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Product Management assignment: JANUVIA
PRODUCT MANAGEMENT ASSIGNMENT:
PROFILE OF PHARMA BLOCKBUSTER JANUVIA
CHARMI POPAT
ROLL NO. 03
PRODUCT MANAGEMENT ASSIGNMENT
MBA PHARMA TECH VTH YEAR
SVKM’s NMIMS SPP SPTM Page 1
Product Management assignment: JANUVIA
TABLE OF CONTENTS
SR NO. TOPIC PG NO.
1. INTRODUCTION 3 - 4
2. MARKET ANALYSIS 5 - 7
3. STRATEGIES ADOPTED BY MSD TO LAUNCH
JANUVIA ACROSS THE GLOBE
8 - 13
4. STRATEGIES ADOPTED BY MSD TO LAUNCH
JANUVIA IN INDIA
13 - 18
5. SUMMARY 19
6. REFRENCES 20
SVKM’s NMIMS SPP SPTM Page 2
Product Management assignment: JANUVIA
INTRODUCTION
What Are JANUVIA® (sitagliptin) tablets?
JANUVIA is a type of prescription diabetes medicine called a DPP-4 inhibitor that enhances
the body's own ability to control blood sugar levels.
JANUVIA helps your body to:
Increase insulin production in your pancreas
Decrease the sugar made in your liver
Increase insulin production when blood sugar is high, especially after you eat. This is
when the body needs the most help in lowering blood sugar.
Reduce the amount of sugar made by your liver, especially after you eat, when your
body doesn't need it.
How Does JANUVIA Work?
With type 2 diabetes, pancreas does not make enough insulin. Liver may also make too much
of sugar. Body’s cells may lose sensitivity to insulin (insulin resistance). Because some cells,
such as muscle cells, are less sensitive to insulin, they cannot effectively absorb blood sugar,
which is needed for energy. As a result, blood sugar level increases.
Before taking JANUVIA: After meal body sends important
messages to pancreas to try to lower blood sugar. In response,
pancreas tries to make more insulin & signal liver to release less
sugar.
When you have type 2 diabetes:
After taking JANUVIA: JANUVIA is type 2 diabetes
medicines allow more messages to get through. This helps
pancreas to release more insulin & liver make less sugar.
SVKM’s NMIMS SPP SPTM Page 3
Figure 1
Product Management assignment: JANUVIA
Mechanism of action of JANUVIA:
First approved by FDA in 2006, the product’s sales grew by a spectacular 45.3 percent in
2011 to $3.66 billion, while Merck’s fixed-dose combination formulation of Januvia and
metformin, Janumet, added another $1.36 billion with 43.9 percent growth.
History of JANUVIA:
SVKM’s NMIMS SPP SPTM Page 4
Merck initiates DPP-4 program1999
In-licensed probiodrug P32/98 to jumpstart internal program. Later discontinued due to preclinical toxicities not related to DPP-4 inhibition
2000
Team discovers that selective DPP-4 inhibition may be important to a favourable safety profile →major effort initiated to identify best-in-class DPP-4 inhibitor
2001
Identification of sitagliptin as a highly selective DPP-4 inhibitor2001
Initiation of clinical trials2002
Approval of JANUVIA (sitagliptin) as 1st DPP-4 inhibitor2006
Product Management assignment: JANUVIA
MARKET ANALYSIS
About MSD: It is a Global Pharmaceutical Company. It operates in more than 140 Countries.
Address major Global health issues by having its eminent presence in Diabetes (75% of
diabetic population lives in emerging markets), Cardiovascular & Respiratory Diseases,
Hepatitis C, Cancer, HIV and so on and so forth.
Diverse Portfolio: Anti diabetic contributes to approximately 30% with just 2 diabetes
medication (JANUVIA & COMBINATION WITH METFORMIN JANUMET).
30%
22%14%
12%
6%
5%
Anti DiabeticDermaGynaec.HormonesRespiratoryGastro IntestinalAnti-infectivesVACCINESOthersCARDIACPain / AnalgesicsHIVNeuro / CNSBlood Related
Source IMS health (2013)
It contributes 5.54% to overall Oral Anti diabetes market & is growing at 28.99% CAGR.
VALUE MAT (IN CRS.) QTY MAT (‘000)
COMPANY JUN'10
JUN'11 JUN'12 JUN'13 CAGR (%)
MS (%) JUN'10 JUN'11 JUN'12 JUN'13
MSD PHARMACEUTICAL
68.6 93.2 142.7 190.0 28.99% 5.54%
29622.7 41115.8 65876.7 90151.0
Source IMS health (2013)
MSD is one of the top players in Oral Anti diabetes market.
