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Summer internship project report Summer internship project report Document Transcript

  • Marketing Research For New Product Launch: Cisatracurium A Summer Training Project Report Submitted in Partial Fulfillment of the Requirements for the Award of degree of MBA (Finance & Marketing) 2011 – 2013Submitted by Guided byManish Ranjan Singh Ms. Ranpreet Kaur
  • Certificate from the Company/OrganizationThis is to certify that Manish Ranjan Singh, son of Dr. Satyendra Narayan Singh PursuingMBA from Institute of Management and Entrepreneurship Development, Pune hassuccessfully completed the Project Report in our organization on the topic titled,“Marketing Research for New Product Launch: Cisatracurium” from 1st June to 10thAugust 2012. During his project tenure in the organization/company, we found him hardworking, sincere and diligent person and his behavior and conduct was good. We wish him allthe best for his future endeavors.SignatureSandeep Pawar (Group Product Manager)Name and Designation of the Guide 2|Page
  • Certificate of OriginalityThis is to certify that the project report entitled “Marketing Research for New ProductLaunch: Cisatracurium” Submitted to Bharati Vidyapeeth Deemed University, Pune inpartial fulfillment of the requirement for the award of the degree of MBA (Finance &Marketing) is an original work carried out by Mr. Manish Ranjan Singh, under the guidanceof Ms. Ranpreet Kaur. The matter embodied in this project is a genuine work done byManish Ranjan Singh to the best of my knowledge and belief and has not been submittedbefore, neither to this University nor to any other University for the fulfillment of therequirement of any course of study.Signature of the Student Signature of the Guide Designation 3|Page
  • CertificateThis is to certify that the project titled “Marketing Research for New Product Launch:Cisatracurium” is an academic work done by “Manish Ranjan Singh” submitted in thepartial fulfillment of the requirement for the award of the Degree of MBA (Finance &Marketing) from Bharati Vidyapeeth Deemed University, Pune. It has been completed underthe guidance of Ms. Ranpreet Kaur (Faculty Guide) and Mr. Sandeep Pawar (CorporateMentor). We are thankful to Abbott India Ltd. for having allowed our student to undergoproject work training. The authenticity of the project work will be examined by the vivaexaminer which includes data verification, checking duplicity of information etc. and it maybe rejected due to non fulfillment of quality standards set by the Institute.Dr. Sachin S. Vernekar(Director IMED) 4|Page
  • ACKNOWLEDGEMENTThe satiation and euphoria that accompany the successful completion of the project would beincomplete without the mention of the people who made it possible.I would like to take the opportunity to thank and express my deep sense of gratitude to mycorporate mentor Mr. Sandeep Pawar and my faculty mentor Ms. Ranpreet Kaur. I am greatlyindebted to both of them for providing their valuable guidance at all stages of the study, theiradvice, constructive suggestions, positive and supportive attitude and continuousencouragement, without which it would have not been possible to complete the project.I would also like to thank Mr. Rajesh Pandey (Country Manager) who in spite of busyschedule has co-operated with me continuously and indeed, his valuable contribution andguidance have been certainly indispensable for my project work.I am thankful to Mr. Sandeep Pawar for giving me the opportunity to work with Abbott IndiaLtd. and learn.I owe my wholehearted thanks and appreciation to the entire staff of the company for theircooperation and assistance during the course of my project.I hope that I can build upon the experience and knowledge that I have gained and make avaluable contribution towards this industry in coming future.Manish Ranjan Singh,BVDU, IMEDPUNEName of the Student Signature 5|Page
  • PrefaceThe objective of the project was “to understand the Neuro Muscular Blocker (NMB) market& develop the medical positioning for Cisatracurium” for Abbott India Ltd., for that we haveto understand the customer needs (doctors), pricing constraints, response, emotions andbeliefs regarding the product, so that they can contribute their valuable inputs for introducingthe “Cisatracurium” in India for the company. The objective of this study was to analyze theclinical practice of the available neuromuscular blocker in Mumbai and Pune city with respectto the survey in the best hospitals of the city.The project was started on 1st of June after knowing all the relevant information regarding theproject, under the guidance of Mr. Sandeep Pawar (Group Product Manager). The first part ofmy project involves the study of the Anesthetists’ armamentarium of drugs, Understand theNMB category & their mechanism of action and Clinical use of NMBs & their place intherapy. For this I used Internet as a primary source of information for study, also attended aday with Dr. Amit Arora discussing the topics. Along with the detailed study of NMBcategory the study was more focused on Cisatracurium.Since, the next part of my project was to develop the questionnaire respected to medicalpositioning for Cisatracurium and clinical preferences of current NMBs available. Hence, thedetailed study provided me a rough idea in developing questionnaire and my corporate mentorguided me in finalizing the questionnaire. For this the questionnaire was prepared which gavethe vague idea about the customers, who were really interested in practicing the new moleculeand wanted to know about the availability of the molecule in the country. Go throughquestionnaire in different hospitals and people in the Pune and Mumbai city. The marketingresearch was undertaken for Pune and Mumbai region during one month. The sample size ofthe marketing research was taken to be 40. The questionnaire contains various aspects liketheir Name, Contact Number, E-mail Id, Hospital Name, NMB preference and Cisatracuriumadvantage etc. The final part of the project consists of 15 days of scanning the questionnaire.Most important part is analyzing the information.Manish Ranjan Singh Signature 6|Page
  • Index1. CHAPTER 1: Introduction……………………………………………..9-30 1.1. Overview of the Industry………………………………………………..10 1.1.1. Pharmaceutical Industry in India 1.2. Company Profile……………………………………………………...…12 1.2.1. About the Company 1.2.2. Corporate Overview Fact sheet 1.2.3. Vision 1.2.4. Dedication 1.2.5. Strategy 1.2.6. The Work Culture 1.2.7. The Abbott Brand Promise 1.3. Company History…………………………………………………….…18 1.3.1. Early Decades 1.3.2. Late 1960s and Early 1970s: Diversification and Crises 1.3.3. Late 1970s through 1980s: Emphasizing R&D, Nutritionals, Diagnostic Equipment 1.3.4. 1990s and beyond: New Drug Introductions and Acquisitions 1.3.5. Recognition 1.3.6. Key dates 1.3.7. Abbott India Ltd. History 1.4. Competition Overview………………………………………………….302. CHAPTER 3: Research Methodology………………………………...31-36 2.1. Objective and Scope of Study…………………………………………..32 2.1.1. Objective of the Study 2.1.2. Scope of the Study 2.1.3. Managerial Usefulness of the Study 2.1.4. Types of Research and Research design 2.2. Research Methodology………………………………………………….33 2.3. Research Design………………………………………………………...34 2.4. Sample Design…………………………………………………………..34 2.4.1. Sample Size 2.4.2. Sampling Method 2.4.3. Sample Type 2.5. Data Collection Method…………………………………………….…..35 2.6. Limitation Of the Study………………………………………………....36 7|Page
  • 3. CHAPTER 2: Conceptual Discussion…………………….…………..37-43 3.1. About Product: Cisatracurium………………………………………….38 3.2. Current Issues/News……………………………………………………394. CHAPTER 4: Data Analysis……………………………………..……44-69 4.1. Methods and Techniques of Data Analysis…………………………….45 4.1.1. Data Analysis Concept 4.1.2. Data Analysis Process 4.2. Detail Analysis……………………………………………………….....475. CHAPTER 5: Findings, Conclusion & Suggestions……………….....70-74 5.1. Interpretation…………………………………………………………....71 5.2. Findings………………………………………………………….……...72 5.3. Conclusion………………………………………………………..……..73 5.4. Suggestions……………………………………………………….…..…746. CHAPTER 6: Appendix & Bibliography…………………………….75-80 6.1. Sample Questionnaire……………………………………………….….76 6.2. Abbreviation & Notations………………………………………….…...79 6.3. Bibliography……………………………………………………….…....80 8|Page
  • CHAPTER 1 Introduction 9|Page
  • Overview of the Industry“The Indian pharmaceutical industry is a success story providing employment formillions and ensuring that essential drugs at affordable prices are available to the vastpopulation of this sub-continent.” Richard GersterPharmaceutical Industry in IndiaThe Pharmaceutical industry in India is the worlds third-largest in terms of volume and stands14th in terms of value.The government started to encourage the growth of drug manufacturing by Indian companiesin the early 1960s, and with the Patents Act in 1970. However, economic liberalization in 90sby the former Prime Minister P.V. Narasimha Rao and the then Finance Minister, Dr.Manmohan Singh enabled the industry to become what it is today. This patent act removedcomposition patents from food and drugs, and though it kept process patents, these wereshortened to a period of five to seven years.The lack of patent protection made the Indian market undesirable to the multinationalcompanies that had dominated the market, and while they streamed out. Indian companiescarved a niche in both the Indian and world markets with their expertise in reverse-engineering new processes for manufacturing drugs at low costs. Although some of the largercompanies have taken baby steps towards drug innovation, the industry as a whole has beenfollowing this business model until the present.The Indian pharmaceutical sector has come a long way, being almost non-existent before1970 to a prominent provider of healthcare products, meeting almost 95 per cent of thecountrys pharmaceuticals needs. The Industry today is in the front rank of India’s science-based industries with wide ranging capabilities in the complex field of drug manufacture andtechnology. It ranks very high in the third world, in terms of technology, quality and range ofmedicines manufactured. From simple headache pills to sophisticated antibiotics and complexcardiac compounds, almost every type of medicine is now made indigenously. 10 | P a g e
  • Playing a key role in promoting and sustaining development in the vital field of medicines,Indian Pharma Industry boasts of quality producers and many units approved by regulatoryauthorities in USA and UK. International companies associated with this sector havestimulated, assisted and spearheaded this dynamic development in the past 53 years andhelped to put India on the pharmaceutical map of the world.The Indian Pharmaceutical sector is highly fragmented with more than 20,000 registered unitswith severe price competition and government price control. It has expanded drastically in thelast two decades. There are about 250 large units that control 70 per cent of the market withmarket leader holding nearly 7 per cent of the market share and about 8000 Small Scale Unitstogether which form the core of the pharmaceutical industry in India (including 5 CentralPublic Sector Units). These units produce the complete range of pharmaceutical formulations,i.e., medicines ready for consumption by patients and about 350 bulk drugs, i.e., chemicalshaving therapeutic value and used for production of pharmaceutical formulations.Following the de-licensing of the pharmaceutical industry, industrial licensing for most of thedrugs and pharmaceutical products has been done away with. Manufacturers are free toproduce any drug duly approved by the Drug Control Authority. Technologically strong andtotally self-reliant, the pharmaceutical industry in India has low costs of production, low R&Dcosts, innovative scientific manpower, strength of national laboratories and an increasingbalance of trade.The number of purely Indian pharma companies is fairly low. Indian pharma industry ismainly operated as well as controlled by dominant foreign companies having subsidiaries inIndia due to availability of cheap labour in India at lowest cost. Most pharma companiesoperating in India, even the multinationals, employ Indians almost exclusively from thelowest ranks to high level management. Mirroring the social structure, firms are veryhierarchical. Homegrown pharmaceuticals, like many other businesses in India, are often amix of public and private enterprise. Although many of these companies are publicly owned,leadership passes from father to son and the founding family holds a majority share.The total Indian production constitutes about 13 per cent of the world market in value termsand, 8 per cent in volume terms. The per capita consumption of drugs in India, stands atUS$3, is amongst the lowest in the world, as compared to Japan- US$412, Germany- US$222and USA- US$191. 11 | P a g e
