Increasing patent expiration may brighten India's export prospects: CARE Ratings Sanjay Pingle, Mumbai

CARE Ratings has pointed out that the drug patent expiry in the USA will create new opportunity for Indian pharmaceutical industry in the coming years and the pharma industry will gain a larger foothold in the world's generic market. In the long term, semi-regulated markets like Latin America, Africa and Asia may offer the next growth avenues for Indian pharma companies as these markets have high demand for drugs and relatively less stringent regulatory compliance resulting in lower cost of servicing these markets. 

However, CARE said that higher number of import alerts issued by the US FDA may hamper the image of Indian pharma companies and there marketing efforts. If this continues in the long term, it may hurt the profitability of Indian generic drug producers. Thus, the need of the hour is that Indian firm should make sure the quality standards are adequately met.  

Out of the total 103 pharma companies rated by CARE, more than 50 per cent are in investment grade category ('BBB' or above category) driven by good profitability metrics, comfortable solvency position, and moderate liquidity profile. Additionally, some of the pharma companies are in the high investment grade categories ('AAA' and 'AA') on account of their wide geographical presence and well-diversified product portfolio. 

CARE report said, India's pharma industry is the world's third-largest market in terms of volume and 13th largest in terms of value. The lower market share in terms of value can be attributed to the predominance of generic medicines which command lower prices. As per the industry experts' the industry size is expected to increase from US$ 24.87 billion in 2013 to US$ 47.88 billion by 2018 at a CAGR of 14 per cent. 

This growth would be primarily driven by factors like increasing sales of generic medicines, a greater penetration in rural markets and heightened health awareness. Other factors are increasing affluence, changing lifestyles resulting in higher incidence of lifestyle-related diseases, increasing government expenditure on healthcare such as Central Government Health Scheme (CGHS), National Programme for Healthcare of the Elderly (NPHCE), Rashtiya Arogya Nidhi (RAN) and Janani Surakasha Yojna (JSY). The industry is highly fragmented with more than 20,000 registered manufacturing units, of which approximately 250 large units that constitute about 70 per cent of the total domestic market value.

According to CARE report, domestic consumption accounted for about 47 per cent and export market about 53 per cent of the total production in India in FY'13. The domestic market has grown at a CAGR of about 11 per cent in the past five years ended FY13 on the back of increase in lifestyle-related diseases, rising penetration of medical insurance, healthcare infrastructure development, increase in per capita income, etc. On the other hand, export market has grown at a higher CAGR of about 19 per cent in the past five years ending FY13 due to increase demand for generics on the back of patent expiries of several high-value drugs such as Lipitor (Pfizer), Boniva (Roche), Combivir (GlaxoSmithKline), etc. 

India exports pharmaceutical products to more than 200 nations and the USA is the largest export market among all countries; being the world's largest generic drug market. Exports to the USA are primarily driven by increased ANDAs approvals by US FDA and Indian pharma companies ability to produce high-quality medicines at competitive prices.

According to the commerce ministry data, the country's pharma exports aggregated US$ 10.1 billion during FY13 as against US$ 8.48 billion during FY12. Exports to US accounted for approximately 31 per cent of the total pharmaceutical product export by India during FY13. During first nine months of FY14, the country's pharma exports aggregated to US$ 8.04 billion, out of which USA accounted for 31 per cent. 

Indian pharma companies have the opportunity to capitalise on the patent cliff and gain a greater share of the growing generic market. Currently, India accounts for nearly 40 per cent of generic drugs and over-the-counter products and 10 per cent of finished dosages used in the USA. During 2014-2016; about US$92 billion worth patented drugs are expected to go off patent in the USA as compared with US$65 billion during 2010-12. Indian companies share in the US generic market has growth rapidly on the back of aggressive ANDA filings and successful pursuit of Para-IV, captalising on the patent expiries of blockbuster drugs.

CARE report pointed out that Indian pharma companies secured 39 per cent of total 400 ANDA approvals from US FDA as against 37 per cent of total 476 ANDA approvals during 2012. Thus, generic manufacturers are leveraging this opportunity by increasing their ANDA filings. Further, low-cost manufacturing base and around 523 US FDA drug manufacturing facilities as at the end of March 2013 will able to tap future opportunity. Rising M&A activities and US Healthcare Insurance reforms will also play positive role in future growth. CARE Ratings has pointed out that the drug patent expiry in the USA will create new opportunity for Indian pharmaceutical industry in the coming years and the pharma industry will gain a larger foothold in the world's generic market. In the long term, semi-regulated markets like Latin America, Africa and Asia may offer the next growth avenues for Indian pharma companies as these markets have high demand for drugs and relatively less stringent regulatory compliance resulting in lower cost of servicing these markets. 

However, CARE said that higher number of import alerts issued by the US FDA may hamper the image of Indian pharma companies and there marketing efforts. If this continues in the long term, it may hurt the profitability of Indian generic drug producers. Thus, the need of the hour is that Indian firm should make sure the quality standards are adequately met.  

Out of the total 103 pharma companies rated by CARE, more than 50 per cent are in investment grade category ('BBB' or above category) driven by good profitability metrics, comfortable solvency position, and moderate liquidity profile. Additionally, some of the pharma companies are in the high investment grade categories ('AAA' and 'AA') on account of their wide geographical presence and well-diversified product portfolio. 

