DIABETES In India…biggest chronic illness making a spurt in immense future opportunities...
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High prevalence, late diagnosis, poor control over time with all possible medications and low awareness have been adding the highest Diabetes patient pool, affecting millions of Indians each year…Paradoxically this biggest chronic illness is making bigger growth opportunities for all related industries and millions of individuals… Diabetes in India and antidiabetic’s outperformance over Indian Pharma Market is probably a great reflection of a make and break (indeed break and make) phenomena
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DIABETES In India…biggest chronic illness making a spurt in immense future opportunities...
- 1. DIABETES…biggest chronic illness making a spurt in immense future opportunities in India… Saikat Chaudhury Email Id: saikat.chaudhury@rediffmail.com http://www.linkedin.com/pub/saikat-chaudhury/1a/b05/ab High prevalence, late diagnosis, poor control over time with all possible medications and low awareness have been adding the highest Diabetes patient pool, affecting millions of Indians each year…Paradoxically this biggest chronic illness is making bigger growth opportunities for all related industries and millions of individuals… Diabetes in India and antidiabetic’s outperformance over Indian Pharma Market is probably a great reflection of a make and break (indeed break and make) phenomena http://articles.economictimes.indiatimes.com/2014-11-19/news/56265356_1_pharma-market-therapies-volume-growth “Gearing up for the growth of chronic illnesses in the country, Indian pharma companies have gradually changed their portfolio from being predominantly acute therapies focussed to include more of the higher-margin chronic therapies…”
- 2. Antidiabetics are now 6th largest therapy area and contributes 8% of sales in IPM Currently 17 multinationals and approx. 150 domestic companies are playing with approx. 1220 brands with close to 2800 SKUs… Organizations A.MENARINI INDIA* ACRON COMED CHEMICALS HAMDARD LIFEMEDICARE ORCHID CHEM&PHARM* STRIDES SHASUN ABBOTT* AIMIL CORONA REMEDIES HEGDE & HEGDE LINCOLN PHARMA ORDAIN HEALTHCARE SUN* ADCOCK INGRAM AJANTA PHARMA D.R.JOHNS LAB HELIOS LISTER OVERSEAS SYSTOPIC ASTRAZENECA AKESISS PHARMA DELCURE LIF.SCIEN. HIMALAYA DRUG LIVIDUS PHARMA OZONE TALENT BAYER ZYDUS PHARMA AKUMENTIS HEALTH DEY S ICON LIFESCIENCES LLOYD HEALTHCARE PALSONS DERMA TAS MED BOEHRINGER INGELH. ALDE MEDI IMPEX DINDAYAL AUSHADI INDI PHARMA LUPIN LIMITED PANACEA BIOTEC TORRENT PHARMA ELI LILLY ALEMBIC DR REDDYS LABS INDIAN NAT DRUG MAC PARENTERAL DRUGS TTK HEALTHCARE LTD GLAXOSMITHKLINE* ALKEM* EAST AFRICAN INDICA MACLEODS PHARMA PRECIA PHARMA U S V JANSSEN AMRUT EAST INDIA INDOCO* MAKERS LABS PREMIER NUTRACEUT. UNICHEM* MEDREICH LIFECARE ANTHUS PHARMA EAST WEST PHARMA IND-SWIFT MANEESH PHARMA* PSYCHOTROPICS UNIDENT MANUFACT. MERCK LIMITED APEX KOYE PHARMA INEXIOS PHARMA MANKIND RADICURA PHARMA UNISON PHARMA MSD PHARMACEUTICA* APRICA PHARMA LA PHARMA INGA MARC LABORATORIES REGENIX DRUGS UTH HEALTHCARE NOVO NORDISK ARISTO PHARMA* ELDER PHARMA INTAS PHARMA* MARK LAB RELIANCE LIFESCIE. VENUS REMEDIES NOVARTIS INTL.* BAIDYANATH EMCEE IPCA LABS MED MANOR ORGANICS RETORT LABS VERITAZ HEALTHCARE PFIZER* BAN LABS. EMCURE* J J.DECHANE MEDLEY PHARMA RHINE BIOGENICS WALLACE SANOFI* BIOCON ERIS LIFE SCIENCES JAGSON PAL MEDO PHARMA RPG LIFE SCIENCES WIN MEDICARE SERDIA BLUE CROSS FDC JENBURKT MERIDIAN LAB SAMARTH PHARMA WINGS PHARMA BURNET PHARMA FOURTS INDIA JUBILANT LIFESCIEN MEYER ORGANICS SANDU PHARMA WOCKHARDT LTD* CADILA PHARMA FRANCO INDIAN KARNATAKA ANTIBIOT MICRO LABS* SEAGULL LABS ZANDU PHARMA CENTAUR FRANKLIN LABS KHANDELWAL MIDAS CARE SHIELD HEALTHCARE ZYDUS CADILA* CHARAK PHARMA GLAND PHARMA KON TEST CHEMICALS MOREPEN LABS SHINE PHARMA CHEMECH LABS GLENMARK PHARMA KOPRAN MSN LABS SHREYA LIFE SCIENC CIPLA GOLDLINE PHARMACE. PULSE PHARMA NATCO PHARMA SHRINIVAS LABS COLINZ GRAF LABS QUALITY INNOVATION OBSURGE BIOTECH STADMED PRIVATE Source: IMS May’16
- 3. Interesting? It’s fascinating! All possible combinations* and more surprisingly, almost everything has grown year after year and most of them are growing at good pace, I have taken a cut of main Oral Antidiabetics and their growth trajectories (Volume) for consecutive four years… It’s important to mention here, in 2015 four new molecules made excellent debut. Cost effective DPP4 inhibitor, Teneligliptin and SGLT2 inhibitors (Canagliflozin, Dapagliflzin and Empagliflozin) added 12.8 $mio (Teneligliptin 6.1 $mio & SGLT2i 6.6 $mio) in antidiabetic market. 25 brands of Teneligliptin are launched so far by 21 companies (IMS Mat-16), On the other hand 3 MNCs are making inroads with 4 SGLT2i Brands (USV- partner brand of canagliflozin). Injectable contribute ~25% (approx. 350 $mio) of antidiabetic market and currently growing approx. 