Final Cadila Report

7/28/2019 Final Cadila Report

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Internationally the companies are facing short term as well as long-term pressures. To

live auto the past growth rates they are truing to different things. Strengthening of

Research marketing seams to be the focus :

Top companies are merging.

Divesting non-core healthcare businesses.

Spending more on research to bring NCEs faster.

Partnering with genomic and drug discovery companies.

Increasing sales forces.


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Indian Scenario

The Indian Pharmaceutical Industry today is in the front rank of Indias science-

based industries with wide ranging capabilities in the complex field of drug

manufacture and technology. A highly organized sector, the Indian Pharma Industry is

estimated to be worth $ 4.5 billion, growing at about 8 to 9 percent annually. It ranks

very high in the third world, in terms of technology, quality and range of medicines

manufactured. From simple headache pills to sophisticated antibiotics and complex

cardiac compounds, almost every type of medicine is now made indigenously.

Playing a key role in promoting and sustaining development in the vital field ofmedicines, Indian Pharma Industry boasts of quality producers and many units

approved by regulatory authorities in USA and UK. International companies

associated with this sector have stimulated, assisted and spearheaded this dynamic

development in the past 53 years and helped to put India on the pharmaceutical map

of the world.

The Indian Pharmaceutical sector is highly fragmented with more than 20,000

registered units. It has expanded drastically in the last two decades. The leading 250

pharmaceutical companies control 70% of the market with market leader holding

nearly 7% of the market share. It is an extremely fragmented market with severe price

competition and government price control.

The pharmaceutical industry in India meets around 70% of the country's demand for

bulk drugs, drug intermediates, pharmaceutical formulations, chemicals, tablets,

capsules, orals and injectibles. There are about 250 large units and about 8000 Small

Scale Units, which form the core of the pharmaceutical industry in India (including 5

Central Public Sector Units). These units produce the complete range of

pharmaceutical formulations, i.e., medicines ready for consumption by patients and

about 350 bulk drugs, i.e., chemicals having therapeutic value and used for production

of pharmaceutical formulations.

Following the de-licensing of the pharmaceutical industry, industrial licensing for


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most of the drugs and pharmaceutical products has been done away with.

Manufacturers are free to produce any drug duly approved by the Drug Control

Authority. Technologically strong and totally self-reliant, the pharmaceutical industry

in India has low costs of production, low R&D costs, innovative scientific manpower,

strength of national laboratories and an increasing balance of trade. The

Pharmaceutical Industry, with its rich scientific talents and research capabilities,

supported by Intellectual Property Protection regime is well set to take on the

international market.

ADVANTAGE INDIA

Competent workforce: India has a pool of personnel with high managerial and

technical competence as also skilled workforce. It has an educated work force and

English is commonly used. Professional services are easily available.

Cost-effective chemical synthesis:

Its track record of development, particularly in the area of improved cost-beneficial

chemical synthesis for various drug molecules is excellent. It provides a wide variety

of bulk drugs and exports sophisticated bulk drugs.

Legal & Financial Framework:

India has a 53 year old democracyand hence has a solid legal framework and strong

financial markets. There is already an established international industry and business

community.

Information & Technology:

It has a good network of world-class educational institutions and established

strengths in Information Technology.

Globalisation:The country is committed to a free market economy and globalization. Above all, it

has a 70 million middle class market, which is continuously growing.

Consolidation:

For the first time in many years, the international pharmaceutical industry is finding

great opportunities in India. The process of consolidation, which has become a

generalized phenomenon in the world pharmaceutical industry, has started taking

place in India.


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THE GROWTH SCENARIO

India's US$ 3.1 billion pharmaceutical industry is growing at the rate of 14 percent

per year. It is one of the largest and most advanced among the developing countries.

Over 20,000 registered pharmaceutical manufacturers exist in the country. The

domestic pharmaceuticals industry output is expected to exceed Rs.260 billion in the

financial year 2006, which accounts for merely 1.3% of the global pharmaceutical

sector. Of this, bulk drugs will account for Rs. 54 bn (21%) and formulations, the

remaining Rs. 210 bn (79%). In financial year 2005, imports were Rs. 20 bn while

exports were Rs.87 bn.

STEPS TO STRENGTHEN THE INDUSTRY

Indian companies need to attain the right product-mix for sustained future growth.

Core competencies will play an important role in determining the future of many

Indian pharmaceutical companies in the post product-patent regime after 2005. Indiancompanies, in an effort to consolidate their position, will have to increasingly look at

merger and acquisition options of either companies or products. This would help them

to offset loss of new product options, improve their R&D efforts and improve

distribution to penetrate markets.