CARE report said, India's pharma industry is the world's third-largest market in terms of volume and 13th largest in terms of value. The lower market share in terms of value can be attributed to the predominance of generic medicines which command lower prices. As per the industry experts' the industry size is expected to increase from US$ 24.87 billion in 2013 to US$ 47.88 billion by 2018 at a CAGR of 14 per cent. 

This growth would be primarily driven by factors like increasing sales of generic medicines, a greater penetration in rural markets and heightened health awareness. Other factors are increasing affluence, changing lifestyles resulting in higher incidence of lifestyle-related diseases, increasing government expenditure on healthcare such as Central Government Health Scheme (CGHS), National Programme for Healthcare of the Elderly (NPHCE), Rashtiya Arogya Nidhi (RAN) and Janani Surakasha Yojna (JSY). The industry is highly fragmented with more than 20,000 registered manufacturing units, of which approximately 250 large units that constitute about 70 per cent of the total domestic market value.

According to CARE report, domestic consumption accounted for about 47 per cent and export market about 53 per cent of the total production in India in FY'13. The domestic market has grown at a CAGR of about 11 per cent in the past five years ended FY13 on the back of increase in lifestyle-related diseases, rising penetration of medical insurance, healthcare infrastructure development, increase in per capita income, etc. On the other hand, export market has grown at a higher CAGR of about 19 per cent in the past five years ending FY13 due to increase demand for generics on the back of patent expiries of several high-value drugs such as Lipitor (Pfizer), Boniva (Roche), Combivir (GlaxoSmithKline), etc. 

India exports pharmaceutical products to more than 200 nations and the USA is the largest export market among all countries; being the world's largest generic drug market. Exports to the USA are primarily driven by increased ANDAs approvals by US FDA and Indian pharma companies ability to produce high-quality medicines at competitive prices.

According to the commerce ministry data, the country's pharma exports aggregated US$ 10.1 billion during FY13 as against US$ 8.48 billion during FY12. Exports to US accounted for approximately 31 per cent of the total pharmaceutical product export by India during FY13. During first nine months of FY14, the country's pharma exports aggregated to US$ 8.04 billion, out of which USA accounted for 31 per cent. 

Indian pharma companies have the opportunity to capitalise on the patent cliff and gain a greater share of the growing generic market. Currently, India accounts for nearly 40 per cent of generic drugs and over-the-counter products and 10 per cent of finished dosages used in the USA. During 2014-2016; about US$92 billion worth patented drugs are expected to go off patent in the USA as compared with US$65 billion during 2010-12. Indian companies share in the US generic market has growth rapidly on the back of aggressive ANDA filings and successful pursuit of Para-IV, captalising on the patent expiries of blockbuster drugs.

CARE report pointed out that Indian pharma companies secured 39 per cent of total 400 ANDA approvals from US FDA as against 37 per cent of total 476 ANDA approvals during 2012. Thus, generic manufacturers are leveraging this opportunity by increasing their ANDA filings. Further, low-cost manufacturing base and around 523 US FDA drug manufacturing facilities as at the end of March 2013 will able to tap future opportunity. Rising M&A activities and US Healthcare Insurance reforms will also play positive role in future growth. 
http://www.pharmabiz.com/NewsDetails.aspx?aid=84026&sid=1

KPPA wants govt of Kerala to increase number of pharmacists in govt sector Peethaambaran Kunnathoor, Chennai

The Kerala Private Pharmacists Association (KPPA), an association representing qualified pharmacists working in the private sector, has demanded to the state government to increase the number of pharmacists in the government sector.

For submission of its demand, the association mobilized the support of more than 5000 pharmacists from all over Kerala and held a march from the northernmost district (Kasargodu) to the state capital in the south and handed over a memorandum to the health minister and served copies of the same to all the members of the Legislative Assembly.

The pharmacists wanted the government to initiate policies for appointing qualified and registered pharmacists in the government sector. Plenty of vacancies are lying vacant in several healthcare institutions and the situation of government pharmacies are very pathetic due to lack of dispensers there. Government must address the grievances of the pharmacy staff in the government hospitals that they are suffering from overload of work. Besides, government should look into the problems of poor remuneration now available to the pharmacists working in the government and private sectors.

The pharmacists also demanded that government should introduce a living wages system to the jobless pharmacy diploma holders and graduates of pharmacy and undertake myriad programmes under the health ministry to protect the lives of the qualified unemployed pharmacists who are part of the healthcare management system.

For the general public, throughout the yatra, the association raised a demand that the free drug distribution system now prevailing in the state should be made more efficient and well-organised. Likewise, steps should be taken to control the rise in drug prices and protect the small scale drug distribution sector.  Taxes of any kind on drugs should be exempted.

As a state issue, KPPA wanted the government to avoid its sluggish attitude towards the state public sector enterprise, Kerala State Drugs & Pharmaceuticals (KSDP), and embark on projects to protect the company.

On the part of national issues, the state march of the pharmacists highlighted several demands including shifting of department of pharmaceuticals from ministry of chemicals & fertilizers to the ministry of health & family welfare.
http://www.pharmabiz.com/NewsDetails.aspx?aid=84027&sid=1

State FDA implements online system across all zones for issue of mfg licences Shardul Nautiyal, Mumbai

Maharashtra Food and Drug Administration (FDA) been able to successfully implement online Extended Licensing Node (XLN) system for effective and timely issuance of renewal of licenses, testing licences, licences for additional products, performance certificate and free sale licences for over 1700 manufacturing units across the state. 

