The Medicine Box

An Indian pharma company has rebranded itself after almost three decades, 27 years. A firm that is ranked fourth in the Indian pharma industry, fifth in the US generics market via prescriptions and has been at the forefront of fighting COVID-19 by introducing one of the cheapest versions of Remdesivir and more.

The firm Cadila Healthcare (now known as Zydus Lifesciences) has many feathers on its hat, however, its challenges included the offtake of the COVID-19 vaccine and the long gestations and investments required to become an innovative company amid growing competition in the US.

To discuss this and more, CNBC-TV18’s Ekta Batra caught up with Zydus Lifesciences’ managing director Sharvil Patel.

Patel shares the significance of the new name, the firm's plans to be defined as a global life sciences company with a focus on innovation and its generics business.

Pharma industry’s Robinhood, Cipla is looking to increase its presence in the US market, the company’s MD and Global CEO Umang Vohra.

In this edition of The Medicine Box Podcast, CNBC-TV18’s Ekta Batra talks to Vohra about Cipla’s plan to capture a larger share of the US market, the firm’s COVID-19 portfolio – from Tocilizumab to Remdesivir to Favipiravir, new products, growth outlook and more.

Cipla, which is India’s third largest pharma company and is present in more than 80 countries with over 46 manufacturing facilities, is looking to manufacture complex drugs and injectables in respiratory and cancer segments, Vohra said.

Torrent, an over 60-year-old Indian pharma company, the flagship company of the Torrent Group, is most recognised for its strong domestic focus. It is the eighth largest player in India, with around 40 percent of its revenues from the domestic market.

It has strengthened its presence with acquisitions in the past 10 years such as buying Elder Pharma’s domestic business in 2014 for Rs 2000 crore and Unichem’s domestic business in 2017 for Rs 3600 crore. Domestic market brands include Shelcal, Unienzyme and Nebicard.

In this edition of The Medicine Box Podcast, CNBC-TV18’s Ekta Batra gets in conversation with Torrent Pharma’s ED Aman Mehta to know more about the company’s outlook for growth on the domestic as well as the global front.

The company expects underlying domestic growth in double digits whilst seeing quarterly blips. Cardiology is a focus area for the company, which is ranked second in the cardiac segment and expects to grow in double digits.

One of its key brands, Shelcal has shown robust growth in the past few years with a focus on newer extensions in the brand.

Outside of India, the company is looking at remediation measures for plants impacted by USFDA issues and anticipates a 10 percent price erosion in the US. The company has also recently entered newer markets such as Mexico.

Overall, it expects margins to recover to 28-30 percent and is looking at mid sized acquisitions.

On this episode of The Medicine Box, CNBC-TV18’s Ekta Batra gets in conversation with Dr Ashutosh Raghuvanshi, head of Fortis Hospital, to discuss business returning to normal post-COVID-19, medical tourism, long COVID and more.

Dr Raghuvanshi said the occupancy figure is expected to go to 70 percent within a month or two.

He also mentioned that there is a well-identified clinical entity of long COVID-19, which is a post-COVID syndrome in which the effects of the virus linger on for weeks or months after a person has tested positive. Most hospitals have opened post-COVID-19 clinics, he said and added that mental health and chronic illness are areas that could see more virtual consults.

Dr Raghuvanshi also discussed whether medical tourism will pick up in the near future and whether healthcare verticals such as home health and telemedicine are here to stay.

He also talked about rising competition in the diagnostic space and what it means for Fortis's diagnostic arm SRL Diagnostics.

Even as India is hailed as the ‘pharmacy of the world’ for providing generic medicines and vaccines to nations across the globe, much remains to be done on the research and development and innovation front. But what does it take to become leaders in innovation, how can India replicate the generics feat in innovative drugs?

In this episode of The Medicine Box season 5, CNBC-TV18’s Ekta Batra catches up with Dr Reddy’s Laboratories' (DRL) co-chairman and MD, GV Prasad, who believes India has the potential to become a leader in innovation too.

According to Prasad, innovation can not be seen as a natural progression from generics as the skills innovative companies require are different. Such firms need to make highly concentrated bets and therefore, the risk appetites are different as against makers of generic drugs, he said.

DRL’s MD pointed to financing as a huge challenge for innovation, which requires multiple factors to fall in place. “Innovation is a long-term game, sometimes takes decades,” he added.

Prasad said early-stage innovation is thriving in India and as confidence builds, Indian companies will invest in Phase 2 and Phase 3 trials.

India’s pharma market, which comprises chronic and acute medication, is poised for growth. The domestic market grew from $17 billion in FY17 to $21 billion in FY21.