Research and development has always taken the back seat amongst Indian

pharmaceutical companies. In order to stay competitive in the future, Indian

companies will have to refocus and invest heavily in R&D.

The Indian pharmaceutical industry also needs to take advantage of the recent

advances in biotechnology and information technology. The future of the industry will

be determined by how well it markets its products to several regions and distributes

risks, its forward and backward integration capabilities, its R&D, its consolidation

through mergers and acquisitions, co-marketing and licensing agreements.


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The Indian pharmaceutical industry is highly regulated. The Government controls

prices of a large number of bulk drugs and formulations. Profit margins of players

vary widely in both domestic and export sales due to many factors.

Over 20,000-registered pharmaceutical manufacturer exist in the country. The market

share of MNCs has fallen from 75% in 1971 to around 35% in the Indian

Pharmaceuticals market, while the share of India companies has increased from 20%

in 1971 to nearly 65%.

The domestic pharmaceuticals industry output is expected to exceed Rs. 247 billion in

FY 2006, which account for merely 15.6 % of the global pharmaceutical sector. Out

of the bulk drugs will account for Rs. 54bn (21%) and formulations the remaining Rs.

210bn (79%). In 2005, imports were Rs. 20bn while exports were Rs. 87bn.

The Indian Pharmaceutical sector has increased drastically in the last two decades.

The leading 250 pharmaceutical companies control 70% of the market with market

leader having nearly 7% of the market share. It is an extremely fragmented market

with severe price competition and government price control.

External Trade:

Indias pharmaceutical exports are to the tune of Rs. 87 bn, of which formulations

contribute nearly 55% and the rest 45% comes from the bulk drugs. In FY 2005

exports grew by 21%. Indias pharmaceuticals imports were to the tune of Rs. 20.3bn

in FY 2006. Imports have registered a CAGR of only 2% in the past 5 years. Imports

of bulk drugs have slowed down in the past 2-3 years.

The Indian pharmaceutical industry is highly regulated. The Government controls

prices of a large number of bulk drugs and formulations. Profit margins of players

vary widely in both domestic and export sales due to many factors.


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Future Prospects:

As per WTO, from the year 2005, India will grant product patent recognition to allNew Chemical Entities (NCEs) i.e. bulk drugs develop then onwards. This leaves

another 3 years of MNCs research output open to process piracy. But, long-term

prospects for MNCs are good.

Strategies of Domestic players:

Most of the domestic companies are expanding the therapeutic reach through new

product launches in high margin segments, thus enhancing the product portfolio

(proper basket of products helps in convincing the medical fraternity) and increasing

the critical mass. The long-term objective will be to enter into a higher platform of

biotechnology and drug delivery systems.


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CADILA PHARMACEUTICALS

THE INDIAN PHENOMENON

The Indian pharmaceutical industry is a success story providing

employment for millions and ensuring that essential drugs at affordable

prices are available to the vast population of this sub-continent.

Richard Gerster

The pharmaceutical scenario in India consists of a host of varied companies. All

compromising of a wide mix of organizational structures, climates and cultures.

Running the gamut from the deeply traditional to the radically modern. Each

advocating its special parameters for corporate success factors that differentiates

between the merely good and the truly exceptional.

And every once in a while, there comes along one, which is just that, truly

exceptional. An organization that takes its work dead seriously and its word even

more so. A work that stands for its deep-rooted commitment to its end-users,

markets, employees and associates. An organization like CADILA PHARMA

CEUTICALS LIMITED (CPL).

A company that came into being shortly after independence, (1951) when India

wasnt considered capable of handling something as crucial as health care and as

critical as life saving drugs. It wasnt long before the detractors were proven wrong.

Within a year, CADILA became the first pharmaceutical company in the world to

provide Vitamin B1, B6 and B12 together, in a compatible form.

Climbing steadily, from one triumph to another, crossing milestones in rapid

succession, CADILA PHARMACEUTICALS LTD., over the years has established

itself as a major pharma player.

Having emerged successfully with largest range of therapeutic groups, spanning 45

segments, with offices in four countries, exports to 90 nations and a wide range of

products registered oversees, CADILA PHARMACEUTICALS is a top 20 ranking

Indian Pharmaceuticals Group. Backed by world-class R&D and manufacturing

facilities, CADILA PHARMACEUTICALS covers the largest range of therapeutic

groups, in the Indian Pharmaceuticals Industry.