In the process, Konkan division of Maharashtra Food and Drug Administration has cleared 50 per cent of the 800 applications for manufacturing licenses after the introduction of online Extended Licensing Node (XLN) system. The system was introduced in the division recently as a part of the state FDA's drive to speed up the issue of licences and certificates in the state online.

Konkan division accounts for the maximum number of 800 licensed manufacturing units out of the state's 1703 pharma manufacturing units. Apart from renewal of licenses and licences for additional products, applications for licensees also include certificates required for exports and others like free sale certificate, no conviction certificate, capacity certificate, general GMP certificate, GLP certificate and market standing certificate. The new XLN system has led to drastic improvement in terms of processing of renewals of licences and granting of certificates with no bureaucratic hassles.

Says an official associated with the development, "The system has been able to simplify the process of granting certificates and licenses and has considerably brought down the time taken due to bureaucratic hassles."

The XLN system, according to a senior FDA official would be a boon for over 1700 existing manufacturing units across the state as system will deliver online approvals for over 6 certificates required by pharma manufacturing units. The state FDA receives 8000 to 10,000 applications in a year for manufacturing licences.    

The system will help considerable saving in time and manpower as it will be centralised and paperless. There are 1703 manufacturing units in the state out of which 247 units are WHO GMP certified. There are 883 allopathic units, 452 ayurvedic units, 31 homoeopathic units and 337 cosmetic product units across the state. Exports of medicines worth Rs. 15,500 crore have been accounted from Maharashtra in the year 2013-14
http://www.pharmabiz.com/NewsDetails.aspx?aid=84029&sid=1

Karnataka govt strengthens its Drugs Control dept with new staff, promotions Nandita Vijay, Bengaluru

Karnataka government has now gone on to augment the strength of its drugs control department by appointing and promoting officers to its enforcement and laboratory wings.

To begin with BT Khanapure has been promoted as Additional Drugs Controller. He was earlier Deputy Drugs Controller at Mysore.

The department has received the promotion orders of 24 drug inspectors to the post of assistant drugs controller. Further 11 junior scientific officers are promoted as scientific officers who will also be government analysts. In addition, four junior scientific officers are deputed to pursue M Pharma which allows them to garner higher knowledge and enhance their expertise in the field.

The state government is also contemplating to create a post of principal scientific officer to give a fillip to the drug testing activities in the drugs control department.

It has also made efforts to promote seven assistant drug controllers as deputy drugs controllers.  Ten drug inspectors and six junior scientific officers are shortly to be inducted into the department and are currently awaiting their joining orders.

Besides, some of the existing staff in the drugs control department have been promoted to various cadres of junior scientific officers, gazette assistant officers and office superintendents.

The current working strength of the drugs control department in Karnataka stands at 480 personnel.  Although sanctioned strength of the drug inspectors is 112, there are presently 34 functioning in the department. In an effort to fill up the vacancies, the drugs control department will communicate with the Public Service Commission for 74 candidates from the Karnataka Public Service Commission (KPSC), Raghurama Bhandary, drugs controller government of Karnataka told Pharmabiz.

The government has recognised the need for additional personnel and has  embarked on a recruitment drive. This would enable us to delegate the required personnel for the various assignments and developing the capacity to perform efficiently, he added.

Going by the transformations in the pharma and biotech industry, new regulations by the international regulatory authorities, frequent inspections by the global enforcement officials has created the need for additional personnel in the department, noted the Karnataka drugs controller 

He went on state that recently the enforcement officers of Belgaum and Davangere have raided the clinics of four quack doctors and seized various allopathic drugs including steroids and injections worth Rs.2.5 lakh. Cases are registered against these practicing quacks under the provisions of the Drugs and Cosmetics Act also. “This indicates the constant monitoring and need for more personnel to keep a close watch across drug production plants, pharmacy outlets and clinics to keep unethical practices at bay,” he said.
http://www.pharmabiz.com/NewsDetails.aspx?aid=84031&sid=1