Source IMS health (2013)
SVKM’s NMIMS SPP SPTM Page 5
COMPANIESMAT value
(2013) in crs. Market share (2013)
U S V 560.9 16.36%
SUN* 323.4 9.43%
NOVARTIS INTL.* 223.7 6.52%
MSD PHARMACEUTICAL 190.0 5.54%
ABBOTT* 182.9 5.33%
SANOFI* 172.3 5.02%
Product Management assignment: JANUVIA
About JANUVIA & JANUMET:
JANUVIA (sitagliptin phosphate) launched in India in April 2008 available in 3 different strength 25mg, 100mg & 50mg. Price to retailer being Rs. 227.8 per pack containing 7 tablets in each pack.
In Dec 2008 combination product JANUMET (sitagliptin+ metformin phosphate) was introduced which was made available in 2 strengths (50mg + 1000mg) & (50mg + 500mg). Price to retailer being Rs. 234.7 per pack containing 14 tablets in each pack.
VALUE MAT (IN CRS.) QTY MAT (‘000)
BRANDS PACK_DESC PROD_LNCH PTR JUN'10 JUN'11 JUN'12 JUN'13 JUN'10 JUN'11 JUN'12 JUN'13
JANUMET
JANUMET FILM C.TABS 1000 MG x
14 (/50) 200812.0 234.7 8.5 13.9 24.8 35.8 5013.0 8263.8 14803.1 21346.5
JANUMET FILM C.TABS 500 MG x
14 (/50) 200812.0 234.7 19.4 29.3 51.4 74.0 11436.6 17390.8 30637.4 44175.5
JANUVIA
JANUVIA FILM C.TABS 100 MG x 7 200804.0 227.8 35.0 41.2 53.6 61.8 10653.6 12590.6 16483.4 18992.4
JANUVIA FILM C.TABS 25 MG x 7 200804.0 227.8 0.5 1.0 0.7 1.0 144.4 315.0 212.8 305.1
JANUVIA FILM C.TABS 50 MG x 7 200804.0 227.8 4.9 7.8 12.2 17.4 1497.7 2389.4 3740.0 5331.5
Grand Total 68.2 93.1 142.7 190.0 28745.3 40949.6 65876.7 90151.0
Source IMS health (2013)
JANUVIA (sitagliptin phosphate) is growing at CAGR of approx. 19% contributing to 42.19% share to MSD diabetes segment & 2.3% to overall OAD market. The brand ranks 5 th
in OAD segment & ranks 68th in overall pharma market with current market valuation of Rs. 802crs. (as of 2013) in India.
JANUMET (sitagliptin phosphate + metformin) is growing at CAGR 41% contributing to 57.81% share to MSD diabetes segment & 3.2% to overall OAD market. The brand ranks 3 rd
in OAD segment & ranks 40th in overall pharma market with current market valuation of Rs. 1,098 crs. (as of 2013) in India.
MAT Values (INR M) MAT Qty (000's)
BRANDS PROD_LNCH JUN'10 JUN'11 JUN'12 JUN'13 GR ('13)
CAGR
(%) % M.S. JUN'10 JUN'11 JUN'12 JUN'13
GR
('13)
CAGR
(%) % M.S.
JANUMET 200812 278 432 762 1,098 44% 41% 3.2% 16,450 25,655 45,441 65,522 44% 41% 0.8%
JANUVIA 200804 404 500 665 802 21% 19% 2.3% 12,296 20,436 24,629 21% 19% 0.3%
Source IMS health (2013)
SVKM’s NMIMS SPP SPTM Page 6
Product Management assignment: JANUVIA
Product features:
Once daily, oral
24 hour inhibition of DPP-4 activity
Substantial efficacy
Weight neutral
Low risk of hypoglycemia except when used with a SFU or insulin
Unmet needs at the time of development:
OPPORTUNITIES FOR JANUVIA:
Many external factors combined to create the opportunity for JANUVIA success:
1. The growing global obesity epidemic, which is directly correlated with the global
growing type 2 diabetes epidemic, has contributed to exponential growth of the
overall market for type 2 diabetes products.
2. Fortunately for Merck, Novartis’ DPP-IV compound Galvus did not receive FDA
approval, while Januvia did.
