MOLECULES SURVEY IN AIIMS, NEW DELHI AND

PATIENT SATISFACTION SURVEY IN BHIWADI

A summer training project report on training undertaken at

BIOCON LTD.

Post Graduate Diploma in Business Management

Submitted To: Submitted By:

RAHUL PALIWAL VARUN KUMAR
(Regional Business Manager) PGDM, IILM, AHL,
JAIPUR

August
2009
 CONTENTS

MOLECULES SURVEY IN AIIMS, NEW

DELHI
1. PREFACE
2. ACNOWLEDGEMENT
3. EXECUTIVE SUMMARY
4. INTRODUCTION TO PHARMACEUTICAL INDUSTRY
5. INTRODUCTION OF BIOCON
6. RESEARCH METHODOLOGY OF BIOCON MOLECULES
TITLE OF STUDY
DURATION OF PROJECT
OBJECTIVE
TYPE OF RESEARCH
SAMPLE SIZE AND METHOD OF SELECTING SAMPLE
SAMPLE DESIGN
SCOPE OF STUDY
LIMITATION OF STUDY
ANALYSIS AND INTERPRETATION
1. SURVEY OF AIIMS
2. FACTS AND FINDINGS
3. CONCLUSION
4. RECOMMENDATION AND SUGGESTION
PATIENT SATISFACTION SURVEY IN
BHIWADI
1. INTRODUCTION OF PATIENT SATISFACTION
2. RESEARCH METHODOLOGY OF PATIENT SATISFACTION IN
BHIWADI
TITLE OF STUDY
DURATION OF PROJECT
OBJECTIVE
TYPE OF RESEARCH
SAMPLE SIZE AND METHOD OF SELECTING SAMPLE
SAMPLING DESIGN
SAMPLE OF PATIENT SATISFACTION SURVEY REPORT
ANALYSIS AND INTERPRETATION
SCOPE OF STUDY
LIMITATION OF STUDY
1. FACTS AND FINDINGS
2. CONCLUSION
3. RECOMMENDATION AND SUGGESTION
4. APPENDIX
PATIENTS HEALTHY QUESTIONNAIRE
1. BIBLIOGRAPHY
 PREFACE

"Learning categories you and practicing is a learning specialization ". Learning is a

prerequisite for behavior. Training is a process of learning a sequence of programmed
behavior .It is application of knowledge.

Theoretical and conceptual aspect taught in classrooms prove useful only when there
is a projection in practical situation is analyzed and well understood, that is why
practical orientation of management student is or must for generally competence to
deal with issue at grassroots level .It is for this reason six to eight weeks project training
is described as a part of syllabus of Post Graduate Diploma in Business Management.

Pharmaceutical is essential pillar of private sector corporate economy .As the topic of
my study was Molecules Survey in AIIMS, NEW DELHI and Patient satisfaction in
BHIWADI. It was really a wonderful opportunity to get insight in one of the most
important aspect of Pharma market and medical field. The study covers the product of
BIOCON and other brands of pharmaceutical industry and also the patient suffering
from cardiac and other chronic disease. It shows various aspects, latest development in
drugs & new techniques for identifying the cardiac patients through survey in a
particular area in BHIWADI.

As my fortune I have an opportunity to do my project work at “BIOCON LTD.” Leading

manufacturing, research supplying unit of medicine. I have tried my best to represent
on relevant data and information relating to my project work.
 Acknowledgement

I am grateful to, Mr. Rahul Paliwal, Regional Business Manager, Biocon Limited,
for providing me with this opportunity to work on this project. Without his assistance and
continuous guidance this project would not have been completed. My experience from
this project is indescribable and it has certainly broadened my knowledge arena by
introducing me to the practical problems of the field while performing the market
research survey.

I am thankful to Mr. Punit Chawla, Area Business Manager, for his inexhaustible
support and cooperation during my summer training at BIOCON Ltd. New Delhi.

I would like to extend my heartfelt thanks to all the Marketing managers and staff
members of BIOCON LTD. without whose support I would not be able to make this
project a success one.

I am indebted to my family and friends for providing such a support for my project.

Finally I would like to thank Almighty for giving me such an opportunity to work with
BIOCON Ltd.

Thanks with regards

Varun Kumar

Executive summary
The objective of the project was firstly, based on a marketing survey study, as it
required to me to understand the market. To execute the study I preferred to study
about BIOCON market and all the pharmaceutical competitors in the market. Thus, the
first part of the project was executed by learning the following in detail:
1. BIOCON Product marketing in NEW DELHI
2. About given molecules to survey in market
3. Company profile
4. About competitors product in the market
5. Total per week sales of molecules of Biocon in market
6. To do a comparative study of BIOCON product
With other market competitor.
The second part of the project was patient satisfaction in BHIWADI.The learning is:

1. To know about the patient disease

2. To know about there Risk Factor
3. To know about there other chronic symptoms related
to there cardiac disease
4. To know about the ratio of patient suffering from
cardiac, diabetes and other chronic disease
After undergoing the training about the product and operational features I started
exploring the product and contacted the prospective customer by way of telecalling,
emails, corporate presentation, my primary aim was to give better options to the
prospective customers by offering them products specialized features & its unique
incomparable qualities in the services provided by BIOCON LTD and WELLNESS &
RADIAL INTERVENTION SOCIETY.

BIOCON LIMITED
INTRODUCTION OF PHARMACEUTICAL INDUSTRY:

In the global scenario Indian pharmaceutical market is the world's fourth largest by
volume of drugs (8 percent of the global market) and thirteenth largest by value (less
than 1 percent of the global market with 2003 estimated sales of $4.1 billion). The
prices of medicine are among the lowest in the world. In the present scenario 70
percent of the Indian population doesn't have access to drug therapy. According to the
Pharma Handbook Per-capita consumption of drugs in 2003 was only $3.33.

But in spite of such strong positioning, Indian government's patent laws were but put on
trial when on 15 feburary,2007 (HINDUSTAN TIMES) the Swiss pharmaceutical
company Novartis accused the government of failing to comply with World Trade
Organization (WTO) rules after it refused to grant the company a patent on its cancer
drug Glivec. India signed up to the WTO's Trade Related Intellectual Property Rights
(Trips) patent regime when it joined the WTO in 1995.

It was later claimed by Novartis that the failure to acknowledge Glivec as an innovative
drug means that India is operating outside these regulations. But this was strongly
rejected by the Indian government, arguing that Glivec is an existing drug with only a
minor alteration.
The key Indian pharmaceutical players are:

One of the most interesting facts to be noted here is that only three foreign companies
break through the top 10 companies in India and the Midwest's own Abbott Labs is one
of those companies. But on the other hand only a little more than a third of the Indian
market is represented by the top ten companies. Strangely, though world market leader
Pfizer is not among them. The top Indian companies – Cipla, Ranbaxy, Sun Pharma
and Dr. Reddy's – have all initiated their international strategies by establishing offices
and operations in the U.S. Sun Pharma even has some Midwest roots as it has
acquired a substantial equity chunk of Caraco Pharmaceuticals in Michigan.
Some key changes recently made by the Indian government have altered the dynamics
of investing in India for pharmaceuticals companies:

1. In 2002, the Indian government allowed for 100 percent direct foreign ownership.

2. In January 2005, the Indian government implemented a 20-year product patent

protection policy.

