MC Analysis I Why India’s cardiology pharma market is expecting a major disruption this year

And there is more good news. At least 5-7 more drug makers in India are set to follow the Glenmark over the next three months, by the end of the year at least 15-20 companies would be making this medicine, called “miracle drug for heart failure” by many cardiologists.

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According to IQVIA sales data for the 12‐month period that ended December 2022, the total cardiology market is estimated to be Rs 20,730 crore with an annual growth of 7.7 percent over the previous year. The market of this particular drug, on the other hand, is estimated to be Rs 514 crore with an annual growth of 37.2 percent.

Heart failure in India and Vymada’s role

Heart failure is growing in India at an alarming rate and its prevalence is about 1 percent while around 8-10 million individuals are estimated to be affected by the condition.

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Dr Ajay Kaul, chairman, cardiac sciences with Fortis hospital in Noida, pointed out that nearly 1.5 million new patients are admitted with chronic heart failure every year adding to the already overstretched hospital system.

The introduction of Vymada was a game-changer in the treatment of heart failure, he said, as the drug is a combination of two molecules which has resulted in dramatically improved outcomes in patients.

“The results are so spectacular that patients who took this drug while waiting for heart transplants had such a great improvement in their cardiac function that the transplant was no longer necessary and their condition could be managed with medication alone,” Kaul said.

He added that apart from improved outcomes for heart failure, Vymada also prevents repeated hospitalisations.

Pricing concerns

Kaul underlined that despite all these advantages a large portion of our patient population, thus far, could not afford this miracle drug.

“Now with the news that the drug will be off-patent, it will be accessible to a lot more patients in the form of generics. India is the largest exporter of generic medicines and Indian manufacturers have an opportunity to produce a version of Vymada at a much cheaper cost,” he said.

“This will benefit not only the Indian people but also people from around the world.”

Amit Choudhary, co-founder and chief executive of Dawaa Dost, an omni-channel pharmacy chain, said that he expects the cost of the medicine to come down by at least 60- to 70 percent with the availability of its generic versions.

“I would expect its price to stabilise at Rs 100-200 per strip over the next 12 months,” he said. “The first set of people who will launch the drug may keep the price at Rs 400-500 per strip but then it will go down further later.”

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Prescription pattern matters

Choudhary also highlighted that as medicines in India are largely brought on the prescription of doctors, who specify brands rather than molecules, it may be a while before patients start getting the pricing benefit of the drug.

“For example, various generic versions of the blockbuster diabetes drug Sitagliptin, which went off-patent early last year, are now available but still the sale of its generic versions has been pretty low as the doctors continue to prescribe the expensive version,” he said.

Therefore, according to Choudhary, it may take nearly a year before the prescription pattern in the case of Vymada also starts reflecting the change.