3. On top of that, physicians had been using a number of products to manage their
patients’ type 2 diabetes, but many carried an increased risk of hypoglycemia and
other side effects. “Many physicians were looking for newer, safer approaches to
treating type 2 diabetes, and the favorable safety profile of Januvia, combined with its
efficacy story, led a lot of physicians to turn to this new class,”
4. On top of this, Januvia’s positive safety profile has taken centre stage after
negative warnings associated with thiazolidinedione use began to surface. “As a
class, TZDs have fallen off significantly in the past two years, leaving much of that
share to be picked up by Januvia, largely due to its safety and efficacy association,”
5. Januvia’s potential as an add-on to the popular drug metformin was another break
for the product, says Riad El-Dada, senior VP and commercial group leader, diabetes
franchise, Merck
SVKM’s NMIMS SPP SPTM Page 7
Product Management assignment: JANUVIA
STRATEGIES ADOPTED BY MSD TO LAUNCH JANUVIA ACROSS
THE GLOBE
Strategies adopted by MSD to make JANUVIA a huge success:
Riad El-Dada, senior VP and commercial group leader, diabetes franchise, Merck says:
“Our strategy is really built on seeking out patients who are on metformin, to encourage
physicians and patients to make JANUVIA the next step,”
“We have a product that is really the perfect add-on to metformin. Metformin is widely used
in most parts of the world, it’s growing really fast. So we sort of hit the sweet spot with our
marketing strategy.”
1) TAILORED JANUVIA’s CLINICAL PROGRAMS FOR DIFFERENT REGIONS:
Brand team of JANUVIA customized the clinical trials data so that they have right
indications for different regions and the right studies. They focused on strategy “starting
narrow and going wide – earning a single approval as early as possible, then following
up with a stack of additional indications to broaden access.”
Indications for JANUVIA were: added indications for third-line use, indication for use with
insulin, indication for use with TZDs and metformin. Though all the indications were not
filled initially because there was a huge competition from Novartis, BMS/Astrazeneca and so
on & so forth but very rapidly they followed but with them. So they could launch the drug in
a customized manner & fast & first before the competition.
2) EXTENSIVE LIFE CYCLE MANAGEMENT PROGRAM FOR SITAGLIPTIN:
Merck & Co., Inc. announced on Apr 2, 2007 within a year that the U.S. Food and Drug
Administration (FDA) approved JANUMET, the first and only tablet combining a dipeptidyl
peptidase-4 (DPP-4) inhibitor, sitagliptin (also known as JANUVIA), and metformin for the
treatment of type 2 diabetes.
SVKM’s NMIMS SPP SPTM Page 8
Product Management assignment: JANUVIA
The key decision point brand team made was the choice to push a metformin combination
early in development, before anyone really knew if JANUVIA would even be a success on its
own, and then placing substantial marketing muscle behind the new combination when it was
approved, even with the blockbuster JANUVIA already in hand. Development program for
JANUMET was started very quickly and then really put a lot of emphasis on it when they
could launch it. MSD announce its launch on Apr 2, 2007
SVKM’s NMIMS SPP SPTM Page 9
Core Phase IIIProgram
1. Monotherapy (2 studies)
2. Combination therapy with
metformin and PPARγ
3. Renal dosing
1st Phase 1. Add-on to
Metformin versus SulfonylureaJANUMET
Program
2nd Phase1. Add on to
Sulfonylurea ± Metformin
3rd Phase1. Insulin add-on
2. Triple combination with
PPARγ / metformin3. High baseline
HbA1C metformin add-on study4. Metformin
comparison study5. Initial
combination with PPARγ6. Initial
combination with metformin
7. Study in elderly8. Mechanism of
action studies
Ongoing/recently completed
1. Sitagliptin/ Pioglitazone FDC
(MK-0431C)2. Sitagliptin/
Simvastatin FDC (MK-0431D)3. JANUMET
Extended Release Program
4. Cardiovascular Outcomes Study
JANUVIA
FDA approved sitagliptin phosphate tablets (Januvia, made by Merck and Co, Inc) for use with diet and exercise to improve glycemic control in adult patients with type 2 diabetes mellitus.On October 17 2006
JANUMET
FDA Approves Janumet for Type 2 Diabetes, Offering Powerful Glucose Control of a DPP-4 Inhibitor and Metformin in a Single TabletApr 2, 2007
JUVISYNC
FDA approved Juvisync (sitagliptin and simvastatin), a fixed-dose combination prescription medication that contains two previously approved medicines in one tablet for use in adults who need both sitagliptin and simvastatin.Oct. 7, 2011
JANUMET XR
FDA approved “JANUMET XR is a new treatment that adds once-daily convenience to the powerful efficacy of JANUMET for patients with type 2 diabetesFebruary 02, 2012
Product Management assignment: JANUVIA
3) JANUVIA : FIRST TO MARKET TAKES ALL
The first DPP-IV inhibitor on the market was Januvia® (sitagliptin). Januvia was in the right
place at the right time.
