The document summarizes the Indian vaccine market and strategies for enhancing it. It notes that while the overall pharmaceutical market in India is growing at 15% annually, the vaccine segment is growing faster at 30% annually but still only accounts for 2.5% of the total market. It provides an overview of the various players in the public and private vaccine markets in India, the vaccines available, and recommendations for marketing interventions and regulatory strategies for companies looking to enter and grow within the Indian vaccine market.

1. Understanding the Indian conundrum
and developing strategies to enhance its
vaccines market
Speaker:
Shubhendu Kumar Dash
Vice President
Lincoln Pharmaceuticals, India

2. S K DASH
Vaccine marketing professional
Understanding the Indian Conundrum
and developing strategies
to enhance its vaccines market
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3. The vaccination delivery system in India
Indian Pharma Mkt Vaccine segment Penetration(%)
(USD bn) (USD mn)
10.5 (Gr=15 %) 271 (Gr=30 %) 2.5
Central Govt. • GAVI / WHO /
PATH / NTAGI / IAP
(Univ. Immu. Prog)
etc.
Public mkt
USD 130 mn (48%)
State Govt. • Low priced vaccines
(Rabies)
Vaccine • Dynamics does not
USD 271 mn stimulate sustainable
demand
Nursing Homes
Corporate hosp
Private mkt Physicians IAP
USD 140 mn (52%) Anti rabies clinics APCRI
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4. Vaccines available in India
EPI vaccines under IAP recommended IAP recommended
Universal Programme of vaccines for routine use vaccines-special
Immunisation (UIP) (in addition to EPI) circumstances
BCG Typhoid Rabies
OPV IPV Influenza (Flu)
DTwP DTaP / Td PPV-23
Measles PCV-7 JE
DT HPV Meningococcal
TT Hep-A Cholera
Hep B / (DPT+HB+Hib) Varicella (Chicken Pox) Yellow fever
MMR Rotavirus
Hib
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5. Indian Vaccine Scenario (Fig in USD mn)
Paed GP / Phy Other Comment
Vaccine Total Private Public
(%) (%) (%)
Total market 271 139 132 Wt av. Gr is 30%
Rabies 104 52 52 10 75 15-ARV Very good potential
Oral Polio Vaccine 36 2 34 90 10 - Majority GOI purchase
Combination vaccines 19 18 1 90 10 - Future promise for India (GOI)
Hepatitis-B 12 4 8 60 30 10-Nephr Shrinking market (GOI purch.)
Pneumococcal 4 3 1 70 20 10-Nephr Prevnar (Wyeth) dominant
Influenza (Seasonal)+ H1N1 20 9 11 70 20 10-Chest H1N1 was an opportunity
Hib (monovalent) 3 2 1 90 10 - Trend towards combination
DPwT (monovalent) 6 2 4 90 10 - Trend towards combination
DPaT (monovalent) 6 6 - 100 - - Good potential in metros
Varicella (Chicken pox) 7 6 1 80 20 - Very good demand
Hepatitis-A 4 4 - 50 40 10-PSM Good potential in metros
Typhoid 7 2 5 70 20 10-PSM Potential unexploited
HPV (Cervical cancer) 8 8 - 10 30 60-Gyn Very good promise
BCG 4 1 3 90 10 - Majority GOI purchase
Meningococcal 3 1 2 60 40 - Majority Haj pilgrims
MMR / Measles / Rubella 5 2 /1 / - = 3 -/2/-=2 80 10 10-Gyn Majority GOI purchase
JE (Japanese Encephalitis) 3 1 2 30 10 60-PSM Majority GOI purchase
Rotavirus 4 4 - 100 - - Future promise for India
Td / TD / TT / Oral Cholera 16 11 5 30 50 20-Gyn Good potential for TT
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6. Vaccination Schedule in India
IAP IMMUNIZATION TIME TABLE
Some key facts:
Age Vaccines •West and South Zone contribute 60% of market
•Best season is Sept to Feb-70% business
Birth BCG / OPV0 / HepB 1
6 weeks DTwP1 / DTaP1 / OPV1/ IPV1 / Hib1 / HepB2 / PCV Combination
vaccines like
10 weeks DTwP2 / DTaP2 / OPV2 / IPV2 / Hib 2 / Rotavirus DPT+Hib+Hep-B
