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Generic Pharmaceuticals
Industry on a Roll
   Generic Drug is a copy that is the same as a brand name drug
    in dosage, safety, strength, how it is taken, quality,
    performance and intended use

    drug is not sold as the brand name, but it has the identical
    strength, dosage and route with brand-name drug

   Use of generic drugs is now widely accepted and they are
    commonly prescribed by physicians and dispensed at
    hospitals
   The generic drugs are less expensive as compared to
    branded drugs as generic manufacturers do not have the
    investment costs of the developer of a new drug

   When patents are nearing expiration, manufacturers usually
    approach the Government/Drug Control Department to sell
    generic versions.

   In the process, the consumers get genetic drugs at
    substantially lower costs.
   Both branded and generic drugs are manufactured by
    conforming to International standards
   Brand name drugs are usually given patent protection for 20
    years from the date of submission of the patent

   After this period of time any company file to make its
    generic version

   Generic substitution may not be appropriate in certain
    circumstances where only a branded drug would be suitable
    for the patient

   For some patient having generic drug may be a cause of
    problem
   Generic drugs offer an important tool for reducing the rate of
    growth in overall health expenditure.

   Generic drugs play an important role in health care and the
    availability of generic drugs reduces the monopoly and
    oligopoly powers of the patent holder.

   The Government may also impose compulsory licensing so
    as to make available the much needed generic drugs.
   India already has well over 5 million people living with
    AIDS

   India must provide medicines to hundreds of thousands
    of people each year

   For lower cost of medical facility

   Reducing monopoly in the market

   For sustainable growth of other smaller pharma
    industries
   India has had a vibrant generic industry since 1970
    when it lawfully amended its existing patent act to
    disallow patent protection for pharmaceutical
    products.

   This action catapulted India from a medicine importer
    to medicine self reliant nation

   From 10% of total markets world wide in 1995,
    generic producers at this time supply around 65% of
    global sales of, off patent products(Anon 1999)., while
    35% comes from patented molecules
   India has been and remains the producer of choice for
    medications in most developing countries, producing
    medicines of assured quality that meet all international
    standards, at the lowest costs and highest volumes.
Experience in reverse-engineering drugs
Cost advantages in research, development and manufacturing
Launch generic products in less regulated markets, then
  regulated markets
Gain experience, Work out any is, Lower Costs, Experience in
  cGMPs
 Investing capital; yearly estimates up 60% from 8 years ago
 Investing in infrastructure to better control processes
 Meet higher standards in regulatory requirements
 Drug Discovery Agree
   Aurobindo, Cipla, Glenmark, Jubilant, Lupin, Matrix, Orchid,
    Sun Wockhardt, Zydus Cadila
   Geographic Growth
     through acquision
     increased doses product filing from less regulated
      market
     limits depends on any regulated market
    Growth Through Partnering
    Need to compete on price in many cases
   Aurobindo 8-10 quarterly
   Cipla additional 35 prior to FY06
   Glenmark 14 within 2007additional 6-11 with partners
   Jubilant 15 in dev
   Ranbaxy 25 over next year
   Sun Pharmaceuticals 18 -20 per year
   Wockhardt 15 pending
   Zydus Cadila 16 in
   Zydus Cadila
     Distribution agreement with Mallinckrodt; limited period,
        renewable
     50/50 JV with Mayne- cytotoxic dose and APIs


   Glenmark
     Development and Supply Agreement with KV for 8 ANDAs
     Invagen - 7 products
     Konec for nitroglycerin and Interpharm for naproxen


   Lupin
     Injectable ceph generics with Baxter
     Oral ceph generics with Watson
   Dr. Reddy
     Rheoscience- Phase III PPAR
     Argenta-COPD
     Formed drug dev company in India- Perlecan


   Glenmark
     Oglemilast licensed to Forest and Teijin (Japan)


   Ranbaxy
     GSK Drug Discovery & Clinical Development
   Big Pharma, companies in response to their loss of market
    hegemony, have lobbied to strengthen intellectual property
    protections for pharmaceutical products and processes

   Finally the U.S. Trade Representative-Big Pharma team
    succeeded in imposing a patent-monopoly system on India
    and other countries through the World Trade Organization
    (TRIPS) Agreement of 1994.

   TRIPS required WTO member states to grant patents on all
    classes of products (including medicines), to provide
    protections for a minimum of 20 years
   Act creates rights to patent certain new uses, formulations,
    delivery systems, combinations of existing products, and
    minor variations of existing chemical entities.

