that is similar to Instagram, for example.

Bozidar: Got it. I love that. So you produce webinars, you produce Professors in the Hot Seat, and I assume all go through MLR review process. So how do you know what to ask professors in the seat and how many questions are there? Is it delivered on demand? Is it live? Like through webinars? You go, rapid-fire 15 questions and it’s live and then you repurpose it?

Jens: The way we do it currently is that we usually have two experts, sometimes three, and I’m usually the host, but it might also be some of the medical managers we have who are also trained in this kind of interview format. So after we introduce the webinar, each of the experts have around five minutes of presentation, which is classic one-to-many communication. They can use slides if they want. Usually we actually pull the slides apart, make them into graphical elements that fits better into the view and feel of the webinar, as you would see in a television show. Then they have the presentation for five minutes each. And then we go over to an interview format. We have found out that we tried to conduct two rehearsal or briefing meetings with the specialists before the webinar, where we discuss what are the most interesting clinical problems within this topic. So using their expertise to go about selecting topics for discussion. Usually we come out with 10 to 15 themes we want to discuss, but we always allow ample time to go outside manuscripts. So, for example, if we hit something that turns out to be very interesting or that the audience—we always allow the audience to submit questions in the chat that I then review and select the best or most relevant questions. So if we can see that the discussion moved in a certain direction, we let it do so. And then we pursue that direction, which means that sometimes there are interesting parts of the topic that we do not have time for. But we accept that because we feel like the natural conversation sparked by genuine interest engagement makes it a much better broadcast. So we don’t script it in detail, but we agree on what are the most interesting views, topics, problems.

Bozidar: And so you do that in a live format in a webinar, so you say five minutes, so they don’t do like a long presentation and then questions.

Jens: It’s a very short presentation, actually.

Bozidar: Yeah. And then you invite the audience through emails.

Jens: Yeah, they submit it in a chat function in the webinar platform. And sometimes we get zero questions. Sometimes we get 100 questions and we cannot even use it as a benchmark of engagement rate. But it’s completely unpredictable.

Bozidar: Yeah. And because it’s live, you have less control. How does it work with MLR folks? Say a professor says something, like uses a brand name during the live.

Jens: Well, in Denmark, there’s a different set of rules regulating whatever is live and whatever is recorded. Basically, it is accepted that in a live setting, you cannot control it in the same way as when it is recorded. So it obviously can happen that they mention product names or even say something that might be off-label or considered pre-launch or something in that direction. And then as a host, I or the medical manager needs to state that, oh, I’m sorry, what you were saying is off-label information. So obviously we cannot recommend doing so.

Bozidar: Okay, so you have to step in. But I assume it rarely happens because especially those professors, I mean, they’ve been working with pharma, they understand.

Jens: Exactly. And we’re very clear on that in the preparation meetings as well. But it is a challenge when we want to repurpose it for on-demand content, because we might need to cut out entire sections of the interview because of that. Because when they say something product related, I mean, if it is completely unlabeled, if it is easy to find a reference for the claim about the product, then we can use it. Then we will put a reference in on the video. But if it’s something that’s more difficult to put a reference on or off-label, for example, then we will need to cut it out. And we have experienced sometimes when we needed to accept that we could only use very small fractions of the webinar. It also comes to the fact that in Denmark you can only use peer reviewed material as a reference. So, for example, it would be impossible to conduct a webinar about what was the highlight from the most recent conference within a certain topic, because what goes on on a conference, per definition, is either not peer reviewed or pre-launch or off-labeled, because that’s what goes on in conferences. That’s difficult to do in a Danish setting. We know that. So we need to think outside the box.

Bozidar: Yeah, I really like the idea, by the way, because, for example, in the US, there is this thing called Speaker Programs, basically dinners, where there is usually a local or national level speaker who is a clinician and uses product a lot. And they would do a presentation for about 40 minutes that is approved by the company. And it has disease related and product related information. And we’ve done our research a little bit. And it turns out that apart from hanging out with other doctors and stakeholders, typically, doctors really appreciate the fact that they can ask a lot of questions about use of product, they can ask a doctor who is using it a lot. Right. Especially since the new products, doctors will start two, three, four patients, you know, dip their toes, but it takes time for them to adopt something on a grander scale. So asking others is really useful. So I think the fact that it helps you produce meaningful content that is also informed often by the questions that you get within the chat or from others on those days or nights when you get a lot of questions makes it short form, fast, meaningful, relevant content from a trusted source in an engaging format. And I think the fact that you married there is a great idea and it kind of releases a little bit of pressure for perfection when it comes to content, because I also see that being a big barrier. Are there any other learnings from that experience that you think would be useful for listeners? Something I didn’t ask, I should have asked. What would you do differently, for example?

