POSTGRADUATE MEDICAL EDUCATION IN PHARMACOLOGY

8/23/2019 POSTGRADUATE MEDICAL EDUCATION IN PHARMACOLOGY

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POSTGRADUATE MEDICALEDUCATION IN

PHARMACOLOGYBy

Professor Ranjit Roy Chaudhury**

National Professor of Pharmacology (National Academy ofMedical Sciences) &Chairman Task Force for Research

Apollo Hospitals Educational and Research Foundation

Kolkata10th December 2009

** Former Professor and Head, Dept. of Pharmacology, Dean andActing Director

Postgraduate Institute of Medical Education and Research, Chandigarh


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G A P

Pharmacological expertise needed

and

Availability of pharmacologists


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G A P

Type of specialized pharmacologicalexpertise needed

and

Type of pharmacological expertiseavailable


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GLOBAL LEADERSHIP

Drug discovery

International health care

Clinical trials

Traditional medicine research


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DRUG DISCOVERY

New molecules coming from Indianlaboratories

40+ molecules at different stages of clinicaltrials in India

Interesting leads sold to the foreigncompanies

Essential to have drug developmentexpertise in India


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TYPES OF PHARMACOLOGICAL

EXPERTISE NEEDEDImmunopharmacology

Biochemical pharmacology

Pharmacogenetics

Molecular pharmacology


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INTERNATIONAL HEALTH CARECost of Carrying Out

Procedure USA India Thailand Singapore

Coronary arterybypass surgery

$70,000-133,000

$7,000 $22,000 $16,300

Bypass surgerywith heart valve

replacement

$75,000-140,000

$9,500 $25,000 $22,000

Hip replacement $33,000-57,000

$7,200 $12,700 $12,000

Kneereplacement

$30,000-53,000

$7,200 $11,500 $9,600

Prostate surgery(TURPprocedure)

$10,000-16,000

$3,600 $4,400 $5,300

Gastric bypass $35,000-52,000

$9,300 $13,000 $16,500

Face-lift $10,500-16,000

$4,800 $5,000 $7,500


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CLINICAL TRIALSWhy India?

Availability of a large population of patients

Large variety of diseases prevalence

Availability of naive patients, 299 medicalcolleges, competent clinicians with fluencyin english

Greatly reduced cost for carrying out clinicaltrials

Relatively strong drug regulatory agency


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CLINICAL TRIALS IN INDIA

BOON Ethical transparent trials

or

BANE Unethical trials exploitingpoor and illiterate


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PREPARATIONS BY ICMR FORDRUG DEVELOPMENT /

CLINICAL TRIALSAdvanced Centres

NIRRH, Mumbai Reproductive ToxicologyNIN, Hyderabad Toxicology

JIPMER, Pondicherry Genotoxicology

- Reverse PharmacologyRegional Research Institute, Jammu

Standardization


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PREPARATIONS BY ICMR FORDRUG DEVELOPMENT /

CLINICAL TRIALSAdvanced Centres

RMRC, Belgaum Traditional medicine

Himalayan Institute, Palampur Cultivationof medicinal plants

Bose Institute, Kolkata Plant genomeresearch


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CLINICAL TRIAL CENTRES

NIZAMs Institute, Hyderabad -Pharmacodynamics

CMC, Vellore Centre for evidence basedmedicine

Vivekananda Yoga Kendra Effect of yoga

Nair Hospital, Mumbai Clinical Trials

KEM Hospital, Mumbai Clinical Trials


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CENTRES FOR CLINICAL TRIALSOF TRADITIONAL REMEDIES

AIIMS, New Delhi

PGIMER, ChandigarhBHU, Varanasi

Medical Colleges Cuttack

- Trivandrum

- Chennai

- Kottayam


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INSTITUTE ETHICSCOMMITTEE

To protect patient/public from exploitation

Committee needed at all centres whereclinical trials are being carried

No trial to be carried out till proposalcleared by Ethics Committee

and

Placed in Register of Clinical Trials, ICMR


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CLINICAL PHARMACOLOGISTin Institutional Ethics