  • Company ProfileAbout The Company Abbott Laboratories is a Chicago-based global, diversified (multi-division)pharmaceuticals and health care products company. It has 90,000 employees and operates inover 130 countries. The company headquarters are in Abbott Park, North Chicago, Illinois.The company was founded by Chicago physician, Dr. Wallace Calvin Abbott in 1888. In2011, Abbott had over $38.9 billion in revenue. Abbott Laboratories is one of the majormultinational company in the pharmaceutical industry. Abbott, is a company that focuses onturning science into caring – ABBOTT, A Promise for Life. For more than a century, AbbottLaboratories has been working to advance health care for people around the world. Foundedin 1888 by a young Chicago physician, Dr Wallace Calvin Abbott, Abbott Laboratories hasevolved into a diversified health care company that discovers, develops, manufactures andmarkets innovative products and services. Products and services of Abbott, span thecontinuum of care from prevention and diagnosis, to treatment and cure. Abbott today is aglobal, diversified health care company devoted to the discovery, development, manufactureand marketing of pharmaceutical, diagnostic, nutritional and hospital products.Abbott extends this commitment with a strong presence in India as it has grown and evolvedits operations in India over many decades. The products encircle life from newborns to ageingadults. Abbott has built expertise and leadership in primary care therapeutic areas likeGastroenterology and Paincare. Our specialty areas include Neuroscience, Metabolics andHospital Care. Abbott serves the needs of Indian consumers with products backed by scienceand R&D. It has locally developed brands like Digene, Cremaffin, Epilex, Zolfresh andObimet. Abbott has also brought global products including Brufen, Prothiaden, Ganaton,Sevorane, Thyronorm and Leptos to Indian consumers. Abbott’s pioneering products likeSurvanta help infants. As of 2010, Abbott India Ltd. tops the list of publicly listed life sciencecompanies in India and the revenue generated in the year 2011 is the highest than any otherpharmaceutical company doing business in the country.Abbott India, today has strong brand equity and commands esteem in the market place. Toreach the customer, Abbott India has a network of 18 distribution points, which cater to11,000 stockists and 70,000 retailers. Behind Abbott India’s success, is a team of competent, 12 | P a g e
  • committed people, driven by the principles of Value Based Management, and aided by strongalliances and partnerships.Abbott India Limited, provides healthcare solutions through its four business units: 1. Primary Care - which markets products in the areas of Pain Management, Gastroenterology, with well-known brands like Brufen, Digene, Cremaffin. 2. Specialty Care - Metaboloics & Urology provides solutions in the areas of Thyroid, Obesity, Diabetes and Benign Prostratic Hyperplasia. 3. Specialty Care - Neuroscience has a varied portfolio, with specialty products in the Neurology and Psychiatric segments. 4. Hospital Care - offers products in the field of anesthesiology and neonatology namely Forane, Sevorane and Survanta.The company has over 1000 employees and a state-of-the-art formulation plant at Verna inGoa. The manufacturing locations are designed to produce quality, high volume formulationsusing cost efficient processes. The plant has well equipped laboratories and trained personnelto ensure international standards of quality at each step of the manufacturing process.The company has in-house development and medical teams to undertake product and clinicaldevelopment tailored to the needs of the Indian market.Abbott provides quality health care worldwide by creating healthcare solutions, which directlyaffects the life of the common man. 13 | P a g e
  • Corporate Overview Fact SheetFounded in 1888 by Chicago physician Dr. Wallace C. Abbott, Abbott has emerged as one ofthe worlds most diverse health care companies. The company has approximately 91,000employees worldwide serving customers in more than 130 countries. Abbott ranks No. 71 onthe FORTUNE 500 and is headquartered in north suburban Chicago, USA. Abbott India Ltd.ranks No. 1 in India in top performing pharmaceutical company.Primary Businesses  Medical Products – Key lines of business include vascular, laboratory and molecular diagnostics, diabetes care, vision care and animal health.  Nutritionals – Abbott offers a variety of nutrition products for infants, children, active adults and patients with special dietary needs.  Pharmaceuticals – Includes global patented pharmaceuticals and investigative compounds and indications in development, and established pharmaceuticals.Areas of Expertise:Pharmaceuticals Medical Products Nutritional Products  Anesthesia  Animal Health  Pediatric Nutrition  Anti-infectives  Diabetes Care  Healthy Living  Cardiovascular  Diagnostics  Medical Nutrition  Immunology  Hematology  Metabolics  Molecular  Neuroscience  Point of Care  Oncology  Vascular  Pain Care  Renal Care  Virology 14 | P a g e
  • Fast Facts Abbott Chairman and CEO: Miles D. White Corporate Headquarters: North suburban Chicago, Illinois, USA Stock Exchange Listing: New York [ABT: NYSE] Number of Employees: Approximately 91,000 worldwide 2011 Revenue: $38.9 billion 2011 R&D Investment: $4.1 billion Pharmaceutical Abbott Park and North Chicago, Illinois, USA Research Centers: Worcester, Massachusetts, USA Ludwigshafen, Germany Countries Where More than 130 Products are Sold: Key 2011 Financial Measures Revenue: $38.9B  R&D Investment: $4.1B Net Income: $4.7B  Dividend: 39 years of consecutive increases 15 | P a g e
  • VisionTo be the world’s premier health care companyDedicationTo employees, customers, shareholders, suppliers and the publicStrategyValue Based Management is our integral philosophy, directed towards maximizing long-termcash flow and shareholder value through:  Focus on the Companys core profitable segments to build up our position as one of the leading pharmaceutical companies;  Investments in information technology to improve planning and control of operation;  Increased investments in Human Resources Training & Development to upgrade and broaden the skill base of the organization in consonance with changing needs;  Build flexible cost-efficient manufacturing base through a balanced mix of in-house and contract manufacturingOur Basic PrincipleRespect people: Our people are our strengthThe Work CultureAbbott India is an equal opportunity employer and provides a congenial and professionalwork environment for all its employees, with great emphasis on teamwork. We stimulateinnovation, encourage calculated risk taking and accept mistakes as a part of the learningprocess.We encourage experiential learning, and believe in clear delegation of authority andacceptance of personal accountability. We value the involvement of our colleagues in bringingthe best to our organization in a spirit of understanding, trust and appreciation of culturaldifferences. We are open to discussing alternative views and build on constructive feedback. 16 | P a g e
  • The Abbott Brand PromiseA Promise for LifeTurning Science into CaringWe are here for the people we serve in their pursuit of healthy lives. This has been the way ofAbbott for more than a century – passionately and thoughtfully translating science into lastingcontributions to health.Our products encircle life, from newborns to aging adults, from nutrition and diagnosticsthrough medical care and pharmaceutical therapy.Caring is central to the work we do and defines our responsibility to those we serve:We advance leading-edge science and technologies that hold the potential for significantimprovements to health and to the practice of health care.We value our diversity – that of our products, technologies, markets and people – and believethat diverse perspectives combined with shared goals inspire new ideas and better ways ofaddressing changing health needs.We focus on exceptional performance – a hallmark of Abbott people worldwide – demandingof ourselves and each other because our work impacts peoples lives.We strive to earn the trust of those we serve by committing to the highest standards of quality,excellence in personal relationships, and behavior characterized by honesty, fairness andintegrity.We sustain success – for our business and the people we serve – by staying true to key tenetsupon which our company was founded over a century ago: innovative care and a desire tomake a meaningful difference in all that we do.The promise of our company is in the promise that our work holds for health and life. 17 | P a g e
  • Company History In 1888 at the age of 30, Dr. Wallace C. Abbott, an1885 graduate of the University of Michigan, founded theAbbott Alkaloidal Company. At the time he was a practicingphysician and owned a drug store. His innovation was theuse of the active part of a medicinal plant, generallyan alkaloid (morphine, quinine, strychnine, and codeine),which he formed into tiny pills which he called “dosimetricgranules.” This was successful since it allowed moreconsistent and effective dosages for patients.Abbott Laboratories is one of the oldest and most successful pharmaceutical companies in theUnited States. While about 30 percent of annual revenues come from the sale ofpharmaceuticals--including Abbotts flagship drug, the antibiotic Biaxin--the company has ahigher profile in the area of nutritionals, where its products include leading infant formulabrands Similac and Isomil and a leading adult nutritional brand, Ensure. Abbott is also a topmanufacturer of medical diagnostic equipment, with an emphasis on blood analyzers and thedetection and monitoring of infections and diseases. The firms hospital products unitproduces electronic and injectable drug-delivery systems, intravenous solutions and supplies,anesthetics, and products used in critical care settings. Abbotts annual research anddevelopment budget exceeds $1 billion, with areas of emphasis including AIDS/antivirals,anti-infectives, diabetes, neuroscience, oncology, pediatric pharmaceuticals, urology, andvascular medicine.Early Decades Abbott Laboratories has its origin in the late 19th century in a smallpharmaceutical operation run from the kitchen of a Chicago physician named Wallace CalvinAbbott. As did other physicians of the time, Dr. Abbott commonly prescribed morphine,quinine, strychnine, and codeine--all of which were liquid alkaloid extracts--for his patients.Because they existed only in a liquid form, these drugs were prone to spoilage over time,mitigating their effectiveness as treatments. In 1888, Dr. Abbott heard that a Belgian surgeon 18 | P a g e
  • had developed alkaloids in solid form. Alkaloid pills soon became available in Chicago, butDr. Abbott was dissatisfied with their quality, and he decided to manufacture his own.Dr. Abbott began to advertise his products to other doctors in 1891. So successful was hisbusiness that he eventually sold shares to other doctors and incorporated his operation in 1900as the Abbott Alkaloidal Company. By 1905, annual sales had grown to $200,000. Ten yearslater, the company changed its name to Abbott Laboratories. During World War I, Abbottscompany was essential to the medical community, as several important drugs, manufacturedexclusively by German companies, were no longer available in the United States. Abbottdeveloped procaine, a substitute for the German novocaine, and barbital, a replacement forveneral.After the war, Abbott continued to concentrate on the research and development of new drugs.In 1921, the company established a laboratory in Rocky Mount, North Carolina, whichdeveloped a number of new drugs, including sedatives, tranquilizers, and vitamins. Even afterDr. Abbotts death that year, the company continued to invest heavily in new productdevelopment and aggressive marketing campaigns. The company went public in 1929 with alisting on the Chicago Stock Exchange. Two years later, Abbott expanded outside the UnitedStates for the first time with the establishment of an affiliate in Montreal, Canada.DeWitt Clough was named president of the company in 1933, ending a period of somewhatstale communal leadership. A more dynamic character than any since Dr. Abbott, Clough isbest remembered for the inauguration of the company magazine, Whats New? Thepublication had such a positive impact on worker morale and public opinion that several ofAbbotts competitors started similar publications. In 1936 Abbott began its long-termassociation with anesthetics when it introduced sodium pentothal, which had been developedby Abbott scientists Ernest Volwiler and Donalee Tabern (who in 1986 were named to theU.S. Inventors Hall of Fame for this discovery).During World War II, Abbott once again played an important role in battlefield and hospitalhealthcare. By this time, American pharmaceutical companies such as Abbott were much lessdependent on Germanys companies, particularly the IG Farben--a conglomeration of theworlds most advanced drug manufacturers. After the war, much of the IG Farbens researchwas turned over to American manufacturers. Abbott, however, had little to gain from thisinformation; it was already a worthy competitor on its own. 19 | P a g e