Jens: Sad to need to say that, but I think one thing we try at least to do different is always to ask the customers what their needs are. And it actually goes back to what you said just before about the specialist being very good as a trustworthy source of knowledge and experience. But the questions or problems the specialist addresses need to resonate with the audience. And I have seen many examples where it was very clear, alone from the topic on the agenda, what the specific company wanted to communicate in said webinar or meeting, and that it was sorry to say more about the company’s need than the customer’s need. And those kind of meetings tend to receive less engagement, I’d have to say. So we are extremely deliberate about talking to customers about their needs. When we design our educational activities, we have steering committees that are external. We ask previous participants about ideas for new topics, new formats. We ask them to submit different difficult clinical problems they want to be better at addressing. And we try to mix it a lot about being sort of therapy specific, medication specific, but also just disease awareness and soft skills such as communication, conflict management, psychology, destigmatizing behavior, all that sort to mix it up and to address in a very holistic way the clinical questions that I play in the daily life of HCPs. And I think that’s a very big part of the key to the success we have in Denmark with Medical Education. I can say that in 2023, we will have one out of three primary care nurses in the entire nation of Denmark attending full day meetings with our education programs. And that’s because we are able to make it relevant, but we are only able to make it relevant for them to take a few or even two days out of their busy schedules because we take our time to really understand their clinical daily life and also to give up on some of the needs that we would have as a company. So I have frequent discussions with our commercial people about the weight between brand focus, company focus and customer focus. And it’s a very delicate balance. And we have seen it both turning out very good, but also very bad at times if we are too inside out in the approach and you risk losing a lot by being too much inside out focused.

Bozidar: Yeah, I love that you’re fundamental being customer-focused in this case when you’re producing content, really making sure that you understand what questions are on their mind. And given that the format we were discussing today a little bit more, the Professors in the Hot Seat is interview format, so it means that there are questions. And if questions are informed by the audience, then it’s very hard to go wrong because they’re coming from them. So you’re relevant because you ask people, hey, what’s on your mind? You have this Professor XYZ in front of you. What would you ask them about treatment of patients who is XYZ?

Jens: And actually something that works extremely well, and we always encourage our speakers to do so, is to ask each other questions. So for example, if a primary care physician asks the professor in endocrinology a question, I mean, that really works well.

Bozidar: Yeah. Great. We talked a little bit about channels. It said, well, it’s short form. It can be pushed to third party channels like TikTok and Instagram that are very friendly to short format. Do you also stream this content through first party channels, your own websites, portals, how does that work?

Jens: Yeah, we do. We have our own HTTP portal and actually right now we’re working on creating a new one actually, because the previous one didn’t really serve the purpose of hosting a lot of multimedia content, for example. And I think we did a mistake that I have seen you addressing the same one on your LinkedIn profile, Bozi, that we started out creating a lot of content that we thought would be very interesting to the customers, we didn’t ask them. So we produced a lot of video content that was really high quality. It was with a duration about 15 minutes. Then we posted them on our HTTP portal and then nothing happened. When we pushed out specific videos for specific purposes, then something happened. For example, if we were having a full day meeting about Type 2 diabetes complex cases, and before the meeting emailed out a link to a video about, let’s say, cardiovascular complications to Type 2 diabetes with a professor talking 15 minutes about that, then we would see some engagement with those videos. So if we sort of promoted them for a very specific purpose, then we saw engagement rates, but just living their own life on the portal, nothing happened. And my best guess is without remembering the data completely, some of the videos would have around zero views as of today.