   The act leaves in place India's procedurally laborious and
    inefficient compulsory licensing scheme

   The act grants for patent applications between the
    publication and approval of the patent deterring generic
    entry even in cases where the patent application may later
    be denied
   New Drug Application (NDA) is a document where in drug
    sponsors formally propose that the FDA approve a new
    pharmaceutical drug for sale and marketing in the United
    States

   The NDA allows the FDA reviewer to determine:
     Whether the drug is safe and effective in its proposed use(s).
     Whether the benefits of the drug outweigh the risks.
     Whether the drug’s proposed labeling (package insert) is
      appropriate, and what it should contain.
     Whether the methods used in manufacturing the drug and the
      controls used to maintain the drug's quality are adequate to
      preserve the drug's identity, strength, quality, and purity.
   During 1970-1990’s, due to patent expiry, generic
    pesticides became the fastest growing sector elsewhere
    as in India.
   From 10% of total markets world wide in 1995, generic
    producers at this time supply around 65% of global sales
    of, off patent products(Anon 1999)., while 35% comes
    from patented molecules.
   In India too, major share of technical
    production/markets comes from off patent/generic
    products. The Patent Act will now usher in new
    molecules – from R&D based Companies. Generics face
    substitution and regulatory uncertainty elsewhere as in
    India.
   Market for generics in India shows sure erosion in
    price and value offered due to:

   Large capacity, both for actives/ formulations, at
    regional/national levels – consolidation ?

   BT Cotton, changing pest/disease infestations,
    transgenic crops impact on pesticide demand ?

   Imports from China etc. both legal and illegal result
    in wide price difference for same molecules
    between branded and generic producers.
   Local producers resorting to price discount strategy,
    lowering the net value for all times..

   Availability of spurious/substandard products,ready
    to sell network, and corrupt business environment.

    kill brand value chain.
   We ourselves, the fragmented industry, for failing to
    look at the global picture, tolerating illegality,
    partnering corrupt practices, and by an absence of
    product portfolio management.

   The Government, which is unable to provide a
    healthy regulatory environment/understanding.

   The network and the supply chain, who has the last
    laugh at the merry bunch of jokers involved in this
    game of perpetual value reduction.
   The marketers who wish to easy sell and not work
    on product stewardship - <quality <price….

   The end users who buy cheap products without
    thinking of consequences on the crop.
   R&D companies are divesting actives,which can be
    acquired by other generic producers.

   Actives registered before 1993 may not be
    supported due to data generation costs by the
    majors unless generic producers support use
    extension for new crops. Generic producers must
    produce and share data/costs and find new markets

   Allocate resources for product stewardship such as
    resistance management, new usages, dose setting.
   Generic supply and demand issues, production
    capacity rationalization, investment in data and
    development.& exports, real challenges ahead!

   Govt. regulation will limit use of old generics.
   New solutions to crop/ Animal problems to meet
    changing customer needs – need of hour.

   Performance enhancement of existing active
    products by improving formulations, application
    methods, and combinations.(registration).

   Offering generics as a part of crop solutions
    package rather than as stand alone products.re-
    launch generics – don’t write them off..
.
   Allowing easier route for Combinations Registration,
    new formulations and export of generics. – is the
    regulator listening?
   Produce newly off patent products with additional
    services and performance/quality guarantees
   Manufacturers, distributors and dealers must stop
    looking at generics as only(low) profit giving
    commodities, but look at each product as a crop specific
    solution provider. Large producers must assume
    leadership role. Substitution must not be
    automatic – it must be managed by design..
   Many off patent products outside India are potential
    candidates to be examined for manufacture –
    export, or domestic development, by Indian
    manufacturers of actives. This needs positive fast
    track registration regulation based on reasonable
    data requirement.

   Parallel importers from China – eroding or adding
    value? Introspection/regulation needs/partnership?
   R&D Companies in India, and large Indian producers
    must look at potential partnerships, nationally and
    regionally, to promote generics by creating a value
    chain/brands/solutions – to coexist(peacefully) with
    new (patented) products, and biotechnology or
    genomic systems.

   Safer and newer formulations such as SC/WDG/ME
    etc. must be encouraged to breathe some life into
    generic value chain.
   Contract farming, agricultural retail, must get
    involved into the generic value chain to deliver
    quality to end users with monitoring capability.