United States:
It was introduced in the U.S. in 2006 by Merck & Co. In the U.S., Januvia enjoyed three
years of exclusivity in its class before AstraZeneca/BMS introduced Onglyza. During this
period of 3 years, Januvia used strong promotion to gain early buy-in from stakeholders and
to build a positive brand image. It secured its place as “the” gliptin, an image that
AstraZeneca/BMS was unable to change despite heavy U.S. promotional investment.
Novartis’s Galvus® (vildagliptin) was delayed in the U.S. due to questions of side effects.
Tradjenta™ (linagliptin) have also entered the market, and the pipeline promises more to
come.
Europe:
In Europe Januvia was first in class launched in 2007. Galvus,was launched in 2008.
JANUMET:
United States:
In the U.S., Merck’s products were the first to market both for the single-compound therapy
(Januvia) and the combination therapy (Janumet).
Europe:
In contrast, Merck delayed launching its fixed-dose combination product, Janumet®
(sitagliptin/metformin) until a year after Januvia, its single-compound product, was on the
market. Janumet was the second-to-market combination product. In fact, it lagged behind
Eucreas by a full two years in the U.K.
Uptake of Eucreas did not match that of Janumet across the top five European countries—
likely because Janumet benefited from Januvia’s established patient base.
SVKM’s NMIMS SPP SPTM Page 10
Product Management assignment: JANUVIA
4) CLOSING TIME GAP :
The time lag between first global launch and the first entry into a pharmerging market was
reduced. JANUVIA (sitagliptin) was launched in Brazil just 6 months after its first global
entry to speed up the pace of their outreach to the pharmerging sector.
JANUMET launched 4.5 months after JANUVIA. JANUVIA & JANUMET were launched
globally within 4 years from 2006 to 2009. JANUVIA launched in 81 countries &
JANUMET launched in 52 countries
5) COMMUNICATING WITH PHYSICIANS & PATIENT EDUCATION PROGRAM:
Merck invested heavily in educating physicians about the DPP-IV class prior to the approval
of any product
The team made a significant investment in academics and diabetes thought leaders early on,
“because the mechanism was new and the science was new. They also worked with
professional societies on education. They worked with the American Diabetes Association
and others and used them to help with outreach, not just to patients but also to physicians.
In communicating directly with physicians and patients, Januvia’s managers have leaned on
the good old-fashioned sales force – “still probably the most important channel”
“Establishing trust with physicians is a top priority for our marketing and sales organization,”
SVKM’s NMIMS SPP SPTM Page 11
US JANUVIA
US JANUMET & BRAZIL JANUVIA
EU JANUVIA
EU JANUMET
JANUVIA – JANUMET in India & Japan
Product Management assignment: JANUVIA
Brand team provided a lot of support to help physicians help their patients by organizing
unbranded programs that gave them additional credibility with their customers.
Brand team also presented several periodic safety updates both general safety updates and
safety updates that would pertain to particular issues, for example cardiovascular safety
updates.
Merck’s brand team also came up with hypoglycemia awareness campaign: Discusshypo.com
which was deployed across multiple channels, including journal advertising, edetails, direct
mail, and waiting room posters, and which was not a branded campaign, but instead a disease
awareness campaign & for which it was nominated for a Best Disease-Awareness Campaign
Manny Award in 2011.
Target audience of
JANUVIA were both
Healthcare professionals
(M.D., Pharm D etc.) &
Non- Healthcare
professionals (Patients
& Caregivers)
SVKM’s NMIMS SPP SPTM Page 12
Product Management assignment: JANUVIA
6) HUGE INVESTMENT MADE ON TRADITIONAL & DIGITAL MEDICAL EDUCATION CHANNELS
Brand team has invested in both traditional and digital DTC, medical education, and a
significant convention presence, among other things.