  • After the departure of DeWitt Clough in 1945, Abbott shifted its attention to the developmentof antibiotics. The company developed the antibiotic erythromycin, which, introduced underthe brand names Erythrocin and E.E.S. in 1952, constituted a significant portion of Abbottsprescription drug sales for several decades--even after the expiration of its 17-year patent.Sales of the drug increased dramatically when it was found to be an effective treatment forLegionnaires disease.Abbott stumbled onto a lucrative new product when one of its researchers accidentallydiscovered that a chemical with which he had been working had a sweet taste. The chemical, acyclamate, could be used as an artificial sweetener. Initially, from 1950, it was marketed todiabetics, but in the 1960s, as Americans became more health and diet conscious, it wasincreasingly used as a sugar substitute in a wide variety of foods.In 1964 Abbott completed the first major acquisition in company history when it purchasedColumbus, Ohio-based M & R Dietetic Laboratories. M & R was the manufacturer of Similacbaby formula and over the succeeding decades, as the companys Ross Products Division,formed the basis for Abbotts market-leading infant and adult nutritionals business.Late 1960s and Early 1970s: Diversification and Crises By the mid-1960s, Abbott had gone several years without a majorbreakthrough in research, and none was projected at any time in the immediate future. Then,in 1967, Edward J. Ledder was named president of the company. He advocated a reduction inAbbotts emphasis on pharmaceuticals by diversifying into other fields. In the years thatfollowed, Abbott introduced an array of consumer products, including Pream nondairycreamer, Glad Hands rubber gloves, Faultless golf balls, and Sucaryl, the cyclamate sugarsubstitute. In an effort to ensure the success of Abbotts consumer product line, Ledder placedMelvin Birnbaum, a highly experienced and able manager he had hired away from Revlon, incharge of the division. Ledders policy of diversification laid the groundwork for more flexiblecorporate strategies. No longer exposed exclusively within the pharmaceuticals market,Abbott was able to cross-subsidize failing operations until they could be rehabilitated.Despite this flexibility, Abbott soon realized new obstacles to its growth. The companyshospital products competed in a limited, institutional market. New drugs had greater profitmargins but were subject to government approval procedures that kept companies waiting for 20 | P a g e
  • several years before they could market their discoveries. Consumer products, on the otherhand, involved more expensive marketing and generated less profit than pharmaceuticals.Unable to increase profits without substantial risk, Abbotts management decided to maintainthe strategies that were in place.Cyclamate sales had grown so dramatically that by 1969 they accounted for one-third ofAbbotts consumer product revenues--or about $50 million. The increasing popularity ofcyclamates as an ingredient in diet foods, however, led the Food and Drug Administration(FDA) to conduct an investigation of possible side effects from their overuse. The FDAsresearch was widely criticized as fragmentary and fatally flawed, but it was nonethelessused as evidence that cyclamates were carcinogenic. The market collapsed in August 1970when the FDA banned domestic sales of cyclamates. Abbott, which overnight had suffered theloss of one of its most profitable operations, protested the ban, but was unable to reverse thedecision. Although the company continued to petition the FDA, subsequent studies confirmedthat metabolization of cyclamates can lead to chromosome breakage and bladder cancer.Less than a year after cyclamates were banned, Abbott was forced to recall 3.4 million bottlesof intravenous solution. The bottles were sealed with a varnished paper called Gilsonite,which, it was discovered, harbored bacteria. The contamination was discovered only whenhealthcare workers noticed and then investigated the high incidence of infection in patientswho had been administered Abbotts intravenous solutions. The Center for Disease Controllinked the contaminated solutions to at least 434 infections and 49 deaths. With sales downfrom $17.9 million to $3 million, Abbotts share price began to fall. Abbott moved quickly toreplace its Gilsonite seals with synthetic rubber, but the company was unable to regain itsleadership of the intravenous market. Litigation resulted in the company eventually pleadingno contest to a charge of conspiracy and paying a $1,000 fine.Late 1970s through 1980s: Emphasizing R & D, Nutritionals, Diagnostic Equipment The crises of the early 1970s left the companys upper echelon of managementweakened and vulnerable to criticism. Although Edward Ledder was recognized for thesuccess of his diversification program (and largely excused for his inability to prevent eitherthe cyclamate ban or the intravenous solution crisis), conditions were obviously ripe for theexpression of talent by a new manager. Robert Schoellhorn, a veteran of the chemicalindustry, was just such a manager. His efforts as a vice-president in the hospital products 21 | P a g e
  • division at Abbott resulted in a revenue increase of 139 percent for that division between 1974and 1979. He correctly predicted that the next most profitable trend in healthcare would betoward cost-effective analysis and treatment. Schoellhorn was later promoted to president andchief operating officer of the company. Meantime, in 1977 Abbott entered into a joint venturewith Takeda Chemical Industries, Ltd. of Japan called TAP Pharmaceuticals Inc. for thecodevelopment and comarketing of pharmaceuticals.Abbott Laboratories registered an annual sales growth rate of 15.5 percent and an earningsgrowth rate of 16.5 percent by 1979. This expansion was attributed by financial analysts to thecompanys increased productivity, reduced costs, expansion into foreign markets, and greaterinvolvement in hospital nutritionals and diagnostic testing equipment. The company alsointroduced three new drugs in 1979: Depakene, an anticonvulsant; Tranxene, a mildtranquilizer; and Abbokinase, a treatment for blood clots in the lungs. All three products werethe direct result of the companys increased investment in research and development in themid-1970s.Utilizing its knowledge of intravenous solution production, vitamin therapy, andinfant formula, Abbott developed a comprehensive nutritional therapy program to speed therecovery of hospital patients and thereby reduce medical care costs. In the 1980s, as many as65 percent of all hospital patients suffered from some form of malnutrition, so Abbott washighly successful in marketing their program. Another advantage of adult nutritional productswas that they had a place in the growing home care market.Abbott had similar success marketing its lines of diagnostic equipment. Electronic testingdevices developed by Abbott proved more accurate than manual procedures. In order tostrengthen the technical end of its diagnostic equipment research, Abbott hired two topexecutives away from Texas Instruments to head the division.Robert Schoellhorn, who advanced to chairperson and chief executive officer in 1979,continued to emphasize investment in pharmaceutical research and development in the 1980s.Seven new drugs introduced in 1982 accounted for 17 percent of sales in 1985. Foreignoperations also remained extremely important to Abbott, and the company had more than 75foreign subsidiaries and manufacturing facilities in more than 30 countries. Schoellhorncontinued to support Ledders original diversification policy. The introduction of Murine eye-care products and Selsun Blue dandruff shampoo served to expand the domestic consumerproduct line and promised to provide earning stability in the event of a downturn in any of thecompanys other markets. 22 | P a g e
  • Schoellhorn was also credited with promoting Abbotts emphasis on diagnostic equipment,especially blood analyzers. These devices were increasingly used to detect legal and illegalsubstances in the bloodstream. Abbott led the trend, developing the first diagnostic tests forAcquired Immune Deficiency Syndrome (AIDS), in 1985, and hepatitis. The companysVision blood analyzer fit on a desktop and performed 90 percent of typical blood tests withineight minutes. By the end of the 1980s, sales of blood analysis devices represented a billion-dollar business, and medical diagnostic products (at $2.3 billion per year) constituted nearlyhalf of Abbotts annual sales. Meanwhile, in the pharmaceuticals arena, Abbott in 1987received FDA approval for a new drug called Hytrin for the treatment of hypertension. Hytrinwas approved in 1993 for the treatment of noncancerous enlarged prostate.Schoellhorn was widely praised as the driving force behind Abbotts phenomenal growthduring the 1980s--sales nearly tripled, profits doubled, and the pharmaceutical company roseto 90th from 197th on Fortunes list of the worlds top 500 companies. The leaders aggressivemanagement style, however, often led to conflict. Over the course of the 1980s, threepresidents--James L. Vincent (1981); Kirk Raab (1985); and Jack W. Schuler (1989)--quit. InDecember 1989, Abbotts board of directors unseated Schoellhorn, who in turn sued thecompany for his job. Abbott accused Schoellhorn of misappropriation of company assets andfraudulent conduct, adding that the former CEO exercised stock options worth $9.3 millionwithin days of his release. Schoellhorn was succeeded by Vice-Chairman Duane L. Burnham.1990s and Beyond: New Drug Introductions and Acquisitions Unlike many of its competitors (including Merck, SmithKline Beecham, andEli Lilly), Abbott did not acquire a drug distribution manager in the early 1990s. Instead, thecompany plowed funds into research and development. R & D outlays rose from 5.2 percentof sales in 1982 to more than 10 percent of sales by 1994--by the latter year, R & Dexpenditures neared $1 billion. That year marked the companys 23rd consecutive earnings liftand helped Abbotts stock hold its value better than most competitors in the uncertainhealthcare environment of the early 1990s.Among key developments in the early 1990s was the introduction in 1991 of clorithromycin,an antibiotic developed as a successor to Abbotts erythromycin. Marketed in the UnitedStates under the name Biaxin, clorithromycin was useful in the treatment of common upperrespiratory ailments such as the flu as well as other types of infections. It quickly became 23 | P a g e
