How Heads Of Indian Firms Rallied To Sustain Global Supplies Amid COVID-19
Potential Of Telemedicine, Digitalization Also In Focus
Executive Summary
The leadership of top Indian firms recounted at the IPA Forum how they got together on a joint 45-minute call daily in the early phase of the pandemic to collaborate and ensure uninterrupted supplies of medicines both in India and globally. The executives also shared views on telemedicine and digitalization trends at the event.
The pandemic has fostered unprecedented levels of collaboration in pharma across the globe and the Indian industry has also witnessed camaraderie like never before.
Top management executives of the six leading Indian drug firms, Sun Pharmaceutical Industries Ltd., Cipla Limited, Lupin Limited, Zydus Cadila, Dr. Reddy's Laboratories Ltd. and Torrent Pharmaceuticals Ltd. – fierce competitors in normal times – indicated how they all got on to a call each day during the initial months of the pandemic to collectively address any pain points or challenges and ensure uninterrupted medicine supplies globally.
“The biggest surprise for me was the incredible amount of collaboration, whether it was within the industry, especially among the six of us and how we got on to a 45-minute call every single morning…that was relentless, very helpful. Even with the government and across pharma and healthcare bodies, it was just exceptional how industry rallied together,” Samina Hamied, executive vice-chairperson of Cipla, declared at a CEO panel discussion at the sixth India Pharmaceutical Forum, which went virtual this year.
The forum is organized each year by the Indian Pharmaceutical Alliance, which represents leading domestic firms, with McKinsey & Company as the knowledge partner. The event draws participation from leading regulators across the world including the US Food and Drug Administration, EMA, MHRA, EDQM and India's Central Drugs Standard Control Organization.
Lupin’s managing director Nilesh Gupta noted, perhaps half in jest, that he kind of misses the morning CEO]call – “ it is almost like 'get your cup of coffee and sit down and discuss'…we discussed the most serious issues, mundane ones.” And because the top brass was working together, the quality, manufacturing and human resources personnel started working in unison in a “very structured manner”, solving issues not just for an individual company but the industry as well, he said.
“And we addressed everything. The kind of documents that we generated in this time on COVID-19 management, on the protocols to be followed, they became standards for industry. And it also became standard for other sectors to consider,” Gupta said in the panel discussion. Guidelines for “Best Practices – Employee Safety During COVID-19 Crisis” for pharmaceutical employees and a protocol to handle COVID-19 cases in manufacturing facilities, which was endorsed by the Indian Council of Medical Research, were among the documents developed.
Industry Showed 'Tremendous Reliability'
The camaraderie clearly paid off and the Indian industry could ramp up manufacturing and keep supplies steady, despite the initial national lockdown in India and issues around manpower movement in the early days.
Manufacturing activity had recovered from 15-20% of normal on 25 March 2020 (India announced a lockdown on 24 March), to almost 83-87% by early July, while engagement with the Indian government and co-ordination with ancillary industry associations ensured an uptick in activity in the ancillary services segment, from under 10% of normal in March to 70-75% in July, IPA data show. (Also see "COVID-19 Lock-Down: India Pharma Manufacturing Limps Along Amid Challenges" - Scrip, 8 Apr, 2020.)
Sudarshan Jain, secretary general of the alliance, noted how the pharma industry demonstrated “tremendous reliability” despite challenges in the supply chain and changes in the consumption pattern of medicines. The Indian pharma industry lived up to being the “pharmacy of the world" by ensuring consistent global supplies to over 130 countries throughout the COVID-19 crisis, Jain said at a media roundtable during the forum.
Data on pharma production, personnel movement and ancillary services were shared on a daily basis with CEOs and the government to ensure steady supplies. “So there was 24/7 support from the industry, government and others. Many a time there were challenges but it was indeed an example of co-ordination between associations and the government and it has become part of a case study of the Indian Institute of Management, Ahmedabad,” Jain added.
Indian firms also leveraged their manufacturing scale to supply key drugs including hydroxychloroquine (at the time of the initial euphoria over its potential as an effective COVID-19 therapy) and paracetamol to the US and Europe, in addition to regular product supplies. Subsequent studies such as the UK’s RECOVERY trial indicated that drugs such as hydroxychloroquine provide no clinical beneficial effect in patients hospitalized with COVID-19.
Zydus Cadila chairman Pankaj Patel recalled how the Gujarat-based company was requested by the Indian government to produce a diagnostic kit for COVID-19 for surveillance purposes during the lockdown and could deliver on that, despite some labs being located in another state (in Maharashtra) and some raw material being required from abroad, among other logistics issues.
