"India’s per capita healthcare expenditure is well below international recommendations and compares poorly with the other emerging economies (Brazil, Russian Federation, China, Republic of Korea, Turkey and Mexico). Despite an improvement in the country’s healthcare infrastructure over the recent past, there remains a lack of health centers and shortage of health personnel.

India has an extensive healthcare system, reaching even remote areas, yet the country's performance on health indicators remains low. Consequently, private healthcare services have been growing. Publicprivate partnerships have also grown, and represent a promising option which also deals with some of the welfare goals of the state. These partnerships are forged with the objective of improving the quality and efficiency of healthcare delivery while maintaining accessibility and availability for all. Success rate of such initiatives has been variable across states thus far, yet this is a trend set to stay in the country’s healthcare system.

As per the 2008 sales figures, the Indian pharmaceutical market currently ranks 13th among the major global markets, with sales of $7.7bn in 2008. Yet the promise that the country’s pharmaceutical market holds for the long term is much bigger even though its economy has been growing at a slower rate than China. The Indian Pharmaceutical Market Outlook to 2014’ provides comprehensive coverage of the Indian pharmaceutical market, incorporating the market structure, pricing and regulation and detailed analyses of the leading companies and likely healthcare reforms. The report makes a wide-ranging assessment of the marketed product portfolios, R&D pipelines, market share data, sales forecast and competitive landscape of the major players in the Indian market. Furthermore, it highlights the key market and R&D trends that may influence treatment sales, with a thorough analysis of the competitive dynamics of leading brands within the country and across different indications, in order to enable the reader to identify growth trends, key drug classes and leading players through to 2014.

Key findings

Private healthcare systems have been growing in the country due to the rising income levels of people and the inefficiencies of the public systems. The qualified pool of doctors and the advanced infrastructure of these private medical facilities at costs significantly below the developed countries, has positioned India at a strategically advantageous position to grow as a medical tourism hub.

India’s rapidly growing middle class and the ageing population make it an attractive investment destination. The pharmaceutical market is expected to grow at a CAGR of 12.3% through 2014 which could even surpass other emerging economies such as China.

In 1972, a law was passed in India that allowed local manufacturers to manufacture drugs that were still patent protected, with the use of alternative processes. Such a patent regime, though non-compliant with international standards, provided a boost to the local generics industry which could provide drugs both locally and to other emerging markets.

In light of the increasing pricing pressures on the global pharmaceutical industry and a newly found emphasis on generics in countries such as the US, leading global players have been strategizing to evolve an all-new hybrid business model in line with the Novartis–Sandoz model.

Use this report to

• Develop an understanding of the Indian healthcare system and the issues facing it.
• Understand the IP laws in India and how they affect the local and global pharmaceutical industry.
• Discover the new strategies and evolving new business models that companies are developing in order to sustain profitability in the new economic and political climate.
• Gain up-to-date competitive intelligence and understand the major issues affecting the leading pharmaceutical companies.
• Compare the franchises of top pharmaceutical players across major indications, and understand how market share of leading companies will change over the next five years.
• Compare and contrast SWOT analyses of the leading pharmaceutical players to understand their relative market positioning over the next five years.

Key issues

Low healthcare expenditure. Healthcare expenditure in India compares poorly with other emerging markets such as Brazil, Russia and China. In 2006 for instance, the country’s per capita expenditure on health was $109 as against a high of $1,487 in countries such as the Republic of Korea.

Underutilization of funds. Even though there are indications of an increase in public budgets for health, the Central Ministry at the same time is also known to surrender budgets frequently. Possible reasons towards this trend range from institutional to systemic – lack of attention on maintenance of assets and operational expenses, little flexibility and lack of uniformity in health budgeting across the central government and the states, and the impossibility of tracking expenditures by states.

IPR regime stifling innovation. Intellectual property protection in India has been deemed as insufficient and cases of some leading global drugs are testimony to the fact. For instance Novartis’ Glivec patent application was rejected in January 2006 on the premise that the compound is a derivative of a known substance and does not offer significant improvement in efficacy.