3. Import duties on new drugs under development (clinical trials) have been
eliminated.

4. ICH good clinical practice regulations are now mandated.

The contract research organization (CRO) market in India is expected to grow
substantially from a level of $70 million in 2004 to $200 million by 2008 as a result of
the above changes. It doesn't hurt that doing clinical trials in India is between 50
percent and 60 percent cheaper than in the U.S. Beside there is fertile ground for the
study of chronic diseases:

1. 34 million diabetics

2. 30 million with cardiovascular disease

3. 8 million epileptics

Source: Pharma Marketing News 2005

THE SUCCESS STORY OF THE INDIAN PHARMACEUTICAL INDUSTRY:

(PEOPLE BEFORE PATENTS)

The colonial patent law of 1911 secured the Indian market to British industry. A large
majority of drugs were imported from abroad until the Patents Act 1970 brought a
turnaround. Early in the 21st century India has a highly efficient pharmaceutical
industry, blossoming thanks to the weak patent protection of medicines. It provides
essential drugs at affordable prices and creates considerable employment. Today over
90 percent of modern medicine consumed in India are produced locally. From 1
January 2005 India has been complying with the Trade Related Intellectual Property
Rights (Trips) of the World Trade Organization (WTO). The new rules of the game do
threaten India’s achievements.

The Indian pharmaceutical industry is a success story. It is also a potential employment

generator. More than 500 000 people are employed in this sector, in some 12 000 firms
out of which 2900 of them are large scale units. Besides a further 2.5 million jobs are
thought to be involved in the pre- and post-production sector. When compared to the
general price index, the drug prices have risen much less in the last 15 years so much
so that it still remains far below average. "Worldwide, India is a country of very low drug
prices while producing high quality medicines", Nihchal H. Israni, president of the Indian
Drug Manufacturers’ Association (IDMA), states proudly. The pharmaceutics self-
sufficiency exceeds 90 percent – in spite of the fact that the policy of open economy is
being pursued by India since 1991.

Now a question may arise as to what are the main factors that transformed the status of
the Indian pharmaceutical industry from a mere importer and distributor of drugs and
pharmaceuticals to an innovator driven by cost and effective producer of quality drugs.
The answer is strategic government policies that helped India in emerging as one of the
fast growing pharmaceutical industry in the world. To add to this with every passing
year trade surpluses and exports are also growing.

Industry revenues

For the first time ever, in 2006, global spending on prescription drugs topped $643
billion, even as growth slowed somewhat in Europe and North America. The United
States accounts for almost half of the global pharmaceutical market, with $289 billion in
annual sales followed by the EU and Japan. Emerging markets such as China, Russia,
South Korea and Mexico outpaced that market, growing a huge 81 percent.

US profit growth was maintained even whilst other top industries saw slowed or no
growth. Despite this, "The pharmaceutical industry is — and has been for years — the
most profitable of all businesses in the U.S. In the annual Fortune 500 survey, the
pharmaceutical industry topped the list of the most profitable industries, with a return of
17% on revenue."

Pfizer's cholesterol pill Lipitor remains the best-selling drug in the world for the fifth year
in a row. Its annual sales were $12.9 billion, more than twice as much as its closest
competitors: Plavix, the blood thinner from Bristol-Myers Squibb and Sanofi-Aventis;
Nexium, the heartburn pill from AstraZeneca; and Advair, the asthma inhaler from
GlaxoSmithKline.
IMS Health publishes an analysis of trends expected in the pharmaceutical industry in
2007, including increasing profits in most sectors despite loss of some patents, and
new 'blockbuster' drugs on the horizon.

Teradata Magazine predicted that by 2007, $40 billion in U.S. sales could be lost at the
top 10 pharmaceutical companies as a result of slowdown in R&D innovation and the
expiry of patents on major products, with 19 blockbuster drugs losing patent.

Market leaders in terms of revenue-

The following is a list of the 20 largest pharmaceutical and biotech companies ranked
by healthcare revenue. Some companies (e.g. Bayer, Johnson and Johnson and
Procter & Gamble) have additional revenue not included here. The phrase Big Pharma
is often used to refer to companies with revenue in excess of $3 billion, and/or R&D
expenditure in excess of $500 million.

INTRODUCTION OF ORGANIZATION:
Biocon is India's leading biotechnology enterprise. Established in 1978, the company
today is an integrated biotechnology enterprise focused on the development of
biopharmaceuticals. The company serves partners and customers in over 50 countries.
Within the biotechnology space, the company ranks first in Asia in terms of revenues
and market capitalization and sixteenth globally.

The company is headed by Kiran Mazumdar-Shaw. Biocon went for an IPO in 2004.
Biocon became only the second Indian company to cross a market capitalization of one
billion U.S. $ on the first day of listing. Mazumdar-Shaw and her husband John Shaw
own over 60% of the company's stock.
Biocon Limited is a fully integrated biopharmaceutical company focused on
biopharmaceuticals, custom research and clinical research.

Subsidiary Companies:

Syngene International Limited is a custom research organisation offering synthetic

chemistry and molecular biology services for early stage drug discovery and
development.
Clinigene International Limited is a clinical research organization offering Phase I-IV
clinical trials and studies for novel/generic molecules to international pharmaceutical
majors.

Biocon Biopharmaceuticals Private Limited (BBPL) is a joint venture with CIMAB to

develop and market a range of monoclonal antibodies and cancer vaccines.

AxiCorp GmbH is a Friedrichsdorf (Germany) based pharmaceutical marketing

company and is amongst the fastest growing in Europe. Biocon Limited acquired a
majority stake in AxiCorp GmbH (70%) in February, 2008.

NeoBiocon FZ LLC is a research and marketing pharmaceutical company based in

Abu Dhabi. Incorporated in January 2008, NeoBiocon is a 50:50 joint venture with Dr.
B.R.Shetty, Managing Director of NeoPharma, Abu Dhabi.

Intellectual Profile of 3600+ Personnel

Biocon, Syngene and Clinigene together employee approximately 3600 qualified
personnel - from biologists, chemists, medical practitioners, pharmacologists,
engineers, finance / legal / marketing analysts, HR generalists to general
administrators. 5% of our employees have PhD degrees, 41% have a master’s degree
in science and the remaining are graduates with a bachelors degree in science,
commerce or arts. 15% of Biocon employees are women (across the group). The
employee attrition last quarter was 7% and last year it was over 20%. The average age
of the employees is 29 years.

Biocon has rapidly developed a robust drug pipeline, led by monoclonal antibodies and
several other molecules at exciting stages in the biopharmaceutical value chain. With
the successful commercial launch of our first anti-cancer drug and several promising
discovery partnerships in the clinic, we remain committed to scaling new heights in
frontier science and achieving new milestones in affordable medicine.

The Innovation Matrix: A Strategic Framework

To navigate the challenges of innovation in the next decade company adopted a well-
defined strategic framework that will transform scientific discoveries into advances in
human healthcare and generate incremental value for shareholders.

The Innovation Matrix is a four-dimensional endeavour which extends into the realms of
the known and the unknown. Creativity in the known realm builds on existing
knowledge and can result in two types of innovation: INCREMENTAL and
EVOLUTIONARY. Creativity that challenges unknown boundaries and creates new
knowledge is EXPERIMENTAL and TRANSFORMATIONAL in its impact. A portfolio
that covers allfour spheres enables Biocon to sustain innovation in the short, medium
and long term
HISTORY OF ORGANISATION
November 29, 1978
Biocon India is incorporated as a joint venture between Biocon Biochemicals Ltd. of
Ireland and an Indian entrepreneur, Kiran Mazumdar-Shaw . It was the Biocon’s
Founding Day - the start of a biorevolution in India

1979
Biocon is the first Indian company to manufacture and export enzymes to USA and
Europe

1989

Unilever plc. acquires Biocon Biochemicals Ltd. in Ireland and merges it with its
subsidiary, Quest International
Biocon is the first Indian biotech company to receive US funding for proprietary
technologies

1990
Biocon scales up its in-house research programme, based on a proprietary solid
substrate fermentation technology, from pilot to plant level

1993
Biocon's R&D and manufacturing facilities receive ISO 9001 certification from RWTUV,
Germany

1994
Biocon establishes Syngene International Pvt. Ltd. as a Custom research Company
(CRC) to address the growing need for outsourced R&D in the pharmaceutical sector

1996
The commercial success of Biocon's proprietary fermentation plant leads to a 3-fold
expansion
Biocon leverages its technology platform to enter biopharmaceuticals and statins

