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February 2022 marks my completing 47 years of working in Pharma Industry. Allah be praised. I am still working. The first half of my working career was spent in Multinational companies, and the latter half in the Local Pharma, making me well-versed with both innovators and generics markets. I also had the opportunity to work in business as well as operations.
My journey of near half century is also the journey of Pharma Industry in Pakistan. Great changes have occurred in this time and a lot could be written about it. In my blogs, which were started about four and a half years ago, I have covered several topics related to Pakistan Pharma Industry. This multi-part series shall do and review the SWOT – Strengths, Weaknesses, Opportunities, Threats – of the Pharma Industry.
SWOT – OPPORTUNITIES……
As mentioned in the introduction of SWOT, Strengths and Weaknesses are internal while Opportunities and Threats are external.
Another point to mention is that my focus is mostly on Local Pharma which is dominating the Pharma Industry since many years.
- Awareness – Another window of opportunity is the awareness about health, healthcare, and healthcare providers. Various companies, hospitals, and the government bodies have run campaigns to create/raise awareness about diseases and prevention. The biggest and most successful was the ORS campaign many years ago by the government. It was made to reach almost entire population and it was done with such consistency and repetition that lots of people came to know about the importance of rehydration in diarrhea. It must be appreciated that the small, cheap, ORS sachets have saved more lives than all the treatments put together. Similar campaigns have been run about use of tobacco and its relation to cancer. Breast Cancer awareness campaigns are also a huge success. Need of calcium in women campaign by Novartis is constantly raising awareness about importance of calcium.
Alongside mass campaigns, TV talk shows and FM radio programs have also contributed to create and raise awareness about serious health issues, such as Diabetes, Heart problems, psychiatric disorders and more. Guest doctors explain in simple terms about the disease, its prevention, and the need for treatment, if it occurs. Diabetes, as we know, is exploding in Pakistan. However, public is still following quacks claiming 100 percent cure with their unknown concoctions. Social Media is rife with treatment claims about various fruits and health foods. While it misleads the public, it also creates awareness.
It is now commonplace for hospitals, public and private, to advertise their services. Diagnostic Labs are also advertising their facilities. Cardiac emergencies, stroke, ICU, Ventilator, CCU, pulse oximeter, have entered common language thanks to COVID19. In fact, COVID19 has contributed in a huge way in raising awareness about the need for early detection and treatment.
The summary is that awareness about diseases and treatments has risen considerably, and more patients seek treatment early. The number of new patients is increasing exponentially thereby expanding the Pharma market beyond usual estimates. Pharma companies must avail this huge opportunity, the likes of which may not be seen again for many decades.
- Affluence – people have become more resourceful and have greater means now compared to the past. The positive change in socio-economic sphere has been caused by multiple factors: foreign remittances, new businesses, higher wages, and manifold increase in parallel economy, some of which trickles down to local markets. There was a time when Specialist doctor, rank of Professor, charged 100 rupees for consultation at his private clinic, he/she would charge half fee for next visit and would not recommend a long battery of tests, but few patients visited his clinic to get consulted. Now, Professor doctor’s fee ranges from 2,500 to 5,000, he would advise long list of diagnostic tests costing thousands of rupees and would prescribe full page of medicines costing few thousand rupees more, the patients are queuing up at the specialist clinic. Average waiting time for appointment with a busy consultant may range from 2 – 12 weeks. These are clear indications that public has more expendable money than ever before. Affluence is also leading to building of new private hospitals to accommodate more patients. Private medical treatment is a multibillion-rupee industry which is burgeoning yet undocumented. There are complaints about fleecing the patients through innovative ways, but the rush at the same places is not decreasing. An established, highly expensive, private hospital was accused by parents of a small girl who died allegedly due to staff negligence and callousness. The grief-stricken parents raised a lot of alarm and were supported by public also, but nothing happened, and the hospital is flourishing more than ever before.
Affluence may also be judged by the rise of brands, fashions, social activities, parties, wedding events and the craze for designer things. We are a consumer society and our appetite for goods is insatiable. The advertising campaigns create competition among people as to who would get it first, and the manufacturers are feeding the frenzy. It is now ironically common to see a guy driving a 50,000-rupee motorbike and using a 100,000-rupee cell phone. Gaming is an expensive hobby, but it is relentlessly being pursued by those who can afford.
The opportunity for Pharma Industry is that they can easily sell more expensive drugs along with regular ones.
- New Therapies – The world is seeing unprecedented number of new therapies being made available to treating physicians. True, that the focus of research is still limited to certain disease areas such as oncology, gene therapy, genetic disorders, and rare diseases. These areas offer most lucrative prices and profits. Gilead made waves with its oral drug for Hepatitis C, SOVALDI which sold at 100 US$ a tablet in the US market. They were considerate enough to reduce the price in poorer regions. Novartis launch of ZOLGENSMA for genetic disorder of Spinal Muscular Atrophy at 2.12 million US$ looked outrageous, but the company did not reduce the price for anyone in any country. They offered in the US that patients could pay in five years, but the price would be the same. These actions have led to breaking of all price barriers previously considered to be strong. In Pakistan, the MNCs are regularly getting prices in multiples of hundreds of thousands for new drugs.
Another important development is that acceptance to new drugs is now almost instant. Couple of decades ago, the new products had to be introduced and discussed and reminded for many times before one would see the prescription, not anymore. The great recent successes of Gliptins and Gliflozins and dexlansoprazole shows that the age-old resistance to accept new products immediately has broken.
There is great opportunity for Pharma companies here. They can bring new and expensive products and can hope to have early breakthrough, big revenues, and even bigger profits.
To be Continued……
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