   Minor use registrations must be on fast track, to
    encourage precision farming.
   Regulation should be concerned with safety of
    environment, quality, bio efficacy and MRL not with
    market protection or data shields.

   Regulation should encourage sharing data,
    partnerships and rules for data compensation,not
    product monopoly..

   Playing with data exclusivity leads to market
    exclusivity. Drives majors into investing time and
    resources for minor changes rather than develop
    innovative products.
   Patent protection is now 17 to 20 years. (ankit
    check it out I think it is for 4,8 12 years
    as well)
   Generic industry has a positive role to play.
    Regulators must recognize this. So must industry.
   Indian Agrochemical industry in present form
    unsustainable to support innovative strategies in
    the future for generics.
   Food safety, environment, health, key
    regulatory concerns – are these industry
    concerns too?
   Corporate need to better handle its image.
   Our network – partners in crime or value?
   Provide services not only products!
   Regulation must facilitate sustainable agriculture
    with industry, rather than make law to fill jails..

   Generics in India …..God & Rain be with you! They
    are your only support left……..unless..
Position 2006   company            No of R&D products   No of own
(2005)                             in 2005 (2004        products
1 (1)           Sanofi-Aventis     205 (226)            139
2 (2)           GlaxoSmithKline    181 (170)            123
3 (4)           Merck & Co         159 (128)            119
4 (3)           Hoffmann-La Roche 145 (144)             72
5 (7)           Novartis           123 (109)            66
6 (5)           Johnson & Johnson 116 (117)             65
7 (6)           Pfizer             109 (115)            68
8 (8)           AstraZeneca        108 (105)            81
9 (12)          Astellas           89 (68)              52
10 (10)         Bristol-Myers      81 (84)              50
                Squibb
   Overall 28.2% of pipeline projects are targeted against cancer, indicating that
    oncological agents account for almost a third of drugs in R&D. This figure has
    consistently increased year-on-year, as the industry focuses on this massive killer
    which will affect one in three of us in our lifetimes.

   It is also an area which has made huge strides therapeutically, and one for which
    targeted treatments can command high prices.

   Elsewhere, diabetes is another area which continues to see growth, as the
    prevalence of the disease rises due to poor western diets. The 10% growth in the
    size of the antidiabetic pipeline is certainly significant. Vaccine R&D has increased
    by an even greater percentage, as emerging infections continue to challenge the
    global community.

   Also posting an increase, although slipping down the chart, is the analgesic
    category, which continues to build on rises reported last year. Also of interest are
    the fact that gene therapy has arrested its decline, and Parkinson’s disease and
    multiple sclerosis appear to be other growth areas.
   Opportunity and threats for generics
   Increasing demand for low-cost therapies

   Aging population

   Consumers becoming more cost sensitive

   Increased generic substitution

   Government involvement
     ▪ US Medicare Drug reimbursement
     ▪ Reference pricing in Europe
Percent of Population over 60




                  10
                          20
                                   30
                                             40




  0
       Less Dev

        World




1950
        More Dev




1975
2000
2025
2050
   Products with $100B in branded drug sales
    are coming off patent in the next 7 years

   Patent challenges by generic companies
25                                                     40




                                                                                 patent (Newport Constraint Date)
                          20.1




                                                                                   Number of drugs coming off
                     20
                                                       18.4                 30
Sales Billions USD




                                         15.2
                     15
                                  12.4                               12.3   20
                                                10.5          10.0
                     10
                          Top 5
                          Sales
                                                                            10
                      5



                      0                                                     0
                          2006    2007   2008   2009   2010   2011   2012
   Rapid price erosion in the U.S. and UK

   Diminishing margins on both dose and API sales

   New regulations in Germany (AVWG)

   Settlements between generics and brand
    companies are delaying generic entry in the U.S
    (leapfrog strategy ).
   ANDA approval backlog in the U.S.

   Fewer new launches by innovators over the past
    years will translate into fewer opportunities for
    generics down the road

   Tie up between patient drug maker and generic
    drug maker before the patient get over (Foresight)
   Demand
     Purchasers focus on price
     Past relationships matter less
     Reverse auctions
   Supply
     Generic filings and approvals at all-time high
     A number of new entrants, many from India, often with
      access to low- cost APIs
     Overcapacity in manufacturing
     Focus on market share rather than bottom line
     Authorized generics in the U.S.
   Consolidation
   Geographic diversification
   Backward integration into API
   Sourcing from India, China, and other low-cost
    countries
   Alliances with companies in low-cost countries
   Moving manufacturing to low-cost countries
   Focus on niche products
   Will focus on price backfire?

