7/31/2019 Indian Onco

1/4

The Changing Oncology Market Scenario in India

The Indian oncology market is forecast to grow strongly in the next decade, driven by the rise in

cancer incidence and diagnosis, improved access to cancer therapies, better health insurance

coverage, and higher pharmaceutical spending, particularly among the growing middle class. But

while pharmaceutical companies are keen to establish a strong presence in India, a number ofchallenges remain

Cancer is one of the ten leading causes of death in India and accounts for 8% of the main causes of

deaths in the country. Cancer of the oral cavity and lung cancers are the leading cancer types in

Indian males while cervix and breast cancer are the predominant cancer types in females. These

cancer types account for over 50% of all cancer deaths in India.

Rising disposable income has lead to various lifestyle changes such as increasing rates of smoking,

decline in physical activity among affluent, increase in the consumption of red meat and fast food

in urban areas. These trends have lead to increase rates of various cancers in India.

Increased rates of incidence of various cancer types prevailing in India and a booming economy

has made India one of the key emerging markets for various multinational pharmaceutical

companies with an oncology portfolio.

Treatment Scenario

The diagnosis and treatment of cancer has progressed a lot in the last few decades in India.

Almost all major cities in India have a 500 to 1000 bedded specialized oncology centers. These

centers have state of the art facilities for diagnosis and treatment of cancer. In addition almost all

large hospitals in India have oncology units. The talent pool of medical, surgical, and radiation

oncologists continue to grow though the demand far outstrips the supply.

Market Overview

The oncology market in India is about $186 million, and is expected to reach $693 million by 2012,

a Compound Annual Growth Rate (CAGR) of nearly 30%. More than 30 drug companies are active in

Indian oncology market. The current market is largely generic and dominated by regional players.

In the last few years many multinational drug companies have entered the Indian oncology

market.

Pfizer, GlaxoSmithKline, AstraZeneca, Novartis, BMS, Sanofi-Aventis, Schering Plough, Baxter,

Johnson & Johnson, Merck and Amgen are some of the large Pharmaceutical companies who have

launched products in the Indian market. These companies are targeting a small but significant

proportion of Indian cancer patients who will be able to afford the newer and premium-priced

anti-cancer treatments. The medical insurance sector has become stronger over the last decade

and provides an ever increasing opportunity to the MNCs.

7/31/2019 Indian Onco

2/4

Indian pharmaceutical companies are currently dominating the conventional chemotherapy

market. Dr.Reddys, Shanta Biotech, Dabur, Natco, Sun pharma have strong R & D oncology setup

and are key manufacturers in the Indian Market. The challenge they pose is the increasing ability

to genericize small molecules products. Additionally, Indian companies like Dr. Reddys, Ranbaxy,

and some other leading biotech companies are also looking at manufacturing biologics and may

pose a serious threat for MNCs manufacturing targeted agents.

Challenges for Pharma Companies

Multiple hurdles face a Pharmaceutical company entering the Indian market. Epidemiological

surveillance is weak and forecasting future epidemiological figures is challenging. Forecasting the

market potential is even more challenging with multiple complexities unique to the Indian market.

While the economy is booming more than one-third of the Indian population lives below the

poverty line. The highly priced innovator products are out of reach of most of the patients. The

current IP and regulatory scenario in India is weak but offers the hope of becoming stronger in the

near future. However decades may pass before the secure environs of stable North American and

European markets is achieved. The Indian market is attractive but targeting the right patient and

physician customer with an innovative sales force strategy will be critical to achieving growing

sales and high ROI.

Highlights

A large part of the Indian population lacks access to appropriate cancer care. A number of reasons

contribute to this including inadequate healthcare infrastructure, low health insurance coverage,

poor education and low cancer awareness.

While domestic companies dominate the market with branded generics, all major multinational

pharmaceutical companies have a presence in India, targeting a small but significant part of the

population that can afford the price premium associated with global brands.

As the Indian economy continues to grow, more people will gain the financial ability to seek

cancer treatment, while the growing middle class will drive demand for innovative brandedtherapies. Plans to increase government expenditure on health and improve access to cancer

drugs will also drive the uptake of cancer therapeutics in the future

SUCCESS

7/31/2019 Indian Onco

3/4

The high level of commercial success experienced by the key companies in the oncology market

makes it extremely attractive to drug developers. However, the shift toward a more personalized

approach means fewer drugs will achieve blockbuster status. The evolution of a fragmented

oncology market will decrease the value of the top 20 branded therapies by $8.6 billion between

2010 and 2020.

In 2020, targeted therapies will dominate the top 20, but as developers focus on niche subsets of

patients with specific genetic mutations the market will fragment. As a result, the total sales of

the

top 20 branded therapies in the seven major markets will decrease from $36.6 billion in 2010 to

just

over $28 billion in 2020.

Generic erosion of multiple key brands in the cytotoxic class will be the key driver in decreasing

its

share of the top 20 branded sales in the seven major markets from 21% in 2010 to 3% in 2020.

However, differing brand loyalty means patent expiries will have varying effects on the top 20 in

individual markets.

Roche dominated the top 20 in 2010, with combined seven major market sales of $13.2 billion.

Avastin, Rituxan, and Herceptin look set to maintain the top three positions in 2020 and Roche

looks

set to consolidate its leading position in the oncology market.

The Indian government has granted marketing licenses for about 25 recombinant protein

therapeutics. Some of the recombinant products already approved by the Genetic Engineering

Approval Committee (GEAC) are:

Insulin Interferon alpha Interferon gamma Interleukin-2 Gm-CSF G-CSF Hepatitis B vaccine

7/31/2019 Indian Onco

4/4

Erythropoietin Strptokinase EGF Chymotrypsin

Traditionally India has been a very strong player in conventional generics due to established track

record of process engineering skills and capability to set up comparable manufacturing units at a

fraction of the capital cost utilized overseas.

Companies such as Shantha biotech, which started with just one product, are now effectively

using this experience to launch other products like plasminogen activators, interferons,

sophisticated vaccines etc. Following the suit of globalization many multinationals like Monsanto,

Pfizer, Unilever, Dupont, Bayer, have set up their businesses in India. Eli Lilly- Ranbaxy 50:50 joint

venture in India has been marketing a range of biotech products such as Humalog and Huminsulin

for diabetes. Hoechst Roussel Vet has developed a cow abortion IBH vaccine in India. Chiron-

Boehringer is setting up a vaccine venture in India.