Indian family refuses to receive body of MERS victim | Business Standard News

Indian family refuses to receive body of MERS victim | Business Standard News

Indian origin scientists discover gene related to sleep patterns Mihika Basu

SCIENTISTS have discovered a gene that is responsible for your sleep patterns. So if you find your sleep cycle disrupted after a jet lag or a graveyard shift at work, it's because Lhx1, the body's timekeeper of sorts, is doing its job.
According to the scientists, both of Indian origin, the discovery of the gene is relevant for modern society where our sleep-wake cycles are disrupted by the schedules we choose to keep. They say the discovery can help in finding treatments for sleep problems, enabling shift-workers or jet-lagged travellers to adjust to time differences.
“We found a gene called Lhx1 that controls how individual clock neurons talk to each other. Such cross-talk helps consolidate activity and sleep to the right time of the day and prevents the sleep time from wandering when the light or dark cycle changes. The study shows that weakening the cross-talk among clock cells can be an effective method to change sleep- or activity-time, which is particularly useful for people who work between day and night shifts, so that they can adjust their sleep-time easily when their work-shift changes. Nearly 10-15 per cent of the workforce in most countries are shift-workers. When they change from night to day shift or when they try to be 'day active' during the weekend, it is very difficult for them to readjust their sleep time. Consequently, they get less sleep, have reduced productivity and, in the long run, are predisposed to many chronic diseases. Finding a treatment to readjust sleeping time will hugely benefit them," said Dr Satchidananda Panda, associate professor at the Salk Institute, in an email interview.
Dr Shubhroz Gill, researcher at Salk Institute and co-first author of the paper, which has been published in the journal eLife, further explained that humans have internal biological clocks that generate 24-hour rhythms for sleep, waking hours and to maintain body temperature, among other things.
“The internal clock is useful only when it is in sync with the external clock, that is the day or night cycle. When a person travels from one time-zone to another, say, from San Diego to Mumbai, as soon as he or she lands in Mumbai, the internal clock is still running on San Diego time and is thus not very useful. As a result, it is realigned to Mumbai time, a process that takes a few days. In the meantime, the person undergoes the well-known adverse effects...namely, jet
http://www.financialexpress.com/news/indian-origin-scientists-discover-gene-related-to-sleep-patterns/1288489

Memory Loss affected by Blood type group

The study suggests that people with AB blood group developed 6 percent cognitive mutilation, which is 4 percent more than other blood group people.The study, published in Neurology, found that AB blood group people, about 4 percent of the population, are more likely to face memory loss problems when compared to those with other blood types or groups.

The study identified 495 participants who developed thinking and memory problems, or cognitive impairment, during the three-year study. They were compared to 587 people with no cognitive problems.An aid organization said the best method to keep the mind and brain healthy can be achieved with balanced diet, minimal exercises and non-smoking.


Get medical X-rays printed on plain paper, courtesy Ricoh India

Ricoh India has unveiled a printing solution that can print medical images like X-Rays on plain paper instead of conventional films. This printing solution aims to bring down the cost of healthcare delivery,
DICOM or Digital Imaging and Communications in Medicine, has revolutionized the practice of Radiology. DICOM has enabled advanced medical imaging applications that has “changed the face of clinical medicine”. From the emergency department, to cardiac stress testing, to breast cancer detection, DICOM is the standard that makes medical imaging work – for doctors and patients.
Ricoh DICOM print solution is designed specifically for healthcare sector, to meet the needs of Medical Imaging Department. Using this solution all medical images from different modalities, like X-ray, CT, MRI, Ultrasound, etc can be directly printed on plain paper by Ricoh MPC2003SP printer. This colored printer has been specifically customized for this process. The printing solution also impacts the environmental aspects of customer’s daily operations, as DICOM plain paper print reduces the need for chemical-based film processing and equipment, and further can be shredded and recycled.
One of the major challenges that the Indian diagnostic and health care industry faces is high print cost of medical imaging. It is also tedious to manage multiple printing devices for different medical images, and administration of various output sheets like films and papers. This conventional method and its higher running cost forces the diagnostic industry to compromise on the profits in order to ensure the customer retention. Ricoh claims to reduce costs by 50 per cent through its MPC2003SP printer.
http://www.financialexpress.com/news/get-medical-xrays-printed-on-plain-paper-courtesy-ricoh-india/1288646

Merck supports diabetes education programme in Maharashtra Our Bureau, Mumbai

Merck, a leading German pharmaceutical and chemical company, in collaboration with Maharashtra University of Health Sciences and Directorate of Medical Education & Research, Mumbai, has pledged to support diabetes education as part of its Capacity Advancement Programme in the state. 

During her visit to India, Rasha Kelej, vice president, Head of Global Business Responsibility and Market Development, Merck Serono, said: “Merck is pleased to launch the Merck Capacity Advancement Programme in India as part of our commitment to providing sustainable access to high-quality health solutions and safe medicines in India and the rest of Asia.”

The Merck Capacity Advancement Programme aims at expanding the professional capacity in the areas of research and development, clinical research, supply chain integrity and efficiency, pharmacovigilance, medical education and awareness for medical and pharmacy undergraduates, physicians and pharmacists in rural areas.

Honourable Minister of Medical Education and Horticulture of Maharashtra, Shri. Jitendra Awhad, welcomed Merck stating: “We are especially delighted to partner with Merck, the world’s oldest pharmaceutical and chemical company, to implement such a noble initiative such as Merck’s Capacity Advancement Programme and to associate with other institutions whose overall objectives and goals are directed towards alleviating challenges of emerging diseases such as Diabetes by supporting Diabetes education.”

He added, “We welcome initiatives of this kind in our country and look forward to its success to help medical students, healthcare providers and public to have access to safe and high quality health care solutions across India.”

Elcin Ergun, executive vice-president, head of Global Commercial of Merck Serono, “We are fully committed to partner with Governments, Universities, Healthcare institutions and Patients Associations in India to develop and deliver solutions to expand healthcare capacities and improve access to health as part of the Merck Capacity Advancement Programme. The 5 year Programme was kicked off successfully in 7 sub- Saharan countries which are Kenya, Uganda, Namibia Angola, Ghana, Tanzania and Mozambique and will further expand to other Sub-Saharan and Asian countries and in 2014.”

