Schizoprenia: NAMI Interview: Mr. Dilip Sanghvi Chairman & M.D. – Sun Pharma
Interview:
Mr. Dilip Sanghvi
Chairman & M.D. – Sun Pharma
Conducted By:
Akila Maheshwari
Convenor NAMI-INDIA
Qus.1- Sun has been a forerunner in providing cost-effective
medication in India for diseases of the central nervous system. How has this come
about?
Ans – Sun has been a forerunner in providing cost-effective
medication in India for diseases of the central nervous system. How has this come
about? Essentially when we started the company in 1983, with 5 people and 5
products, psychiatry was still in its infancy as a speciality. The larger
companies at that point had only a marginal interest in this area, some company
had a single product, some had two, but these were only marginal products
that did not really get much attention as they did not contribute to the
company’s revenues. Hence we focused on this area for beginning the business.
This focus helped us learn how the speciality customer worked, what
his prescribing requirements were, what kind of products did he choose
and how he handled and viewed different ailments in the spectrum of psychiatry.
This single therapy area emphasis helped us to understand the sector well. It
showed me how I could focus on solving problems, and use this learning to my
advantage. As you know, in psychiatry treatment is individualized and unlike
some other fields depending on the presenting signs the doctor may use the
latest medicine, an older medication or any from a bouquet of medicines
available. We were able to learn a great deal from this interaction, specifically
understand the prescribing habits of consultants and later we were able to
apply this learning to other therapy areas. So in a sense, psychiatry market
was both a beginning point and a learning school for us.
Qus.2- With the availability of quitpin (quetaipine) consumers have
an added choice of medication? However what would be the impact if new drugs
like ariprapazole (abilify) enter the market?
Ans – We have introduced both these molecules- quetiapine with the
brand name Qutipin and aripiprazole, with the brand name Arpizol.
Schizophrenia is a complex and multifaceted illness, and as you know the magnitude of
the presenting symptoms can vary from patient to patient, and even the
symptoms can be different- auditory, visual, hallucinatory etc. A particular drug
treats one set of symptoms better than another set of symptoms. In order to
handle and treat this range of symptoms, generally more than one drug is
prescribed.
Qus.3 – What kind of commitment does Sun Pharma have towards
research in mental illness? In USA Companies like Eli-Lilly and Jansenn-Cilag
have spent enormous amounts on the same.
Ans – Over the years one problem area in psychiatry that has
remains inadequately addressed is that of compliance and maintaining blood
levels of the drug over time, especially when patients are uncooperative or
violent. This is one area that we have extensively focused on, at Sun Pharma. Several
of our products use a novel drug delivery system to deliver the medication
predictably, avoid the need for repeat dosing and ensure that
symptoms are controlled.
We’ve brought several products to market, such as the bipolar mood
disorder treatment Lithosun SR, which was amongst the first products we
launched. While many of the new molecules have a long half life and are
intrinsically once a day, we have formulated Oleanz rapitabs- olanzapine rapidly
dissolving, to deal with the difficulty in swallowing that may be seen with
geriatric patients. We have introduced Prodep LA, a once a week
antidepressant. We continue to look for ways that dosage form delivery areas where modifications in the dosage form would make a difference to the patient . I believe if we
help patients handle this issue of compliance better, we would be making
an important contribution to the way mental illness is treated in the country.
Qus.4 – Approximately 1% of the population suffers from severe
mental illness like schizophrenia. This means in a country like India the
number of sufferers is high. The level of awareness appears to be low
especially in rural areas. What do you think should be the strategy to reduce this?
Ans – Yes, awareness is an issue. But possibly the stage when mental
illness was viewed as a taboo, has slowly gone, possibly, atleast in city
areas.
Awareness about solutions in any field- even in mental healthcare
are a function of education, literacy levels, affluence, levels of
disposable income.
We are sure that as these factors improve in our country, awareness
will also increase.
On their part several companies are working to increase awareness
using patient information booklets, posters and educational material.
But even then its possible that it will take some time for this
message to spread to the grassroots.
Qus.5 – You have adopted a marketing strategy focused on doctors;
don’t you think it should be a consumer driven approach focusing on side-
effects comparative to other medication?
Ans – In our opinion, psychiatry is a complex area, with coexisting
disorders and overlapping symptoms. The treatment of choice depends
on the presenting symptoms of a particular patient, and even with the extensive range
of medicines available for prescription, normally more than one drug is
prescribed in order to treat the range of symptoms. Hence the selection of the
right medication is best left to the doctor, because he has had both the
expertise and experience to decide the medicine and, how best the dose is to be
titrated, for each patient. And this is true everywhere in the world,
medications for mental illnesses are prescription only, and are decided by the
medical professional. Otherwise there is a high risk of self medication
which is certainly not in the patients best interests.
As a pharma company, we shall work to ensure that the latest
molecules are made available to patients in India at a sensible cost and that
these products are of a dependable, standard quality
Qus.6 – With the implementation of IPR regime in India from 2005
what is Sun’s strategy for growth?
Ans – Sun Pharma is preparing to compete globally as a research
based speciality pharma company.
We have over the years spent over Rs200cr in research, and have
substantially increased these investments with Rs75cr to be invested
in this year and in the next. This year alone we are doubling our research staff and
adding 275,000 sq ft of floor area for research.
International markets represent a tremendous opportunity and we
expect this part of the business, which is 20% of sales to grow very rapidly
over the next two years.
In the Indian market while we are recognized as leaders in our core
speciality areas , we want to reach this position of leadership in
all therapy areas including newer ones like oncology and gynecology.
In my opinion, we’ve built a strong platform so far, and this
enables us to make the most of growth for the future.
Qus.7 – Do you think consumers will have a greater role to play in
choice of drugs in the future?
Ans – In ensuring the proper use of medication, yes perhaps not in
the choice of treatment per se for that requires medical expertise and
experience.
Qus.8 – What should be the role of Patient Advocacy Groups in this
regard?
Ans – You already said that awareness was one area- we agree this is
one area where advocacy groups cd play a major role.
We also see a very important role they could play for emotional
bonding, forming sharing support systems – after all social support, empathy
and understanding are as important an element of the treatment
procedure, as medication is. Treatment non-compliance, is an important issue which support
groups can help handle.
We also see a role for patient advocacy groups in working with the
government bodies and authorities at different levels in order to
modify the laws so that a fair chance is given to people who are challenged, and that
their needs too are looked after.
Qus.9 – As per your website psychiatry and neurology account for 33%
of your turnover. What expectations do you have for sales turnover in this
segment in the future?
Ans – We expect this segment to account for a large part of our
turnover in the future too, and grow at a brisk pace. Awareness itself is
increasing. If one applies textbook incidences to the extent that the ailments are
reported in India, then its obvious that these ailments are grossly under-
treated. As people realize that treatment and medication can help improve the
quality of life and help live a life that is as normal as possible, the number
of people who reach out for treatment for these ailments will also increase.
On the other hand, continuing life pressures and the pace of living,
means that the need for medical treatments of ailments that arise as a
consequence of high paced living will also increase.
Qus.10 – Thank You, and we wish that Sun Pharma becomes one of the
world class global companies in the future. Do you have any message for
consumers in India?
Ans – Expect the worldclass – worldclass products, global level
quality and support services that focus on serving the customer first.