  • Abbotts flagship pharmaceutical--eventually achieving $1 billion in annual sales--remainingso into the early 21st century.New product introductions continued in the middle years of the decade. In 1994 Abbottintroduced sevoflurane, an inhalation anesthetic that soon gained popularity because of itswide range of uses. The following year, TAP, the joint venture with Takeda Chemical,received FDA approval for Prevacid, an ulcer treatment (sales of Prevacid reached $1.3 billionby 1998). In 1996 FDA clearance was granted for Norvir, a protease inhibitor for thetreatment of HIV and AIDS.Despite these R & D successes, Abbotts earnings were failing to increase at the high-double-digit rate that they had in the 1980s, and the company was beginning to face the risk of beinggobbled up by a larger rival in the rapidly consolidating healthcare industry of the 1990s.Shrugging off the conservative management of the early 1990s, Abbott moved aggressively inthe second half of the decade to expand via acquisition and thereby stave off being acquireditself. In 1996 Abbott bolstered its diagnostics division through the $867 million purchase ofMediSense, Inc., a Waltham, Massachusetts-based maker of blood-testing devices fordiabetics. This was the companys first major deal since the 1964 acquisition of M & RDietetic Laboratories. In 1997 Abbott spent about $200 million for certain intravenousproduct lines of Sanofi Pharmaceuticals, Inc., the U.S. unit of Frances Sanofi S.A. Included inthis deal was Carpujet, an injectable drug-delivery system based on preloaded, single-dosesyringes. Also in 1997, Abbott suffered a potential setback when Takeda Chemical did notrenew a ten-year contract that gave Abbott the right of first refusal to distribute Takedas newdrugs in the United States via the TAP venture. Takeda had decided to set up its own sales andmarketing organization in the United States. By this time TAP was generating annual sales inexcess of $2 billion, primarily from the marketing of Prevacid and Lupron, a prostate-cancerdrug.By 1997 Abbott had doubled its sales and earnings since Burnham had taken over from theousted Schoellhorn. In early 1998 Burnham announced that he would retire in 1999. At thebeginning of that year, Miles D. White, who had been a senior vice-president in charge of thediagnostics division, took over as CEO. Later in 1999, White was named chairman as well.During the leadership transition period in 1998, Abbott acquired Murex TechnologiesCorporation, a maker of diagnostics products, for $234 million. During 1999, Abbottsappetite for growth increased exponentially with the announcement in June of a deal to 24 | P a g e
  • acquire ALZA Corporation for $7.3 billion in stock. ALZA was a leading producer ofadvanced drug-delivery systems and had a solid pipeline of new pharmaceuticals underdevelopment. The Federal Trade Commission (FTC), however, raised antitrust concerns aboutthe merger, and when the two sides were unable to reach an agreement with the FTC, theycalled off the merger in December. Another possible factor in the collapse of the deal was thedecline in Abbotts stock price following the companys agreement in November to pull 125types of medical-diagnostic test kits off the U.S. market and to pay a $100 million civilpenalty to the U.S. government. Since 1993 the FDA had been issuing warnings to Abbottregarding quality control deficiencies at its test kit plants, with the market withdrawal andpayment of the fine being the outcome of this process. The FDA also cited poormanufacturing controls as the reason for its halting the sales of Abbotts clot-dissolving agentAbbokinase in early 1999.In the meantime, Abbott managed to complete two smaller acquisitions in 1999. It acquiredPerclose, Inc., a maker of sutures used to close arteries during angioplasty procedures, forabout $600 million in stock. Abbott also paid $217 million in cash to Glaxo Wellcome Inc. forfive anesthesia products. In January 2000 Abbott sold its agricultural products business toSumitomo Chemical Co., Ltd. Abbott was now for the first time in decades a pure healthcarefirm. Abbott in April of that year began marketing Biaxin XL, a new once-daily formulationof its flagship Biaxin antibiotic. The FDA in September 2000 granted expedited approval toKaletra, a second-generation AIDS medication developed by Abbott. Kaletra had the potentialto overtake the top AIDS drug, Pfizer Inc.s Viracept, because it had fewer side effects. It alsoappeared that patients did not develop resistance to Kaletra over time, as happened with mostother AIDS drugs, including Viracept. Then in December 2000 Abbott launched anotherattempt at a major acquisition when it reached an agreement to acquire the KnollPharmaceutical Co. unit of German chemical giant BASF AG for $6.9 billion in cash. Onceagain, Abbotts aim was to bolster its product pipeline, and Knoll had at least one potentialblockbuster in a drug called D2E7, an experimental rheumatoid arthritis treatment. Knollsexisting products included Meridia, an obesity drug with annual sales of about $400 million,and Synthroid, a $150 million thyroid drug.In 2010, Abbott Laboratories acquired Piramal Healthcare Ltd.’s branded generic-medicineunit in India for $3.72 billion, making it the country’s biggest drug maker and tapping into amarket expected to more than double by 2015. Abbott said it will pay $2.12 billion upfrontand $400 million annually for four years from 2011 for the unit, which sells retail-ready 25 | P a g e
  • pharmaceuticals in India, Sri Lanka and Nepal. The Abbott Park, Illinois-based company willpay cash for the transaction, expected to close in the second half of 2010.The acquisition is the second-largest takeover in India’s health-care industry and gives Abbotta 7 percent stake in the $8 billion Indian pharmaceutical market. The move fits into Abbott’sstrategy of broadening its business beyond brand-name pharmaceuticals in the U.S. andEurope, where sales are slowing because of generics competition and pricing pressure fromgovernments.In India, the pharmaceutical market is expected to increase as much as 16 percent a yearthrough 2014, according to IMS Health Inc. The $300 billion U.S. market will grow at aslower rate of 3 percent to 6 percent over the same period, said IMS. The slower growth in theU.S. and Europe has Abbott and other drug maker turning toward developing countries toincrease sales. Tokyo-based Daiichi Sankyo Co. bought 64 percent of Ranbaxy LaboratoriesLtd., India’s largest drug maker, for about 488.7 billion yen ($5.45 billion) in 2008, thebiggest takeover in the South Asian nation’s pharmaceutical industry, and Pfizer Inc. has beenlicensing products from Indian generic-drug maker Aurobindo Pharma Ltd.Recognition  FORTUNE: Among "Most Admired Companies," 1984-present  Barrons: Listed No. 29 in 2012 ranking of worlds 100 most respected companies  Barrons: Miles White among world’s 30 "Most Respected CEOs" four straight years  Dow Jones Sustainability Index: Listed among world leaders in economic, environmental and social performance seven straight years  Scrip:2011 award for Leadership in Corporate Social Responsibility  The Deal magazine: Most Admired Corporate Dealmaker in health care four straight years  Working Mother: "100 Best Companies for Working Mothers" 11 straight years  DiversityInc: "50 Best Companies for Diversity" nine straight years  Science and The Scientist magazines: Recognized as a top employer for scientists for many years  Honored for workplace leadership in more than 25 countries 26 | P a g e
  • Key Dates:1888 Dr. Wallace Calvin Abbott begins manufacturing alkaloid pills1900 Abbott incorporates his firm as Abbott Alkaloidal Company1915 Company changes its name to Abbott Laboratories.1929 Abbott goes public with a listing on the Chicago Stock Exchange1936 Company introduces the anesthetic sodium pentothal1952 Company launches a new antibiotic, Erythrocin1964 Abbott acquires M & R Dietetic Laboratories, maker of Similac baby formula New president Edward J. Ledder begins a diversification into consumer products,1967 including Sucaryl, a cyclamate sugar substitute.1970 FDA bans the sale of cyclamates1971 Abbott is forced to recall 3.4 million bottles of intravenous solution Company forms joint venture with Takeda Chemical Industries, Ltd. of Japan1977 called TAP Pharmaceuticals Inc.1985 Abbott develops the first diagnostic test for AIDS.1987 Abbotts Hytrin is approved by the FDA for the treatment of hypertension.1991 Clorithromycin, an antibiotic, is introduced.1996 Abbott acquires MediSense, Inc., a maker of blood-testing devices for diabetics Abbott agrees to acquire ALZA Corporation for $7.3 billion but the deal later1999 collapses; Abbott agrees to pay a $100 million fine relating to quality control problems at its medical test kit plants; suture maker Perclose, Inc. is acquired. FDA approves the AIDS drug Kaletra; Abbott agrees to acquire the Knoll2000 Pharmaceutical Co. unit of BASF AG for $6.9 billion in cash.Abbott India Ltd. History Company was originally incorporated on August 22, 1944 under theCompanies Act, 1913 as Boots Pure Drug Company (India) Limited. Its name was thenchanged to The Boots Company (India) Limited on November 1, 1971, thereafter to BootsPharmaceuticals Limited on January 1, 1991. On October 31, 1995 the name was changed toKnoll Pharmaceuticals Limited, thereafter to Abbott India Limited on July 1, 2002. 27 | P a g e
  • 1944: All shares issued to Boots Pure Drug Co., Ltd. Only 5 shares issued for cash1963: 2,00,000 shares issued to the present Company1965: The Company was incorporated on 15th December On 19th October, the Company entered into a technical collaboration agreement with Boots Pure Drug Co. Ltd., England In December, 2,00,000 shares issued to public (prem. Rs 13 per shares).1969: 25,000 shares issued at par to L.I.C., U.T.I. and I.C.I.C.I. on conversion of 5% debenture holdings1976: The Company undertook to set up a new chemical plant at Ahmednagar, a backward area in Maharashtra, for the manufacture of Ibuprofen from the basic stage in technical collaboration with its parent company. Ibuprofen is a raw material of Boots original research1977: 1,48,150 Right Equity shares issued to Indian shareholders (prem. Rs 3.50 per shares: prop. 2:9)1979: 2,66,050 Bonus shares issued in prop. 1:31983: The Company issued 1,70,000-15% non-convertible debentures of Rs 100 each. These debentures were redeemed on 5th October, 1990 at a premium of Rs 5 per debenture The Company also issued 4,27,290 No. of Equity shares of Rs 10 each at a premium of Rs 45 per share as rights to resident Indian equity shareholders The object of rights issue and offer for sale was to reduce the holding of Boots Company PLC, England in the Company from 53% to 40%.1984: 13,58,520 Bonus equity shares issued in prop.3:51986: 4,27,280 new equity shares were offered as Rights to the resident Indian equity shareholders at a premium of Rs 45 per shares1987: The Company received a letter of intent for both the products and the expansion capacity of Ibuprofen was being implemented 40,50,000 bonus equity shares issued in prop. 1:11988: The Company undertook a project to set up a new formulation factory at Jejuri in Pune district1989: A number of new products, namely Brufen Junior Syrup, Chota Strepsils Icy, Optrex Eye Lotion, Highly Purified Insulins and Nausidome were launched during the year 28 | P a g e
  • 1994: Products such as Novopen, Human mixtard, Mixtard penfills were launched Beem Healthcare Ltd., Lenbrook Pharmaceuticals Ltd. and Valencia Pharmaceuticals Ltd are the subsidiaries of the Company1995: It is proposed to change the name of the company to Knoll Pharceuticals Ltd. effective 31st October, name was changed to Knoll Pharmaceuticals Ltd.1997: The Company has acquired the product Epilex for a total consideration of Rs 9.90 crores. The product is used in the treatment of epilepsy The new Goa plant of Knoll Pharmaceuticals, a part of the BASF group, has been set up. BASF India has also set up two state-of-the-art plants to manufacture speciality dyes and dispersons in Mangalore and these were commissioned.1998: Lupharma GmbH, a wholly-owned subsidiary of Knoll AG of Germany, had made a public offer for acquisition of a further 11 percent holding in Knoll Pharmaceut- icals in order to take its stake up to 51 percent from the current levels of 40 percent1999: Beem Healthcare which was engaged in marketing of consumer brands has been merged with Knoll with effect with July 1998 Knoll Pharma has entered into a three-way pact with the Gujarat-based Torrent Pharmaceuticals and Danish giant, Novo Nordisk, in the anti-diabetes segment2000: The Company has entered into a agreement with Kalpataru Homes for the assignment of the leasehold Ranbaxy Laboratories Ltd has entered into an agreement with Knoll Pharmaceutic- als Ltd to market the latters leading brands in select overseas markets2001: Lupharma UK Holding One Ltd., a wholly-owned subsidiary of Lupharma GmbH has proposed to acquire 82,62,000 shares i.e. 51 per cent of the share capital of Knoll Pharmaceuticals from Lupharma Gmbh2002: Knoll Pharmaceuticals, the maker of popular painkiller Brufen, has changed its name to Abbott India following global takeover of Knolls majority stakeholder - German firm BASF Pharma - by US drug major Abbott Laboratories2003: Mr V D Narkar, Director of Abbott India Ltd, has resigned with effect from June 19, 2003 Mr.Ashok Dayal is appointed as Additional Director of the company Scheme of amalgamation of Lenbrook Pharmaceuticals (a wholly owned subsidi- ary of the company) with the company2008: Abbott India Ltd has informed that the Board of Directors of the Company at its meeting held on February 14, 2008, has appointed Mr. Thomas Dee as the Additional Director of the Company2010: Abbott Laboratories bought Piramal Healthcare Ltd.’s branded generic-medicine unit in India 29 | P a g e
