Interview:
Mr. Dilip Sanghvi
Chairman & M.D. - Sun Pharma

Conducted By:
Akila Maheshwari
Convenor NAMI-INDIA

Qus.1- Sun has been a forerunner in providing cost-effective medication in India for diseases of the central nervous system. How has this come about?

Ans - Sun has been a forerunner in providing cost-effective medication in India for diseases of the central nervous system. How has this come about? Essentially when we started the company in 1983, with 5 people and 5 products, psychiatry was still in its infancy as a speciality. The larger companies at that point had only a marginal interest in this area, some company had a single product, some had two, but these were only marginal products that did not really get much attention as they did not contribute to the company's revenues. Hence we focused on this area for beginning the business.

This focus helped us learn how the speciality customer worked, what his prescribing requirements were, what kind of products did he choose and how he handled and viewed different ailments in the spectrum of psychiatry. This single therapy area emphasis helped us to understand the sector well. It showed me how I could focus on solving problems, and use this learning to my advantage. As you know, in psychiatry treatment is individualized and unlike some other fields depending on the presenting signs the doctor may use the latest medicine, an older medication or any from a bouquet of medicines available. We were able to learn a great deal from this interaction, specifically understand the prescribing habits of consultants and later we were able to apply this learning to other therapy areas. So in a sense, psychiatry market was both a beginning point and a learning school for us.

Qus.2- With the availability of quitpin (quetaipine) consumers have an added choice of medication? However what would be the impact if new drugs like ariprapazole (abilify) enter the market?

Ans - We have introduced both these molecules- quetiapine with the brand name Qutipin and aripiprazole, with the brand name Arpizol. Schizophrenia is a complex and multifaceted illness, and as you know the magnitude of the presenting symptoms can vary from patient to patient, and even the symptoms can be different- auditory, visual, hallucinatory etc. A particular drug treats one set of symptoms better than another set of symptoms. In order to handle and treat this range of symptoms, generally more than one drug is prescribed.

Qus.3 - What kind of commitment does Sun Pharma have towards research in mental illness? In USA Companies like Eli-Lilly and Jansenn-Cilag have spent enormous amounts on the same.

Ans - Over the years one problem area in psychiatry that has remains inadequately addressed is that of compliance and maintaining blood levels of the drug over time, especially when patients are uncooperative or violent. This is one area that we have extensively focused on, at Sun Pharma. Several of our products use a novel drug delivery system to deliver the medication predictably, avoid the need for repeat dosing and ensure that symptoms are controlled. We've brought several products to market, such as the bipolar mood disorder treatment Lithosun SR, which was amongst the first products we launched. While many of the new molecules have a long half life and are intrinsically once a day, we have formulated Oleanz rapitabs- olanzapine rapidly dissolving, to deal with the difficulty in swallowing that may be seen with geriatric patients. We have introduced Prodep LA, a once a week antidepressant. We continue to look for ways that dosage form delivery areas where modifications in the dosage form would make a difference to the patient . I believe if we help patients handle this issue of compliance better, we would be making an important contribution to the way mental illness is treated in the country.

Qus.4 - Approximately 1% of the population suffers from severe mental illness like schizophrenia. This means in a country like India the number of sufferers is high. The level of awareness appears to be low especially in rural areas. What do you think should be the strategy to reduce this?

Ans - Yes, awareness is an issue. But possibly the stage when mental illness was viewed as a taboo, has slowly gone, possibly, atleast in city areas.

Awareness about solutions in any field- even in mental healthcare are a function of education, literacy levels, affluence, levels of disposable income.

We are sure that as these factors improve in our country, awareness will also increase.

On their part several companies are working to increase awareness using patient information booklets, posters and educational material.

But even then its possible that it will take some time for this message to spread to the grassroots.

Qus.5 - You have adopted a marketing strategy focused on doctors; don't you think it should be a consumer driven approach focusing on side-effects comparative to other medication?

Ans - In our opinion, psychiatry is a complex area, with coexisting disorders and overlapping symptoms. The treatment of choice depends on the presenting symptoms of a particular patient, and even with the extensive range of medicines available for prescription, normally more than one drug is prescribed in order to treat the range of symptoms. Hence the selection of the right medication is best left to the doctor, because he has had both the expertise and experience to decide the medicine and, how best the dose is to be titrated, for each patient. And this is true everywhere in the world, medications for mental illnesses are prescription only, and are decided by the medical professional. Otherwise there is a high risk of self medication which is certainly not in the patients best interests.

As a pharma company, we shall work to ensure that the latest molecules are made available to patients in India at a sensible cost and that these products are of a dependable, standard quality

Qus.6 - With the implementation of IPR regime in India from 2005 what is Sun's strategy for growth?

Ans - Sun Pharma is preparing to compete globally as a research based speciality pharma company.

We have over the years spent over Rs200cr in research, and have substantially increased these investments with Rs75cr to be invested in this year and in the next. This year alone we are doubling our research staff and adding 275,000 sq ft of floor area for research.

International markets represent a tremendous opportunity and we expect this part of the business, which is 20% of sales to grow very rapidly over the next two years.
In the Indian market while we are recognized as leaders in our core speciality areas , we want to reach this position of leadership in all therapy areas including newer ones like oncology and gynecology.

In my opinion, we've built a strong platform so far, and this enables us to make the most of growth for the future.

Qus.7 - Do you think consumers will have a greater role to play in choice of drugs in the future?

Ans - In ensuring the proper use of medication, yes perhaps not in the choice of treatment per se for that requires medical expertise and experience.

Qus.8 - What should be the role of Patient Advocacy Groups in this regard?

Ans - You already said that awareness was one area- we agree this is one area where advocacy groups cd play a major role.

We also see a very important role they could play for emotional bonding, forming sharing support systems - after all social support, empathy and understanding are as important an element of the treatment procedure, as medication is. Treatment non-compliance, is an important issue which support groups can help handle.

We also see a role for patient advocacy groups in working with the government bodies and authorities at different levels in order to modify the laws so that a fair chance is given to people who are challenged, and that their needs too are looked after.

Qus.9 - As per your website psychiatry and neurology account for 33% of your turnover. What expectations do you have for sales turnover in this segment in the future?

Ans - We expect this segment to account for a large part of our turnover in the future too, and grow at a brisk pace. Awareness itself is increasing. If one applies textbook incidences to the extent that the ailments are reported in India, then its obvious that these ailments are grossly under-treated. As people realize that treatment and medication can help improve the quality of life and help live a life that is as normal as possible, the number of people who reach out for treatment for these ailments will also increase.

On the other hand, continuing life pressures and the pace of living, means that the need for medical treatments of ailments that arise as a consequence of high paced living will also increase.

Qus.10 - Thank You, and we wish that Sun Pharma becomes one of the world class global companies in the future. Do you have any message for consumers in India?

Ans - Expect the worldclass - worldclass products, global level quality and support services that focus on serving the customer first.