Sunday, April 12, 2009
The Three Ps of Indian Innovation
I got the above image from here. I got the above (top) image of Dr. Salim Yusuf ( a dedicated medical researcher who was involved in the telmisartan Transcend study and is involved in the polypill concept) from here. Dr. Salim Yusuf is of Indian origin who has done his MD from Bangalore.
Who says India does not innovate?! If you want to know the level of innovation in any country - I have a suggestion: check the cuisine or textiles or dressing styles. If it is not variety rich ... well, you know what!
India has a diverse, popular, and variety rich cuisine. And check out the wide variety of traditional Indian textiles too. You will agree, innovation has been a part of India's rich culture. Oh! Yes!! in recent centuries, innovation has been sluggish, however, there is a new empowered generation, an entire set of people with high level of self-esteem, and they are driving innovation with resilience.
To be innovative one requires marketing sense, communication finesse, courage, and the drive. The mindset of the new generation is rich in these values, hence, the offshoot is innovation.
Innovation makes strong business sense. Innovation provides the first-mover advantage in to markets to boost revenues, innovations provide sustainable competitive advantages to firms, thus, innovation is indispensable for survival and growth.
The first P of innovation: Polypill and Polycap (the Indian connection)
India has a very interesting culture of syncresis. There are hundreds of cultural strands in India. There is a lot of diversity in all dimensions of life - food, languages, faiths, denominations, rituals, etc. It is indeed mindboggling to visualize the diversity in India. Hence, it is a sort of cultural thing to mix a lot of good things to make some thing better. Popular chaat food dishes like bhel puri, masala puri etc are mixes of diverse things. Walk in to any vegetarian darshini restaurant at Bangalore- you can order North Indian, South Indian, Chinese and other dishes. So syncresis and the instinct to combine good things in to one is seen in various activities - cooking, dressing styles, and ... yes in pharmaceuticals and therapies too.
In India you can access homeopathy, traditional Tibetan healing, Ayurveda, Siddha, Unani, Varmakalai (a sort of accupressure), medical tourism, allopathy, Yoga, and many other native forms. However, what has lacked these innovations is scientific temper, documentation, and other modern approaches. Today, many individuals are pouring in scientific efforts to justify the claims of traditional therapies.
The cultural instinct to mix good things together, has led to various fixed dose and combination formulations. Many have been dismissed as irrational as they have lacked scientific clinical back up. However, the concept of polypill is different. Dr. Salim Yusuf wrote about the concept of polypill to manage cardiovascular disease first in an editorial in the Lancet (2002). Wald and Law used analytic techniques to justify a polypill concept in another article in the BMJ (2003). May be, it appealed culturally to Indian pharma marketers, and Cadila Pharmaceuticals involved itself to clinically study the concept further - this initiative is called POLYCAP (a five in one formulation). The study making waves internationally is called the Indian Polycap Study (TIPS).
The ramifications of the Polycap project are many. It will redefine the consumption of antihypertensives, statins, and change the market consumption patterns of well established single ingredient formulations from Pfizer, Merck etc. It has the potential to disrupt the market to create a new trend. BUT WHY? THE ANSWER IS HERE:
One of the main challenges in chronic disease management is PATIENT COMPLIANCE OR PATIENT ADHERENCE.
Getting patients to pop in several tablets or capsules is a major challenge. Further, patients on such medications are always on the lookout for more convenient ways to manage the disease, reduce frequency and quantity of medications, without compromising on health outcomes.
The most important of the standard approaches to manage patient compliance is (please click here for a very very good article and to see more details on this concept):
Technical intervention: this is an important approach to improve compliance. It has one of the highest ratings to increase patient adherence to the dosage regimen. The POLYCAP concept is a technical intervention approach to improve PATIENT ADHERENCE (and health benefits) through improved convenience, with probably reduced cost. Hence, the POLYCAP concept has the potential to get huge medical and patient acceptance. There will be better patient adherence to the POLYCAP concept.
The other approaches to improve patient adherence are behavioral interventions (modification), social support interventions, structural interventions and educational interventions.
Hence, with some good marketing, the polypill concept will prove to be a winning horse.
The second P of innovation: Pranayama - Yoga concept from Baba Ramdev
Yogi Ramdev Baba - the health messiah - is creating a global lifestyle revolution by encouraging pranayama-yoga. The best thing about his approach that is heralding success, is the scientific investigations and documentation. This is redefining the way people see pranayama. Hence, the second P of Indian innovation will certainly do wonders globally.
The third P of innovation: Polydrink (the electrolyte energy drink concept)
The concept of electrolyte energy drink with aseptic technology processing and packing, for the management of mild to moderate dehydration and fatigue, has succeeded admirably. One of the significant reasons for market success is the excellent compliance for this product (technical intervention). Compliance is a key reason for the success of products. Patient compliance provides positive feedback from patients to prescribers, this reinforces prescriber behavior. Furthermore, it improves auto OTC (over-the-counter) purchases.
Indians have traditionally been very innovative producing 'poly' formulations (poly with respect to many ingredients or many uses, as in polydrink). Ayurvedic formulations are primarily poly in nature with respect to uses and composition. Furthermore, with many new biotech and stem cell research companies doing innovative work in pharmaceuticals and healthcare, in India, it is possible we are entering a new era of innovation in pharmaceuticals and healthcare.
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