Bozidar: Yeah, there is traffic that needs to be brought in, but also, you know, say specific questions, specific problems focused on the customer delivered in the right way. It’s all that matters. And I think that’s where I’m coming back to this, your thought about that being a discipline. And I think that in this game, we’re discussing a game of content, there are a lot of things that need to be done right. And it’s not like you do one thing right, and that’s it. It’s almost sometimes I think you need all of your organs. It’s a little bit dramatic metaphor, but you need your heart and you need your liver and you need your lungs here. You also need to have a specific format and focus on the customer and the right format delivered here. So all of these things matter. And that’s why it’s a discipline and requires knowledge or learning through a lot of mistakes through a long time.

Jens: We did the latter.

Bozidar: So I’m glad you’re sharing and sharing goes to the learnings and showing that other side, because sometimes also in pharma people talk only about what worked. You share like a mix of what worked and what didn’t. So basically it’s a constant learning, which is how everything functions. Great. Is there anything that I didn’t ask you and I should have asked you when it comes to content that you feel strongly about what pharma could be doing better?

Jens: No, I think my main points is about you can actually manage to get very high engagement rates with digital content, but you need to ask the customers what their concrete issues or questions are. And you need to be very good at producing it and you need to put them on a suitable channel. And that might mean that you give up on certain commercial messages, key messages that you would want to relay. But doing this more unbranded or at least less branded focus will build a lot of trust and ethos with your customers. And that can lead you to become a thought leader if you do it correctly. And virtual is here to stay, but we need to be very good at it. And we need to get inspiration from other businesses than only pharma.

Bozidar: Great. Well, thank you. This has been a great conversation and I love the specific examples you shared. And please continue to be the voice of doing things a little bit differently, catering to the needs of modern conditions. At the very end, and if you listen to a podcast, I like to ask our guests questions so the audience gets to know them better. First question I always ask is what’s your favorite industry buzzword of 2023?

Jens: We’re talking a lot about uncomfortable excitement in my company at the moment. And while I get the term, I think it’s horrible because you almost cannot pronounce it.

Bozidar: Yes, I agree.

Jens: And it’s used frequently that you get very tired of it.

Bozidar: Best book you read in last year or so?

Jens: I recently read a fantastic book by a Danish professor called Bent Flyvbjerg, which is called How Big Things Get Done, which is about why megaprojects fail. Bent Flyvbjerg is the world’s leading researcher within megaprojects. He’s been project leader on more than 100 projects, which are worth more than $1 billion, and he has analyzed what goes wrong with megaprojects from building bridges to nuclear storage to space exploration programs and IT systems. And basically the book is about that it’s always the same thing that goes wrong. And he gives very concrete examples and advice on what you can do to avoid those mistakes. And one example he mentions that I really love and we recently tried it out in my team was to do something called a pre-mortem exercise where you imagine yourself looking back at the finalized project, having been going completely wrong. Your project crashed, you exceeded timelines, you went way above projects and things didn’t work anyway. And then you start walking backwards, speaking about what went wrong and what led to that and what was the root causes and what could then have been done in the planning phases to avoid those root causes. And it’s a very fun exercise to make. And the book is full of those examples. And I think anybody who works with any kind of projects should be reading it.

Bozidar: Okay. And share the name again?

Jens: How Big Things Get Done.

Bozidar: How Big Things Get Done. All right. That sounds super intriguing. And in the world of startups, pre-mortems are quite often used. It’s a powerful exercise. What music do you listen to when you need some inspiration?

Jens: Oh, it depends a lot. Actually, recently I picked up classical music. I like choral works. I really haven’t been doing that a lot previously. You mentioned before that when I was a student, I worked as a DJ. So I’ve been spending a lot of time listening to music. It definitely was not classical music, but I’ve picked that up recently and it really does something very good to my brain. I love Johann Sebastian Bach and his choral works.

Bozidar: All right. And where can people find you online?

Jens: I would say LinkedIn is a very good opportunity and I’m really happy to connect and engage in. I love sharing my reflections and experiences with all kinds of people. It really gives me a lot of energy. So please reach out.

Bozidar: Yeah, no, thank you so much. Yes, really enjoyed the conversation and specific examples and you being the voice of what works actually when it comes to this good discipline. Thank you so much for that and have a great day.

Jens: Thanks for having me.

Bozidar: Ciao.