Mumbai: French drug maker Sanofi SA, a relative newcomer in India’s Rs.4,600 crore diabetes management market, is changing the rules of the game by lowering prices and localizing products for treatment of the disease in a country that has the world’s second largest population of diabetes patients, next only to China.
The Paris-based pharmaceutical company in October launched a low-cost, reusable insulin pen called AllStar, priced at Rs.650. Used by patients for injecting insulin, the device is manufactured at a new facility in Gujarat, one of two such plants Sanofi has worldwide.
India, which is home to 61 million diabetes patients, had been importing such devices before the introduction of the product. The imports are not only priced higher, but are less convenient for use by Indian patients, said Shashank Joshi, a senior endocrinologist and consultant at Lilavati Hospital in Mumbai.
“AllStar is a real trendsetter as it is the first such device developed to fit the country’s requirement in terms of insulin stability in Indian conditions, reusability of the device by changing the cartridge, and its affordability,” said Joshi.
Sanofi is the third largest diabetes drug maker in India, with an 8% share of the market and sales growing by at least 18% a year. Its larger rivals are Danish insulin maker Novo Nordisk A/S, USV Ltd, Sun Pharmaceutical Industries Ltd, Abbott India Ltd and Eli Lilly and Co., which have a presence in the market.
Apart from being the first to produce an insulin device locally, Sanofi, which established an active diabetes portfolio globally in 2009, is planning insulin production in India shortly through local subsidiary Shantha Biotechnics Ltd as it seeks a greater market share.
Cyrus Aibara, senior director of Sanofi’s diabetes business unit, said in an interview in October that production of insulin will begin in a year or two. “We will transfer insulin-making technology to Shantha, which produces vaccines at present, and the company is evaluating the whole process,” he said.
India has about 126 large and small companies competing in the fragmented market for treatment of diabetes; only 41 have sales of more than Rs.10 crore a year. While most top companies are also engaged in patient screening and counselling to understand the reasons for the spread of the disease and to prepare suitable market strategies, bringing appropriate solutions to the market is often difficult.
“There are various challenges in managing diabetes in a country like India, including low awareness of the disease, and low access to new drugs and healthcare services,” said an industry adviser with a global consulting firm. “New solutions to address these in a quality and cost-effective manner is a welcome trend.” He didn’t want to be identified.
Sanofi, which has identified diabetes as one of its core segments, has been tailoring strategies to local conditions. India is one of the most important markets for the company in its diabetes business.
Differential pricing, low-cost manufacturing, introduction of innovative products, and rapid penetration into vast rural markets are some of the strategies it has adopted in the world’s second most populous nation.
“We have developed an innovative model to provide comprehensive disease management through an economically viable approach which places patients and their needs at the centre of concerns,” Robert Sebbag, vice-president, Access to Medicines, a corporate social responsibility initiative of Sanofi, said in an interview in November.
Sanofi is planning to introduce yet another innovation in diabetes treatment by combining different therapies targeting the overall management of diabetes and related complaints including weight gain, blood pressure and heart disease through a “diabetes pack” aimed at emerging markets including India.
“We are exploring the possibilities of combining various therapies in a single pack for better patient compliance by partnering with other providers as well to help combat the disease,” Sanofi chief executive officer Chris Viehbacher said in Paris last week.
Other global pharma companies are also trying to expand in India’s diabetes management market, which is growing by at least 22% a year, but localization in terms of pricing and manufacturing is still not a viable option for many of them.
“Our central focus remains on diabetes in India,” said a executive from Eli Lilly India, had in an earlier interview. He declined to be named.
Eli Lilly last year announced a $30 million (around Rs.163 crore) project to fight non-communicable diseases such as diabetes and cancer in Brazil, India, Mexico and South Africa. It has put in place a team of some 70 diabetes educators to provide counselling services in India to patients and healthcare providers.
The US-based company, which has a market share of around 5% in India, has formed marketing alliances with German drug maker Boehringer Ingelheim GmbH and India’s Lupin Ltd to enhance the product portfolio and marketing reach.
Market leader Novo Nordisk has initiated an India-centric study to screen children and adolescents for young-age diabetes. The company has also joined hands with many state governments to fight diabetes.
While the Indian market is unique in terms of the nature of the disease and the affordability of treatment, the most successful competitors will be those that can quickly adapt to specific local needs, said the industry adviser quoted above.
Data from Sanofi shows that only 15 million, or less than 25%, of Indian patients are currently treated for diabetes, leaving the rest with no access to modern treatments or under alternative treatments.
Most patients in India suffer from type 2 diabetes, accompanied by related health complications such as high blood pressure, obesity and other ailments. Sanofi plans to shortly launch its first combined treatment for obesity and diabetes with the expected approval of a new drug, Lyxumia, in India.
Type 2 diabetes typically starts at the age of 40. But in India, it is also seen in children and adolescents, and is often linked to obesity.
According to a Pharmaceutical Research and Manufacturers of America report released last Friday, patients battling diabetes and associated complications may benefit from new therapies targeting abnormalities of the pancreatic cells, seeking to increase insulin secretion without significantly reducing blood sugar, minimizing painful nerve damage, and preventing diabetic kidney disease, if early research pans out.
“Innovative bio-pharmaceutical research companies currently are developing 221 innovative new medicines to help the nearly 347 million patients affected by diabetes, including India, which is known as the diabetes capital of the world,” the report said.