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Sphere of Activities

Research &Development Travel & Tea Estate HospitalHuman Branded Pharmaceutical Disposables

Formulations Machinery Mfg. Critical Care

Generics SpecialtyVeterinary Chemicals &

Herbal Lab care

Ago Business

Bulk Drugs

International Business


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SPHERE OF ACTIVITIES


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COMPANY PROFILE

Name of the concern Cadila Pharmaceuticals Limited

Constitution Public Limited Company

Date of Incorporation February 28, 1991

Business Group Cadila Pharmaceuticals

(Modi Group)

List of companies under Cadila Pharmaceuticals Ltd.Same management Casil Health Products Ltd.

Karnavati Engineering Ltd.Green Channel Travel ServicesLtd.IRM Labs Ltd.


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Corporate office

Cadila Pharmaceuticals Limited

"Cadila Corporate Campus"

Sarkhej-Dholka Road,

Bhat, Ahmedabad-382 210, INDIA.

Phone : +91-2718-225001 (15 Lines)

Fax :+91-2718-225039

e-mail :[email protected]

Situated in the close vicinity of Ahmadabad, yet away from the hustle and bustle of

the city life, is a serene location called Bhat. And their new Corporate Complex at

Bhat has already sensationalized the location! Spread over 15 Acres piece of verdant,

lush green land free from any kind of pollution, CADILA PHARMACEUTICALS

New Corporate Complex is setting an example, in the corporate history of India.

Cadila vision
mailto:[email protected]:[email protected]:[email protected]


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Our aim, to be a global player, will lead to the establishment of operations

in the key markets of the world, including the developed countries.

We shall seekjoint ventures with partners who are major players in their

country or region.

We aspire to enrich our people - our driving force to become highly

competent professionals and technology based.

By the turn of this decade, we shall be amongst the most admired

companies in India."

Cadila mission


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"We strive for a happier, healthier tomorrow. We shall provide

total customer satisfaction and achieve leadership in chosen

markets, products and services across the globe, through

excellence in technology, based on world-class

Research and Development.

We are responsible to the society. We shall be good

corporate citizens and will be driven by high

Ethical standards in our practices."

Our human resources will continue to be the most valuable

asset in this pursuit of leadership and the prime

driving force for our growth.


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CADILA PHARMACEUTICALS

A True Life Sciences Company

CADILA PHARMACEUTICALS, Ahmedabad, India is a top ranking

pharmaceuticals group with an annual turnover of Rs. 5500 million.

In tune with its corporate objectives, CADILA PHARMACEUTICALS is rapidly

expanding its global presence. CADILA PHARMACEUTICALS envisages a sharp

focus on product segments for growth, coupled with strategic alliances in key areas.

CADILA PHARMACEUTICALS is an integrated healthcare solutions provider

comprising Strategic Business Units: Human Branded Formulations, Generic &

Ontological Products, Animal Health & Natural Products, Biotech, Bulk Actives and

International Business.

The Company aims to take its exports turnover. Last year, in an effort to tape the

North and South American markets, the company set up a US subsidiary; CPL Inc.

Besides the company has already applied for 40 patents in the US to grow into new

categories.


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Manufacturing Excellence

Pursuant to its corporate philosophy of striving for continuous improvement and

betterment, the Company has re-located its manufacturing operations at the state-of-

the-art plant at Dholka, located 50 km from Ahmedabad, the commercial capital of

Gujarat. Spread over 44 acres of verdant, picturesque surroundings, amidst lush green

lawns and thick foliage, the new locale is the most envied pharmaceutical installation

in the Asian sub-continent.

Truly unique in every sense of the term, the Plants standards and facilities can match any other,

worldwide. Seven zones of cleanliness have been defined and adhered to, as per the 1997 GMPguidelines of the European Union. Some of the salient features of the design concepts:

No wood or asbestos component.

Each zone has separate AHUs (Air Handling Units), dehumidification unit and

dust extraction systems.

Segregation of every critical processing activity in each zone, to avoid cross-

contamination.

Adherence to stringent specifications of USFDA, MCA(UK), MCC(South

Africa) and TGA(Australia).


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Respective zones, areas and even uniforms marked with specific colours of the

rainbow (Indradhanush in the vernacular), to ensure total segregation.

Air environment conditioned in each area with respect to temperature,

humidity, filtration, particle counts, etc.

Conformation of each processing stage with US Federal Standard 209E class

of cleanliness; viz. 100, 1,000, 10,000, 100,000 with respect to room air

changes, pressure, particle count, flow direction etc.

