While companies no more possesses deep and extensive product pipeline, this is the perfect time to innovate! Innovate not only in terms of product (although that is the core), but also

1. Innovation in patient care
DR. AMIT GARG
MEDICAL DIRECTOR AND HEAD, EMERGING MARKETS
DR. REDDY’S - INDIA

2. Dr. Reddy’s
 Our purpose – “We accelerate access to affordable and innovative
medicines because Good Health Can’t Wait”
 Our promise:
 Bring expensive medicines within reach
 Address unmet patient needs
 Help manage disease better
 Ensure products are always on the shelf
 Equip partners to succeed

3. Objective
 Growth history of pharmaceutical industry
 Diminishing rewards for pharma companies
 Existing Un-met needs in disease management
 Diversification and innovation trends in industry
 Taking patient centric approach
 Future opportunities; thinking “beyond the pill”

4. Drug development: then and now
- Small molecule focused
- Low throughput screening
- Animal based modelling
Med/Chem lead optimisation
- Small/ focused CT
- All activities in-house
- Target based HTS of lib.
- Structure based rational
drug designing
- Partnership with
universities/ biotech
- Extensive/ expensive CT
Increasedtimetovalidatethecompound
Failureofcompoundsinclinicalstage
IncreasedR&Dcostto~20%perannum
Improvedoverallselectionprocess
10foldincreaseinpotentialdrugtargets
Emergenceofbiopharmindustry

5. R&D productivity over years
Average peak sales per drug launch (Bn$)

6. Overall R&D efficiency is decreasing

7. GP Survey results

8. Future un-met needs

9. Healthcare segment challenges
Rising extreme age patient groups
Chronic and multiple diseases
Low quality of care impacting outcomes
Increase influence of payers
Rising penetration of insurance companies

10. Other External challenges
Price regulation and INN law
Push for local industry growth
Hunger for innovative products
Increasing generics entry
Devaluating currencies

11. Motivation for change differs

12. If you get it right... You make it BIG!!

13. Unhappy??

14. Various strategies

15. Keeping patient always in the center
 As pharmaceutical physician, it is important for us to understand what patients want,
but it is more important to know why they want!
▪ See, feel and live the patient experience
▪ Understand why people do what they do
▪ Check closely what motivates them
▪ Know patients better than they knew themselves

16. Big-Data of the patient’s world
R&D Data
Behaviour Data
Consumption
Data
Outcomes Data

17. What consumers want?
Characteristics Importance
Is generally easy to swallow 74%
Doesn’t get stuck in your throat 69%
Works quickly 69%
Leaves no bad aftertaste 61%
~~~ ~~~
Is natural / Vegetarian 22%
Is unique, different from other forms 21%

18. Woman’s healthcare needs
Adolescent
Acne medicines
PMT therapies
Weight loss
drugs
Birth control
Adult
Fertility
treatments
Pregnancy tests
Peri-natal
complications
Mature
Hormone
therapies
Oncology
products
Vitamin
supplements
Elderly
Arthritis
treatments
Osteoporosis
drugs
Joint
replacement
devices
Evolve over time

19. Takes us beyond disease management
Adolescent
Derma advice
Dietary
guidance
Exercise
facilities
Counselling
Adult
Pregnancy
screening
Nutritional
advice
Breastfeeding
support
Sexual health
services
Mature
Health checks
Physiotherapy
Cancer support
services
Elderly
Bone mineral
density
scans
Lifestyle advice
Physiotherapy

20. Emerging opportunities
 Repurposing drugs based on unmet needs
 New indications, Differentiated formulations
 Patient friendly packaging solutions
 Easy to peel/ open, drug identifier
 Patient adherence
 Smart caps, smart bottles, chip on a pill
 Chronic disease management
 Automatic refill, Mobile apps
 Closed loop monitoring
 Online glucose monitors, connected heart monitors
 Drug test combinations
 Oncology

21. Helping patient remember in dementia
 Nicergoline is required to be given 3 times in a day in pre-dementia or MCI

22. Unmet need based repurposing

23. MetSmall: A big innovation
In some doses of metformin , the pill is very large
Patients find it difficult and even painful to swallow.
Patients avoid the medication or take it inappropriately
Diabetes is an exponentially growing problem

24. Bonalon® : Oral Jelly
More than 200 Mn people suffer from osteoporosis
Current formulations are difficult to swallow
Risk of esophageal irritation

25. Patient friendly packaging

26. Patient adherence: Smart bottles

27. SOURCE: McKinsey analysis, novartis.com, http://mobihealthnews.com
Improving Compliance
▪ Recognized need for greater compliance to Diovan
▪ Partnered with Proteus for patient study using “chip in the pill” technology
▪ Chip activated by stomach acid, transmits information through a skin patch which is
sent to doctor through internet or mobile
▪ Compliance increased from 30% to 80% within 6 months

28. BlueStar Mobile app for glucose control
SOURCE: https://www.bluestardiabetes.com/, http://www.welldoc.com/
BlueStar
Nationwide
network of
trainers
Analyses important
data for clinicians to
develop personal care
plans
Helps patients
with various
test, exams,
diets
▪ Lack of
motivation
among patients
to remain faithful
to treatment
▪ Mobile phone–based
treatment/behavioural
coaching intervention
improved glycated
haemoglobin by 1.9%,
compared with 0.7% for UC
over 12 months.

29. SOURCE: McKinsey analysis, www.bayer.com
Increased compliance in child
diabetes patients through gamification
▪ Partnered with Humana, Nintendo
to build DIDGET
▪ DIDGET is a blood glucose meter
that connects directly to Nintendo
DS
▪ DIDGET helps kids manage their
diabetes by rewarding them for
consistent testing habits
▪ DIDGET users improved their
self-care and
reduced diabetes-related
urgent and emergency-care
visits by 77%
▪ Lack of patient
motivation to remain
faithful to treatment
regimen

30. Novartis is partnering with start-ups especially in
digital space
SOURCE: Sanofi website, ‘eyeforpharma Value Added Services Summit’ presentation 18/09/2014; Sanofi Annual Report 2015, ‘Sanofi and Medtronic to
form strategic alliance in diabetes to improve patient experience and outcomes’, Press Release, Medtronic 14 June 2014
▪ Entered into licensing
agreement for
Google’s passive
glucose-sensing
contact lenses
▪ Partnership to launch
an awareness
campaign on MS
called ‘The 7 Day
Challenge to Live like
You’.
▪ $100m Investment
Fund to invest in
technologies, products
or services that “go
beyond the pill”
▪ Non-digital initiatives
within specific TAs and
geographies (e.g.,
helping define and
raise awareness of the
CV pathway in
Yaroslavl region in
Russia)

31. Future outlook of leaders
“I really believe that in the future, companies like Novartis are going
to be paid on patient outcomes as opposed to selling the pill . . . (we
will be) creating value by embedding products into a holistic offering
with the aim to improve patient outcomes and provide tangible
competitive advantages.”
– Novartis CEO Jospeh Jimenez

32. No more “Moon shots”
 3D printing technology: manufacturing of drugs, devices, or organs
 Predictive analysis based on wearable
 Machine learning for early detection
 Genomics for disease predisposition and prevention
 Crowd sourcing information from social media
 Wearable monitors and early detection kits
 Virtual reality based patient awareness and patient education
 Automated health Kiosks

33. Thank you
Questions... Comments...
amitgarg.pharm@gmail.com