  • Competition Overview Competition is mainly from the domestic manufacturers and imports fromChina because of the low manufacturing cost. With the new patent regulations the industryexpects to see a major structural shift with the entry of foreign pharmaceutical manufacturers.There are five government-owned companies the Indian public sector. These companies arethe Indian Drugs and Pharmaceuticals, Hindustan Antibiotics Limited, Bengal Chemicals andPharmaceuticals Limited, Bengal Immunity Limited and Smith Stanistreet PharmaceuticalsLimited. Some of the major Indian private companies are Alembic Chemicals, AurobindoPharma, Ambalal Sharabhai Limited, Cadila Healthcare, Cipla, Dr. Reddy’s, IPCALaboratories, Jagsonpal Pharma, J.B. Chemicals, Kopran, Lupin Labs, Lyka Labs, NicholasPiramal, Ranbaxy Labs, Matrix Laboratories, Orchid Chemical and Pharmaceuticals, SunPharmaceuticals, Ranbaxy Laboratories, Torrent Pharma, TTK Healthcare, Unichem Labs,and Wockhardt. The foreign companies in India include Abott India, Astra Zeneca India,Aventis Pharma India, Burrough-Wellcome, Glaxo SmithKline, Merck India, Novartis, PfizerLimited, and Wyeth Ledele India.Top 10 Publicly Listed Life Science companies in India, as of 2011Rank Company Name Revenue 2011(USD million)1 Abbott India Ltd. 1348.512 Ranbaxy 1327.563 Dr. Reddys Laboratories 11784 Lupin Ltd 929.845 Aurobindo Pharma 865.196 Dabur 700.37 Sun Pharmaceutical 673.998 Cadila Healthcare 629.459 Jubilant Life sciences 561.0310 GlaxoSmithKline Pharmaceuticals Ltd 475.8 30 | P a g e
  • CHAPTER 2Research Methodology 31 | P a g e
  • OBJECTIVE & SCOPE OF STUDYObjective of the StudyThe main objective to conduct this research is to understand the Neuromuscular Blocker(NMB) market & develop the medical positioning for new product launch i.e. CisatracuriumPrimary Objective  To study and understand the concept and process of marketing research.  To understand and get the concept of Marketing of Pharmaceutical products  To get the practical implication of the process involved in any product launchScope of the StudyThe project scope involves the study of the Anesthetists’ armamentarium of drugs.Understand the Neuromuscular Blocker (NMB) category, their mechanism of action andclinical use of NMBs & their place in therapy. The project scope also involves the finding ofclinician preferences in current NMBs available with the marketing research and developing amedical positioning for Cisatracurium from the above collected data.Managerial Usefulness of the StudyThis study helps to understand marketing research basic terminologies & different strategiesfor different market situationTypes of Research and Research Design  Quantative Research- Quantitative research generates numerical data or information that can be converted into numbers. Only measurable data are being gathered and analyzed in this type of research.  Qualitative Research- Qualitative Research on the other hand generates non- numerical data. It focuses on gathering of mainly verbal data rather than measurements. Gathered information is then analyzed in an interpretative manner, subjective, impressionistic or even diagnostic 32 | P a g e
  • Research Methodology  A questionnaire was prepared to gauge the awareness of new molecule in customer.  Survey has been done out of the company covering a wide cross-section of the industry.  The question was presented in one to one interview with each of the respondents.  Responses of the concerned persons had been thoroughly analyzed.  Conclusions had been arrived at using the response of the concerned persons and not on questionnaire alone.Generally speaking, doctors are most reserve persons on the planet and they are not flatteredby attention and this sometimes overcomes any inhibitions so that matters quite secret areparaded before the observer with seeming abandon. At other times, particularly where an issuehas been the subject of recent press attention, the shutters go up and there is no way in. Allyou can do in such circumstances is to give up and try something else likely to be moreproductive - you havent the time to spend on lengthy negotiation. Crucial to the business ofinitially gaining access is the whole matter of assurances of confidentiality, anonymity, etc,which I consider below. Your stance, once granted access, depends on how much of an activeparticipant you want to be in the arena you are observing - the more obviously committed youare to one particular stance or ideology the more others will take this into account whenrevealing their thoughts or their actions to you.In this context the questionnaire was not a fully fledged one and was made with an intentionof getting the main information as doctors don’t have that much time to spare and also a longquestionnaire may irritate them. So the questionnaire used in my research was really crisp andwas aimed at getting the required information in the least time, also the questionnaire wasused for primary purpose only. 33 | P a g e
  • Research DesignResearch design specifies the methods and procedures for conducting a particular study. Aresearch design is the arrangement of conditions for collection and analysis of the data in amanner that aims to combine relevance to their search purpose with economy in procedure.Research design is broadly classified into three types as:  Exploratory Research Design  Descriptive Research Design  Causal Research DesignDescriptive Research DesignDescriptive research studies are those studies which are concerned with described thecharacteristics of particular individual. In descriptive as well as in diagnostic studies, theresearcher must be able to define clearly, what he wants to measure and must find adequatemethods for measuring it along with a clear cut definition of population he want to study.Since the aim is to obtain complete and accurate information in the said studies, the procedureto be used must be carefully planned. The research design must make enough provision forprotection against bias and must maximize reliability, with due concern for the economicalcompletion of the research study.SAMPLE DESIGNA Sample Design is a definite plan for obtaining a sample from a given population. It refers tothe technique to the procedure adopted in selecting items for the sampling designs are asbelow:SAMPLE SIZEThe sample size has been 40 doctors. Conclusions had been arrived at using the response ofthe questionnaire.SAMPLING METHODIn this marketing research project, I am using Random sampling method.SAMPLE TYPEArea Sampling, and the area of sampling is Mumbai & Pune. 34 | P a g e
  • Data Collection Method  Primary Data: - Primary data means data that are collected by different techniques like questionnaire, Depth interview, Survey, Schedules etc. In this project, primary data has been collected by the means of questionnaire.  Secondary Data: - Secondary data means data that are already available i.e.: they refer to the data which have already been collected and analyzed by someone else. Usually published data are available in: Various publications of the central, state/local governments or foreign governments, technical and trade journals etc. The secondary data involved in this project has been gathered from the medical journals, literatures and internet. 35 | P a g e
  • Limitation of the Study The sample area and sample size has been limited due to time constraint. Doctors (respondents) are reluctant for their feedbacks & opinions, and authenticity of their statements can’t be verified too. All the observation and recommendation will be made on the feedback obtained from survey. 36 | P a g e
  • CHAPTER 3Conceptual Discussion 37 | P a g e
  • About The ProductNIMBEX® (Cisatracurium besylate) NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal muscle relaxant forintravenous administration. Compared to other neuromuscular blocking agents, it isintermediate in its onset and duration of action. Cisatracurium besylate is one of 10 isomers ofatracurium besylate and constitutes approximately 15% of that mixture.AbstractCisatracurium is a neuromuscular-blocking drug or skeletal muscle relaxant in the category ofnon-depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to facilitateendotracheal intubation and to provide skeletal muscle relaxation during surgery ormechanical ventilation. It is a bisbenzyltetrahydroisoquinolinium agent with an intermediateduration of action.It is the R-cis, R-cis isomer of atracurium besilate and is approximately 3-fold more potentthan the mixture of isomers that constitute the parent drug. The ED95 for cisatracuriumbesilate (dose required to produce 95% suppression of twitch response to nerve stimulation) inadults is 0.05 mg/kg during N2O/O2 opioid anaesthesia. As for atracurium besilate, theprimary route of elimination of cisatracurium besilate is by spontaneous degradation.Cisatracurium besilate is not associated with dose-related histamine release (at bolus doses of< or = 8 x ED95) and, consistent with this, has demonstrated cardiovascular stability in bothhealthy patients (< or = 8 x ED95) and those with coronary artery disease (< or = 6 x ED95).In clinical trials, cisatracurium besilate has been used successfully to facilitate intubation (at 2to 4 x ED95) and as a muscle relaxant during surgery and in intensive care. Compared withvecuronium, cisatracurium besilate was associated with a significantly faster recovery aftercontinuous infusion in patients in intensive care. Relative to atracurium besilate, cisatracuriumbesilate has a lower propensity to cause histamine release is more potent but has a slightlylonger onset time at equipotent doses. It also offers a more predictable recovery profile thanvecuronium after prolonged use in patients in intensive care. Thus, comparative data providesome indication of the potential of cisatracurium besilate as an intermediate-durationneuromuscular blocking agent but further comparisons with other like agents are required todefine precisely its relative merits. 38 | P a g e
  • Current Issue/NewsMarch 21, 2012Abbott Selects AbbVie as New Name for Future Research-Based PharmaceuticalCompany  Company Remains on Track for Separation into Two Publicly Traded Global Health Care Companies by End of 2012Abbott Park, Illinois (NYSE: ABT) — Abbott today announced that AbbVie [pronouncedAbb-vee] will be the name of the new, independent research-based pharmaceutical company itexpects to launch by the end of 2012.The naming of the new company is the latest milestone in the process that began in October2011, when Abbott announced it would separate into two publicly traded companies, one indiversified medical products and the other in research-based pharmaceuticals. AbbVie, theresearch-based pharmaceutical company, will include Abbott’s current portfolio of leadingproprietary pharmaceuticals and biologics. The diversified medical products company, whichwill retain the Abbott name, will consist of Abbott’s existing diversified medical productsportfolio, including its branded generic pharmaceutical, devices, diagnostics and nutritionalbusinesses. Both companies will be global leaders in their respective industries.Miles D. White will remain chairman and CEO of Abbott. Richard A. Gonzalez, currentlyexecutive vice president, Global Pharmaceuticals, will become chairman and CEO of AbbVie.The name is derived from a combination of Abbott and "vie," which references the Latin root"vi" meaning life."The beginning of the name connects the new company to Abbott and its heritage ofpioneering science," said Mr. Gonzalez. "The vie calls attention to the vital work thecompany will continue to advance to improve the lives of people around the world." 39 | P a g e