Based on its long experience in diabetes management, which began in 1957 with the development of metformin, Merck Serono seeks to raise awareness of diabetes in Africa by educating the public and supporting the healthcare system to prevent, diagnose and manage the condition effectively. As part of the Merck Capacity Advancement Programme, more than 1,000 medical students from the Maharashtra University of Health sciences will benefit from European-accredited clinical diabetes and chronic diseases management training, which is seeking to equip them with skills to avert the diabetes epidemic. Merck is planning to target 9,000 students by the end of 2018 expanding to more sub-Saharan and Asian countries.

During the meeting Hon. Minister, Shri. Jitendra Awhad said: “Working in partnership with Merck, we have no doubt that we are getting quality, mature and professional partnership that will help to build Diabetes health care Capacity in India.”

Merck is greatly honored to collaborate on this Programme with our valuable partners in Maharashtra State to improve the standard of diabetes healthcare, medical education and awareness of diabetes in India. 

The rising numbers of diabetics all over the world calls for prioritising diabetes care and awareness to prevent the disease from turning into an epidemic. The Merck Capacity Advancement Programme seeks to improve the healthcare sector in India with special focus on rural areas through educating and empowering those affected by diabetes on how to manage and prevent it.

It is evident that with such support diabetes will be better managed and even preventable as information on the disease spreads across the nation.

In addition to medical education and awareness, Merck shall continue to work with partners in India at large to expand the capacity of professionals in diabetes management through its Capacity Advancement Programme.
http://www.pharmabiz.com/NewsDetails.aspx?aid=84017&sid=2

Expert panel recommends expanded adoption of drug and transfusion treatments for individuals with sickle cell disease Bethesda, Maryland

An expert panel has recommended expanded adoption of the drug hydroxyurea for the care of people with sickle cell disease, according to a report issued. The report also suggests that clinicians give periodic blood transfusions to children with the disease to reduce stroke risk. According to the panel, both treatments are underutilized.

The National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, convened the panel to review the evidence and make recommendations relating to care available to those with this inherited blood disorder. The report, Evidence-Based Management of Sickle Cell Disease, Expert Panel Report, 2014, gathers the latest sickle cell prevention and treatment information into one document.

Along with those recommendations, the report emphasizes the need for consistent, high-quality health maintenance for people with sickle cell disease. Examples of health maintenance recommendations include the regular use of penicillin through age 5 to reduce the chance of deadly infections, and the importance of pneumococcal vaccines for children and adults.

“Since the NHLBI’s earliest days, sickle cell disease has been an important part of its mission,” said Gary H. Gibbons, M.D., director of the NHLBI. “This report represents an important milestone as NHLBI continues to seek new ways to reduce the burden of this devastating condition.”

Sickle cell disease is relatively rare, affecting an estimated 70,000 to 100,000 Americans. African-Americans make up the majority of those with the disease, though others affected include people of Hispanic/Latino, Mediterranean, and Middle Eastern descent. The report aims to provide a clinical resource for primary care providers, nurses, specialists, emergency care personnel, and other members of the health care community, many of whom have limited experience treating people with this condition.

Sickle cell disease results from an abnormality in hemoglobin, the protein found in red blood cells responsible for moving oxygen throughout the body. People living with this condition carry two copies of an altered gene that produces sickle-shaped hemoglobin instead of normal adult hemoglobin, which looks more like a disk. Sickle hemoglobin causes the red blood cell to become stiff, misshapen and sticky, which can slow blood flow to tissues. This process can damage organs and cause pain throughout the body. Severe pain episodes often require emergency room visits.

The NHLBI formed a 12-member external expert panel to thoroughly examine evidence and review current practices in the management of sickle cell disease. In addition to experts in adult and pediatric hematology, the panel included representatives from the fields of family medicine, general internal medicine, psychiatry, transfusion medicine, emergency nursing as well as obstetrics and gynecology. George R. Buchanan, M.D., of the University of Texas Southwestern Medical Center in Dallas, and Barbara Yawn, M.D., of the University of Minnesota, co-chaired the panel.

The NHLBI plans to work with organizations such as the American Society of Hematology and the Sickle Cell Disease Association of America to help broadly disseminate the report so that it can be more quickly put into wider practice and improve consistency of care.

“We recognize that these clinical guidelines are not the end of the conversation,” said Dr. Gibbons. “The NHLBI remains committed to being a global leader in sickle cell research. The panel report provides guidance for our future research agenda to enhance the well-being of patients with sickle cell disease.” 

Among the known information gaps is the lack of a widely available cure and the fact that some children with the condition are at high risk of stroke. Modified bone marrow transplants have cured some children and adults, but the procedure is only currently viable for a small number of people.

Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. 
http://www.pharmabiz.com/NewsDetails.aspx?aid=84015&sid=2

NPPA warns of penal action against cos failing to maintain production level of essential drugs Ramesh Shankar, Mumbai

Concerned over the scarcity of certain essential medicines like anti-malarial combination of sulfadoxine + pyrimethamine tablets, rabies vaccine, anti-snake venom, etc in the country, the National Pharmaceutical Pricing Authority (NPPA) has warned the concerned manufacturers and importers of penal action under the relevant provisions of Essential Commodities Act, 1955 if they fail to resolve the issue of shortage of these drugs in the country immediately.