In this edition of The Medicine Box Podcast season 5, CNBC-TV18’s Ekta Batra speaks to Nikhil Chopra, the CEO of JB Chemicals and Pharmaceuticals Ltd, about how big the chronic and acute market is in India, the competition from generic medicines, and the pharma firm’s plans for the near future.

According to Chopra, consumer awareness about wellness and immunity has risen in the past 24 months, the majority of which includes the COVID-19 pandemic period, he said.

Acute therapy, which includes anti-infectives, gastro, vitamins, etc, saw a decline during the period as more people were indoors and hence fewer caught infections. Now, given a gradual return to normalcy, besides recovery in acute therapy, Chopra believes chronic therapies, which include medication for cardiovascular, metabolic diseases, etc., could grow and beat the domestic market growth.

JB Chemicals and Pharmaceuticals Ltd generates 49 percent of its revenue from the domestic market and has outperformed the industry growing 14 percent in FY21 against the industry growth of 4 percent. The CEO said the company is beating the industry due to strong brands in the Indian market. And, it is looking to improve its ranking from its current 27th position in the domestic market.

AstraZeneca, a British-Swedish pharmaceutical firm that has become popular in India due to its COVID-19 vaccine Covishield, has tied up with Bengaluru-based health-tech startup Tricog for Project Heartbeat in the country.

In this edition of the Medicine Box season 5, CNBC-TV18’s Ekta Batra gets in conversation with Dr Anil Kukreja, Vice President, medical affairs and regulatory, AstraZeneca about the project that aims to ensure early and accurate diagnosis of possible heart attacks of patients in Tier 2 and 3 cities.

Dr Kukreja noted early diagnosis and timely treatments are critical for heart attacks. With the project that has been piloted in eight hubs and 39 spokes across India, patients in Tier 2 city can have their electrocardiogram (ECG) test read by a qualified cardiologist.

The tech for Project Heartbeat has been created with ECG machines and communicators. The communicator sends ECG reading to a cardiologist who provides the diagnosis in a matter of minutes, Dr Kukreja explained.

“The focus is to reduce ‘Door to Needle’ and ‘Door to Balloon’ time,” the top AstraZeneca official said, adding that they are trying to train healthcare practitioners and technicians to ensure accurate medications in time.

The Indian healthcare market is fragmented and has efficiency gaps. But, health technology is helping bridge this gap. The COVID-19 pandemic resulted in a fundamental behavioural change in India in terms of health technology, which means buying more medicines online, booking diagnostic tests, Teleconsultations, etc. 

In this edition of the Medicine Box Podcast season 5, CNBC-TV18’s Ekta Batra catches up with Prashant Tandon, founder and chief executive officer (CEO) of Tata 1MG to discuss the Indian health tech market and its potential growth. 

​Health tech also comprises new technologies such as the Internet of things (IOT), artificial intelligence (AI), and data sciences, Tandon said, adding that data will be a huge part of health tech in the future.

Pointing to digitisation of the entire value chain such as pharma and diagnostics, Tata 1MG founder said, COVID-19 led to a 3x rise in people transacting on digital health platforms. Tata 1 MG’s traffic has risen to 150 million unique users vs 90 million users in FY20, he said. According to him, healthcare, as an ecosystem, is very profitable and digital will make it more efficient

Tune in to Medicine Box Podcast to know more about B2C health tech market and what the future holds for it 

Twin Health, a US and India-based start-up, aims to reverse chronic metabolic diseases in patients with underlying conditions such as diabetes, blood pressure and cholesterol via their technology called the Whole Body Twin. The company has claimed its success rate in reversing diabetes is over 90 percent.

In this edition of The Medicine Box podcast, CNBC-TV18's Ekta Batra speaks to CEO and Founder of Twin Health, Jahangir Mohammad, to find out all about the technology and how it helps patients.

 Tune in to The Medicine Box podcast to know all about the Twin Health and their Whole Body Twin technology.

In a significant development this year, the United States Food and Drug Administration granted interchangeable status to two biosimilar drugs— Biocon's diabetes drug insulin glargine branded as Semglee and Boehringer Ingelheim’s biosimilar Cyltezo.

In this edition of The Medicine Box Podcast season 5, CNBC-TV18’s Ekta Batra talks to Kiran Mazumdar-Shaw, the chairperson of Biocon, about Semglee, the first interchangeable biosimilar insulin product to have received approval from the US drug regulator for the treatment of diabetes.

Interchangeability essentially means a pharmacist in the US can give a person the drug approved with an interchangeable status other than reference biologic on prescription. 

The development possibly paves the way for more life-saving drugs seeing greater accessibility and reducing price.

Shaw also talks about Cyltezo, which is the biosimilar version of one of the world’s largest selling biologic drugs Humira, used for arthritis and other conditions.

Tune in to The Medicine Box Podcast to find out more about interchangeable biosimilars, their competition, prices, and more.