Duo Pass Reverse Osmosis (RO) water system, multi-stage distillation plant,

self-sanitizing, sanitary SS 31 6L loops water, water for injection with online

monitoring of pH, temperature, conductivity and TOC requirements as per

USP XXIV.

Zero-discharge Effluent Treatment Plant constructed using technology from

Advent Integrated System, USA.

Environment-friendly VAHP chillers.

Rigvent heat extraction devices and Natural Skylit system in raw material,

packing material and finished good stores.

Isolated and dedicated production facilities for B-Lactum and Cephalosporin

dosage forms

.


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Cadila Pharmaceuticals has also commissioned a modern, sophisticated

manufacturing facility for Soft Gelatin Capsules at its Kadi Complex. Designed to

meet the most stringent international standards, all operations in this plant from

encapsulation to packaging, are carried out under class 100,000. All systems are

validated to meet International FDA standards, and the present capacity of one million

capsules per day can be doubled with marginal investments

OTHER MANUFACTURING LOCATIONS

Surgical Supplies, Halol

Plant Tissue Culture, Hirapur

Casil Health Products Ltd.,

Pharma Machinery Manufacturing Facilities at Kadi

Speciality Chemicals & Soft Gelatin Capsules Manufacturing Facilities at

Kadi

Active Pharmaceutical Ingredients (APIs), Ankleshwar

New Facility in J & K

Cadila Pharmaceuticals Ltd will commission its manufacturing facility for

formulations in Jammu and Kashmir, by December this year. The Rs.600 Crore

SOFT GELATIN MANUFACTURING


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Pharma company is investing Rs.45 Crore in bringing up this new facility at Samba to

take advantage of the excise and income tax benefits being doled out by the Centre to

promote investments in Jammu and Kashmir.

This will not only help the company in fulfilling its corporate objective of making

available quality medicines at affordable prices but also help in providing ample

employment opportunities to the local population in Jammu, said Shri I. A. Modi,

Cadila Pharmaceuticals Ltd.

The unit will have a capacity to manufacture 1, 019.4 million tablets per annum, 1329

million tablets and capsule packing (strips and blisters), 150 million capsules, 1500

kiloliters liquid formulations and 14.4 million bottles.

Several pharma companies from Gujarat have set up manufacturing facilities in tax-

free zones such as Baddi in Himachal Pradesh, Uttaranchal and J&K. The facility will

have a linear manufacturing structure with six manufacturing lines. Four lines will be

for tablets, one for capsules manufacturing and sixth for liquid formulations.

A company spokesman said that the total value of production from this unit is likely

to be close to Rs.350 Crore per year. It would solely cater to the domestic market.

The Jammu unit will also help us boost exports from the present facility at Dholka,

near Ahmedabad, the spokesman said.

The centre has exempted the payment of excise duty on the goods produced in Jammu

and Kashmir for 10 years. They have also provided for income tax exemption for 10

years from the year of commercial production, besides several other financial

benefits. Samba is situated on the National highway and CPL's factory is only 1.5 km

away from the national highway.

Distribution Network


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The company has more than 1,10,000 retailers, 2200 stockiest, 25 C & F agents and

36 full-fledged divisional agencies to keep the company in touch with the people in

almost each and every part of the country. The countrywide distribution network is so

strong that any new product launched by the company is available across the country

within 72 hours.


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RESEARCH METHOD

DEFINE THE RESEARCH PROBLEM

DESIGN THE RESEARCH PROCESS

CONDUCT THE PILOT SURVEY

ANALYSIS & MODIFICATION

CONDUCT THE MAIN SURVEY

COLLECT PRIMARY DATA FROM CUISTOMER

ANALYSIS & TABULATE THE DATA

INTERPRETE & REPORT THE FINDING


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RESEARCH METHODOLOGY

The research was conducted in the following stages.

1. To define the research problem and identify the research objectives.

A molecule which is new in the market and presence of other substitute antibiotics makes

competition high, it is necessary to understand the Drs choices of treating infection. Hence the

objective of the project was decided as Potential Of Linezolid In ICU / Hospital

2. Design a research process.

Research approach

Personal interviews with a structured questionnaire with doctors was decided as the medium to

collect data which would be first hand and unbiased, directly from the customer.

Research instrument

A sample of questions first made and than after consulting with person in-charge relevant

questions were filtered out for pilot survey.