1997
Biocon spearheads initiatives in human healthcare through a dedicated manufacturing
facility

1998
Unilever inks a deal with ICI to sell its specialty chemicals division of which Quest
International is a part. Unilever agrees to sell its shareholding in Biocon to the Indian
promoters. Biocon becomes an independent entity

2000
Biocon commissions its first fully automated submerged fermentation plant to produce
specialty pharmaceuticals

Biocon establishes Clinigene, India's first Clinical Research Organisation (CRO) to

pursue clinical research and development

2001
Biocon becomes the first Indian company to be approved by US FDA for the
manufacture of lovastatin, a cholesterol-lowering molecule

Biocon's proprietary bioreactor, PlaFractor™ is granted a US 2001 and world-wide

patent

2002
Clinigene's clinical laboratory is the first in India to receive CAP accreditation

2003
Biocon is the first company worldwide to develop human insulin on a Pichia expression
system

2004
Biocon creates a buzz in the stock market in March 2004 with its hugely successful
IPO. Day 1 on the bourses closes with a market value of $1.11 billion, making Biocon
only the second Indian company to cross the $1 billion mark on the first day of listing.

Biocon Limited announces the launch of INSUGEN®, the new generation bio-insulin,
manufactured in Asia's largest human insulin plant.

2005
Biocon signs a commercial agreement for supply of insulin API to Asia, Africa and the
Middle East.

2006
Biocon inaugurates Biocon Biopharmaceuticals, India's largest multi-product Biologics
facility at Biocon Park

Biocon inaugurates Biocon Park, India's largest integrated biotechnology hub,

comprising an integrated cluster of research laboratories and manufacturing facilities
spread across 90 acres in KIADB (Karnataka Industrial Areas Development Board)
industrial estate.

Biocon announces a licensing agreement with Bayer HealthCare (BHC) for the
exclusive marketing and trademark rights for INSUGEN® for the Chinese market.

Biocon launches India's first anti-cancer drug BIOMAb EGFR™.

2007
Biocon and Abu Dhabi based pharmaceutical company Neopharma sign an MOU to
establish a JV to manufacture and market a range of biopharmaceuticals for the GCC
countries (Gulf Cooperation Council). .

Biocon announces the launch of its Nephrology Division and a comprehensive portfolio
of renal therapy products.
Syngene enters into a research partnership with Bristol-Myers Squibb and completes
the ground breaking ceremony of new research facility at Biocon Park.

Biocon presents the results of Phase 1 studies on its oral insulin product, IN-105 at the
European Association for Study of Diabetes (EASD) meeting held at Amsterdam.

2008
Biocon acquires a 70% stake in German pharmaceutical company, AxiCorp GmbH for
a consideration of €30 Million

Biocon and Abraxis Bioscience launch ABRAXANE in India for treatment of Breast
Cancer.

Biocon is ranked among the top 20 global biotechnology companies (Med Ad News).

Biocon is the 7th largest biotech employer in the world (Med Ad News).

2009
Biocon's Syngene partners with Sapient Discovery to expand integrated drug discovery
offerings

Biocon's Syngene and DuPont Crop Protection Forge Alliance Partnership

Bristol-Myers Squibb and Biocon's Syngene open new R&D Facility at Biocon Park

Biocon launches BASALOG - long lasting basal insulin for Type 1 & Type 2 Diabetics

Products & Services

“Biocon’s impressive range of products and partnered services continue to build a
robust pipeline of biosimilar and discovery-led biologicals programs in oncology,
nephrology, diabetes and autoimmune diseases”
Through partnerships and alliances, Biocon has strategically moved up the value chain
from supplying pharmaceutical bulk actives to developing proprietary molecules and
branded formulations. Differentiation and a high degree of innovation distinguish all
products and services.

Biopharmaceuticals

Biocon is among few companies in the world with a diverse scientific skill base and
advanced manufacturing capabilities for the development and commercialisation of
biopharmaceuticals. It offers a range of products from fermentation derived small
molecules to recombinant proteins and antibodies.

Anti-Diabetic Agents:

Acarbose
Acarbose is an alpha-glucosidase inhibitor that helps in slowing down digestion of
carbohydrates. By lengthening the time taken to convert carbohydrates to glucose, it
facilitates better blood glucose control, after meals, used in the treatment of type II
diabetes mellitus.

Pioglitazone
Pioglitazone lowers glucose level in the blood by reducing its production and secretion
from the liver. In addition, it alters the concentration of lipids (fats) in the blood,
specifically, decreasing triglycerides and increasing HDL level. Used in the treatment of
type II diabetes mellitus.

Repaglinides
Repaglinide is a fast & short-acting, oral hypoglycemic agent. It is an insulin
secretogogue that stimulates the release of insulin from beta cells of the pancreas.
Used in the treatment of type II diabetes mellitus.
Rosiglitazone
Rosiglitazone is a hypoglycemic agent that sensitizes insulin binder cells in the body to
increase uptake of glucose from the blood, thereby reducing blood glucose level. Used
in the management of type II diabetes mellitus.

Anti-Inflammatory Agents:

Serratiopeptidase
Serratiopeptidase is a proteolytic enzyme derived from bacteria. It specifically digests
the Bradykinins and fibrin formed in the process of inflammation and hence acts as an
anti- inflammatory agent. Used in the treatment of various diseases caused by
inflammation.

Trypsin Chymotrypsin
Trypsin is a proteolytic enzyme involved in the digestion of proteins, cleaving peptide
bonds at only positively charged side chains of amino acids, like lysine and arginine. It
is considered a debriding agent for cleaning of necrotic wounds, ulcers, sinuses and
fistulas. Used in the treatment of bronchial asthma, bronchitis and thrombophlebitis.

Anti-Oxidants:

Alpha Lipoic Acid

Alpha lipoic acid is a fat and water soluble antioxidant that traps free radicals in the
body and thus prevents cell damage. Alpha Lipoic Acid supplementation protects the
brain from damage caused by free radicals. Widely used in the treatment of various
diseases caused by free radicals such as Dementia, Stroke, Parkinsons and
Alzheimer’s.

L-Carnitine
L-Carnitine, an amino acid derivative, is found in nearly all cells of the body. It
transports long-chain fatty acids across the inner mitochondrial membranes in the
mitochondria, where they are processed by beta-oxidation to produce biological energy
in the form of adenosine triphosphate or ATP. Used in the management of cardiac
ischemia and peripheral arterial disease.
Cardiovascular Agents:

Atorvastatin
Atorvastatin is a cholesterol-lowering agent that acts by inhibiting the HMG CoA
reductase, enzyme which plays an important role in the biosynthesis of cholesterol.
Used in the treatment of Coronary heart diseases.

Lovastatin
Lovastatin is a cholesterol lowering agent that decreases the LDL levels, total-
cholesterol and LDL-cholesterol and below average HDL-cholesterol. Used to prevent
coronary heart disease, without symptomatic cardiovascular disease.

Pravastatin
Pravastatin is competitive inhibitor of HMG-CoA reductase, the enzyme catalysing the
early rate-limiting step in cholesterol biosynthesis, i.e. conversion of HMG-CoA to
mevalonate. Widely used in the treatment of arteriosclerosis.

Simvastatin
Simvastatin is a hypolipidemic drug used to treat hypercholesterolemia. It is competitive
inhibitor of HMG-CoA reductase, the enzyme catalysing the early rate-limiting step in
cholesterol biosynthesis, i.e. conversion of HMG-CoA to mevalonate .Successfully used
in the treatment of coronary heart diseases.

Fluvastatin
Fluvastatin is a water soluble cholesterol-lowering agent. It is competitive inhibitor of
HMG-CoA reductase; the enzyme catalysing the early rate-limiting step in cholesterol
biosynthesis, i.e. conversion of HMG-CoA to mevalonate .It also reduces low density
lipoproteins and triglycerides while increasing high density lipoprotein levels in the
blood. Used in the treatment of hypercholesterolemia.