   Is the number of suppliers going to decrease enough
    to give the remaining players more negotiating
    power?

   What will be the impact of generic entries from
    China?
Thank you

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Generics, Industry on the Roll

  • 2. Generic Drug is a copy that is the same as a brand name drug in dosage, safety, strength, how it is taken, quality, performance and intended use  drug is not sold as the brand name, but it has the identical strength, dosage and route with brand-name drug  Use of generic drugs is now widely accepted and they are commonly prescribed by physicians and dispensed at hospitals
  • 3. The generic drugs are less expensive as compared to branded drugs as generic manufacturers do not have the investment costs of the developer of a new drug  When patents are nearing expiration, manufacturers usually approach the Government/Drug Control Department to sell generic versions.  In the process, the consumers get genetic drugs at substantially lower costs.  Both branded and generic drugs are manufactured by conforming to International standards
  • 4. Brand name drugs are usually given patent protection for 20 years from the date of submission of the patent  After this period of time any company file to make its generic version  Generic substitution may not be appropriate in certain circumstances where only a branded drug would be suitable for the patient  For some patient having generic drug may be a cause of problem
  • 5. Generic drugs offer an important tool for reducing the rate of growth in overall health expenditure.  Generic drugs play an important role in health care and the availability of generic drugs reduces the monopoly and oligopoly powers of the patent holder.  The Government may also impose compulsory licensing so as to make available the much needed generic drugs.
  • 6. India already has well over 5 million people living with AIDS  India must provide medicines to hundreds of thousands of people each year  For lower cost of medical facility  Reducing monopoly in the market  For sustainable growth of other smaller pharma industries
  • 7. India has had a vibrant generic industry since 1970 when it lawfully amended its existing patent act to disallow patent protection for pharmaceutical products.  This action catapulted India from a medicine importer to medicine self reliant nation  From 10% of total markets world wide in 1995, generic producers at this time supply around 65% of global sales of, off patent products(Anon 1999)., while 35% comes from patented molecules
  • 8. India has been and remains the producer of choice for medications in most developing countries, producing medicines of assured quality that meet all international standards, at the lowest costs and highest volumes.
  • 9. Experience in reverse-engineering drugs Cost advantages in research, development and manufacturing Launch generic products in less regulated markets, then regulated markets Gain experience, Work out any is, Lower Costs, Experience in cGMPs  Investing capital; yearly estimates up 60% from 8 years ago  Investing in infrastructure to better control processes  Meet higher standards in regulatory requirements  Drug Discovery Agree
  • 10. Aurobindo, Cipla, Glenmark, Jubilant, Lupin, Matrix, Orchid, Sun Wockhardt, Zydus Cadila  Geographic Growth  through acquision  increased doses product filing from less regulated market  limits depends on any regulated market Growth Through Partnering Need to compete on price in many cases
  • 11. Aurobindo 8-10 quarterly  Cipla additional 35 prior to FY06  Glenmark 14 within 2007additional 6-11 with partners  Jubilant 15 in dev  Ranbaxy 25 over next year  Sun Pharmaceuticals 18 -20 per year  Wockhardt 15 pending  Zydus Cadila 16 in
  • 12. Zydus Cadila  Distribution agreement with Mallinckrodt; limited period, renewable  50/50 JV with Mayne- cytotoxic dose and APIs  Glenmark  Development and Supply Agreement with KV for 8 ANDAs  Invagen - 7 products  Konec for nitroglycerin and Interpharm for naproxen  Lupin  Injectable ceph generics with Baxter  Oral ceph generics with Watson
  • 13. Dr. Reddy  Rheoscience- Phase III PPAR  Argenta-COPD  Formed drug dev company in India- Perlecan  Glenmark  Oglemilast licensed to Forest and Teijin (Japan)  Ranbaxy  GSK Drug Discovery & Clinical Development
  • 14. Big Pharma, companies in response to their loss of market hegemony, have lobbied to strengthen intellectual property protections for pharmaceutical products and processes  Finally the U.S. Trade Representative-Big Pharma team succeeded in imposing a patent-monopoly system on India and other countries through the World Trade Organization (TRIPS) Agreement of 1994.  TRIPS required WTO member states to grant patents on all classes of products (including medicines), to provide protections for a minimum of 20 years
