Saturday, April 19, 2008

Great fortunes in the Indian Pharma market

I got the above image from here.

India is a great destination for pharmaceutical and healthcare marketers. I do not recollect any pharma firm (manufacturer, marketer or trader) who has suffered losses - yes some have folded up due to gross mismanagement or lack of interest, but even the loosely managed firms survive and make profits. Such is the nature of this recession proof and growing pharmaceutical and healthcare industry. The reason is that the healthcare needs are vast and growing in India. It is something like the banking sector. Even the largest private bank in India (ICICI) has a savings bank account depositor base of 13 million (1.30 crores) in a population of 1.02 billion (102 crores). (SBI is the largest bank in India, a public sector bank). There is a large population that is 'unbanked'. Similarly, there is a large population that is not served adequately through the pharmaceutical and healthcare players.

The pharmaceutical and healthcare market is really big

India has 604 districts, population of 1.02 billion, and a pool of around 13 lakh odd doctors with some 5.5 lakh pharmacies. So the best company may be covering about 2 lakh doctors. A recent company like Atrimed has a coverage of 20,000 doctors and turns in a healthy financial picture. So the potential is growing and huge. Morever, patients constantly move up the value chain of clinical health offerings, from basic management of acute illnesses (infections, fevers, and transient headaches), to chronic illnesses (cardiovascular disease, respiratory allergies, arthritis, diabetes, and neuropsychiatry disorders) and then on to aesthetic medicine. So, as the purchasing power of the individual grows, there are newer and newer needs that are met by clinical services. The large market for pharmaceuticals and healthcare is hence constantly growing with a growth in the economy of India. It is for this reason that propaganda cum distributors (started by senior MRs or stockists) turn in tidy profits even if their base of doctors is just 50 core doctors per MR.

Let us see the anticancer market for some insights below

Disclaimer: I did this survey two months back and this is based on market buzz. The survey brings the scope of anticancer segment and the challenges in this market segment.

The challenging anticancer market is a roller-coaster ride. The approximate Rs. 500 crore market for anticancer drugs, is controlled by some 1200 medical oncologists (market buzz: at an all India level). So each oncologist can give a business of Rs. 41.6 lakhs per annum of anticancer drugs…

The use of chemotherapy is mainly in a multimodality approach, since most of the cancers are detected at advanced stage, and surgery and radiation therapies are the mainstay. While conversing with a patient’s attender near Bangalore Insititute of Oncology, Bangalore; he shared the information that he was buying Cipla’s tamoxifen tablets for a patient who had undergone lumpectomy (in treatment of breast cancer), for the past 5 years. Along with tamoxifen he was regularly buying Shelcal M tablets. The market for anticancer drugs is high competitive, high value - low volume compared to other Pharma products, and purely prescription driven (hence doctor – company relationships are very important). The roller coaster nature of the market is due to the fact that doctors enter in to annual contracts for prescribing brand(s) in return for some inputs from the company.

Kidwai Inst. Of Oncology, Bangalore does business of about Rs. 80 lakhs to Rs. 100 lakhs per month. While higher molecules are prescribed, routinely moving anticancer drugs are cisplatin, daunorubicin, vinchristine, and vinblastin. Pfizer is a leading company here at Kidwai. A new trend noticed at Bangalore Institute of Oncology, Bangalore is a pharmacy company called HCG that is directly purchasing certain injectable drugs from a manufacturer on their brand name, price and payment terms bypassing MRs and intermediaries. (In fact, this is marketing phenomenon is seen at Apollo Hospitals too, they have some 150 private label brands of analgesics, antipyretics, antiulcerants (including pantoprazole and rabeprazole) and other injectables which are sold to in-patients at Apollo Hospital network). At Bangalore Inst of Oncology, calcium leucovorin, cisplatin, adrinamycin, fluorouracil, oxyplatin, gencitabine, docetaxel, and isophosphamide are fast moving. Filgrastim is making some waves now. While head, neck, oesophageal, and lung cancers are mostly seen, bone and liver cancer too abound.

Auxiliary drugs that move fast include: antiallergics (particularly cetirizine), budesonide nasay spray, calcium tablets, blood products, analgesics, antidepressants, and antibiotics.