  • "With a powerful family of products and a continued focus on breakthrough innovationstargeting some of the most critical medical needs, AbbVie will be positioned to delivermarket-leading performance and better health for patients," said Mr. White.The research-based pharmaceutical company has nearly $18 billion in annual revenue todayand will have a sustainable portfolio of market-leading brands, including Humira, Lupron,Synagis, Kaletra, Creon and Synthroid. An attractive pipeline of innovative R&D assets – inimportant specialty therapeutic areas such as Hepatitis C, immunology, chronic kidneydisease, womens health, oncology and neuroscience – will help drive future growth.The AbbVie logo and graphic identity will be unveiled when the new company is launched.May 03, 2012Abbott Announces Collaboration with Syngene to Open First Nutrition R&DCenter in IndiaMumbaiand Bangalore, India — Abbott (NYSE: ABT), one of Indias largest health carecompanies, today announced plans to establish its first nutrition research and developmentcenter in the country in collaboration with Syngene, Indias leading contract researchorganization. The Abbott Nutrition R&D Center in India will focus on the development ofscience-based, affordable nutrition products for the country and enable the expansion ofAbbotts nutrition product portfolio there.Abbott selected Syngene – a subsidiary of Biocon, the largest biotech company in India – toprovide a science-based research and innovation team to work closely with Abbottresearchers. More than 50 researchers and scientists will be based at the Abbott NutritionR&D Center in India at Biocon Park in Bangalore, which is expected to open in June 2012.The new R&D center will focus on the development of nutrition products for maternal andchild nutrition and diabetes care. Preventing undernutrition has emerged as one of the mostcritical health challenges in India. An estimated 50 percent of Indians (570 million people)have adequate calorie intake but are not consuming a sufficient level of essential nutrients.1India also has the worlds largest diabetes population, with an estimated 51 million people 40 | P a g e
  • living with diabetes.2 Among the products being developed for the Indian market are mealcomplements for diabetics and pre-diabetics. In addition, the center will address local tasteand texture preferences with new flavors and formulations."India is a priority market for investment, growth and innovation," said Robert H. Miller,Ph.D., divisional vice president, Global R&D and Scientific Affairs for Abbott Nutrition."Our strategic collaboration with Syngene will accelerate the design, development anddelivery of science-based, affordable nutrition products in India, for India.""Health care in India has reached a tipping point as patients seek quality care and products ataffordable prices," said Rehan Khan, managing director, Abbott Nutrition India. "We haveconsistently invested in India, and this world-class R&D center will allow us to leverage localexpertise and insights to develop the products we need to successfully expand our portfoliohere."The nutrition market in India is relatively new and growing steadily. In addition to theundernutrition and diabetes issues facing India, a rapidly expanding middle class and agingpopulation are driving increased demand in the country for high-quality, affordable nutritionproducts."With malnutrition and common chronic diseases at their highest in this region, Abbott andSyngene have a common vision and commitment to support the development of a healthierIndia," said Kiran Mazumdar-Shaw, founder, chairman and managing director, Biocon Group."The combined market insights and nutrition science expertise of our two organizations willenable us to address these immediate needs by developing critically important, innovative yetaffordable nutrition products for the Indian population."Commenting on the collaboration, Peter Bains, director, Syngene & Clinigene, said, "We areextremely delighted to partner with Abbott for this synergistic collaboration for its nutritionbusiness. Our objective will be to develop new products for Abbotts nutrition portfolio. Thissymbolizes Syngenes growing capability to offer science-based research and developmentsolutions across a wide range of life science platforms." 41 | P a g e
  • About AbbottAbbott (NYSE: ABT) is a global, broad-based health care company devoted to the discovery,development, manufacture and marketing of pharmaceuticals and medical products, includingnutritionals, devices and diagnostics. The company employs approximately 91,000 people andmarkets its products in more than 130 countries. Abbott currently employs more than 12,000people throughout India.About Abbott NutritionFor more than 85 years, Abbott Nutrition has been developing and marketing science-basedpediatric and adult nutritional products to support the growth, health and well-being of peopleof all ages. Abbott offers a variety of nutritional products in India including PediaSure®(complete, balanced nutrition for children), Similac® (infant milk formula for infants andchildren), Mamas Best® (nutritional supplement for pregnant and breastfeeding mothers),Ensure® (adult nutritionals), Glucerna® (nutrition for people with diabetes) and Prosure®(nutrition for people with cancer).About Biocon LimitedBiocon Limited (BSE code: 532523, NSE Id: BIOCON, ISIN Id: INE376G01013) is Indiaspremier biopharma enterprise focused on innovation to deliver affordable health care solutionsto patients, partners and health care systems across the globe. Established in 1978 by Ms.Kiran Mazumdar-Shaw, Biocon is committed to reduce therapy costs of chronic diseases likediabetes, cancer and autoimmune diseases to provide access to affordable treatment to patientsglobally. Biocons key innovations include the worlds first Pichia-based recombinant humanInsulin, INSUGEN®, insulin analog Glargine, BASALOG® and Indias first indigenouslyproduced monoclonal antibody, BioMAb-EGFR®, for head & neck cancer. INSUPen® is anext-generation affordable insulin delivery device introduced in India. With a risk-balancedbusiness model comprising small molecules, novel molecules, biosimilars, brandedformulations and research services, Biocon has evolved into an emerging global enterpriseserving its partners and customers in over 70 countries.More information is available at www.biocon.com 42 | P a g e
  • About Syngene International LimitedSyngene is Indias leading contract research organization offering integrated drug discoveryand development services with capabilities in medicinal chemistry, biology, in vivopharmacology, toxicology, custom synthesis, process Research and Development, andformulation development for small and large molecules. Syngene has an expert team of over1,500 scientists and 1 million sq. ft. of built-up laboratories equipped with state-of-the-artinfrastructure to support the Research and Development programs of global pharma, biotechand nutrition companies. More information is available at www.syngeneintl.com. 43 | P a g e
  • CHAPTER 4 Data Analysis 44 | P a g e
  • METHODS & TECHNIQUES OF DATA ANALYSISData Analysis ConceptData analysis is a practice in which raw data is ordered and organized so that usefulinformation can be extracted from it. The process of organizing and thinking about data is keyto understanding what the data does and does not contain. There are a variety of ways inwhich people can approach data analysis, and it is notoriously easy to manipulate data duringthe analysis phase to push certain conclusions or agendas. For this reason, it is important topay attention when data analysis is presented, and to think critically about the data and theconclusions which were drawn.Raw data can take a variety of forms, including measurements, survey responses, andobservations. In its raw form, this information can be incredibly useful, but alsooverwhelming. Over the course of the data analysis process, the raw data is ordered in a waywhich will be useful. For example, survey results may be tallied, so that people can see at aglance how many people answered the survey, and how people responded to specificquestions.In the course of organizing the data, trends often emerge; modeling the data with the use ofmathematics and other tools can sometimes exaggerate such points of interest in the data,making them easier for the researcher to see. Charts, graphs, and textual writeups of data areall forms of data analysis. These methods are designed to refine and distill the data so thatreaders can glean interesting information without needing to sort through all of the data ontheir own. 45 | P a g e
  • Data Analysis processOnce the necessary data collected, the next task is to aggregate the data in a meaningfulmanner. A number of tables are prepared to bring out the main characteristics of the data. Theresearcher should have a well thought out framework for processing and analyzing data, andthis should be done prior to the collection.It includes the following activities: I. Editing The first task in data processing is the editing. Editing is the process of examining errors and omissions in the collected data and making necessary corrections in the same. II. Coding Coding is necessary to carry out the subsequent operations of tabulating and analyzing data. If coding is not done, it will not be possible to reduce a large number of heterogeneous data into meaningful categories with the result that the analysis of data would be weak and ineffective, and without proper focus. III. Tabulation Tabulation comprises sorting of the data into different categories and counting the number of cases that belong to each category. This is also called universal tabulation. The analysis based on just one variable is obviously meager. Where two or more variables are involved in tabulation, it is called vicariate or multivariate tabulation. IV. Analysis After the all three above steps, the most important step is analysis of the data. 46 | P a g e
  • DETAIL ANALYSISOBJECTIVE 1: NMB Molecule Practiced by DoctorsIn the process of market survey, the first thing to determine was to find out the NeuromuscularBlocker (NMB) preferred by the doctors in their clinical practice. Out of those visited, theinformation has been collected and it has been noticed that though most of the Doctorspreferred one or more available NMB molecule.Hence, in order to find out the actual figure for the preference of the available NMB, thecriteria has been set to find out the actual preference of the NMB by doctors.This is done by maintaining the criteria for NMB preference by doctors, if the percentage ofconsumption of the particular molecule is 50 % or more than only it is counted in thefollowing chart: Preference of NMB in Clinical Practice 16% 19% Atracurium 65% Vecuronium Rocuronium Chart 1: Most Commonly Prefered NMB agent in Clinical Practice 47 | P a g e
  • INFERENCE  65% of doctors Preferred Atracurim than any other available molecule and their percentage of consumption ranged above 50% to 90%, some of them were using 100% only Atracurium  The 2nd and 3rd preference by doctors were consecutively Vecuronium and Rocuronium, with 19% and 16% respectively  Other molecules, like Pancuronium & Succinylcholine too stand in the preferred list of molecules but their percentage of consumption is too less to be considered in the above chart. Preference of NMB in Clinical Practice (Mumbai Region) 21% Atracurium 11% Vecuronium 68% Rocuronium Chart 2: Preference of NMB in Clinical Practice (Mumbai Region) 48 | P a g e
  • Preference Of NMB in Clinical Practice (Pune Region) 9% Atracurium 33% 58% Vecuronium Rocuronium Chart 3: Preference of NMB in Clinical Practice (Pune Region)INFERENCE  From the above chart, it is quite obvious that Atracurium is the most preferred molecule in both Pune & Mumbai Region.  But, another fact noticed here is that Rocuronium is the 2nd best preferred and consumed in Mumbai, while it is Vecuronium in the case of Pune. 49 | P a g e
  • 90% 80% 77% 74% 70% 60% 55% 50% 40% 30% 22% 23% 20% 16% 16% 10% 10% 7% 0% Atracurium Vecuronium Rocuronium < 30 % of Consumption 30 - 60 % of Consumption > 60 % of Consumption Chart 4: % of Distribution % of Consumption of different NMBINFERENCE  The above Chart gives the clear view of the actual percentage of consumption of each molecule.  As seen above, Atracurium is the most preferred as well as most consumed molecule compared to Vecuronium & Rocuronium,  55% of doctors have higher degree of consumption of Atracurium, i.e. - more than 60%. While in the case of both Vecuronium and Rocuronium, only less than 20% of doctor’s consumption value ranges in the same category.  Again, from the chart it can be easily determined that Vecuronium has edge over the Rocuronium in terms of consumption which lies between 30-60%.  Pancuronium is no more practiced in the GA procedures. Only one or two cases were found where Pancuronium is still being practiced, but in very few cases.  Apart from this, Succinylcholine is used in the most of GA procedures, but its use is mostly restricted to the intubation cases or difficult airway cases. 50 | P a g e
  • OBJECTIVE 2: Characteristics doctors prefer in an ideal NMBIn the process of marketing survey, the most important task was to gather the informationregarding the characteristics which doctors expect in an ideal Neuromuscular Blocker (NMB).For this a set of characteristics was prepared and while interaction with doctors, they wereasked to number them in accordance to their preference which they consider most importantin the NMB.After the detailed analysis of the information collected, the following table has been tabulatedto form the facts desired:Table 1: Percentage of Doctors and their Preference (Mumbai Region) Preference of Characters- tics in an ideal NMB 1 2 3 4 5Onset of Action 35% 30% 13% 13% 9%Duration of Action - 9% 17% 48% 26%Safety 52% 39% 5% 4% -Recovery Time 9% 13% 52% 13% 13%Potency 4% 9% 13% 22% 52%With respect to above table it can be concluded that, in Mumbai doctors prefer the followingcharacteristics in an ideal NMB.(The list given below is in ascending order) 1. Safety 2. Onset Of Action 3. Recovery Time 4. Duration of Action 5. Potency 51 | P a g e