  • 15. Act creates rights to patent certain new uses, formulations, delivery systems, combinations of existing products, and minor variations of existing chemical entities.  The act leaves in place India's procedurally laborious and inefficient compulsory licensing scheme  The act grants for patent applications between the publication and approval of the patent deterring generic entry even in cases where the patent application may later be denied
  • 16. New Drug Application (NDA) is a document where in drug sponsors formally propose that the FDA approve a new pharmaceutical drug for sale and marketing in the United States  The NDA allows the FDA reviewer to determine:  Whether the drug is safe and effective in its proposed use(s).  Whether the benefits of the drug outweigh the risks.  Whether the drug’s proposed labeling (package insert) is appropriate, and what it should contain.  Whether the methods used in manufacturing the drug and the controls used to maintain the drug's quality are adequate to preserve the drug's identity, strength, quality, and purity.
  • 17. During 1970-1990’s, due to patent expiry, generic pesticides became the fastest growing sector elsewhere as in India.  From 10% of total markets world wide in 1995, generic producers at this time supply around 65% of global sales of, off patent products(Anon 1999)., while 35% comes from patented molecules.  In India too, major share of technical production/markets comes from off patent/generic products. The Patent Act will now usher in new molecules – from R&D based Companies. Generics face substitution and regulatory uncertainty elsewhere as in India.
  • 18. Market for generics in India shows sure erosion in price and value offered due to:  Large capacity, both for actives/ formulations, at regional/national levels – consolidation ?  BT Cotton, changing pest/disease infestations, transgenic crops impact on pesticide demand ?  Imports from China etc. both legal and illegal result in wide price difference for same molecules between branded and generic producers.
  • 19. Local producers resorting to price discount strategy, lowering the net value for all times..  Availability of spurious/substandard products,ready to sell network, and corrupt business environment. kill brand value chain.
  • 20. We ourselves, the fragmented industry, for failing to look at the global picture, tolerating illegality, partnering corrupt practices, and by an absence of product portfolio management.  The Government, which is unable to provide a healthy regulatory environment/understanding.  The network and the supply chain, who has the last laugh at the merry bunch of jokers involved in this game of perpetual value reduction.
  • 21. The marketers who wish to easy sell and not work on product stewardship - <quality <price….  The end users who buy cheap products without thinking of consequences on the crop.
  • 22. R&D companies are divesting actives,which can be acquired by other generic producers.  Actives registered before 1993 may not be supported due to data generation costs by the majors unless generic producers support use extension for new crops. Generic producers must produce and share data/costs and find new markets  Allocate resources for product stewardship such as resistance management, new usages, dose setting.
  • 23. Generic supply and demand issues, production capacity rationalization, investment in data and development.& exports, real challenges ahead!  Govt. regulation will limit use of old generics.
  • 24. New solutions to crop/ Animal problems to meet changing customer needs – need of hour.  Performance enhancement of existing active products by improving formulations, application methods, and combinations.(registration).  Offering generics as a part of crop solutions package rather than as stand alone products.re- launch generics – don’t write them off.. .
  • 25. Allowing easier route for Combinations Registration, new formulations and export of generics. – is the regulator listening?  Produce newly off patent products with additional services and performance/quality guarantees  Manufacturers, distributors and dealers must stop looking at generics as only(low) profit giving commodities, but look at each product as a crop specific solution provider. Large producers must assume leadership role. Substitution must not be automatic – it must be managed by design..
  • 26. Many off patent products outside India are potential candidates to be examined for manufacture – export, or domestic development, by Indian manufacturers of actives. This needs positive fast track registration regulation based on reasonable data requirement.  Parallel importers from China – eroding or adding value? Introspection/regulation needs/partnership?
  • 27. R&D Companies in India, and large Indian producers must look at potential partnerships, nationally and regionally, to promote generics by creating a value chain/brands/solutions – to coexist(peacefully) with new (patented) products, and biotechnology or genomic systems.  Safer and newer formulations such as SC/WDG/ME etc. must be encouraged to breathe some life into generic value chain.