Big daddies of this fiercely competitive market are Pfizer, Roche, Nicholas, Alkem, DRL, Claris, Sun, Fulford…some 45 companies are said to control 70 to 80% of the market.

Herbapharmaceutical, OTC (over-the-counter nutritional supplements and healthcare products), wellness, and the alternative healthcare markets are uncluttered and growing

In fact, homeopathy has some 24% of the alternative healthcare market share. The wellness market is seeing some action with Yash Birla group showing interest in entering this segment. The ayurvedic - herbal market, for instance, is dominated by only 3 or 4 companies.

Cipla's growth hunger

Cipla is the number #1 Pharma company in India's retail market. This position is thanks to the aggressive spirit and intellectual hunger in the company. It is said that very few in the Pharma industry in India can even imagine the kind of approaches that Cipla undertakes. The market buzz is that Cipla is overhauling its marketing approaches, something on the following lines:

a) Use of electronic devices in Pharma marketing - through laptops or tablet PCs. This is done to ensure very persuasive marketing communication efforts.

b) closed loop marketing communication: this is related to the use of laptops or tablet PCs in pharma marketing. Essentially here the MR customizes the messaging with the laptop during in-clinic communication based on the conversations with the doctor. In essence, the MR will create a kind of electronic visual aid with his laptop and the MR is able to access relevant clinical reports as he is talking to the doctor and can show the same to the doctor on the screen. This makes better impact and ensures that the doctor gets convinced faster. Read more about closed loop marketing HERE.

c) Key account management: as such, in today's healthcare scenario, there are more than one opinion builders who affect a pharma brand's establishment and consumption. Hence, it is imperative for the MR to understand the full range of people/professionals, who influence the brand's consumption and strategize on how to manage the relationships and marketing communication efforts, for full impact, this concept is called key account management. This is being put slowly in to action by Cipla's marketing dept. You can read more about key account management in Pharma HERE.

Sun Pharma: the quiet conqueror

Sun Pharma is the one of the most profitable Pharma companies in India. In fact, its CMD, Mr. Dilip Shangvi, the billionaire, who shies away from the limelight is one of the richest persons in India. This company is a quiet conqueror but very aggressive and hungry for more - more topline and more bottom line. A company that makes quiet waves.

Piramal Healthcare: success because there was no baggage

The husband - wife team of Piramal Healthcare, entered the Pharma industry through acquisition of Nicholas Laboratories. Rest as they say is history. From a few crores of business the company is now having a turnover of Rs. 3000 crores. The main reason was that Mr. Piramal being new to the Pharma industry, carried no baggage, had a fresh and open mind, brought in management concepts and took the Piramal's pharma business to new heights.

Innovation wins through creation of product categories

Competing interest: the author of this blogpost is employed by Juggat Pharma.

Certain companies like Juggat Pharma have created history by creating product categories - the category created by Juggat Pharma is the tetra pak based product range electrolyte energy drinks for prescription promotion. ( This goes to show that innovative and courageous thinking can create records.

The fact that there are great fortunes in the Indian Pharma market is reflected in the Economic Times report dated 17.4.2008, where the reporter, Kiran Kabtta, says domestic growth story boosts Q4 pharma margins.

The above report also states Average estimates point to a 25% annual increase in revenues for domestic pharma companies, though there will be some exceptions to the growth picture. An IMS-ORG MAT report in February valued the home market at Rs 31,900 crore, growing at nearly 15%.

Thanks for going through this blogpost, please feel free to go through the other blogposts, by clicking on OLDER POSTS wherever required.


John Mack said...

How are you?

I am trying to open up my Pharma Marketing News to authors with a different, non-US perspective on
pharmaceutical marketing and would like to reprint a couple fo your blog posts about the Indian
market in the upcoming issue. The 2 posts I am interested in are:

Great fortunes in the Indian Pharma market (Apr 18)
The healthcare sector in India - is rocking! (Apr 7)

I would like to combine these into one article with some light editing. I would show the result to
you before publishing and give you full attribution.

In fact, I'd like it if you were a regular contributor.

I cannot pay you anything, but I hope it would give you access to may subscribers -- I can offer you
some advertising for your consulting business (such as a listing in the vendor directory, etc.)

Please let me know if (1) I can use the above posts amd (2) your interest in a continued
relationship where you make contributions from time to time.

John Mack

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