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[Today is 100th Post of PharmaVeterans Blog]

Continuing with the Pharma Industry Evolution……

If you looked at the market make up in 1970s and !980s, you would notice that the local pharma was mostly selling acute care products while MNCs were in acute and chronic care both, may be more in chronic care. Acute care included cough syrups, antidiarrheals, antibiotics, pain killers etc. The MNCs were into cardiology, diabetes, hypertension, rheumatology, psychiatry and so on. It was understandable because local pharma did not have any research in these areas. Until mid 1980s, local pharma and MNCs operated in two different segments of the market, differentiated on the basis of longevity of treatment, specialization, price, and tier of consulting physicians.

Acute care drugs were used for short time, a few days. It meant that one prescription lasted for 3-5 days on average. Chronic care drugs were used for long time, mostly for several years. One prescription lasted for many years. In chronic care business, you built layer upon layer of patients and you would keep getting and growing business. I had been handling cardiology and diabetes in Hoechst and had firsthand experience with it.

Things started changing with coming of generic versions of Proton Pump Inhibitors and high-priced antibiotics. Antibiotics were still acute care, but anti-ulcers were medium term. The patients had to take the drug for extended period and might even have to repeat the treatment. This brought on the understanding that chronic care was more sustainable business. However, no one rushed to get into it. There were isolated ventures.

Platinum introduced generic version of anti-epileptic drug Carbamazepine and became very successful. As far as I remember, the biggest and most successful attempt on cardiology was done by Werrick. They introduced multiple products in this segment and took these to all hospitals and consultants. They must have had initial resistance, but they pursued and made very big brands for themselves. Other companies followed suit. But even in 1999, there were still several products whose generics had not been launched.

We were in the beginning of 2002. Max team had already completed two years since its launch. The management started discussing about another brand-new team with brand-new products. With this team, CCL decided to enter chronic care segment in a fully organized manner.

We had already introduced antihypertensive Losartan potassium and mecobalamin in existing teams. We also entered anti-anxiety segment with a patented, licensed product. Results were mixed, mainly because our teams did not have experience in chronic care market, hence the decision.

We selected to-be-first generics of anti-platelet Clopidogrel, antidiabetic Glimepiride and lipid lowering Atorvastatin. We also added antirheumatic Celecoxib. Products were assigned to product development. Registrations were applied, and we made preparations for hiring a team of fifty medical reps, plus area managers. The team was named STAR and it was on ground in September 2002.

Introduction of generic Clopidogrel was interesting and I would like to share with you.

We came to know that Pharmevo was also rushing to bring the first generic of Clopidogrel. Innovator brand Plavix had not been registered in Pakistan. It was smuggled into the country and sold on the black market at 120 or more rupees per tablet. We fixed the price at 15 rupees a tablet. Pharmevo (Lowplat) came on to market two weeks before us; CCL (Noclot) followed.

The reception of this product was with huge reservation. The first objection was on price. Rather than appreciation for a very affordable price, aspersions were cast upon the efficacy. Many consultants commented that they would not risk giving this product to patients who had undergone angioplasty and paid a large sum for it. They agreed to use it in place of Aspirin to begin with. Both Pharmevo and CCL did not get disheartened and persisted. Today, those barriers stand broken.

Entering diabetes market was no less challenging. We did a large number of screening camps at the doctors’ clinics. Blood sugar levels were checked for free and those having higher BSL were referred to the doctor for treatment. We offered support like dietary instructions, awareness pamphlets and sometimes free starter samples.

It was a long, hard road. Our teams and management sustained and achieved the desired results. It had profound implications for the corporate as a whole. It added a new dimension of expertise and steered the business toward a new direction.

Today, more business comes from chronic care segment……

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