Rosuvastatin
Rosuvastatin is an oral cholesterol-lowering agent. It is competitive inhibitor of HMG-
CoA reductase, the enzyme catalysing the early rate-limiting step in cholesterol
biosynthesis, i.e. conversion of HMG-CoA to mevalonate Used for the treatment of pure
hypercholesterolemia and mixed hyperlipidaemia.

Ezetimibe
Ezetimibe is a cholesterol lowering agent that selectively inhibits intestinal absorption of
cholesterol. Used to treat hypercholesterolemia.

Anti-Obesity Agents:

Orlistat
Orlistat is a reversible inhibitor of lipases. It exerts its therapeutic activity in the lumen of
the stomach and the small intestine. It is indicated for obesity management including
weight loss and weight maintenance, when used in conjunction with a low-calorie diet.

Digestive-Aid Enzymes:

Bile Extract
Bile contains bile acids, which are critical for digestion and absorption of fats and fat-
soluble vitamins in the small intestine. Oxbile extract is prepared from the fresh bile of
the ox. Widely used for replacement therapy in pathological conditions in which the
concentration of bile acids in upper intestine is low for e.g. biliary fistula, disease of the
ileum, hepatic or extra-hepatic cholestasis.

Fungal Lactase
Lactase is the enzyme in the small intestine that digests lactose (the naturally occurring
sugar in milk).Fungal lactase is an enzyme obtained by the controlled fermentation of
aspergillus oryzae and is characterized by its ability to hydrolyse lactose over a wide
range of temperatures and pH. The lactase catalyses the hydrolysis of the lactose beta-
D-galactoside linkage liberating one mole of D-glucose and one mole of D-galactose.
Used to treat lactose intolerance.

Pancreatin
Pancreatin plays a major role in the human digestive system. It is composed of different
enzymes like amylases, proteases and lipases that hydrolyse food components and
facilitate their digestion and assimilation in the intestinal tract. Used as a digestive aid.
Papain
Papain is a proteolytic enzyme derived from papaya and certain other plants. It digests
protein to give smaller peptides and amino acids. It is used as a digestive aid.

Pepsin
Pepsin is an excellent fibrinolytic and caseinolytic enzyme, which in combination with
amylase and lipase, has proved to be a formidable digestive aid. It may be
administered in acid solution to increase the digestive power of gastric juices,
particularly where there is a deficiency of pepsin secretions. Used as a digestive aid.

Amylase
Amylase catalyzes the hydrolysis of alpha -1, 4- glycosidic linkages of polysaccharide
to yield dextrins, oligosaccharides, maltose and glucose. Used to treat natural digestive
enzyme deficiency.

Hemicellulase
Hemicellulase breaks down hemicellulose (a variety of polysaccharides) that are more
complex than sugars and less complex than cellulose found in plant walls.
Hemicellulase is often used in baking. Used as a supplement for digestive system and
general nutritional support.

Alpha Galactosidase
Alpha Galactosidase catalyzes the hydrolysis of terminal, non-reducable alpha D
galactose residues in alpha galactosides, including galactose oligosaccharides,
galactomanans and galactoloipids. Used as an anti flatulent food supplement.

Hemostatic Agents:

Ethamsylate

Ethamsylate reduces bleeding time by improving platelet adhesion. It is a membrane-

stabilising agent that acts on capillary walls and inhibits the individual prostaglandin-
specific enzyme in its synthetic pathway. Used in gynecological as well as surgical
hemorrhagic conditions.

Tranexamic Acid

Tranexamic Acid is an anti-fibrinolytic agent. Used to treat serious bleeding, especially

when it occurs after dental surgery (particularly in patients with hemophilia) or certain
other kinds of surgery.

Hepatoprotective Agents:

L-Ornithine L-Aspartate
L-Ornithine-L-Aspartate is a combination of two "conditionally-essential" amino acids,
i.e. amino acids that are specifically needed under disturbed liver conditions. Used in
the treatment liver disorders.

Urso Deoxy Cholic Acid

Urso Deoxy Cholic Acid is an oral gallstone solubilising agent intended for dissolution of
radiolucent gallstones and to treat primary biliary cirrhosis. UDCA is a naturally
occurring bile acid, found in small quantities in normal human bile that suppresses
hepatic synthesis, secretion of cholesterol and the intestinal absorption of cholesterol.
Used in the treatment liver disorders.

Immunosuppressant:

Mycophenolate Mofetil
Mycophenolate Mofetil (MMF) is a pro drug for the immunosuppressive agent
mycophenolic acid (MPA). It is an inosine monophosphate dehydrogenase (IMPDH)
inhibitor. Used in conjunction with cyclosporine and corticosteroids for the prevention of
transplant rejection in patients undergoing organ transplantation.

Mycophenolic Acid Sodium

Mycophenolate Acid Sodium, a mycophenolic acid prodrug, is an inhibitor of T-
lymphocyte proliferation. Mycophenolic acid reduces the incidence of acute rejection in
renal transplantation. Mycophenolate Acid Sodium is enteric coated and has been
suggested as a potential method to reduce the gastrointestinal adverse events seen
with Mycophenolate Mofetil

Tacrolimus
Tacrolimus is a macrolide antibiotic that suppresses both cellular and humoral
mediated immune responses. It specifically binds T cell receptors, inhibits cytokine
production and IgE sensitivity. Used to lower the body's natural immunity in patients
who receive organ transplants. Also a topical immunomodulator indicated for use in
moderate to severe eczema.

Sirolimus
Sirolimus reduces organ rejection in patients receiving kidney transplants. To be used
in combination with cyclosporine and corticosteroids and has been shown to
significantly reduce rejection rates when compared to control regimens.

Pimecrolimus
Pimecrolimus is a new topical steroid-free medication with immune-modulating and
anti-inflammatory properties. It is an ascomycin macrolactam derivative. Pimecrolimus
cream is used for mild to moderate atopic dermatitis.

Everolimus
Everolimus is an immunosuppressive agent used to prevent the rejection of organ
transplants. Used in various Organ transplantation process.

Gastro-Intestinal Agents:

Prebiotics
Prebiotics are nondigestible food ingredients that may beneficially affect the host by
selectively stimulating the growth and activity of a limited number of bacteria in the
colon. Prebiotics consist mainly of oligosaccharides, sugar molecules of 3 to 6 chains
and soluble fiber. Prebiotic foods are vital to encourage probiotic organisms to survive
and thrive in the human gut. Used to treat constipation and hepatic encephalopathy.

Probiotics
Probiotics are cultures of live microorganisms that, when ingested in sufficient amounts,
confer beneficial health effects on a host by improving the balance of the intestinal
micro flora. Widely used to prepare fermented dairy products such as yogurt or freeze-
dried cultures. Used to treat diarrhea, bloating and constipation.

Neutraceuticals:

Chondroitin Sulphate
Chondroitin Sulphate is a glycosaminoglycan found in human cartilage and the cornea.
It is a cartilage matrix enhancer, which is purported to prevent the breakdown and
promote the rebuilding of cartilage. Treatment with Chondroitin leads to significant
increases in hyaluronate concentration and the intrinsic viscosity of the synovial fluid.
Used in the treatment of Osteoarthiritis.

Glucosamine Sulphate
Glucosamine Sulphate is one of several naturally-occurring 6-carbon amino sugars
found in the body. Amino sugars are essential building blocks for mucopolysaccharides,
mucoproteins, and mucolipids. The exact mechanism of action of Glucosamine has not
been studied. Used in the treatment of arthritis.

MOLECULES USED IN SURVEY :

ENOXAPARIN - Enoxaparin is a low molecular weight heparin marketed as Lovenox or

Clexane. It is used to prevent and treat deep vein thrombosis or pulmonary embolism,
and is given as a subcutaneous injection (by a health care provider or the patient). Its
use is evolving in acute coronary syndromes (ACS).