Discover

• What is the regulatory setup of the Indian pharmaceutical market?
• How does the Indian pharmaceutical market compare with other emerging economies?
• What will be the major growth drivers in the Indian pharmaceutical market over the period 2008-14?
• Which companies were leading the Indian pharmaceutical market in 2008?
• What are the key relative strengths of the leading pharma companies in India?
• Which therapeutic categories have the potential to drive significant growth in the market over the period 2008-14?
• What are the promising R&D pipeline products and the timeline of commercialization?

The Indian Pharmaceutical Market Outlook to 2014
Executive summary 10
Overview of India 10
The Indian healthcare system 11
The pharmaceutical industry in India 12
Key players in the Indian pharmaceutical market 13
Indian pharmaceutical market SWOT analysis 14
Chapter 1 Scope and methodology 16
Scope 16
Methodology 16
Scope of IMS data 17
Chapter 2 Overview of India 20
Summary 20
Introduction 21
Overview of Indian history 21
The government 21
A burgeoning economy 22
Key economic parameters 23
An imprint of the global slowdown 24
Population profile and demographic trends 26
Disease burden 27
Vector-borne diseases 31
Chapter 3 The Indian healthcare system 34
Summary 34
Introduction 35
Healthcare system 37
The rural healthcare system 38
The urban healthcare system 39
Specialist and emergency medical care 40
The regulatory set-up 41
Intellectual property rights 41
Effect of IPR regime on innovation 42
Financing healthcare 43
Inefficiencies fueled by underutilization of funds 45
Pricing and reimbursement 46
Private health insurance 47
Private healthcare 49
A range of private healthcare services 50
Public-private partnerships 50
Alternative medicine: AYUSH 51
Ayurveda 51
Yoga 52
Naturopathy 52
Unani 52
Siddha 53
Homoeopathy 53
Chapter 4 The pharmaceutical market in India 56
Summary 56
Introduction 57
Key market trends, events and issues 59
Therapy area analysis 64
Therapy area sales forecast 74
Leading brands 75
Leading brands sales forecast 79
Over-the-counter medication 80
The Indian generics advantage 80
Chapter 5 Key players in the Indian pharmaceutical market 84
Summary 84
Introduction 85
Leading players of the Indian pharmaceutical market 86
Detailed analysis of the Indian pharmaceutical market players 87
Cipla 87
Overview 87
Sales focus by leading drug classes 88
Sales focus by leading brands 91
New product launches 92
SWOT analysis 94
Strengths 94
Weaknesses 95
Opportunities 96
Threats 96
Ranbaxy 97
Overview 97
Sales focus by leading drug classes 97
Sales focus by leading brands 99
R&D pipeline analysis 101
SWOT analysis 103
Strengths 103
Weaknesses 104
Opportunities 105
Threats 106
GlaxoSmithKline (India) 106
Overview 106
Sales focus by leading drug classes 107
Sales focus by leading brands 108
R&D pipeline analysis 111
SWOT analysis 112
Strengths 112
Weaknesses 113
Opportunities 113
Threats 115
Piramal Healthcare 115
Overview 115
Sales focus by leading drug classes 115
Sales focus by leading brands 117
R&D pipeline analysis 119
SWOT analysis 120
Strengths 120
Weaknesses 122
Opportunities 122
Threats 123
Zydus Cadila 123
Overview 123
Sales focus by leading drug classes 124
Sales focus by leading brands 125
R&D pipeline analysis 126
SWOT analysis 127
Strengths 127
Weaknesses 128
Opportunities 128
Threats 129
A snapshot of other key market players 129
Sun Pharma 129
Lupin 130
Alkem 131
Sanofi-Aventis 132
Mankind Pharma 133
Leading players in the Indian pharmaceutical market: sales forecast 134
Chapter 6 Appendix 136
IMS data 136
Anatomical Therapeutic Classification (ATC) 136
A: Alimentary tract and metabolism 136
B: Blood and blood-forming organs 136
C: Cardiovascular system 136
D: Dermatologicals 137
G: Genito-urinary system and sex hormones 137
H: Systemic hormonal preparations 137
J: General anti-infectives systemic 137
L: Antineoplastic and immunomodulating agents 137
M: Musculo-skeletal system 137
N: Nervous system 138
R: Respiratory system 138
S: Sensory organs 138
T: Diagnostic agents 138
V: Various 138
Glossary 139
Index 141