Sampling plan

The nature of research necessitated the use of doctors with sample size of 60 in Ahmedabad.

Main hospitals of Ahmedabad were surveyed.

Pilot survey

Twenty-five doctors from Ahmedabad was visited to check the efficacy of the research

questionnaire

3. Analysis and modification.

The finding of the pilot survey suggested no change in the questionnaire, so as to obtain

maximum possible information from the customer. No change were require in the research

approach.


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4. Main survey

Some potential doctors were also surveyed from the private clinics and ICU in-charge in

hospitals with the total sample size of 60 doctors.

5. Data analysis

The data was analyzed systematically to give the following information.

No of doctors which are normally using particular antibiotics in ICU/critical caresetting.

Preference of culture sensitivity test in percentage.

Percentage of resistance gram(+)ve infection and resistance gram(-)ve infection. Top five choice of treatment for resistance gram(+)ve infection and resistancegram(-)ve infection.

Effectiveness of different drugs in doctors point of view. Attributes for their prefrence. Brand that is in the top of doctors mind. Average no. of prescription given by doctors in a month.

6. Present the major findings.

The major findings of the survey have been highlighted. Certain suggestions and

recommendation have been given to improve the sales.


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ABOUT LINEZOLID

Linezolid is the leading agent in a new chemical class of antibiotics, the oxazolidinones,which have a novel structure. Oxazolidinones are protein synthesis inhibitors that prevent

the formation of the bacterial 705 ribosomal initiation complex. Linezolid's unique

targeting of the protein synthesis machinery has no pre-existing resistance mechanism in

nature. During evaluation, there were no bacteria found that were resistant to linezolid.

Thus, linezolid can be used as an empirical therapy when there is a known resistance to

other classes of drugs.

Oxazolidinones are active against Gram-positive bacteria, including antibiotic-resistant

strains, such as methi-cillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant

Streptococcus pneumoniae (PR5P), and vanco-mycin-resistant f nferococeus faecium

(VREF). Linezolid is particularly useful in treating nosocomial infections that are resistant to

other antibiotics. Linezolid is available in oral formulations, tablets, or oral suspensions,

and is injectable. This gives linezolid an advantage over vancomycin, which can only be

given by the intravenous (IV) route. Patients may be discharged from hospital early

following IV linezolid therapy and continue oral therapy at home with no loss of efficacy.

When administered to patients, a single 600 mg oral dose of linezolid results in a plasma

concentration of up to 18 mg/L, which is higher than the minimal concentration required to

inhibit the growth of S. aureus (4 g/L) for about 16 hours.3 This pharmacokinetic profile

illustrates the effectiveness of linezolid in treating Gram-positive infections in humans.


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DRUG FOCUS

Glycopeptlde-resistant enterococci The enterococci are normal commensals of the bowel

with only moderate virulence in normals. They cause infections of the urinary and biliary

tracts, sometime* wounds, and occasionally more serious and invasive disease in the

compromised. They are becoming more common, probably because they are increasingly

antibiotic resistant, especially to the cephulosporins. quinolones and aminoglycosidcs used

against Gram-negative infections." Among the enterococci. Enterococcus fatcalis is the most

common human pathogen; however, Enterococcta faecium, which is more inherently

resistant, is being seen with increasing frequency. Furthermore, since the mid-1980s,

VRE or ORE have appeared. This glycopeptide resistance is most commonly seen in K.faecium and usually occurs in renal, hepatic or haematological transplant patients. Some

enterococci are thus now resistant to all commonly available antibiotics.

GRE are most common in the US, where the percentage of enterococci resistant to

vancomycin causing nosocomial infection increased from 0.4% to more than 10%

between 1989 and 1995." GRE infections are less common in Europe, where, however,

these organisms arc said to colonise the bowels of normal people in low numbers." This

may be because, until recently, farm animals in many European countries were fed the

growth-promoting glycopeptide avoparcin, which encourages colonisation with GRE

and subsequent contamination of meat products." In the UK, GRE are being isolated

from hospital patients in increasing numbers and several hospital outbreaks have besn

seen.

The most important and commonest type of glycopeptide resistance is called Van A,

which is high-level resistance to both vancomycin and teicoplanin which can transfer

between enterococci on plasmids and transposons.This resistance has been transferred in

the laboratory to several other Gram-positive bacteria, including S. aureus." It is

probably inevitable this will eventually happen in nature and the resulting high-level

glycopeptide resistance in MRSA will be a much more serious problem than the present

low-level resistance seen in sporadic isolates of VISA. Since we have become so

dependent on the glycopeptides as the treatment of last resort for MAR Gram-positives,

the transfer of high level Van A resistance from GRE to pneumococci and staphylococci

could produce potentially untreatable and lethal infections.