The NPPA has also directed them to maintain the production level and adequate supply of these medicines and also ensure submission of the information in Form- III of the Schedule -II of the DPCO, 2013 quarterly. Besides, the NPPA has directed them to comply with the requirements contained in para 21(1) and provide the month-wise production and sale figures for these drugs for the last 12 months under para 29 of DPCO, 2013. 

In a notification, the NPPA said that the scarcity of certain essential medicines, namely, anti-snake venom, rabies vaccine, rabies immunoglobulin, albumin injection and anti-malarial combination of sulfadoxine + pyrimethamine tablets has been reported to the NPPA and in absence of regular reporting under DPCO, 2013 by the manufacturers, it appears that the concerned manufacturers are not maintaining normal supplies of these medicines in domestic market and/or institutions. Hence, the availability of such vital and essential drugs has been affected many parts of the country. 

“Now, therefore, in exercise of the powers delegated under para 21(1) and para 29 of the Drugs (Prices Control) Order, 2013 vide S.O. No. 1394(E) dated 30th May, 2013 issued by the Government of India in the Ministry of Chemicals and Fertilizers, in exercise of powers conferred by section 3 and 5 of the Essential Commodities Act, 1955, the National Pharmaceutical Pricing Authority after being satisfied that it is necessary in the public interest so to do, hereby direct that all the concerned manufacturers/importers shall comply with the requirements contained in para 21(1) and provide the month-wise production and sale figures for the last 12 months under para 29 of the said Order immediately to the NPPA. All the manufacturers/importers of the essential medicines specified in para 7 above shall also submit a compliance report of resolving the shortage of these drugs in the country immediately but not later than 96 hours from the date of issuance of this notification to NPPA”, the NPPA notification said.

Para 21(1) of DPCO inter alia authorises that the government, shall monitor the production and availability of scheduled formulations and the active pharmaceutical ingredients contained in the scheduled formulation and the manufacturer of scheduled formulations and the active pharmaceutical ingredients contained in the scheduled formulation shall furnish the information as stated in Form-III of Schedule-II of this Order quarterly.

And para 29 of DPCO provides that every manufacturer shall maintain records relating to the sales of individual active pharmaceutical ingredients or bulk drugs manufactured or imported and marketed by him, as the case may be, and the sales of formulations units and packs and also such other records as may be directed from time to time by the government and the government shall have the power to call for any record and to inspect such records at the premises of the manufacturer.

“In case of failure/non-compliance of para 8 above, the manufacturer/marketer/importer shall be liable for penal action under the relevant provisions of Essential Commodities Act, 1955”, the NPPA has warned.
http://www.pharmabiz.com/NewsDetails.aspx?aid=84006&sid=1

Cipla, Pfizer, Sanofi cut prices of diabetic, cardiac drugs as per NPPA order on July 10 Shardul Nautiyal, Mumbai

Cipla, Pfizer and Sanofi have started supplying drugs capped in the anti-diabetic and cardio-vascular segments as per the July 10 NPPA notification which has brought in as many as 108 anti-diabetic formulation and cardiovascular formulation packs under price control. Few other pharma companies have however approached the Courts against the NPPA order. 

National Pharmaceutical Pricing Authority (NPPA) had fixed the prices of 108 formulation packs of 50 non scheduled drugs in antidiabetic and cardiovascular segments effective from July 10, 2014 in the wider public interest. 

As per sources, the prices of antidiabetic and cardiovascular drugs across all brands would vary in the range of 10 per cent to 40 per cent. Anti-diabetic drug Amaryl 1mg 15 tablets from Sanofi is currently being supplied at the revised DPCO price at Rs.60.15 as compared to the earlier price ofRs.112 and Amaryl 2 mg 15 tablets is currently being supplied at the revised DPCO price at Rs.98.10 as compared to the earlier price of Rs.160.15. Sanofi's anti-hypertensive drug Cardace 2.5 mg is now available at the current revised price of Rs.59.30 for 15 tablets as compared to the earlier price of Rs.79.80. Cardace 5 mg is now available at the current revised price of Rs.92.10 for 15 tablets as compared to the earlier price of Rs.128.80.

As per sources, Ranbaxy has issued a letter to the stockists with reference to the subject of notification by NPPA dated 10 July 2014. The copy of the letter which is with Pharmabiz states - "We draw kind attention of stockists to our circular dated 26 August 2014 on the above subject and wish to share the update on the matter pending before Bombay High Court. The matter which was initially fixed for hearing on 28 August, 2014 got postponed to 2nd September 2014. On 2nd September, 2014 also, the matter could not be heard and next hearing is fixed for 24 February, 2015. 

The letter further stated that "As you are aware the aforesaid notification is being challenged by IPA and as per Bombay HC direction no coercive action is to be taken until the matter is heard by the court on next hearing viz., 24 February 2015. As informed earlier, we shall abide by the Order of the Hon'ble Court and we shall keep you posted on the final outcome of this case. Meanwhile, we would like to mention that business will continue to be as usual with you and that Ranbaxy shall take all due steps to be in compliance with law and at the same time we assure to protect business interest of all our business partners. We appreciate your continued business support and request you to maintain inventory level commensurating to your secondary sales in the interest of patient servicing." 