List of Figures
Figure 1.1: Indian pharmaceutical market SWOT analysis 14
Figure 2.2: Real GDP growth rate at factor cost across different quarters of the fiscal years 2008
and 2009 (%) 24
Figure 2.3: Comparative position ($bn) of India among the top service exporters globally, 2007 25
Figure 2.4: Deaths by cause for non-communicable diseases in India, 2005 28
Figure 3.5: Total expenditure on health per capita ($) in seven emerging pharmaceutical markets, 2006 36
Figure 3.6: Rural healthcare network in India 39
Figure 3.7: Public spending on healthcare (% GDP) in India, 1950-2006 44
Figure 4.8: Comparative position of India among the different global markets, 2008 58
Figure 4.9: Top 10 drug classes of the alimentary tract and metabolism therapy area ($m), 2008 66
Figure 4.10: Top 10 drug classes of the anti-infective therapy area ($m), 2008 68
Figure 4.11: Top 10 drug classes of the cardiovascular system therapy area, ($m) 2008 69
Figure 4.12: Top 10 drug classes of the respiratory system therapy area ($m), 2008 70
Figure 4.13: Top 10 drug classes of the nervous system therapy area ($m), 2008 72
Figure 4.14: Therapy area sales growth trend, 2004–08 73
Figure 5.15: Market share of leading players in the Indian pharmaceutical market (%), 2008 86
Figure 5.16: Cipla's Indian market sales by therapy area ($m), 2008 89
Figure 5.17: Cipla's SWOT analysis 94
Figure 5.18: Ranbaxy's Indian market sales by therapy area ($m), 2008 98
Figure 5.19: Ranbaxy's SWOT analysis 103
Figure 5.20: GSK's Indian market sales by therapy area ($m), 2008 107
Figure 5.21: GSK (India) SWOT analysis 112
Figure 5.22: Piramal Healthcare's Indian market sales by therapy area ($m), 2008 116
Figure 5.23: Piramal Healthcare's SWOT analysis 120
Figure 5.24: Zydus Cadila's Indian market sales by therapy area ($m), 2008 124
Figure 5.25: Zydus Cadila's SWOT analysis 127

List of Tables
Table 2.1: Political snapshot of India 22
Table 2.2: Economic snapshot of India 23
Table 2.3: Demographic snapshot of India 26
Table 2.4: Ten leading causes of death (%) in India, 2002 27
Table 2.5: Forecast epidemiology of major diseases in India, 2008–14 29
Table 2.6: Vector-borne diseases in India 31
Table 4.7: Indian pharmaceutical market by therapy area sales, 2008 65
Table 4.8: Indian pharmaceutical market therapy area sales forecast ($m), 74
Table 4.9: Indian pharmaceutical market by leading brands, 2008 75
Table 4.10: Top 10 brands of the Indian pharmaceutical market, sales forecast 2008–14 79
Table 5.11: Leading players of the Indian pharmaceutical market by sales, 2008 87
Table 5.12: Cipla’s leading brands in the Indian market (($m), 2008 91
Table 5.13: Leading recently launched products of Cipla in the Indian market 93
Table 5.14: Leading brands of Daiichi-Ranbaxy in the Indian market ($m), 2008 100
Table 5.15: Leading pipeline compounds of Ranbaxy in the Indian market 102
Table 5.16: Leading brands of GSK in the Indian market, 2008 109
Table 5.17: Key patented products of GSK launched in India 114
Table 5.18: Leading brands of Piramal Healthcare in the Indian market, 2008 118
Table 5.19: Piramal Healthcare's key acquisitions 121
Table 5.20: Piramal Healthcare's key alliances and licensing agreements 122
Table 5.21: Leading brands of Zydus Cadila in the Indian market, 2008 125
Table 5.22: Key pipeline drugs for Zydus Cadila 126
Table 5.23: Leading players in the Indian pharmaceutical market, sales forecast 2008–14 134