The document provides an overview of emerging trends in the pharmaceutical industry globally and in India. Key trends include a shift towards chronic disease therapies, growing women's health and geriatric markets, increased competition for doctors, growth of alternative therapies, latent demand from improved access and pricing, and non-obvious trends like more empowered patients, non-adherence to dosages, and novel drug delivery systems. The future of the industry in India is seen as promising due to its large population providing opportunities for R&D, low costs making it a manufacturing hub, and established companies targeting niche areas and partnerships.

1. Emerging Trends...
Pharmaceutical
Industry
( Overview, Performance factors, Key Certainties,
Key Uncertainties, Obvious trends, Non-obvious trends )

2. Overview
• World Market $500Bn (India’s GDP), 8% grw
• US- 47% of world market, Top 10 Nations 86%
• India(14th)- $5Bn @ 8%; 1% WPM;
• India 14th in value, 4th in volumes
• World- Largest segments 2004- Cholesterol/
Ulcers ; By 2010- Hypertension & Obesity
• India- Antibiotics-16% of market, Diabetes
fastest growing

3. Performance factors
• Growth - Single digit, NPL, Price rise
• NDAs-All time low, R&D productivity challenge
• Generics- Opportunity
• Outsourcing- CRO, Research, Manufacturing
• M&A-Synergies not evident
• Pricing pressures-US,EU,India,Japan- Profits erode
• Margins- Retailers 15%+, Companies 5%+

4. Key Certainties
Don’t think of it as an injection for Flu, think of it as
an Anti- Virus Software Installation

5. Sedentary Lifestyle
• Demand Spurt- CNS, CV, Diabetes
• Worldwide-Chronic (long term) therapies like
CNS, CV, Diabetes, Nutritionals contribute 65%+
• India Acute (short term) therapies like cold, cough,
fever, pain, infections contribute 70%+
• Perceptible shift towards chronic therapy in India

6. Market Shifts
• Vulnerable age group for Chronic disorders
reducing from 40+ to 30+years
• Growing geriatric market due to increased life
expectancy (India 64 years)-resulting in high
incidence of Alzheimers, Parkinsonism, Kidney
(Renal) & Eye disorders

7. Women’s Health
• Key consumer
• More no of Rx & Patients than men
• Unique disease / profile
• Pregnancy, Osteoporosis, Menopause, Genito-
Urinary infections, Cancer, Menstrual
disorders
• Focus of the Pharma Industry

8. Key Uncertainties
You seem to have nothing wrong, so we will call it
symptom-deficit disorder

9. USFDAApprovals
• NDAs- $500 million + in investment
• 10-12 years of R&D
• Non approval can threaten existence
• New products not necessarily better or safer
• Lowest approvals in 2003- only 30 drugs
• Safety or Efficacy concerns can arise later
• Vioxx / PPA / Bayer

10. Critical Transforming Technology
• Genomics
• Proteomics
• Nanotech
could obviate the
need for drugs &
if commercially
viable, can
redefine
medicine
You caught a virus from your
PC, so we had to erase your
brain, we hope you have kept a
back-up copy

11. Patents
• Drugs worth > $ 50 Billion off patent by 2010
• Patent period-20 years wef application
• Patent extensions-newer indications, forms
• Patent expiry- 80% sales erosion in exclusivity
period
• Cost of litigation of Pfizer, GSK & Wyeth was $
4.5 Billion in 2003 = Entire Indian industry

12. Obvious Trends
You seem to be working very hard, instead of a heart-beat,
I get fax tone

13. Fight for the DRs mind
• Intense competition- India 24000 companies
• DRs unable to meet MRs
• Unethical Practices on the rise
• ‘Cuts’ on referrals to patho/diag/specialists
• CRM extensively used

14. Alternate Therapies
• AYUSH & Asian Medicines on the rise
• Perceived as devoid of side-effects
• India-More ISM practitioners than Allopathy
• Serious threat to Allopathy
• Standardisation is a concern

15. Latent demand
• Poor access to medicines
• India- Only 35-40 % population can afford
• Government support can ensure availability
& affordability
• Medical Insurance can ensure better access
• Per capita Healthcare spend- $3 in India, $6
in Pakistan, $ 10 in China & $100+ in US,
UK, Japan

16. Pricing
• Dual Pricing- Major issue in Europe, US
• Viagra available online from Canada into
US, 35% cheaper
• Rip-Off pricing- GSK’s patented AIDS
therapy costs 50 times the cost of Cipla’s
AIDS therapy containing same drugs
• Indian drugs most economical due to
established Bulk drug & Formulation
industry

17. Non Obvious trends
Its called a Miracle-Drug, if you can afford it, it is a miracle

18. Enlightened Patient
• Increasing Health consciousness
• Internet Info on Health, drugs, diseases
• Emphasis on activity, diet
• Downside- More self medication, consult DRs only
when condition worsens
• Patients go directly to consultants, circumvent GPs
even for minor ailments, especially in children
• Hypochondria on the rise

19. Dosage Incompliance
• Non-adherence to dosage
• Skipping dosages
• Not finishing the full course
• Swallowing, Relief, Inconvenience, Costs
most common reasons
• Risky in infections- relapse likely
• Smaller doses/packs, value pricing, drug
delivery

20. NDDS
• Novel Drug Delivery System
• Inhaled Insulin, Nasal Viral spray, Anti-
Cold Chewing gums, Angina Patches
• Viability, Commercial feasibility issues
• Ease of use can revolutionise treatments

21. Improving sanitation
• Water borne diseases on the decline
• Smallpox eradicated worldwide
• Communicable diseases continue to grow

22. Successful future Drugs
• Safety
• Efficacy
• Dosage convenience
• Multiple indications
• Serendipity to strategy-Viagra, Minoxidil

23. Internet & Promotion
• Potential to obviate the need for MRs, Trade
• Fewer promotional & distribution channels can
lower prices significantly and give online access
to patients
• PRM- Pharma companies sponsor activities that
deepen the Dr-patient bond
• Check-ups, Lectures,Camps, Booklets, Films
• Medical Books/Excerpts/CDs are the fastest
growing promotional activity inspite of free
medical info on the net

24. The Future for India ….
• Large population-R&D,Clinical Research capital
• Intellectual capital
• Low operational cost-Pill factory to the world
• Generics, Formulations
• Exports
• Bulk drugs & intermediates
• Strategic location
• Established Indian companies-Niches,partnerships