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Continued from previous……
Phase II. Introduction of Generics of New Chemical Entities (NCEs)
Come 1990s, the Local Pharma got into manufacturing and marketing of newer molecules. They particularly targeted high-priced products. For example, Losec (omeprazole) was becoming popular and became a favorite molecule for bringing generics. There were many more like this. These generics offered some relief in price, 15-25%. They were not cheap, but the doctors did not fully believe that these would give comparable efficacy.
Let me narrate an interesting anecdote of that time.
I took a patient to a senior gastroenterologist in Lahore. In his prescription he wrote Losec 20mg/ Klofix 20mg (Klofix was generic omeprazole of Himont). Then he explained in these words. “this first one (Losec) is the original brand but it is expensive. The second one (Klofix) is you can say a copy. It may be 25% cheaper but it may be 50% less effective. You can choose which one you want to take.” This was not a verdict on the efficacy of Klofix; it was an impression carried by most doctors who firmly believed that generic drugs do not have comparable efficacy. I heard many doctors say that they would prescribe generic drug to patients with less resources. Even if they would not get full efficacy, but it would be better than having none because they could not buy innovator brands.
From this shaky start, the generic products started making inroads. several things evolved over time in this phase.
- Prices of generic products kept going down as more companies came in and competed for market share. In the beginning, the Ministry of Health granted prices to generic drugs which were usually 15-20% less than the innovator brand. However, the companies actually marketed at much lower prices in order to get more business. It was also true, that even at lower prices, it was still profitable for generic manufacturers.
- The evidence of generic products’ efficacy kept building although the doctors prescribed them reluctantly. As more patients reported relief, the doctors’ perception changed. The market share of generic products kept growing steadily.
- Local Pharma got highly encouraged with these developments and they started aiming higher in two ways.
- Besides acute-care drugs, they started getting into medium-term use drugs. Anti-ulcer was a big example which saw a huge number of generic products. Cholesterol lowering drugs were another popular category.
- A race started among the bigger Local Pharma as to who would bring the generic of the latest molecules first. Generics were launched almost immediately after the launch of innovator brands. Some generics performed better than the innovator (example, ciprofloxacin, ceftriaxone). Some generics were launched even before the launch of innovator brand (example, azithromycin).
- Due to mergers and re-mergers, a large number of highly trained, experienced and seasoned professionals became surplus in MNCs. They all came to Local Pharma and started building the local industry working in the same manner as the MNCs. This single development is probably the most significant one in the emergence, evolution and development of Local Pharma.
The Local Pharma working, particularly on the business side, is quite comparable with the MNCs presently.
To be continued……