CommitteesInformed Consent

Use of Placebo

Ownership of data

Rights of patient after completion of trial


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TRADITIONAL MEDICINE

Kolkata

Col. R. N. Chopra

Dr. B. B. Dikshit

Dr. B. Mukherjee

School of tropical medicine,Kolkata


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RESEARCH

Resources Technology Bio-diversity

North Yes Yes No

South No No Yes


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GOLD STANDARD

For Synthetic DrugControlled

Comparative

Placebo

Double-Blind

RandomizedMulti-centred

Clinical trial


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OTHER DESIGNS MAY BEAPPROPRIATE FOR

TRADITIONAL MEDICINES

Observational pharmacology trials

Open trials

Single blind studies

Sample of one trials


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RATIONAL USE OF MEDICINESADVANTAGES

Better therapeutics

Reduction of side effects- Inappropriate dose

- Inappropriate duration of treatment- Interactions

Reduction in cost of medication- Individual- Family

- Community

- Country


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THE DELHI MODEL

Rajasthan

Himachal Pradesh

Uttar Pradesh

Haryana

Mumbai Corporation


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OTHER ORGANIZATIONSUSING CONCEPT OF

RATIONAL USE OF MEDICINES

Helpage

Family Planning Association

National Rural Health Mission


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NEED FOR PHARMACOLOGISTS

Development of drug policySelection of drugs to be used in country

Drug regulation

Drug discoveryCarrying out clinical trials

Corporate and government hospitals

Research in traditional medicines

Pharmacovigilance

Memberships/Chair Ethics Committees


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NEED FOR PHARMACOLOGISTS

Traditional role as professors ofpharmacology in medical colleges

and

in drug research institutes

and

in drug regulatory agenciesand

in pharmaceutical industry

D M COURSE IN CLINICAL


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D.M. COURSE IN CLINICALPHARMACOLOGY AT PGI,

CHANDIGARHTeam: Professor Ranjit Roy Chaudhury

Professor V. S. MathurProfessor P. L. SharmaDr. K. S. RaghavanDr. S. K. Garg

Collaboration: Professor P. K. Devi

Professor R. N. ChakravartyGuidance and

Support: Professor P. N. ChhuttaniProfessor K. L. Wig

Professor Santokh Singh Anand


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D.M. CLINICALPHARMACOLOGY

Open to pharmacologists and cliniciansafter receiving first advanced degree

Two year course

Clinical attachment

WHERE ARE THEY 36 TILL


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WHERE ARE THEY 36 TILLDECEMBER 2009

India and Abroad

Professors of clinical pharmacology

Medical Directors/Vice-Presidents inpharmaceutical houses

Heads of drug regulatory agencies

Heads of divisions in research institutes

Academic staff of medical colleges


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D.M.S QUALIFYING EVERYYEAR

PGIMER, Chandigarh - 2

KEM, Mumbai - 2

Nizams, Hyderabad - 2

A.I.I.M.S - 1

Others - 2

- 10

DNB in clinical pharmacology 4 to 5

TOTAL 15 per year

NEED - 100 per year


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OTHER TRAININGPROGRAMMES

Masters in pharmacology from collegesof pharmacy

Masters course in pharmaceuticalmedicine run by KEM Hospital, Mumbai

90 trainees each year

WHY IS THERE SO MUCH


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WHY IS THERE SO MUCHNEED?

Healthcare IndustryAt present 20 billion dollars

In ten years 45 to 63 billiion dollars

+ 9.00 billion dollars

If health insurance comes in

Clinical trial turnover

1.0 billion dollars by 2015


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INTERNATIONAL HEALTHPatients from Abroad

1999 10,000

2004 180,000Annual growth rate 25 to 30%

ExampleApollo HospitalsIn last five years 60,000

from 55 countries


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M.D. COURSE OF A.I.I.M.SContains

Molecular biology in pharmacology

Clinical pharmacology and recent

advancesDrug regulations

Drug development process

Clinical trials

Therapeutic drug monitoring


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AREAS WHICH COULD BEADDED

Drug delivery systems

- Transdermal drug delivery

Ocular pharmacology

Pharmacovigilance

Regulations regarding IPRPharmacogenetics

Genomic pharmacology

PHARMACOLOGY


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PHARMACOLOGYPOSTGRADUATES

More needed- Scaling up

Different expertise needed- Broaden curriculum horizons

NEED tremendous

No time to lose

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POSTGRADUATE MEDICAL EDUCATION IN PHARMACOLOGY

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