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NEW ANTIMICROBIALS FOR RESISTANT GRAM-POSITIVE

INFECTIONS

The problem of increasing antibiotic resistance is now recognised as a global emergencyand

has been recently addressed in the UK by the reports of the House of Lords Science andTechnology Committee (1998) and the Standing Medical Advisory Committee (1998).14

The problem can be partly resolved by improvements in the control of hospital cross-infection

and the reduction of unnecessary antibiotic usage, but it is also essential to have new agents

to treat MAR staphylococci, streptococci and enterococci.

Figure 1. The structure of linezolid


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Several new drugs for resistant Gram-positive infections are in development, including

new derivatives of macrolidex, kctolidcs. sireptogramins, quinolones and glycopeptides.

The new intravenous streptogramin combination quinupristin plus dalfopristin (Synercid) was

licensed for clinical use in Europe in 1999. Synercid is active against MAR pneumococci,

staphylococci and enlerococci, but not E.faecalis. Fortunately, E.faecalis usually remains

susceptible to ampicillin. All these agents are developments or derivatives of older drugs. To

these can now be added the oxazolidinoncs. the first new class of antibacterial compounds

to be developed in more than two decades.

LINEZOLID, THE FIRST OF THE OXAZOLIDONONES

The oxazolidinones are entirely artificial compounds that were first discovered by the

DuPont Company in the 1970s. Some early oxazolidinones had in vitro activity against

Gram-positive bacteria, but they were not developed for human use because of serious

animal toxicity. The Upjohn Company (now Pharmacia & Upjohn) revived oxidolidinone

research in the 1990s and discovered new derivatives that retained good antibacterial

activity but without animal toxicity. The first of these to be developed for clinical use is

linezolid (Zyvox) (formerly U-100766), a synthetic 3-(fluoropbenyl)-2-oxazolidiiione that

has a morpholin-1-yl group substitution (Figure 1). Linezolid was licensed for clinical use

in the US in March 2000, but much of the information on linezolid has not yet been

published in peer reviewed journals and is held on file by Pharmacia & Upjohn. However,

a document produced by the manufacturers for the Anti-Infective Drug Products Advisory

Committee meeting of the Food and Drug Administration (FDA) last March contains much

of the relevant information.

Antimicrobial activity, mechanism of action and development of resistance

Linezolid is active against most clinically important Gram-positive cocci, including

penicillin-resistant pneumococci, MRSA and GRE, with minimum inhibitory

concentrations (MICs) ranging from 0.25 to 4 mg/1 and usually falling between 1 and 2

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mg/1" . Breakpoints of 2-4 mg/l" have been suggested ( isolates with in vitro linezolid

MICs of =


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No.of Doctor

40%

22%

19%

13%

6%

1 Cephalosporin

2 Aminoglycocide

3 Augmentin

4 ceftazidine

5 Amoxicillin

Interpretation:

In I.C.U./critical care setting majority of Drs. are Preferring

cephalosporin.

Reason :

Cephalosporin good result (Cefotexin +Amikacin+metrogyl) combination. Cover all bacterialinfections.

Aminoglycocide good response from patients.

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Mainly ceftazidine for good result & both gram +ve and gram vecoverage.

2) How many cases of infections do you investigate for culture sensitivity?

(a) upto 25% (b) upto 50%

(b) (c) upto 75% (d) upto 100%

Finding:

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Interpretation:

All doctors preferring culture sensitivity test.

33

Sr .no Option No.of Drs

1 (a)up to 25% 17

2 (b)up to 50% 11

3 (c)up to 75% 13

4 (d)up to 100% 19

18%22%

32% 28%

25%

50%

75%

100%


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(3) From these what are % of resistant gram (+)ve and gram (-)ve infections?

______________________________________________________________________________________________________________________

Finding:

Average

37%

63%

0%

20%

40%

60%

80%

Gram +ve Gram -ve

Average

Interpretation:

Cases of gram (+)ve infection is comparative low than gram (-)ve infection.

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(4) Your choice of treatment for gram (+)ve infection.

(a)_______________________________________________________.

(b)_______________________________________________________.

(c)_______________________________________________________.

(d)_______________________________________________________.