The Indian Pharmaceutical Alliance (IPA) and the Organisation of Pharmaceutical Producers of India (OPPI), had challenged the order in the Bombay and Delhi high courts, respectively. While the Delhi High Court has refused to entertain the OPPI petition seeking a stay on the DPCO, the Bombay HC is yet to hear the IPA plea.

The Delhi High Court had on August 1 refused to stay NPPA's July 10 order fixing prices of 108 non-scheduled drugs, but sought responses from the pricing authority by September 29, when it will hear the petition.

Significantly, the Delhi HC observed that paragraph 19 of the 2013 DPCO does not restrict price fixation to only essential drugs. Paragraph 19 of DPCO, 2013, authorises the NPPA in extraordinary circumstances, if it considers necessary so to do in public interest, to fix the ceiling price or retail price of any drug for such period as it deems fit, the court had said.
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Mumbai FDA lab report says drugs with ADRs in patients are of standard quality Shardul Nautiyal, Mumbai

Maharashtra Food & Drug Administration's (FDA) Mumbai testing lab, in its recent report, says the concoction of drugs ceftriaxone and cefotaxime which led to adverse reactions in patients at three state run government hospitals a fortnight ago in Mumbai are of standard quality. Maharashtra FDA is also in the process of directing stockists and hospitals to allow use of ceftriaxone and cefotaxime.  

Maharashtra FDA had started a probe a fortnight ago into three other cases of adverse drug reactions at the state-run Indira Gandhi Memorial Hospital (IGM) in Bhiwandi and later at BMC-run K B Bhabha and Rajawadi hospitals in Ghatkopar. In the case of the Bhiwandi and Ghatkopar hospitals, all patients went home after some days, but the drug reaction at Bhabha Hospital claimed the life of a 47 year old lady.

Says a senior Maharashtra FDA official, "FDA lab investigated the samples for carrying several tests including microbiology and sterility tests. Over 50, 000 samples were distributed to 14 hospitals across the city and no such drug reaction has been reported. The incidents of adverse drug reaction were reported only in the female ward of the civic run Bhabha Hospital. Drugs are of standard quality and may be considered safe for use."

Meanwhile, experts continue to debate the drug reactions and say that ceftriaxone and cefotaxime are not known to cause serious reactions. Adverse drug reactions are known to occur frequently in females but such an observation has not been reported as yet with this group of drugs. 

Based on the scientific literature available, experts also advocate that the drug injected should be checked for degradation and the allergic history for the penicillins and cephalosporins of the dead patient should be cross verified. ceftriaxone is the common drug which is associated with adverse drug reactions. Many of the reactions subside after the discontinuation of the drug.

Cefotaxime which is used to treat bacterial infections was the common drug to be tested and drugs used were from separate batches at both hospitals. The Bhiwandi incident saw only children getting affected, whereas at Bhabha and Rajawadi, women suffered adverse effects. 

FDA officials had instructed stockists and hospitals to stop use of over thousand vials of ceftriaxone injection (batch number 314-331) manufactured under the brand name, Sefxim, by Zee Labs, Himachal Pradesh, and sterile water for injection (batch number 3WT-259) manufactured by Parenteral Drugs Limited, Baddi, Himachal Pradesh, until the completion of investigation. Cefotaxime injection is currently being manufactured under the brand name, Sanocef, by Sanjivini Parenteral Drugs, Navi Mumbai.
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TeamLease receives big spurt in applicants from scientists with closure of 2 R&D facilities Nandita Vijay, Bengaluru

TeamLease, the country’s temporary staffing major, has observed a noticeable increase in the number of job hunters in the pharmaceutical research & development space. This is because of the recent closures of research centres of Piramal Life Sciences and AstraZeneca in India leaving scientists to search for new openings in the sector.

“Pharmaceutical R&D industry is going through a turmoil. Regulatory procedures are complex in clinical trials. There are constraints like paucity of financing opportunities for R&D and the delay in securing intellectual property rights (IPR). With increase in the investments and discovery failures at later stages has not justified expansions. The number of new drugs reduced drastically over a decade, Hussain Tinwala, general manager, TeamLease Services, told Pharmabiz.

The early stages of drug development are limited to a handful of local companies or few contract research organisations (CROs). Drug discovery is about productivity, companies need to focus on measures to boost productivity and efficiency at the same time work around on reducing time-to-market, he added.

R&D talent is limited for niche areas and with increasing demand, retaining key talent is also an important factor for companies engaged in R&D. Loss of key resources leads to loss of knowledge base and this further adds to the bottleneck which impacts the lead-time and people productivity. TeamLease had received few applications of candidates open to explore other industries apart from pharma, he said.

According to TeamLease, the fast moving consumer goods (FMCG), food and chemical industries attracts few skills which are found and similar to pharma R&D industry. While AstraZeneca and Piramal have close down their R&D units, Cipla has made a recent announcement to invest Rs.600 crore in R&D. From talent perspective, opportunities are immense. Hiring for key talent within pharma happens mainly through network or internal recommendations. Key individuals armed with niche skills find considerable opportunities through their own network.