  • Table 2: Percentage of Doctors and their Preference (Pune Region) Preference of Characters- tics in an ideal NMB 1 2 3 4 5Onset of Action 14% 36% 7% 29% 14%Duration of Action 7% 29% 43% 14% 7%Safety 79% 14% 7% - -Recovery Time - - 29% 50% 21%Potency - 22% 14% 7% 57%With respect to above table it can be concluded that, in Pune doctors prefer the followingcharacteristics in an ideal NMB.(The list given below is in ascending order) 1. Safety 2. Onset Of Action 3. Duration of Action 4. Recovery Time 5. PotencyINFERENCE  From the data collected, it can be easily figured out that Safety is the most important characteristics that doctors seek in any molecule, while Potency is the least important characteristics in the list.  But, there is variation in the sequence of preference of the characteristics in an ideal NMB in Mumbai and Pune area  Considering the above facts now the data is further compiled and analyzed to get a real picture of the preference. 52 | P a g e
  • Table 3: Overall % of Doctors and their Preference of Characteristics Preference of Characters- tics in an ideal NMB 1 2 3 4 5Onset of Action 27% 32% 11% 19% 11%Duration of Action 3% 16% 27% 35% 19%Safety 62% 30% 5% 3% -Recovery 5% 8% 44% 27% 16%Potency 3% 13% 14% 16% 54%With respect to above table it can be concluded that, doctors prefer the following character-istics in an ideal NMB (the list given below is in ascending order): 1. Safety 2. Onset Of Action 3. Recovery Time 4. Duration of Action 5. PotencyOn compilation of entire sample size, it is now clear that Safety is the most important elementin the molecule which doctors values most, followed by Onset of action, Recovery Time,Duration of Action and last Potency.Out of the whole sample size, 62% of the sample space considers ‘Safety’ to be most idealcharacteristics in NMB. 53 | P a g e
  • OBJECTIVE 3: Parameters that best describes the NMB MoleculeThe five characteristics that make a molecule an ideal NMB are: Safety, Onset of action,Recovery time, Duration of action & Potency. Now, another task in the survey is out of thesecharacteristics which characteristics best describes the available NMB molecule.For this, simple survey technique of multiple choices has been adapted and after the detailedanalysis of the collected data following output has been derived: Onset Of Action Atracurium Pancuronium 6% 3% Succinylcholine Rocuronium 47% 44% Chart 5: Best positioning of NMB with Onset of Action 54 | P a g e
  • Duration Of Action Succinylcholine 3% Pancuronium Rocuronium 22% 17%Vecuronium 25% Atracurium 33% Chart 6: Best positioning of NMB with Duration of Action Recovery Time Rocuronium 22% Succinylcholine 6% Cisatracurium 5% Atracurium 67% Chart 7: Best positioning of NMB with Recovery Time 55 | P a g e
  • Safety Rocuronium 19% Cisatracurium 11%Vecuronium 28% Atracurium 42% Chart 8: Best positioning of NMB with Safety Potency Pancuronium 8% Vecuronium Atracurium 33% 14% Rocuronium 42% Succinylecholine 3% Chart 9: Best positioning of NMB with Potency 56 | P a g e
  • 70% 60% 50% % of Doctors 40% 30% 20% 10% 0% Atracurium Rocuroniu Vecuroniu Succinylch Pancuroni Cisatracuri m m oline um um Onset of Action 6% 44% 0% 47% 3% 0% Duration Of Action 33% 17% 25% 3% 22% 0% Recovery Time 67% 22% 0% 6% 0% 5% Safety 42% 19% 28% 0% 0% 11% Potency 14% 42% 33% 3% 8% 0% Chart 10: Overall % of doctors supporting NMB with its best attributeINFERENCEFrom the above chart the positioning of the molecules can be easily derived.  While considering the Safety aspect of NMB, 42% doctors consider Atracurium as the safest NMB followed by Vecuronium & Rocuronium.  47% of doctors are with Succinylcholine & 44% of doctors are with Rocuronium, in terms of onset of action.  In terms of recovery time, 67% of doctors consider Atracurium the best neuromuscular agent.  With the 42% of doctors supporting Rocuronium, it is considered the most potent NMB agent.  Most interesting fact came in the study is that, before the launch of Cisatracurium- it has positioned itself as the safe molecule and also holds a position with good recovery time. 57 | P a g e
  • OBJECTIVE 4: Preference of NMB with following ParametersThough preference of molecule in GA procedures has been determined earlier, it is evident tofind out whether the use of that molecule is independent of surgery duration or not. Hence, theparameter has been set to find out the desired facts.All the surgery procedure has been classified into three parts: - < 30 minutes - 30 - 60 minutes - > 60 minutesIn the process of survey, further remarks were collected from doctors for the use of themolecule. Though no. of vials used for the single surgical procedure couldn’t be determined. < 30 minutes Surgery Procedure Vecuronium Succylincholine 3% 5% Rocuronium 5% Atracurium 87% Chart 11: Preference of NMB in <30 minutes GA procedures  Atracurium is the most commonly used molecule in less than < 30 minutes surgery procedure.  Vecuronium is the least preferred molecule with the above parameters. 58 | P a g e
  • 30 - 60 minutes Surgey Procedure Pancuronium 13%Rocuronium 3% Vecuronium Atracurium 26% 58% Chart 12: Preference of NMB in 30-60 minutes GA procedures > 60 minutes Surgery Procedure Pancuronium 3% Atracurium 32% Rocuronium 39% Vecuronium 26% Chart 13: Preference of NMB in >60 minutes GA procedures 59 | P a g e
  • INFERENCE  From the above chart, it is evident that 87% doctors prefer Atracurium in <30 minute surgery while only 58% doctors prefer Atracurium in 30-60 min. surgery procedure.  But, the percentage is quiet low in case of >60 minute surgery. Only 32% doctors prefer Atracurium in long surgery procedure.  The positioning of Rocuronium is best in terms of long surgery procedures with an hour or more than that. 39% of doctors prefer Rocuronium over other molecule in >60 minute surgery procedures.  Vecuronium is the second most preferred molecule in the 30-60 minutes surgery procedure.  Though Pancuronium is very less in clinical practice these days. But still 13% of doctors prefer it in 30-60 minutes procedures.  From the above facts, it is quite clear that choice of NMB in GA is also dependent of the surgery duration.Remarks Sited by Doctors for their Preference of NMB Succinylcholine  Recovery is complete & good Pancuronium  Longer acting Rocuronium  Duration  Safe  Better relaxant  No repetition  Longer duration of action 60 | P a g e
  • Atracurium Short Acting, Less recovery time Short duration & safe Early and easy Recovery No histamine release Best for kidney & liver dysfunction, renal disease Ultra short acting & self reversal Good relaxation & cardiostable Only short acting muscle relaxant available No residual blockade Recovery is good Alter the duration by using in DIP Adaptable for any duration Can be used for intubation Vecuronium No cardiac effect Longer duration of action Intermediate acting Cardiostable & Potent NMB agent Top ups needed after some reasonable period Potency & Safety 61 | P a g e
  • OBJECTIVE 5: Use of Reversal AgentDoctors use the reversal agent in all the cases, has been the common belief for years. Hence,in order to determine the actual fact regarding this it is essential to directly interact withdoctors and collect the needful information. What has been basic motive behind using thereversal agent?With all such questions, after the analysis correct fact and figure has been derived: Need of Reversal Agent in GA Procedures 21% Yes No 79% Chart 14: Distribution of Doctors that prefer Reversal Agent 62 | P a g e
  • 100% 16% 16% 90% 24% 80% 70% 63% 60% 92% 50% 84% 84% 40% 76% 30% 20% 37% 10% 8% 0% Atracurium Rocuronium Vecuronium #Cisatracurium Succinylcholine Yes NO Chart 15: Distribution of NMB Agents with their % of Need of Reversal AgentNote: - In terms of Cisatracurium, most of the doctors resisted in providing opinions about itsince they weren’t using it. Hence, total sample size is only 16 in the case of Cisatracurium.Out of which, 63% of doctors believed it don’t any reversal agent.Reasons for the Need of Reversal Agent as mentioned by Doctors  The patient should be reversed even though it is a self reversal agent, to rule out residual blockade if any.  There has been common belief that, reverse all patients.  Used to be sure of reversal  Hoffman’s elimination  Just as a safety, major though not mandatory  Cannot avoid reversal 63 | P a g e
  • Major findings from the above analysis and chart can be concluded as: -  79% of doctors have a belief that a patient must be reversed, even though if it is a self reversal agent.  Though, it is not true in the case of Succinylcholine, 92% don’t use any reversal agent with it.  Compared to Rocuronium & Vecuronium, Atracurium has better positioning as self reversal agent as only 76% of doctors use reversal if Atracurium has been used in GA.  Rocuronium & Vecuronium stands at similar situation having 84% doctors using reversal while used in GA.  Most important concept in the analysis came out as, Cisatracurium is considered as self reversal agent as likes of Succinylcholine.  63% doctors believe it doesn’t need any reversal. 64 | P a g e
  • OBJECTIVE 6: Determination of Intubation & Maintenance NMBIn the process of marketing survey, it is essential to determine whether doctors prefer thesame Neuromuscular Blocking Agent for intubation as well as in maintenance. The mainpurpose of finding this is to know whether doctors use different combination of drugs insurgical procedure. If yes, what possible combination they follow.In the course of analysis, it came to notice that not all the doctors use different combination ofmolecule. Mostly, the surgery is initiated by using Succinylcholine in intubation and followedby any other available NMB agent. The finding of analysis is as: 24% Different NMB 76% Same NMB Agent 0% 10% 20% 30% 40% 50% 60% 70% 80% % of Doctors Using Same NMB Chart 16: Percentage of Doctors using same relaxant in GA proceduresSince, percentage of doctors using the different NMB molecule in intubation andmaintenance is very low but most of doctors still mix the molecule as per the patient norms.Mostly, it depends on the type of surgery and the criticality of the case. Availability ofmolecule also influences the decision of using the same NMB agent in intubation as well as inmaintenance. 65 | P a g e
  • Different Combination of NMB which doctors prefer:Succinylcholine  Atracurium/Vecuronium/Rocuronium/PancuroniumRocuronium  AtracuriumAtracurim  VecuroniumVecuronium  AtracuriumFrom the above facts & feedbacks collected in research process, it can be said mostlySuccinylcholine is used in intubation and continued by any of the muscle relaxant available orthe muscle relaxant of their choice. But, as the above chart shows 76% doctors don’t mix themolecules in surgery procedures. If Atracurium/Rocuronium is used in intubation than it isfollowed by same molecule in maintenance. Only in few cases, Rocuronium is followed byAtracurium & Atracurium is followed by Vecuronium 66 | P a g e
  • OBJECTIVE 7: Most Vital Characteristics of CisatracuriumOne of the most important information needed to conceptualize is to determine, what is themost vital characteristics of the Cisatracurium? The options for this question were: a. More potent than available NMB agents b. Less risk associated with the molecule c. Very less histamine release than Atracurium d. Among other intermediate acting NMB, it has slower onset of actionAmong the choices, the doctors supported for the following choices which according to themare vital characteristics of the molecule. A. Only a B. Only b C. Only c D. Both b & c E. All the three(a, b & c) F. All the choices(a, b, c & d) Most Vital Characteristics of Cisatracurium 47% A 16% B C D 18% E 13% F 3% 3% Chart 17: Distribution of most vital characteristics of Cisatracurium 67 | P a g e