Finding:

Top Five Choice of antibiotics

Interpretation:

35

Sr. no Name No.of Doctor

1 Cephalosporin 21

2 Augmentin 13

3 (Amoxicillin+clavulinic acid) 12

4 Linezolid 11

5 Vancomycin 11

No.of Doctor

31%

19%18%

16%

16%

1 Cephalosporin

2 Augmentin

3 (Amoxicillin + clavulinic

acid)

4 Linezolid

5 Vancomycin


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IIIrd or IVth Cephalosporin, (Amoxicillin + Clavulinic acid) combination,

Vancomycin, Linezolid.

These are the main choice of doctors while treating gram positive infections,

in that Cephalosporin is most preferable.

(5) Your choice of treatment for gram (-)ve infection .

(a)________________________________________________________.

(b)________________________________________________________.

(c)________________________________________________________.

(d)___________________________________________________________.

Finding:

Top Five Choice of antibiotics

Sr.no Name No.of Doctor

1 Amikacin 24

2 Cephalosporin 20

3 Aminoglycocide 18

4 (Piperaceline+Tazobactum) 75 Quinolone 6

Interpretation:

36

32%

27%

24%

9%

8%

1 Amikacin

2 Cephalosporin

3 Aminoglycocide

4

(Piperaceline+Taz

obactum)

5 Quinolone


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Aminoglycocide, (Amikacin/Tobramycin), (Piperaceline +

Tazobactum) combation, IIIrd or IVth Cephalosporin.

Main preference of the doctors is Aminoglycocide and

(Amikacin/Tobramycin) while treating gram ve infection .

(6) While treating gram (+)ve infections how do you define effectiveness of

these drugs.

Not Good Ok Good Excellent

(a) Linezolid

(b)Vancomycin

(c) Teicoplanin

(d) Meropenam

(e) __________

(any other please specify)

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Effectiveness

1

14

26

10

6

0

13

31

14

1 0

13

23

12

7

2

15

20

14

9

0

5

10

15

20

25

30

35

Performance

cases

Linezolid

Vancomycin

Teicoplanin

Meropenam

Interpretation:

Vancomycin is Excellent one in case of effectiveness against

gram(+)ve infection, than comes Meropenam.

Linezolid and Teicoplanin are consider as a Good one.

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(7) In ICU/ critical care setting which antibiotic do you feel is must and why ?

____________________________________________________

____________________________________________________

Finding :

Sr .no Option No. of Drs In Percentage

1 Depend 36 60%

2 Others 24 40%

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Interpretation:

60% doctors thinking depends upon culture sensitivity.

40% doctors giving other antibiotics name.

Some doctors preferring Cephalosporin for gram (+)ve infection and

Aminoglycocide for gram ()ve infectionand some are preferring

(Piperaceline + Tazobactum) combination.

(8)Please rank the below given criteria for Rx in terms of their importance while

treating resistant gram (+)ve infection.

(a) Cost (b) Efficacy

(c) Safety (d) Availability

Finding:

40

Any must antibiotics

60%

40%Depend on culture

sensitivity

Others


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Ranking

53

18

0 06

41

2 01 0

24

34

0 0

3326

0

20

40

60

Factors

Performance

First

Second

Third

Forth

First 53 18 0 0

Second 6 41 2 0

Third 1 0 24 34

Forth 0 0 33 26

Efficacy Safety CostAvailabili

ty

Interpretation:

Majority of Drs. preferring EFFICACY hence they are preferring SAFETY

also, but the no. 1 ranking is EFFICACY.

Very few doctors concerning with price, but the availability is in-evitable.

9) Do you use Linezolid ? Yes No

Why ?

___________________________________________________________________

___________________________________________________________________.

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Using Linezolid

Yes

80%

No

20%

Yes

No

Finding :-

Sr. no Using No.of Drs

1 Yes 48

2 No 12

Interpretation:

80% doctors are using Linezolid so, great potential ofLinezolid was found.

Reasons :-

Good coverage.

Economically and effective.

To cover M.R S.A.

I.V & oral available.

10) Name one brand / company of Linezolid which come first to your mind. (a)

_______________________

Why ?

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(i) Efficacy

(ii) Regular M. R. visit

(iii) CME attended

(iv) Regular information provided by company

(v) Price

(vi) Discount

(vii) Availability

Finding:

Sr. no Name of Brand No.of Doctor

1 Linox 16

2 Linid 16

3 Lizolid 7

4 Lizbid 5

5 Targocid 1

Interpretation:

43

No.of Doctor

35%

36%

16%

11% 2%

1 Linox

2 Linid

3 Lizolid

4 Lizbid

5 Targocid


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Linox ( from Unichem) and Linid( from Cadila) both

are equal positioning in the mind of doctors as shown

in pie chart.