  • 28. Contract farming, agricultural retail, must get involved into the generic value chain to deliver quality to end users with monitoring capability.  Minor use registrations must be on fast track, to encourage precision farming.
  • 29. Regulation should be concerned with safety of environment, quality, bio efficacy and MRL not with market protection or data shields.  Regulation should encourage sharing data, partnerships and rules for data compensation,not product monopoly..  Playing with data exclusivity leads to market exclusivity. Drives majors into investing time and resources for minor changes rather than develop innovative products.
  • 30. Patent protection is now 17 to 20 years. (ankit check it out I think it is for 4,8 12 years as well)  Generic industry has a positive role to play. Regulators must recognize this. So must industry.
  • 31. Indian Agrochemical industry in present form unsustainable to support innovative strategies in the future for generics.  Food safety, environment, health, key regulatory concerns – are these industry concerns too?  Corporate need to better handle its image.  Our network – partners in crime or value?  Provide services not only products!
  • 32. Regulation must facilitate sustainable agriculture with industry, rather than make law to fill jails..  Generics in India …..God & Rain be with you! They are your only support left……..unless..
  • 33.
  • 34. Position 2006 company No of R&D products No of own (2005) in 2005 (2004 products 1 (1) Sanofi-Aventis 205 (226) 139 2 (2) GlaxoSmithKline 181 (170) 123 3 (4) Merck & Co 159 (128) 119 4 (3) Hoffmann-La Roche 145 (144) 72 5 (7) Novartis 123 (109) 66 6 (5) Johnson & Johnson 116 (117) 65 7 (6) Pfizer 109 (115) 68 8 (8) AstraZeneca 108 (105) 81 9 (12) Astellas 89 (68) 52 10 (10) Bristol-Myers 81 (84) 50 Squibb
  • 35. Overall 28.2% of pipeline projects are targeted against cancer, indicating that oncological agents account for almost a third of drugs in R&D. This figure has consistently increased year-on-year, as the industry focuses on this massive killer which will affect one in three of us in our lifetimes.  It is also an area which has made huge strides therapeutically, and one for which targeted treatments can command high prices.  Elsewhere, diabetes is another area which continues to see growth, as the prevalence of the disease rises due to poor western diets. The 10% growth in the size of the antidiabetic pipeline is certainly significant. Vaccine R&D has increased by an even greater percentage, as emerging infections continue to challenge the global community.  Also posting an increase, although slipping down the chart, is the analgesic category, which continues to build on rises reported last year. Also of interest are the fact that gene therapy has arrested its decline, and Parkinson’s disease and multiple sclerosis appear to be other growth areas.
  • 36. Opportunity and threats for generics
  • 37. Increasing demand for low-cost therapies  Aging population  Consumers becoming more cost sensitive  Increased generic substitution  Government involvement ▪ US Medicare Drug reimbursement ▪ Reference pricing in Europe
  • 38. Percent of Population over 60 10 20 30 40 0 Less Dev World 1950 More Dev 1975 2000 2025 2050
  • 39.
  • 40.
  • 41.
  • 42. Products with $100B in branded drug sales are coming off patent in the next 7 years  Patent challenges by generic companies
  • 43. 25 40 patent (Newport Constraint Date) 20.1 Number of drugs coming off 20 18.4 30 Sales Billions USD 15.2 15 12.4 12.3 20 10.5 10.0 10 Top 5 Sales 10 5 0 0 2006 2007 2008 2009 2010 2011 2012
  • 44.
  • 45.
  • 46.
  • 47. Rapid price erosion in the U.S. and UK  Diminishing margins on both dose and API sales  New regulations in Germany (AVWG)  Settlements between generics and brand companies are delaying generic entry in the U.S (leapfrog strategy ).
  • 48. ANDA approval backlog in the U.S.  Fewer new launches by innovators over the past years will translate into fewer opportunities for generics down the road  Tie up between patient drug maker and generic drug maker before the patient get over (Foresight)
  • 49. Demand  Purchasers focus on price  Past relationships matter less  Reverse auctions  Supply  Generic filings and approvals at all-time high  A number of new entrants, many from India, often with access to low- cost APIs  Overcapacity in manufacturing  Focus on market share rather than bottom line  Authorized generics in the U.S.
  • 50. Consolidation  Geographic diversification  Backward integration into API  Sourcing from India, China, and other low-cost countries  Alliances with companies in low-cost countries  Moving manufacturing to low-cost countries  Focus on niche products
  • 51. Will focus on price backfire?  Is the number of suppliers going to decrease enough to give the remaining players more negotiating power?  What will be the impact of generic entries from China?