Enoxaparin is manufactured by Sanofi-Aventis and is derived from the intestinal

mucosa of pigs.
 ENOXAPARIN SODIUM

STREPTOKINASE - Streptokinase is a protein produced by beta-haemolytic

streptococcus and is used as an effective and inexpensive clot-dissolving medication in
some cases of myocardial infarction (heart attack) and pulmonary embolism.

It belongs to a group of medications known as fibrinolytics, and works by activating

plasminogen through cleavage to produce plasmin.

The half life of streptokinase is approximately 20 minutes (quoted in SPC).

ATORVASTATIN - Atorvastatin (INN) (pronounced /əˌtɔrvəˈstætən/) (Lipitor, Pfizer), is

a member of the drug class known as statins, used for lowering blood cholesterol. It
also stabilizes plaque and prevents strokes through anti-inflammatory and other
mechanisms.

Atorvastatin inhibits HMG-CoA reductase, the rate-determining enzyme located in

hepatic tissue that produces mevalonate, a small molecule used in the synthesis of
cholesterol and other mevalonate derivatives. This lowers the amount of cholesterol
produced which in turn lowers the total amount of LDL cholesterol.
Atorvastatin was first synthesized in 1985 by Bruce Roth while working at Parke-Davis
Warner-Lambert Company (now Pfizer).With 2006 sales of US$12.9 billion, Lipitor is
the largest-selling drug in the world.Lipitor is not the only statin; there are several other
statins on the market

ATORVASTATIN

TELMISARTAN - Telmisartan (INN) is an angiotensin II receptor antagonist (ARB)

used in the management of hypertension. It is marketed under the trade names Pritor
or Kinzal (Bayer Schering Pharma), Micardis (Boehringer Ingelheim), Telma (Glenmark
Pharma), Telday (Torrent Pharmaceuticals) and Teleact D by (Ranbaxy).

The usually effective dose Telmisartan (Telso marketed by Mascot Health Series) is 40
mg once daily. Some patients may already benefit at a daily dose of 20 mg. In cases
where the target blood pressure is not achieved, telmisartan dose can be increased to
a maximum of 80 mg once daily.
 TELMISARTAN

METAPROLOL - Metoprolol is a selective β1 receptor blocker used in treatment of

several diseases of the cardiovascular system, especially hypertension. It is marketed
under the brand name Lopressor by Novartis, and Toprol-XL (in the USA); Selokeen (in
the Netherlands); as Minax by Alphapharm (in Australia), Metrol by Arrow
Pharmaceuticals (in Australia), as Betaloc by AstraZeneca, as Neobloc by Unipharm (in
Israel) and as Corvitol by Berlin-Chemie AG. A number of generic products are
available as well. The active substance metoprolol is employed either as metoprolol
succinate or metoprolol tartrate (whereas 100 mg metoprolol tartrate corresponds to 95
mg metoprolol succinate), respectively as prolonged-release or conventional-release
formulation.

METOPROLOL
ROSUVASTATIN - Rosuvastatin is a member of the drug class of statins, used to treat
high cholesterol and related conditions, and to prevent cardiovascular disease.
Shionogi developed the product and the pharmaceutical company AstraZeneca
markets it as Crestor.

Rosuvastatin is available as Crestor in tablet form (5, 10, 20, or 40 mg) for oral
administration. Tablets are pink, round or oval (40 mg), biconvex, film-coated, and
imprinted with "ZD4522" and tablet strength.[1] Japanese approval is in the dose range
of 2.5 mg to 20 mg; therefore, smaller dose tablet forms might also be available outside
the United States. Note that 97% of worldwide sales have been at or below the 20 mg
dose.

ROSUVASTATIN CALCIUM

RAMIPRIL - Ramipril (marketed by Sanofi-Aventis as Tritace and by King

Pharmaceuticals as Altace) is an angiotensin-converting enzyme (ACE) inhibitor, used
to treat hypertension and congestive heart failure. ACE inhibitors lower the production
of angiotensin II, therefore relaxing arterial muscles while at the same time enlarging
the arteries, allowing the heart to pump blood more easily, and increasing blood flow
due to more blood being pumped into and through larger passageways.
Ramipril is a prodrug and is converted to the active metabolite ramiprilat by liver
esterase enzymes. Ramiprilat is mostly excreted by the kidneys. The half-life of
ramiprilat is variable (3-16 hours), and is prolonged by heart and liver failure, as well as
kidney failure.

It is marketed by King Pharmaceuticals under the brand name Altace and was
protected by the U.S. Patent 5,061,722 (was scheduled to expire on 29th Oct, 2008)
assigned to Aventis. On September 11, 2007 in an appeal by Lupin Pharmaceuticals
the United States Court of Appeals for the Federal Circuit reversed a district court trial
verdict, finding that Aventis's patent on Altace was invalid for obviousness - opening the
gate of this medicine to generic manufacturers.

RAMIPRIL

CLOPIDOGREL - Clopidogrel is an oral antiplatelet agent (thienopyridine class) to

inhibit blood clots in coronary artery disease, peripheral vascular disease, and
cerebrovascular disease. It is marketed by Bristol-Myers Squibb and Sanofi-Aventis
under the trade name Plavix, by Sun Pharmaceuticals under the trade name Clopilet,
by Ranbaxy Laboratories under the trade name Ceruvin. It works by irreversibly
inhibiting a receptor called P2Y12. Adverse effects include hemorrhage.
Plavix is marketed worldwide in nearly 110 countries, with sales of US$5.9 billion in
2005. It had been the 2nd top selling drug in the world for a few years as of 2007 and
was still growing by over 20% in 2007.

In 2006, generic clopidogrel was briefly marketed by Apotex, a Canadian generic

pharmaceutical company before a court order halted further production until resolution
of a patent infringement case brought by Bristol-Myers Squibb. The court ruled that
Bristol-Myers Squibb's patent was valid and provided protection until November 2011.

Generic clopidogrel is also produced by several pharmaceutical companies in India at

significantly lower retail prices, up to 1/30th of the price.

Counterfeit Plavix is in circulation, as with many popular medicines.

About cardiovascular diseases

Cardiovascular disease refers to the class of diseases that involve the heart
and/or blood vessels (arteries and veins). Heart attacks are a form of cardiovascular
disease. Heart attacks are usually acute events and are mainly caused by a blockage
that prevents blood from flowing to the heart or brain. The most common reason for this
is a build-up of fatty deposits on the inner walls of the blood vessels that supply the
heart or brain. Strokes can also be caused by bleeding from a blood vessel in the brain
or from blood clots.

Cardiovascular diseases are among the leading causes of death across the
world. The prevalence of chronic disease is showing an upward trend in most countries
and for several reasons this trend is likely to increase. For one reason, life expectancy
is increasing in most countries and a greater number of people are living to older ages
and are at greater risk to chronic diseases of various kinds. For another, the life-styles
and behavioral patterns of people are changing rapidly, these being favorable to the
onset of chronic diseases. Modern medical care is now enabling many with chronic
diseases to survive. The impact of chronic diseases on the lives of people is serious
when measured in terms of loss of life, disablement, family hardship and poverty and
economic loss to the country.

Cardiovascular disease accounts for 16.7 million or 29.2 per cent of total global
deaths in 2003. With modernization, a large proportion of Asians are trading healthy
traditional diets for fatty foods, physical jobs for deskbound sloth, the relative calm of
the countryside for the stressful city. Heart-attack victims are just the first wave of a
swelling population of Asians with heart problems. While deaths from heart attacks
have declined more than 50% since the 1960s in many industrialize countries, 80% of
global cardiovascular diseases related deaths now occur in low and middle-income
nations, which cover most countries in Asia.
 RESEARCH METHODOLOGY

Research methodology is a way to systematically solve the research problem. It

includes the various steps that are generally adopted by a researcher in studying in the
research problem along with reason behind them.

