Mhealth in India- Pharmaceuticals

The Technology Driven data channels offers a key opportunity for pharma companies to restructure their sales and marketing model, improving their relationships with physicians and increasing compliance among patients. At the same time, patients are demanding a greater role in treatment decisions and seeking information from a range of online sources, resulting in a new age of consumerism in healthcare.

If you take a look at the screenshots below, you will realize the biggest problems for Pharma companies today where mhealth can be a solution. Courtesy- Businessmonitor.

Potential areas where Mhealth can be of use and can be deployed to tap the captive market driving non linear revenue.

As far as returns are concerned in the Pharma sector in India, India has one of the largest pharmaceutical markets in Asia, currentlyvalued at US$16.32bn. However, due to the country’s vast 1.17bn population, individual spending is actually very low. Pharmaceutical expenditure in 2009 was 1.24% of GDP,
which is just below the global average of 1.40%.

Chemists are Doctors....

The separation of the prescription and OTC medicines remains problematic, given the large volume of prescription drugs available over the counter.

Counterfeit is Easy....

Given that a number of essential drugs are already imported due to their low profit margins at home, the move to include more drugs under the price-fixing system has potential to worsen access to products and put the local industry at a disadvantage. This would open the door to regional competition, especially from parts of South East Asia. Furthermore, industry sources claim the change may also encourage the counterfeit industry to the overall detriment of both legitimate pharmaceutical industry and public health. The development of the healthcare system should improve the situation with the respective sectors gradually becoming more clearly defined.

Market Problems:

1. While prescription drugs account for approximately 85% of sales, the share of drugs prescribed by a doctor is likely to be far lower...
2. Alimentary tract, antibiotics and respiratory drugs are some of the most prominent prescription segments...
3. Cardiovascular and nervous system remedies, with vitamins lead the OTC sector.
4. Traditional and Ayurveda medicines very popular.

Policy Problems:

1. Prescription-only drugs are listed in Schedules H and X, which are included in the Drug & Cosmetics Act.
2. Schedule G drugs – mostly antihistamines – do not require a prescription, but must carry a warning label.
   
3. Drugs listed in Schedule H, X and G cannot be advertised to the public. Schedule K medicines (‘household remedies’) can be sold in certain non drug-licensed stores, but only in villages that have fewer than 1,000 inhabitants.
   
4. All drugs that are not classed as prescription can be sold as OTCs, although the OTC category is not legally defined.

Awareness and Advertising Problems:

1. Pharmaceutical advertising is regulated by the Drug & Magic Remedies (Objectionable Advertisement) Act, which bans advertising of certain conditions and misleading marketing.
   
2. The Organisation of Pharmaceutical Producers of India (OPPI) and the DCGI’s office have produced a joint Voluntary Code on OTC Advertising, with the OPPI also creating a Code of Pharmaceutical Marketing Practices.
3. While there is no formal ban on medical advertising, prescription-only drugs are not advertised by the industry, which is a general agreement. However, the DCGI is considering issuing a formal notification regarding the practice.
4. *Vigilance Problems-The WHO has described the lack of adverse event reporting in India as ‘alarming’. The New Delhi-based federal regulator employs only 25 staff members to cover the entire country, which has a population of approximately 1.1bn. In comparison, Sweden – which has a population of 9.9mn people – has 250-300 drug regulators with the same responsibility.

Disease Burden

1. non-communicable diseases – such as diabetes and cancer – have a slightly greater burden in India than non-communicable diseases – such as tuberculosis and HIV/AIDS.=Mhealth# Compliance and Adherence systems like Simpill to be deployed.
2. Hypertension is a serious issue on the sub-continent. Driven by changing lifestyles, studies indicate that prevalence of the disease has risen from under 5% in 1960s to 12-15% in the 1990s.= Mhealth# Remote monitoring of the Affected populace.
   
3. The WHO estimates that by 2020, a staggering 60% of the world’s cardiac patients will be found in India.In the past 50 years, rates of coronary disease among India’s city dwellers have increased from 4% to 11%.= Mhealth# Daily tips for self care, Drug reminders and Diet and exercise.
   
4. India is said to have over 2.5mn people living with HIV. The Joint UN Programme on HIV/AIDS
   (UNAIDS) estimates that the number of AIDS cases topped 124,000 in 2006, with a third of patients
   being under the age of 30. Overall, 0.36% of India’s population lives with HIV and accurate figures are
   extremely difficult to gauge.= Mhealth# the number of cases has been falling in recent months, suggesting that the infection rate has effectively been decelerated by prevention campaigns and programs urging people to practice safe sex.
5. More than 2.5mn Indians are reported to be suffering from cancer.Oncologists are expecting a five-fold increase in cancer cases in the next 10 years.=Mhealth# Information, Awareness, Remote diagnosis using Telemedicine.

Clinical Trials Problems:
One drawback to conducting clinical trials in India is that the country does not allow phase I clinical trials on the basis of patient safety, and began allowing phase II trials only a couple of years ago. Additionally, India lacks adequate numbers of research personnel.

Pricing Problems:

1. Ayurvedic medicines, traditional Indian remedies based on natural and herbal ingredients, are also regulated by the Drugs & Cosmetics Act (DCA), but can be sold freely.There is no formal price control on ayurvedic medicines.
2. The NPPA is responsible for fixing and controlling the prices of 74 bulk drugs and formulations under the Essential Commodities Act, although only a few OTC ingredients (such as ephedrine) are price controlled.Overall, price control covers only around 40% of the total pharmaceutical market in India.

India will continue to struggle to provide adequate healthcare services to its rapidly growing population, which is also exhibiting signs of ageing. According to the statistics recently released by Population Statistics Bureau (PSB), India is predicted to overtake China by 2050 as the most populous country in the world, with just under 1.63bn people. Such demographic changes will significantly alter and increase India’s demand for pharmaceuticals and health services, the needs of which still remain unmet.