or,
14 weeks DTwP3 / DTaP3 / OPV3 / IPV3 / Hib3 / HepB3 DPT+Hib+IPV
preferred
9 months Measles / Influenza
15-18 months DTwP B1/DTaP B1/ OPV4 / IPVB1/ Hib B1/ MMR1/ Varicella / JE
2 years Typhoid / Hep-A Preference is for such
companies which have
5 years DTwP B2 / DTaP B2 / OPV5 / MMR2 DPT / Hib / Hep-B / IPV
cluster even though
10 years Tdap / Td and HPV (Female) combination is unavailable
Adults: Rabies / Hep-B / Hep-A / Influenza / MMR / Typhoid / HPV / Varicella
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7. Market attractiveness in vaccines segment
PCV
High DPT+Hib+HB
Varicella
Influenza
Growth
Hep-A
HPV
30%
Rabies
Typhoid
Hib
OPV
Segments dominated by Indian companies
Low DPwT
BCG
Hep-B
Segments dominated by MNC
Low Price / unit High
USD 2 per dose
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8. Distribution channel in India
• Cold chain is the life line of the vaccine and
• Manufacturer therefore differs substantially from Pharma
Company distribution network. Ingrained:”Colder is better”
• Depot points in •Most of the pediatric vaccines are handled through
various states for ‘vaccine dealers’ who directly supply to the doctors
CFA Tax implications
(Pediatricians).This has a substantial impact on
profitability leading to imperfections in system
• MRP= USD 100 (Purchased by Subject)
• Distributor in each • Price to retailer / Doctor= USD 80
city • Price to Stockist= USD 72
Stockist
•Only mass-marketed vaccines like Rabies / Hep-A /
• Pediatricians and Influenza /TT have movement through conventional
some physicians
dispense vaccines distribution system.
Doctor
•The distribution and cold-chain integrity costs have
substantial financial impact
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9. Vaccine-Storage conditions: +20c to +80c
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10. Major players in the Indian vaccine market
Company Private mkt Public mkt Major revenue generators in
(% dependent) (% dependent) trade mkt
GSK 92 8 Rotavirus / DPaT+Hib / Varicella
Sanofi - Aventis 70 30 DPaT+Hib+IPV / Inflz / Rabies
Novartis / Chiron 45 55 DPwT+Hib+Hep-B / IPV /Rabies
MSD 90 10 HPV
Serum Institute 40 60 (DPwT+Hep-B)+Hib / Hib / MMR
Bharat Biotech 15 85 DPwT+Hib+Hep-B / Rabies
Biological E Ltd. 40 60 TT
Wyeth 40 60 DPwT+Hib+Hep-B
VHB 80 20 Varicella
Biomed 70 30 Typhoid / OPV
Wockhardt 85 15 Hep-A
IIL (Human Biolo) 33 67 Rabies
Zydus Cadila 70 30 Rabies / Influenza
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11. Major players-Sourcing strategy
Company Major products in trade mkt Source
GSK Hep-A / Rotavirus / DPaT+Hib / Varicella / HPV 100% Imported
Sanofi - Aventis DPaT+Hib+IPV / Inflz / Rabies / IPV / Varicella / DPaT 100% imported
/ Pneumo
Novartis / Chiron DPwT+Hib+Hep-B / IPV / Rabies / Hep-A Imported except Rabies and
DPwT+Hib+Hep-B
MSD HPV 100% imported
Serum Institute (DPwT+Hep-B)+Hib / Hib / MMR 40% compo imported
Bharat Biotech DPwT+Hib+Hep-B / Rabies OPV contributing to 80% business
imported
Biological E Ltd. TT Indigenous
Shantha Biotech DPwT+Hib+Hep-B DPwT imported
VHB Varicella 100% imported
Biomed Typhoid / OPV Indigenous
Wockhardt Hep-A 100% imported
IIL (Human Biolo) Rabies Indigenous
Zydus Cadila Rabies Indigenous
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12. Marketing dynamics in vaccines segment
• All the vaccines are cold chain products hence they are sold through predominantly
“vaccine dealers” who directly sell it to the pediatricians. Exceptions are Rabies and
TT which follow conventional distribution channel.