According to Clifford Woody, “ research methodology comprises of defining and

redefining the problem, formulating the hypothesis or suggesting the solutions,
collecting, evaluating the data, making deductions and reaching to conclusion and at
last carefully testing the conclusion to determine whether they fits the formulated
hypothesis”.

TITLE OF STUDY: The title of the study is “market survey of various molecules of
Biocon in AIIMS and other Hospitals”.

DURATION OF PROJECT: 6 weeks

OBJECTIVE: Cardiovascular has been a key therapy area for BIOCON and
launching of a polypill is a major strategy towards strengthening their cardiovascular

portfolio. The basic aim of the study is:

1. To find out about the market condition of cardiovascular drugs.

2. To determine the number of prescriptions of various molecules per week.

3. To determine the top three brands in cardio-polypill according to the chemists .

4. To determine the names of the doctors who are prescribing various pills.

5. To determine the source of purchasing of various chemists.

TYPE OF RESEARCH: The research done is descriptive in nature where

researcher is aware of the problem.
SAMPLE SIZE AND METHOD OF SELECTING SAMPLE:

Nineteen chemists near various hospitals and ten chemist in AIIMS were selected to
collect the required information. The survey method was used to gather the primary
data for the study. Based on the objectives of the study, the Standardized
Questionnaires were distributed. We are having open ended questionnaires as this type
of questionnaires give a concrete answer and based on the facts.

For this study populations of chemists from various hospitals were examined. The first
were from the east region hospitals of Delhi and secondly chemists from south region
were surveyed. This sample becomes more specific by limiting the chemists that are
interviewed to those that specifically deal with cardio drugs.

SAMPLE DESIGN

In this project non-probability sampling is being used. Here the sampling involves the
selection of the sample based on factors other than random chance. The methods
being used is convenience sampling. Since we have not been given a list of particular
chemists that must be targeted therefore, we are able to target anyone that fits into our
different sample populations. This type of sampling is of convenience

SCOPE OF STUDY

India is undergoing an epidemiological transition and is on the threshold of an

epidemic of cardiovascular disease. Cause-specific mortality data indicate that
cardiovascular disease is already an important contributor to mortality. Demographic
projections suggest a major increase in cardiovascular disease mortality as life
expectancy increases and the age structure of the growing population changes.
Surveys in urban areas suggest that coronary risk factors are already widespread and
that urgent action is needed to prevent a further rise as socioeconomic development
proceeds.

Current projections suggest that by the year 2020 India will have the largest
cardiovascular disease burden in the world. One fifth of the deaths in India are from
coronary heart disease. By the year 2020, it will account for one third of all deaths.
Sadly, many of these Indians will be dying young. Heart disease in India occurs 10 to
15 years earlier than in the west. There are an estimated 45 million patients of coronary
artery disease in India. An increasing number of young Indians are falling prey to
coronary artery disease.

This study would help in formulating the initial lunching and subsequent marketing

strategies while taking into account a holistic view about the market condition. The

polypill would be more effective as it would simultaneously reduce cardiovascular risk

factors. This would mean success both for the company and also for patients.

LIMITATIONS OF THE STUDY

1. Some respondents did not provide authentic information.

2. Some respondents were reluctant to provide all essential information regarding

their attitude towards the product.

3. Most of the chemists were not aware about the Biocon’s pollypills.

4. Time also proved as one of the constraints for the study.

5. The area of survey has been restricted to Delhi only.

6. The formidable heat was another constraint.

ANALYSIS AND INTERPRETATION

For the analysis purpose, I have the South Region AIIMS in Delhi into various
Chemists- .

REGIONS IN DELHI CHEMISTS COVERED

SOUTH (AIIMS) BHUTANI’S MEDICOS, SOUTH DELHI
MEDICOS, B.L & CO., TIRUPATI
MEDICOS, HELPLINE CHEMIST, CHAWLA
CHEMIST, SUPER CHEMIST,
SAFDARGUNG MEDICOS, PARAS
CHEMIST,

Survey of AIIMS
BHUTANI’S MEDICOS

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/WEEK
STREPTOKINASE STREPTASE (UNITED 1
BIOTECH),
THROMBOSOL

ENOXAPARIN CLEXIN (GSK) 70

ATORVASTATIN STORVAS, ATORVAS 210

TELMISARTAN TELISTAIR,TELMA 350

METAPROLOL METOLAR 385

ROSUVASTATIN ROSUVAS (RANBAXY) 35

RAMIPRIL CARDACE 30

SOUTH DELHI MEDICOS

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/ WEEK
STREPTOKINASE THROMBOSOL, 28
THROMBOFLOX
(BHARAT SERUM)

ENOXAPARIN CLEXIN (GSK) 42

ATORVASTATIN STORVAS, ATORLIP 210

(CIPLA), ESTER (S.P),
LIPICURE (INTAS)

TELMISARTAN TELMA 420

METAPROLOL METOLAR, BETALOC 105

ROSUVASTATIN ROSUVAS (RANBAXY), 56

 RAMISTAR (LUPIN)

CLOPIDOGREL DIPLET 400

RAMIPRIL CARDACE 40

B.L & CO.

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/ WEEK
STREPTOKINASE NOT AVAILABLE 0

ENOXAPARIN CLEXIN (GSK) 7

ATORVASTATIN STORVAS, ATORLIP 210

(CIPLA), ESTER (S.P),
LIPICURE (INTAS)

TELMISARTAN TELMA 10

METAPROLOL METOLAR, BETALOC 15

ROSUVASTATIN ROSUVAS (RANBAXY), 4

RAMISTAR (LUPIN)

RAMIPRIL CARDACE 15
 TIRUPATI MEDICOS

MOLECULES PRODUCTS AVAILABLE QUANTITY SOLD/ WEEK

STREPTOKINASE CHEMIKINASE 2

ENOXAPARIN CLEXIN(GSK), 40
CLEXIPARIN(SUNOFFY)

ATORVASTATIN STORVAS, AZIRVA,ASTOR, 10

LIPICURE(INTAS)

TELMISARTAN TELMA 5

METAPROLOL METOLAR, METPURE 4

ROSUVASTATIN ROSUVAS (RANBAXY), 4

RAMISTAR (LUPIN),
BESTOR

RAMIPRIL CARDACE 20
HELPLINE CHEMIST

MOLECULES PRODUCTS AVAILABLE QUANTITY SOLD/ WEEK

STREPTOKINASE STREPTOKINASE 1

ENOXAPARIN CLEXIN(GSK), LMWX 5

ATORVASTATIN STORVAS, ATORVAS 10

TELMISARTAN TELMA 5

METAPROLOL BETALOC 4

ROSUVASTATIN ROSUVAS (RANBAXY), 4

RAMIPRIL CARDACE, ZIGPRIL 1

 CHAWLA CHEMIST

MOLECULES PRODUCTS QUANTITY SOLD/

AVAILABLE WEEK
STREPTOKINASE STREPTOKINASE 2

ENOXAPARIN CLEXIN(GSK), 4

ATORVASTATIN STORVAS, ATORVAS 10

TELMISARTAN TELMA 10

METAPROLOL BETALOC 25

ROSUVASTATIN ROSUVAS (RANBAXY), 9

RAMIPRIL CARDACE, ZIGPRIL 25

CLOPIDOGREL DIPLET, CLAVIX 30

SUPER CHEMIST

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/ WEEK
STREPTOKINASE STREPTOKINASE (U.B) 2

ENOXAPARIN CLEXIN (GSK), 5

ATORVASTATIN STORVAS, ATORVAS 10

TELMISARTAN TELMA 28

METAPROLOL BETALOC 15

ROSUVASTATIN ROSUVAS (RANBAXY), 9

RAZEL, CRESTOR

RAMIPRIL CARDACE, RAMISTA 12

CLOPIDOGREL DIPLET, CLAVIX, CLOPITAB 40

SAFDARGUNG MEDICOS

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/ WEEK
STREPTOKINASE THROMBOSOL 3