  • OBJECTIVE 8: Ideal Condition for use of CisatracuriumWith the most vital characteristics of Cisatracurium known to us, thus it is evident to find outthe target market in which it would function smoothly. Hence, it is necessary to find out theideal condition for use of Cisatracurium. For this purpose, the GA procedure has beensegmented into three categories: a. All the GA procedures with duration below 30 min. b. All the GA procedures with duration between 30-60 min c. All the GA procedures with above 60 min.Though, given with only three choices most of the doctors considered Cisatracurium to beused in all GA procedures. The final analyses of this research concluded with the followingfindings: A. Only a B. Only b C. Both a & b D. Both b & c E. All of the GA procedures (a, b & c) Clinical use of Cisatracurium in GA Procedures 8% 11% 41% A B 16% C D E 24% Chart 18: Distribution of clinical opinion about Cisatracurium in GA procedures 68 | P a g e
  • INFERENCEFrom the chart above, it can be derived that:- - 41% of doctors out of total sample size, thinks Cisatracurium can be used in all GA procedures. - 24% of doctors feel it will be useful only in GA procedures below 30 minutes of surgery duration. - Rest all has the mix opinion about Cisatracurium. - One of the major findings, from the above analysis is that majority of doctors feel it can be used in all the GA procedures.Though, Cisatracurium is yet to be launched in India. Hence the initial opinion about themolecule has positive response from doctors. Some of doctors consider that Cisatracurium ismore useful in Kidney disease patients. One of the other positioning characteristics ofCisatracurium came in research process is that, few doctors has belief that Cisatracurium maynot require reversal agent as complete recovery is possible out of it. 69 | P a g e
  • CHAPTER 5Findings, Conclusion And Suggestions 70 | P a g e
  • INTERPRETAIONAbbott Lab’s strength is in its differentiation. Its strength in differentiation comes from theimmense diversity of products the company offers that are considered innovative and uniquecompared to products made by competitors. Abbott Labs produces pharmaceutical, medical,and nutritional products. They are the leading innovators in anesthetics, and diabetes care.Abbott’s financial performance is consistent with its mission, objectives, and organizationalenvironment. The company’s vision is “Always at the forefront, always first choice,” and thecompany embraces the idea of “focusing on a culture of continuous improvement and adedication towards organizational excellence”. This includes the improvement of employees,products, and the company as a whole. Abbott’s greatest differentiator is in the diverse mix oftheir business portfolio. Abbott’s broad line of products and the success of their employees iswhat contribute to such high numbers, as well as the company’s ability to produce whatpeople need throughout the world, medically, pharmaceutically, and nutritionally.The industry is changing fast. To survive and to prosper involves managing drug pipelines –as drugs come off patents they no longer bring in enough revenues and must be replacedquickly by other drugs with durable patents. This means that the companies have to thinkahead, something that sounds easy but involves great risks. Huge sums must be invested inuncertain in-house research and development and/or must go toward mergers and acquisitionswith other promising companies. Strategic alliances can be used to augment opportunities aswell. As companies develop their new pipelines, they must be mindful of changes caused byregulations and deregulations in countries all over the globe. The global competitiveenvironment creates challenges and opportunities for the companies – with equal importancefor the communities in which they reside.This research offers no new insights into what it takes to build a viable new product launchbut it surely underlines two facts – that it is worth doing in Indian market and that it willinvolve retaining and attracting more market share with financial boost that need to takesizeable financial risks. 71 | P a g e
  • FINDINGS FROM THE RESEARCHAn important facet of research is “the analysis and positioning of available NeuromuscularBlocker (NMB), and discuss opinion about the Cisatracurium before the launch in the Indianmarket”. Cisatracurium has been available in International market for years, but theavailability of the new molecule in India solely depends on the Abbott Laboratories. Since,Cisatracurium is licensed to use by Abbott Laboratories.In terms of the new molecule Cisatracurium, Abbott holds monopoly in the market. But, it isessential to study the detailed performance of available muscle relaxant in the market, in theNMB category. This would determine the clinical positioning of Cisatracurium.  From the research, it has been figured out that ‘Safety’ is the most important characteristics that individual seek in a NMB agent.  Atracurium has been in the top of the list in their clinical practice in any GA procedures, followed by Rocuronium and Vecuronium. This creates a good market for Cisatracurium, since most of the doctors consider it as one of the safest molecule in the NMB category.  Apart from this, use of reversal agent in GA procedure has been very often or common. Though, the main reason cited for the need to use reversal has been that, 79% of doctors believe the patient must be reversed.  But, it is not true for all the molecules. In terms of Succinylcholine, 92% doctors believe it doesn’t need any reversal, as it is considered as self- reversal agent. 63% of doctors have similar belief about Cisatracurium, which gives it competitive advantage over available NMB agents.  While considering the distribution of GA procedures, it has been found that Atracurium dominates the market share when it comes to below 30 minutes surgery or 30 – 60 minutes surgery.  But more than 60 minutes surgery is controlled by nearly equal market share of Vecuronium, Rocuronium & Atracurium. Where, Rocuronium has edge over the other two.  From the above analysis it is evident that Atracurium is the most preferred molecule by doctors and also holds larger market share than other competitors. 72 | P a g e
  • CONCLUSIONThe pharmaceutical industry currently represents a highly competitive environment.Pharmaceutical companies have to operate in a highly regulated environment; the degree ofregulation to a significant extent depends on the country and type of the product. One of themost important aspects of government regulation for pharmaceutical companies is priceregulation, and different countries have different policies on this issue. As the result of pricecontrol, prices of the same products can significantly differ in different countries.Abbott Laboratories has been enjoying the long run of its monotonous market in terms of itsproduct Sevorane. With the new product launch, Cisatracurium it wouldn’t be wrong to saythat company will enjoy the similar situation, if price being the competitive factor.With the Atracurium occupying the maximum market shares in NMB category, it would beeasy to be replaced by Cisatracurium. Since, it is one of the 10 isomers of original moleculeatracurium besylate. Prior to its launch and clinical use Cisatracurium has been wellpositioned as self reversal agent. Hence, it has good positioning in terms of need of reversalagent. Cisatracurium being one of the safest molecule in the NMB category, it can pick up inthe market quiet well. As in the research it has been found that ‘safety’ is the most importantcharacteristics that doctor seek in an ideal NMB. Apart from this, majority of doctors has abelief that it would be essential for all GA procedures.Hence, it can be considered that the market condition and initial opinion about the product isideal for the launch of Cisatracurium. 73 | P a g e
  • SUGGETIONSThe main challenges for drug companies come from four areas. First, they must deal withcompetition from within and without. Second, they must manage within a world of pricecontrols that dictate a wide range of prices from place to place. Third, companies must beconstantly on guard for patent violations and seek legal protection in new and growing globalmarkets. Finally, they must manage their product pipelines so that patent expirations do notleave them without protection for their investment.Lastly, in terms of Cisatracurium the market development is essential which would help thecompany in creating increased market share. For this purpose Abbott India Ltd. should focuson following:  Cisatracurium being one of the 10 isomers of original molecule atracurium besylate; it should be market as that way. Its advantages over Atracurium should be counted in its marketing strategy.  There is a need of self reversal agent in the NMB category, since the Succinylcholine is only muscle relaxant available hence Cisatracurium should be positioned as self reversal agent. Most of the individual already believe that it doesn’t need any reversal.  ‘Safety’ and ‘Onset of action’ are two most vital characteristics for an ideal NMB which doctors prefer and Cisatracurium is considered to possess both characteristics. Thus, it should be counted in the marketing strategy of the product.  Cisatracurium is considered to perform better in Kidney & Renal patients. Thus, this market should be targeted prior to expansion of any other area.  Abbott Labs’ should launch it India with price being competitive. It will be the best molecule available in market so if priced competitively it will be picked up like anything. 74 | P a g e
  • CHAPTER 6Appendix & Bibliography 75 | P a g e
  • Marketing Research (Sample Questionnaire)Objective: To understand the Neuro Muscular Blocker (NMB) market & develop the medical positioning for Cis-AtracuriumName:Hospital Name:E-mail:Ph No.:1. Kindly mention the NMBs that you use in your clinical practice and the % of GA proced- ures in which they are used? NMB Molecule Name Percentage of Consumption Atracurium Pancuronium Vecuronium Rocuronium Succinylcholine2. What are the characteristics you expect to be in an ideal Neuromuscular Blocker (NMB)? Put the numbering as per your preference. Parameters Preference Onset of action Duration of action Safety Recovery time Potency3. Among the given parameters, which parameter you consider, best defines the below ment- ioned NMB? (Kindly mark only one molecule with [√ ], against each parameter) Neuromuscular Onset of Duration of Recovery Safety Potency Blocker Agents Action Action Time Atracurium Vecuronium Rocuronium Succinylcholine Cisatracurium Pancuronium 76 | P a g e
  • 4. Kindly mention the dosage protocol you follow for each of the following NMB agents. Intubation Maintenance 1st maintenance 2nd maintenance NMB (mg/kg) (mg/kg) (Time in min) (Time in min) Atracurium Vecuronium Rocuronium Succinylcholine Cisatracurium Pancuronium5. Under the following parameters, what is your preference of the NMB molecule? Mention the quantity of the molecule used along with the reason for the choice. Surgery NMB Agent Quantity Used in single Procedure Reason for the Duration Preference No. of Vials Strength Choice <30 minutes 30-60 minutes >60 minutes6. Do you need to use the ‘Reversal agent’ with the following NMB molecules? If yes, What is the percentage of surgery procedure in which you have to use ‘reversal agent’? Also give the remarks for its need of use. Reversal Agent? What % of Procedures? NMB Agents Remarks if any? Yes No Atracurium Vecuronium Rocuronium Succinylcholine Cisatracurium Pancuronium7. Do you use the same agent for intubation and maintenance of neuro muscular blockade? If No, what are the different combinations of NMBs that you use clinically? Intubation NMB Maintenance NMB % of procedures? 77 | P a g e
  • 8. According to you, which of the following is the most vital characteristic of the Cisatracu- rium? a. More potent than available NMB agents b. Less risk associated with the molecule c. Very Less histamine release than Atracurium d. Among other intermediate acting NMB, it has slower onset of time9. Considering the above advantages, which of the following will be the ideal condition for the use of Cisatracurium? a. All the GA procedures with duration below 30 min b. All the GA procedures with duration between 30 – 60 min c. All the GA procedures with duration above 60 minDate: - Signature 78 | P a g e
  • AbbreviationsNMB: Neuro Muscular BlockerGA: General AnaesthesiaR & D: Research and DevelopmentABT[NYSE]: ABBOTT[New York Stock Exchange]E.E.S.: Erythromycin EthylsuccinateFTC: Federal Trade CommissionFDA: Food and Drug Administration 79 | P a g e
  • BibliographyReference BooksMarketing Management, Philip Kotler 14th EditionResearch Methodology, C. R. Kothari Second EditionStrategic Marketing Management, Richard M. S. Wilson, 3rd EditionMedical JournalsClinical LiteraturesWebsite References  www.generalanaesthesia.info  www.drugs.com  www.wiki-meds.com  www.druglib.com  en.wikipedia.org  www.abbott.co.in  www.abbott.com 80 | P a g e