Product promotion of
JANUVIA highly focused on
following parameters:
Parameters % contribution
to
communication
Efficacy 11
Safety 26
Other benefits 7
Patient access 37
Administration 4
Comparison 10
MOA 4
Marketing channels used to
promote JANUVIA were as
follows:
SVKM’s NMIMS SPP SPTM Page 13
Product Management assignment: JANUVIA
Parameters % usage of
communication
channel
Conference 6
Web / Internet 1
Medical office,
hospital, pharmacy
36
Publications 22
Manf-sponsered
programs
35
TV 0
STRATEGIES ADOPTED BY MSD TO LAUNCH JANUVIA IN INDIA
MSD/ JANUVIA: The Game Changing Launch in INDIA!
India pharmerging market a different Game:
The dynamics for first-to-market products are less rigid in the Tier 1 and Tier 2 pharmerging
markets than we’ve observed in developed markets. In Brazil, Russia, and India, for example,
Merck’s JANUVIA was launched before Novartis’s GALVUS.
Nevertheless—and unlike mature markets—Novartis’s family of products accounted for
more than 50 percent of the DPP-IV market in 2011. Most of this success is attributable to
EUCREAS, which has outperformed JANUMET considerably. Meanwhile, GALVUS has
held its own against JANUVIA; its uptake has been comparable to that of JANUVIA in
Brazil and Russia, and greater than JANUVIA in India.
SVKM’s NMIMS SPP SPTM Page 14
Product Management assignment: JANUVIA
The reason why Novartis family of products (GALVUS & EUCREAS) outperformed MSD
family of products (JANUVIA & JANUMET) was Novartis entered India in 2009 with
GALVUS & EUCREAS and at the same time (i.e. 2009) Novartis entered in a Co-marketing
agreement with USV (2009), a leading pharmaceutical companies with Oral Anti Diabetes
segments and it introduced two brands JALRA & JALRA-MET. This helped Novartis to
outdo MSD’s product market demand & increase its product distribution & reach. First to
Market in India for MSD was not beneficial as it did enter in the Co-marketing agreement
unlike its competitor Novartis. MSD entered India in 2008 with JANUVIA & JANUMET but
it entered Co-marketing with SUN in 2011 i.e. 3years after the launch of JANUVIA & 2
years after the launch of JANUMET which was the reason why MSD market share is lower
as compared to Novartis till date.
Timeline of JANUVIA launch in India:
SVKM’s NMIMS SPP SPTM Page 15
Product Management assignment: JANUVIA
PRE-LAUNCH STAGE :
1) AFFORDABILITY:
With generally lower levels of income and greater emphasis on out-of-pocket or private
payment for healthcare, affordability is an important consideration for launching in
pharmerging markets. Many multinational companies are implementing discounted price
schemes to overcome this potential hurdle.
MSD undertook rigorous market research, quantitative & qualitative, involving 350
Physicians and 200 patients which helped them arrive at differential pricing. MSD came up
with different prices for different market. In case of JANUVIA per unit cost (cost per tablet)
in US is $8.84 & India is Rs. 16.76
2) DIVESED AN INTEGRATED DISEASE MANAGEMENT PROGRAM:
Brand team devised an integrated disease management program involving physician &
patients. This program helps to implement and expand the Diesease management program
under the brand name-SPARSH.
SVKM’s NMIMS SPP SPTM Page 16
Product Management assignment: JANUVIA
MSD’s SPARSH Program was launched to Complement Prescriber Focused Efforts. MSD
tied up with Thyrocare, a company that provides specialised tests for comprehensive health
evaluation.
3) Created class awareness via extensive communication in medical journals (explained
earlier)
4) Positioning the product with targeted physician/diabetologists in specified
geographical area (explained earlier)
POST – LAUNCH STAGE:
1) Putting Patients First: SPARSH Health line (Patient support services)
Launched on Date: Jan-09
Services provided by SPARSH
Counseling services1
• Counseling over telephone by trained personnel, based on needs assessed by
physician, patients, counselor
SVKM’s NMIMS SPP SPTM Page 17
Disease awarenes
s
HBA1c lipid
profile monitorin
g
Reminder alerts
to keep appointm
ent
Home Delivery
of medicines
Counseling
SPARSH
Product Management assignment: JANUVIA
• Awareness about the disease and its management
• Practical situations, complications; diet counseling with customized diet charts and
personalized follow ups
• Exercise counseling with suggested lifestyle changes, do's and don'ts
2) JOINT VENTURE WITH INDIA’S SUN PHARMA
"Our emerging markets strategy is driven by our focus on applying innovations across our
business from introducing novel compounds to broadening our focus on innovative branded
generics," MSD President (Emerging Markets) Kevin Ali said.