ENOXAPARIN CLEXIN (GSK), 120

ATORVASTATIN ATORVA, SYMBASTATIN 224

TELMISARTAN TELMA 450

METAPROLOL METOLAR, REVILOL 350

ROSUVASTATIN ROSUVAS (RANBAXY) 60

RAMIPRIL CARDACE, RAMISTA 20

CLOPIDOGREL DIPLET, CLAVIX, CLOPITAB 84

PARAS CHEMIST

MOLECULES PRODUCTS QUANTITY

AVAILABLE SOLD/ WEEK
STREPTOKINASE THROMBOSOL 1

ENOXAPARIN CLEXIN (GSK), 10

ATORVASTATIN STORVAS, STATIX, METADOZ-1PR 28

TELMISARTAN TELMA 35

METAPROLOL METOLAR, BETALOC 42

ROSUVASTATIN ROSUVAS (RANBAXY) 60

RAMIPRIL CARDACE 10

CLOPIDOGREL DIPLET, CLAVIX 10

From the above finding in AIIMS HOSPITAL , the average prescription per week for
different molecules can be calculated as :

Average prescription/week = Total quantity sold / week

Total no. of chemists surveyed
 MOLECULES QUANTITY SOLD/ WEEK

STREPTOKINASE 4

ENOXAPARIN 31

ATORVASTATIN 77

TELMISARTAN 134

METAPROLOL 95

ROSUVASTATIN 28

RAMIPRIL 17

CLOPIDOGREL 57

It shows that the sales of ENOXAPARIN among inject-able drugs are maximum and
that of TELMISARTAN is maximum among all oral molecules.

As per the study of various chemists near AIIMS hospital, the top three brands are
TELMA, STORVAS and METOLAR.

Various doctors who prescribe these products are Dr. SANDEEP MISHRA, DR. R.K.
MARYA, DR. GAUTAM NAGAR, DR. S. SETH, DR. B. BHARGAVA, DR. S.
RAMAMURTHY, DR. S. MISHRA, DR. N. NAYAK, DR. G. KARTHIK, DR. D.
PRABHAKARAN, DR. R. YADAV, DR. SANDEEP SINGH, DR. GAUTAM SHARMA and
DR. R. NARANG.

According to chemists of AIIMS, their source of purchasing is central purchasing from

A.R. LAB, KOTLA, and R.K/D.R distributors.
 FACTS AND FINDINGS
By the extensive market analysis done, it is clear that various established brands like
SUN-PHARMA, RANBAXY, GLAXOSMITH KLINE, CIPLA, LUPIN and INTAS are
giving tough competition to BIOCON in cardiology division in Delhi. Some points as a
brief of findings are:

1. Since it has been only one year for the Biocon to come up with its various pills in
cardiology department in NCR region, its sales was not so impressive compared
to other competitors.

2. According to the information provided by most of the chemists, most of the pills
were getting expired.

3. Most of the chemists were unaware of the all products of Biocon. The sales of
only Atorvastatin molecule i.e. statix was satisfactory among all the molecules.
Various products of Biocon are-

MOLECULES BIOCON’S PRODUCT

STREPTOKINASE MYOKINASE

ENOXAPARIN DYNALIX

ATORVASTATIN STATIX

TELMISARTAN TELISTA

METAPROLOL ACTIBLOCK-IPR

ROSUVASTATIN BESTOR

RAMIPRIL ZIGPRIL

4. Some chemists have flat out refused to answer the questionnaire once they
discovered that it was on the behalf of Biocon.
 5. Less promotional activities

From the analysis done earlier, it is revealed that sales of Clexin

(Glaxo smith cline) is maximum among inject-able drugs, similarly that of Rosuvas
(Ranbaxy), Atorva (Ranbaxy) and storvas among oral products.

CONCLUSION

As we know that BIOCON is a very big organization and ranks first in Asia in terms of
revenues and market capitalization and sixteenth globally but its sales in in cardiology
products in Delhi is not satisfactory since it has been only one year for the company to
come up with its cardio products. Doctors have believed in Biocon’s product and they
will prescribe its products also if effective actions will be taken.

The survey resulted into following conclusions:

 Biocon must come up with new promotional activities such that doctors
become aware about its new products.
 Quality is the dominating aspect which influences consumer to purchase
product, but prompt availability of other pharma brands and aggressive
promotional activities by others influences the consumer towards them and
also leads to increase sales.
 In comparison to Biocon, the other players such as Sun-pharma, Ranbaxy,
GSK, Intas etc. provide a better availability at retail outlet and give competition
to the hilt.
 Doctors are mostly satisfied with the overall quality of Biocon products, but for
the existence in the market Biocon must use aggressive selling techniques.

RECOMMENDATIONS AND SUGGESTIONS

After analyzing and interpreting the response gathered in the process of survey work,
certain conclusions were reached. On the basis of these, certain recommendations are
being proposed which in my view may help the company in formulating future strategies
for BIOCON products:
1. It has been concluded that awareness level of BIOCON products is less than
expected in Delhi, which leaves a large room for betterment. This is because
company has low level of promotional activities , which is required to build up its
image among the customers (doctors)
2. The company should try to reconcile its sales by awarding some monetary
benefits to its sales people so they recommend more to doctors.
3. The company should sponsor any contest like quiz program on T.V. This will
work automatically as an advertisement for its products.

4. Biocon should give national advertisements apart from the advertisements given
at the local level.
5. Try and change the perception of the doctors through word of mouth about
Biocon’s products.
 APPENDIX

CHEMIST QUESTIONNAIRE:

1. How many Prescriptions are coming per week of BIOCON Product?

2. Which Doctor is prescribing the most of the product of BIOCON?

3. Who are the competitors of BIOCON?

4. Which molecules of BIOCON are mostly prescribed by the Doctor’s?

5. In near AIIMS which are the most competitor of BIOCON product?

6. Through which sources you were collecting the BIOCON product?

PATIENT SATISFACTION SURVEY IN
BHIWADI:
INTRODUCTION OF PATIENT SATISFACTION:
This patient satisfaction survey is conducted by BIOCON and WARIS (WELLNESS
AND RADIAL INTERVENTION SOCIETY Helping people, saving lives).

Definition :
The degree to which the individual regards the health care service or product or the
manner in which it is delivered by the provider as useful, effective, or beneficial.

Survey shows many doctors find the management of atrial fibrillation difficult and
patients are unaware of the risks, complexities and treatment for this most common of
heart rhythm disorders.

June 8, 2009: Four leading patient and medical associations announced today the
formation of AF AWARE (Atrial Fibrillation Awareness and Risk Education), a joint
initiative to highlight and address issues that contribute to the growing burden of atrial
fibrillation (AF) worldwide.

AF is a common yet under-recognized and poorly understood abnormal heart rhythm

that is associated with poor quality of life, substantial numbers of hospitalizations,
increased risk of severe and potentially fatal cardiovascular complications such as
stroke, as well as death.

Marking the start of World Heart Rhythm Week, the World Heart Federation (WHF),
Atrial Fibrillation Association (AFA), Stroke Alliance For Europe (SAFE), and European
Heart Rhythm Association (EHRA) have come together to call upon their peers around
the world to raise awareness and understanding of AF and its cardiovascular
consequences.
Atrial fibrillation (AF), is the most common cardiac arrhythmia (abnormal heart rhythm)
seen by doctors. It is a fast growing public health concern currently affecting an
estimated seven million people in the USA and Europe alone and it is expected to
double by 2050, reflecting the growing proportion of elderly individuals.1,2 AF results
from abnormal electrical activity in the upper chambers of the heart (atria), leading to an
irregular heart rhythm which prevents the blood from efficiently being pumped toward
the rest of the body1. Common symptoms of AF include palpitations (a rapid, irregular,
“flopping” movement or pounding sensation in the chest), shortness of breath, dizziness
and feeling of heaviness in the chest3.