21% (MAT May’16). MIXTARD is the biggest Indian Pharma brand (~80 $mio), newer combinations and innovative drug delivery system of GLP1 agonists (Once Weekly) will enrich this sub category in coming Days Great learnings! How chronic illness made a spurt in business opportunity for pharma and therefore a steady change in portfolio by companies… How parent companies are keeping Share of Voice high for their molecules by adopting partnership model in extremely cluttered market to build top line Molecule Value Parent Partner I When? Partner II When? Partner III When? DPP4 inhibitors $mio (approx.) Cont % Cont % Launch + Cont % Launch + Cont % Launch + Vildagliptin 125 NOVARTIS (53%) U S V (35%) 3 months ABBOTT (7%) 18 months EMCURE (5%) 38 months Sitagliptin 104* MSD (60%) SUN (29%) 38 months Linaglptin 26 BOEHRINGER I (94%) LUPIN (6%) 42 months Saxagliptin 14 ASTRAZENECA (97%) DR REDDYS (3%) 68 months Teneligliptin 21 25 brands (branded generics) SGLT2i inhibitors $mio (approx.) Cont % Cont % Launch + Cont % Launch + Cont % Launch + Canagliflozin 6 JANSSEN (73%) USV (27%) 7 months Dapagliflozin 6 ASTRAZENECA (100%) SUN Yet to launch Empagliflozin 2.5 BOEHRINGER I. * Including Glenmark's brands (Zita & Zita Met) which holds 11% of Sitagliptin MAT TSA May'16 Many people believe that the growth of antidiabetics are largely driven by the newer molecules for last 6-7 years (especially DPP4 inhibitors) however the reality is, older molecules (e.g. SU+Metformin) have shown consistent volume growth despite been getting challenges by competition about their safety profile…
- 4. When going gets tough, how one should strategize…after losing Sitagliptin battle in October 2015 Glenmark made strongest entry with cost effective DPP4 inhibitor, teneligliptin and combination… How evolved science can reshape the expectation of treatment outcome…, SGLT2 inhibitors are setting new expectation by building a concept of multiple benefits for comprehensive diabetes management through an unique MOA How benchmarks are getting challenged every time to set a new benchmark of launch excellence…Forxiga (Dapagliflozin ASTRAZENECA) set a new benchmark in chronic care (5.7 $mio in 12 months of launch) in IPM, left Ryzodeg Flextouch (Insulin Aspart Recombinant + Insulin Degludec Recombinant NOVO Nordisk) and Trajenta (Linagliptin BOEHRINGER INGELHIM) behind… How Patient care initiatives payed off in building brand perception and improved patient HCP interactions over a period of time, beside awareness and patient support it gave enough and more opportunities to understand the patient journey form “first surprise” to “live with it” Future is brighter! Yes! The momentum is so positive, anyone can tell, this will be one of the most strong therapy areas to stick with Beyond intellectual aspects such as, prevalence, awareness, Healthcare spent of Govt., GDP, insurance, epidemiological factors, patient access, affordability, socioeconomic improvement expectations (which are relatively difficult to understand) let me put some definite marker which are easy to understand and evident for Antidiabetic therapy area perspective… 1) This decade is witnessing best of Antidiabetics 28 Antidiabetics are approved by FDA (since 2010)which is double compared to last decade and about 4-5 are expected in next couple of years... interestingly most these drugs are getting launched in India within 1.5 - 2 years of US launch (follow my post https://www.linkedin.com/groups/10310803/10310803-6173452026312257539?trk=hp-feed-group-discussion ) 2) Partnership Model success Looking at the success of Galvus (Novartis) and Januvia (MSD), most parent MNCs are now keen to adopt this model early in the life cycle to leverage the time of patent protection, increased SOV of molecule and early penetration in tier 2,3 and rural markets… 3) Dedicated Diabetes Care Center/Hospitals As the awareness and diagnosis increases over last 5-6 years, Heath care professionals have been playing a great role in developing dedicated diabetes clinic/care center and Diabetes care hospitals, this centers/hospitals will continue to play important role in building brands... “...Hospital will increasingly be instrumental in building pharmaceutical product brand, a material proportion of prescription for chronic ailments is being generated in a hospital settings…” McKinney article: India Pharma 2020 Propelling access and acceptance, realising true potential
- 5. 4) Branded generics It is obvious that anything this growth trend will attract more and more companies to invest in this segment especially when almost everything is growing year after year…What could be a better example of 33 teneligliptin brand in 12 months making approx. 4.2 $mio of business per month Infact there are many in the list, no doubt most of the factors will in favor in creating great opportunities for antidiabetics and related all industries and individuals… A key risk to this outlook seems from the use of price controls if any, which may create some uncertainty in the market and could serve to dissuade investments, particularly from multinational pharmaceutical firms. Saikat Chaudhury Email Id: saikat.chaudhury@rediffmail.com http://www.linkedin.com/pub/saikat-chaudhury/1a/b05/ab