Indian pharma major Sun Pharmaceutical Industries on April 11, 2011 announced a 50:50
strategic joint venture partnership with global drugmaker Merck and Co Inc to develop,
manufacture and commercialise new innovative drugs in emerging markets over the next 2-3
years.
MSD established Joint Venture with India's Sun Pharma to develop novel combinations of
branded generics for emerging markets. Sun Pharma will sell the sitagliptin under brand
name ISTAVEL launched on June 2011 and sitagliptin plus metformin under brand name
ISTAMET launched on Aug 2011; different brand names in India as part of an India-specific
strategic partnership agreement with Merck
3) Free sample to encourage trials (explained earlier)
4) Lifecycle Management Strategies: Successful launch of Janumet (FDC with
Metformin), targeted at tier 2 cities (explained earlier)
LAUNCH STAGE:
1) Launched Januvia at a differential pricing (explained earlier)
2) Launch at CME events :
SVKM’s NMIMS SPP SPTM Page 18
Product Management assignment: JANUVIA
National level CME’s with KOL’s from other countries
CME’s with regional KOL’s
3) Gatherings of 7-8 physicians to discuss and exchange information on DPPIVs
facilitated by MSD reps
4) Marketing based on product clinical profile only – Selling not the focus
5) Made CSR an integral part of business which helped in creating goodwill among
Physicians/Patients
6) Going Forward: DIABETES & OBESITY FRANCHISE STRATEGY:
Develop new therapies for Type 2 diabetes mellitus to help patients achieve and
maintain optimal glucose control across the spectrum of disease, with mechanisms
that:
Increase insulin secretion
Decrease glucose production
Increase insulin sensitivity
Continue to lead in DPP-4 inhibitor class
Sitagliptin on track to be a leading global branded oral agent
Extensive sitagliptin life cycle management program with several fixed dose
combinations in sequential development
Strategic expansion with portfolio of novel mechanisms
Discover and develop novel therapies for obesity
SUMMARY
Factors that help JANUVIA success globally & in India are:
SVKM’s NMIMS SPP SPTM Page 19
Product Management assignment: JANUVIA
Pharmerging markets (a term coined by IMS to include 17 countries with income levels
under $25,000 per capita and relatively rapid growth)
Half of diagnosed patients fail to achieve adequate blood glucose control—and diabetes can
lead to blindness, amputations, heart disease and nerve and kidney damage, among many
other health consequences.
Weber knew that patients, even while they worried about having too much glucose in the
blood, were at risk of having their glucose levels lowered too much using existing treatments.
The condition, hypoglycemia, can cause reactions such as heart palpitations or, worse,
seizures and loss of consciousness.
According to this IMS report, the market for non-insulin diabetes treatments has experienced
strong growth over the last decade, averaging 9.5% over the past five years.
REFRENCES
1. http://www.imshealth.com/ims/Global/Content/Corporate/Press%20Room/IMS%20in
%20the%20News/Documents/MMM-Diabetes_olympics.pdf
SVKM’s NMIMS SPP SPTM Page 20
Speed to Market
Highly Differentiated Products
Rapid and Strong Market Uptake
Strong Foundation for Continued Leadership
Product Management assignment: JANUVIA
2. http://businesstoday.intoday.in/story/sun-pharma-merck-form-joint-venture/
1/14677.html
3. http://www.msdindia.in/about/Pages/home.aspx
4. http://www.expresspharmaonline.com/20090331/management01.shtml
5. http://www.imshealth.com/imshealth/Global/Content/Pharmerging/Document/Launch
%20Evolution%20Across%20Pharmerging%20Markets.pdf
6. http://www.dfid.gov.uk/Documents/publications1/prd/diff-pcing-pharma.pdf
7. IMS HEALTH DATA (JUNE 2013)
8. http://spicyip.com/2013/04/patent-war-intensifies-glenmark.html
For majority of type II diabetics, since medications have to be taken daily to achieve
glycemic control, drug resistance is a major challenge. (Thus there is a therapeutic void
SVKM’s NMIMS SPP SPTM Page 21
Product Management assignment: JANUVIA
which generates demand for novel anti-diabetic product classes. Dipeptidyl peptidase-4
inhibitors (DPP-4) or what is known as “gliptins” offered a new alternative in the treatment
pathway.)
Under an India-specific agreement
SVKM’s NMIMS SPP SPTM Page 22