Reason :

EFFICACY and AVAILABILITY these are main

reasons.

Then comes the regular M.R visit.

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Prescription in a month

12

117

6

6

3 21

2 to 3

1 to 2

4 to 5

3 to 47 to 10

10 to 15

5 to 6

15 to 20

(11) Approx no of prescription given for Linezolid in a month ________________

Finding:

Sr. no Range No.of Doctor

1 2 to 3 12

2 1 to 2 11

3 4 to 5 7

4 3 to 4 6

5 7 to 10 6

6 10 to 15 3

7 5 to 6 2

8 15 to 20 1

Interpretation:

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2 to 3 prescription in a month found 12 times which is highest.

Than comes 1 to 2 prescription in a month found 11 times.

There is also not available or none prescription found in 11

sample.

We can say majority of doctors giving prescription in range of

1 to 3.

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FINDINGS

Cephalosporins is mainly use as antibiotic in critical care setting due to good

coverage.

All the doctors go for culture sensitivity report.

There are comparatively low cases of gram(+) infection found.

Cephalosporins is mainly use for treating gram(+) infection.

Amikacin is mainly use for treating gram(-) infection.

Vancomycin and Teicoplanin these drugs are Execellentwhile treating gram(+)

infections.

Any antibiotics is not must this is depends upon culture sensitivity. But some

doctors preferring Cephalosporin for gram (+)ve infection and Aminoglycocide

for gram ()ve infection and some are preferring (Piperaceline + Tazobactum)

combination.

88% doctors giving the no.1 rank to Efficacy.

80% doctors are using linezolid.

Reason:

Good coverage. Economically and effective. to cover M.R S.A. I.V & oral available.

16 times Linox and 16 times Linezolid both are comes first in the mind ofdoctor.

Reason:

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CONCLUSION

From the overall survey and findings it shows that the

Potential of Linezolid is Good in ICU/hospitals. It is good in

terms of effectiveness but from the doctors point of view

vancomycin is excellent one. Now a days prescription of

linezolid is increasing, so the usage of Linid for treating

gram(+)ve infection is progressive.

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ANNEXURE

Name of Dr. ________________________________

Qualification / Speciality _______________________

Address ____________________________________

____________________________________________

Ph . no ____________ email-id __________________

POTENTIAL OF LINEZOLID IN ICU / HOSPITAL

1) In ICU/critical care setting which antibiotics do you use and why ?

____________________________________________________________________

____________________________________________________________________

__

2) How many cases of infections do you investigate for culture sensitivity?

(a) upto 25%

(b) upto 50%

(c) upto 75%

(d) upto 100%

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(3) From these what are % of resistant gram (+)ve and gram(-)ve infections?

___________________________________________________________

___________________________________________________________

(4) Your choice of treatment for gram (+)ve infection.

(a)_______________________________________________________

(b)______________________________________________________

(c)_______________________________________________________

(d)_______________________________________________________

(5) Your choice of treatment for gram (-)ve infection .

(a)___________________________________________________________

(b)__________________________________________________________

(c)___________________________________________________________

(d)___________________________________________________________

(6) While treating gram (+)ve infections how do you define effectiveness of

these drugs.

Not Good Ok Good Excellent

(b) Linezolid

(b)Vancomycin

(c) Teicoplanin

(f) Meropenam

(g) __________

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(any other please specify)

(7) In ICU/ critical care setting which antibiotic do you feel is must and why ?

____________________________________________________

____________________________________________________

(8) Please rank the below given criteria for Rx in terms of their importance

while treating resistant gram (+)ve infection

(a) Cost

(b) Efficacy

(c) Safety

(d) Availability

9) Do you use Linezolid ? Yes No

why ?

___________________________________________________________________

___________________________________________________________________.

10) Name one brand / company of Linezolid which come first to your mind.

(a) _______________________

why ?

(i) Efficacy

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(ii) Regular M. R. visit

(iii) CME attended

(iv) Regular information provided by company

(v) Price

(vi) Discount

(vii) Availability

(11) Approx no of prescription given for Linezolid in a month _______________.

BIBLIOGRAPHY

Marketing Management by Philip kotler

www.google.com

www.cadilapharma.com

53
http://www.google.com/http://www.cadilapharma.com/http://www.google.com/http://www.cadilapharma.com/


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Final Cadila Report

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