Now the Union government needs to expand investments in healthcare and medical insurance. This will widen the opportunities for generics for pharma companies who could then re-invest in the drug discovery for the future. India is already attractive for global investments because of the access to scientific research acumen. Therefore government should look to attract players to set up R&D centres here or scout for strategic joint ventures with Indian pharma and biotech companies. Further the government needs to expedite and resolve challenges pertaining to intellectual property. All these would only create more job in R&D, pointed out Tinwala.

Pharma companies have to explore possibility of collaborating with different institutes/universities to engage students in generating fresh ideas towards discovery. This investment will not only develop fresh graduates with an innovative approach but also involves as cost effective measure, noted Tinwala.
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Professional bodies of doctors demand formation of Union of Healthcare Commission of India Peethaambaran Kunnathoor, Chennai

The professional bodies of allopathic doctors from all over the country are contemplating on a new idea to put up before the Union government by demanding to form a Union Healthcare Commission for India (UHCI) to bring all the healthcare governance under the control of doctors.

With this demand the leaders of the associations, including those of specialties, will soon meet the Union health minister, Dr Harsh Vardhan, it is learnt.

A discussion in this regard is going on in the national level on an online forum of doctors chaired by Dr MC Gupta, a medico-legal consultant and the former professor from AIIMS, New Delhi.

All the associations of doctors are supporting the idea and the state chapters of Indian Medical Association (IMA) have been asked to unite and brainstorm on this. One Dr CV Rathore from Chandigarh is the mastermind behind this initiative.

According to him, the doctors must involve in every healthcare service and be in control right from strategy to planning to commissioning and delivery of all kinds of services. They should control the whole healthcare services. He says that all the policies should find the workable grounds for doctors, and the budgetary allocation, resource deployment and processes should come in the control of doctors who are the backbone of the delivery system.

However, there are disagreements with this idea of Dr Rathore as some doctors are of opinion that Union Healthcare Commission of India cannot be met through legal means. But, the IMA, which represents the whole medical profession, must take up this issue at the political and government level, said Dr MC Gupta.
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Health ministry makes inclusion of 3 parameters mandatory in clinical trial applications Ramesh Shankar, Mumbai

The Union health ministry has made it mandatory for the clinical research organisations (CROs), clinical trial sponsors, medical institutions and other stakeholders involved in the conduct of clinical trials to provide information on assessment of risk versus benefit to the patients; innovation vis-à-vis existing therapeutic option; and unmet medical need in the country.

A directive in this connection has been issued by the Drugs Controller General of India (DCGI). 

The DCGI's action in this regard comes in the backdrop of the Supreme Court order.  In the case of W.P. (C) No. 33/2012 of Swasthya Adhikar Manch, Indore & Anr Vs Ministry of Health and Family Welfare & Ors with WP © No.779/2012 regarding clinical trials, the Supreme Court had passed an order dated 21/10/2013. As per the said order, all the Global Clinical Trials (GCTs)/New Clinical Trials (NCEs) should be evaluated having regard to three parameters, namely assessment of risk versus benefit to the patients; innovation vis-à-vis existing therapeutic option; and unmet medical need in the country.

“In view of the above, it has been decided with the approval of the ministry of health and family welfare, all the applications for the conduct of clinical trials of new drugs in India should invariably provide the information on (i) assessment of risk versus benefit to the patients, innovation vis-à-vis existing therapeutic option and unmet medical need in the country” the DCGI in his directive said.

All the sponsors/CROs/medical institutions and other stakeholders involved in the conduct of clinical trials in the country are hereby directed to adhere to the above requirement of inclusion of the three parameters in their clinical trial applications with immediate effect, the DCGI directive further said. 
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PCI to soon launch train the teachers programme for upgrading CEPs in line with industry needs Shardul Nautiyal, Mumbai

Pharmacy Council of India (PCI) is in the process of introducing 'train the teachers programme' for upgrading continuing education programme (CEP) for pharmacists across the country in accordance with pharma industry needs. This is part of PCI's plan to upgrade the CEP curriculum towards upgrading the skills of pharmacists. 

Says Dr B Suresh, president, PCI, "It is a step forward in the direction of value enhancement of the knowledge of pharmacists in context of the global regulatory environment. PCI's quality assurance programme envisages to devise new industry based curriculum and modules oriented towards pharmacists to help them in enhancing their competencies in the current regulatory framework." 

"People from the industry and regulatory bodies need to be made part of the CEP programme. This would bring about uniformity in CEPs and offer a level playing field for all the pharmacists across the country," he adds.

PCI is looking into the quality assurance aspect in pharmacy education taking into consideration the pharmacist's role in serving the industry and trade in a professional and ethical manner. "We are working on models to strengthen the educational programme for which we are planning to make certain variations in the CEP. As a part of the Quality Assurance programme, there is a need to strengthen CEP by customising it according to the needs of pharmacists in various parts of the country based on the regions and their requirements. These programmes will also involve industry people and other stakeholders in the process of framing the curriculum to give the much required exposure to the pharmacists," explains Dr Suresh.

Clinical services provided by pharmacists are fairly new to India and there is also a shortage of clinical pharmacy trainers. Besides this, expansion of pharmacy education in India marks an uneven distribution of colleges across states with quality of education being variable.

Around 60,000 students pass out every year from pharmacy colleges in India. There are one million pharmacists and around seven lakh chemists across the country. Therefore, there is a need to empower pharmacists across the country as facilitators in the process of pharmacy practice considering the huge requirement.
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