•In India, 80% of vaccines business (excepting Rabies and TT) is generated by
pediatricians, although adult vaccination is fast upcoming segment due to awareness
•The margin between MRP and “stockist price” is typically 60% to induce
dispensation by pediatricians. However, MNCs do not follow this principle.
•Pediatric vaccine market is slow to respond due to obsession with safety and
therefore requires a good franchisee for acceptance.
•Adult vaccination is fast growing with newer offerings and increased awareness.
Since dispensation profile is not there, margins are better and distribution channel is
more skewed to normal channel (through retailer) although cold chain is required.
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13. A look at Emerging Adult vaccination segment
• Demographic projections for 2026 indicates that there will be a huge shift from
Pediatric segment to Adults.
•Currently in India, the adult vaccination is in primitive shape, but is expected to take
shape in the years to come.
• Companies like Sanofi-Aventis, Novartis, MSD,GSK have taken the initiative of not
only identifying the segments of interest but at the same time they are increasing the
awareness level w.r.t the diseases in the adulthood & their consequences leading to
prevention through vaccination.
• Currently they are focusing on Influenza virus vaccine, Hepatitis-A+ B vaccines,
Varicella, HPV and other vaccines, thus preparing ground for future adult vaccines.
•The fastest growing segment in the adult vaccines area is Influenza vaccine. The
leading flu-vaccine manufacturers include Sanofi , Novartis, GSK and Baxter.
•The price realisation will also be better in the adult vaccination segment.
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14. Demand drivers in Indian vaccines segment
• “Scare”: Swine Flu / Rabies / Hep B / HPV
VPD epidemiology • Organised studies-Pneumococcal / IPV
• Urbanisation
Affordability • Disposable income rising
• GOI public spending-National Immu. Day (Polio)
Accessability • Corp Hosp / “Immun. Camp operators” /
• Cold chain integrity / power backups
• Increasing awareness- increase funnel size
• Harnessing propensity for “wellness”
Acceptability •Promotion beyond Pediatricians to GPs / CPs
•Organised marketing initiatives to increasing
compliance
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15. Marketing interventions to grow vaccine segment
• Create awareness and interest among physicians on
VPD epidemiology vaccines through EIA / Advocacy studies
• Assistance to local producers for producing high end vaccines
Affordability • Introduce policy changes by involving Insurance sector for precluding
VPD from reimbursement
• Help entreprenuers-”Camp operators” into an
organised segment
Accessability • Focusing on innovative solutions- solar power packs
/ thermostable vaccines
• Vaccine safety standards in private sector
•Organised marketing platform for adult vaccination
Acceptability •Developing primary care physicians to recognise
the importance of vaccination
•Focusing on private market by leveraging DTC
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16. The regulatory framework / entry strategy
Activity timeline Year-1 Year-2 2012 Low risk model approach
Q Q Q Q Q Q Q Q Q Q Q Q
1 2 3 4 1 2 3 4 1 2 3 4
Registration of vendor •Finished & packed formulations will
save on time-to-market.
Obtaining test-licence and planning trial
protocol
•Once licenced, lead time in-toto will
Phase III (non-inferiority) trial for licensure
be reduced to 4 months cycle time
Import licence on submission of dossier
•Most MNCs and Indian companies
Import of consignment and CDL-Kasauli follow this business model
testing
India licensure obtained •Field force can be deployed in a
phased manner-South & West ,then
10 Managers to be recruited for product North and then East.
registration at imp institutions / hospitals
Field force recruitment begins 50 MR+10
Managers / training / deployment
Revenue generation starts
Business development activities start for
long-term plans in vaccines
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17. India now requires entry of new players for growing the
vaccine segment
WELCOME
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