"There was so much support we received from everybody, whether it's the internal team, external teams, the government agencies." - Zydus Cadila chairman Pankaj Patel
“In spite of all that, there was so much support we received from everybody, whether it’s the internal team, external teams, the government agencies. That was a big surprise that even during the lockdown, we could produce a kit, send it to the regulatory agencies in India, get an approval and put it on the market,” Patel said in the CEO panel discussion.
The first batch of 30,000 Covid Kavach Elisa Tests made by Zydus Diagnostics was supplied in May last year to the Indian Council of Medical Research (ICMR) free of cost. These kits were manufactured under technology transfer with the ICMR-National Institute of Virology of Pune for surveillance purposes.
Telemedicine And Digitalization
Meanwhile, the CEO panel discussion, which marked the concluding session of the three-day forum, that ran until 26 February, also delved into the potential of telemedicine and accelerating digitalization in the industry.
Dilip Shanghvi, founder and managing director of Sun Pharma, India’s top-ranked drug firm, noted how teleconsultation has been available for a very long time and “never got any traction”, but became an important tool “overnight” for the treatment of patients by many doctors amid the pandemic.
In the Indian context it has many advantages, he explained, especially with a large part of the population staying in semi-urban or smaller cities with limited access to good doctors. He expects teleconsultation to continue even post-COVID-19.
“Digitization of practices will allow doctors to use analytics and have a better understanding of what works and what doesn't, so that they can improve the quality of outcome for their patients,” Shanghvi said on the panel discussion, moderated by McKinsey & Co. managing partner Gautam Kumra.
In a recent interview with Scrip, Sun’s billionaire chief observed that India needs innovative solutions to meet the healthcare requirements of people from diverse social, cultural and economic backgrounds. “Teleconsultation will help in bridging the gaps that exist in our healthcare system. The new telemedicine guidelines issued by the Ministry of Health and Family Welfare and the government’s initiatives like the National Digital Health Mission would further endorse and drive the adoption of such platforms,” Shanghvi said at the time.
Zydus Cadila’s Patel was more emphatic about the growing role of digitalization across all aspects of business, whether in manufacturing, marketing or other activities. “Digital is here to stay and I think that is what is going to happen ultimately,” Patel declared.
He referred to the enhanced potential of teleconsultation, in part because of the large number of smartphone users in India and also since a lot of people would basically prefer to save the time and cost of travelling for consultations, although the approach obviously isn't applicable to more serious health conditions. In particular, he believes follow-up physician visits will more likely move towards teleconsultations.
The number of smartphone subscriptions in India increased to 620 million in 2019 and is expected to reach one billion by 2025, predicts Ericsson’s Mobility report (June 2020 edition).
Bang For The Buck Vs Broad Transformation
Interestingly, EY, which had surveyed the top 12 pharmaceutical companies in India, had earlier indicated 80% had tied up with one or more marketplace teleconsultation platforms, while 8% had launched their own platform and the rest were evaluating different means to adopt teleconsultation.
“They may engage with teleconsultation platform providers initially for developing a connect with the doctors and to help patients reach doctors through an alternate channel, but in the long run, benefits of transaction data and analysis will help in fostering revenue growth,” a September 2020 report by EY and the IPA stated. The telemedicine market in India is expected to grow at a compound annual growth rate of 31% over the 2020-25 period to reach $5.5bn, the report predicted.
Cipla’s Samina Hamied cautioned, however, that while everyone is trying to accelerate the “digital journey”, the challenge will be around how to use the right digital format for the right customer and the right methodology.
"We will have to find a way to live with it [COVID-19]. Maybe like the flu...we may have a COVID-19 season." - Sun Pharma MD Dilip Shanghvi
“Making sure that you get bang for your buck versus just doing every digital kind of transformation that you perceive, I think will be another challenge for the industry,” she said.
Vaccination And Variants
Notwithstanding a series of other forward-looking issues discussed by the CEO panel, most executives emphasized at the IPA Forum that the pandemic is far from over and that the industry and public can't let their guard down and need to keep safety practices going.
“We will have to find a way to live with it [COVID-19]. Maybe like the flu - [for which] there may be annual recurrence during the flu season - we may have a COVID-19 season,” Sun’s Shanghvi predicted.
Satish Reddy, chairman of Dr Reddy’s Laboratories, added that the “two Vs” - variants of the virus and vaccination - are among the key challenges ahead. The pace of vaccination not just in India, but in other countries as well, will be critical to get the pandemic under control.
In addition, the issue of SARS-CoV-2 variants and the effectiveness of vaccines against these, requirements for potential booster shots and improved treatments for COVID-19 alongside, all become very important, Reddy emphasized. (Also see "SARS-CoV-2 Variants And Current Vaccines: “It’s Not All Or Nothing”" - Scrip, 1 Mar, 2021.)