“Patients with AF, have a substantially lower quality of life than healthy individuals as a
result of their condition. If left untreated, they are at higher risk of experiencing stroke or
other cardiovascular complications, which can have serious and debilitating
consequences” said Trudie Lobban, CEO of the AFA.

"As AF carries a fivefold increase in the risk of stroke, the risk of death or severe
morbidity is considerably increased as well. In addition patients who have a stroke and
have AF often have a worse prognosis compared to patients without AF."

Age, obesity, hypertension, myocardial infarction (MI), congestive heart failure (CHF)
and valvular heart diseases4 put patients at increased risk of developing AF and AF
itself worsens the prognosis of patients with cardiovascular risk factors.4,5

“Very few people truly understand the real and significant impact of atrial fibrillation.”
Said Professor Günter Breithardt, from the WHF “There is an urgent need for better
information for patients. AF AWARE aims to expose the poor understanding of this
complex disease and to help healthcare professionals, patients, policy makers and the

General public understand that comprehensive management of AF should address its

multiple impacts.”

Results from an AF AWARE international survey of more than 1600 cardiologists and
patients in 11 countries, confirm that patients need a better understanding of AF, its
consequences and management options.

Despite the nature and risks of AF, [one in four] patients in this survey said he or she
did not understand and could not explain what AF is and [only a third] were worried or
fearful about having AF. Patients indiscriminately rated all risks of complications as high
and confirmed the significant impact of AF on their quality of life and ability to conduct
day to day activities.

Many patients in the survey preferred to receive information about AF from their
cardiologists and primary care practitioners than from any other source. However, the
majority of cardiologists ([61%]) in the survey said their patient’s needed more and
better information on AF: they rated the quality of patient education materials for AF as
inferior to that available for other common cardiovascular diseases, heart attack,
hypertension, high cholesterol, diabetes and stroke.

“AF patients need much better information about their disease and doctors can play a
central role in providing this help.” Said Professor Vardas, president-elect of EHRA.
“These results indicate that AF patients may feel resigned about living with this illness
and its complications. World Heart Rhythm Week and AF AWARE are opportunities for
us to come together to improve patients’ experience of living with AF through
awareness and education.”
For the clinicians, the survey also showed that AF is a challenging disease to manage,
placing increased strain on healthcare systems. Previous research has shown that AF

represents one third of hospitalizations for arrhythmia1 and that 70 percent of the
annual cost of AF management in Europe is driven by hospitalization care and
interventional procedures.6 In this survey, patients visited a doctor nearly nine times
([8.9 times]) a year for AF management. A key concern highlighted in this survey was
the average delay of [2.6] years between the onset of symptoms and diagnosis.

“These findings confirm the need for greater awareness and education about atrial
fibrillation. It is a common condition and growing public health concern, with serious

Consequences for patients and their families. Early identification and treatment of AF
could help to reduce the risk of serious cardiovascular complications associated with
this disease” said [insert local spokesperson from AF AWARE]. “In order to address the
full impact of the disease we call upon the medical profession and our peers to increase
awareness of the disease and improve patient education.”
Research methodology:

Title of the study: Patient satisfaction survey in BHIWADI.

Duration of the project: 6 weeks

Objective: To find out the cardiac and other chronic patient in particular area of
BHIWADI.

Type of Research: Descriptive

Sample size: The size of the sample is 300 but 54 of them are suffering from cardiac
and other chronic disease.

Method of selecting sample:

Primary Data: The survey method was used to gather the primary data for the study.
Based on the objectives of the study, the Standardized Questionnaires were distributed.
We are having open ended questionnaires as this type of questionnaires give a
concrete answer and based on the facts.
Sampling Design

In this project non-probability sampling is being used. Here the sampling involves the
selection of the sample based on factors other than random chance. The methods
being used is convenience sampling.
SAMPLE OF PATIENT SATISFACTION SURVEY REPORT:
NAME AGE SEX DISEASE RISK OTHER
FACTOR CHRONIC
AL
ILLNESS
Mr. SANJAY 38 M CARDIAC
GUPTA
Mr. AMIT 40 M CARDIAC HIGH B.P.
KAPOOR
Mr. 66 M CARDIAC HIGH B.P. DIABETES
D.C.SETH ,
ASTHAMA
Mrs. ASHA 60 F CARDIAC HIGH B.P.
SETH
Mrs. 36 F CARDIAC HIGH B.P.
CHARU
KAPOOR
Mr. VIVEK 36 M CARDIAC SMOKING
SHARMA
Mr. 38 M CARDIAC
PRDEEP
CHATURVE
DI
Mr. ASHISH 32 M CARDIAC SMOKING
GUPTA
Mr. UJLA 49 M CARDIAC HIGH B.P.
KATOCH
Mr. 52 M CARDIAC DIABETES
SURESH ,
AGARWAL SMOKING
Mr. 61 M CARDIAC HIGH B.P.,
SURESH HIGH
KUMAR LIPID
Mr. 49 M CARDIAC HIGH B.P.
VEERAT

Mr. U.B. 68 M CARDIAC HIGH B.P.,

PANT HIGH
LIPID
Mr. ROBIN 50 M CARDIAC DIABETES

Mr. 57 M CARDIAC
SUDESH
DOGRA
Mrs. 83 F CARDIAC
USHADEVI
SHARMA
Mrs. 57 F CARDIAC HIGH B.P.
V.LAKSHMI
SHARMA
Mr. 58 M CARDIAC SMOKING
COLONAL
K.K.
SHARMA
Mr. 39 M CARDIAC HIGH B.P.
SHARAD
JAIN
Mr. 54 M CARDIAC ASTHAMA
RAMESH
TOMAR
Mr. VIVEK 39 M CARDIAC SMOKING
GOYAL
Mrs. 37 F CARDIAC HIGH
VANDANA LIPID
SHARMA
Mr. 42 M CARDIAC HIGH B.P.
UMAKANT
SHARMA
Mr. PAWAN 42 M CARDIAC HIGH B.P.,
HIGH
LIPID
Mrs. 34 F CARDIAC HIGH B.P.,
KALPANA HIGH
SHARMA LIPID
Mrs. RENU 34 F CARDIAC
CHATURVE
DI

Mr. G. 48 M CAREDIAC SMOKING

PRAVEEN
KUMAR
Mr. 52 M CARDIAC
SANDEEP
RASTOGI
Mr. 41 M DIABETES
GAURAV
CHIOKAR
Mrs. 38 F CARDIAC
MANGLA
NAND JHA
Mr. 56 M DIABETES
SOMNATH
PANDEY
Mr. N.N. 49 M CARDIAC SMOKING,
KAUSHIK HIGH B.P.
Mr. P.R. 51 M CARDIAC HIGH B.P.,
VASHISHT HIGH
LIPID
Mr. 47 CARDIAC
M.K.DIXIT M
Mr. D.D. 54 CARDIAC HIGH B.P.
DUA M
Mr. G.S. 48 M CARDIAC
BAMRAH
Mr. Y.P. 39 M CARDIAC
VERMA
Mr. 58 M CARDIAC HIGH B.P.
SANJEEV
BHATIA
Mr. S.K. 47 M DIABETES HIGH B.P.
GUPTA
Mrs. 41 CARDIAC LOW B.P.
SEEMA F
Mr. VIVEK 53 M CARDIAC
PATHAK
Mr. M.K. 48 M DIABETES HIGH B.P.
AGARWAL
Mrs. 53 F CARDIAC DIABETES
SUNITA
Mr. H.K. 49 M DIABETES
GOYAL
Mr. RAJESH 38 M CARDIAC SMOKING
KUMAR
Mr. AMIT 56 M CARDIAC HIGH B.P.,
PANDEY SMOKING
Mr. SANJAY 45 M CARDIAC SMOKING
KATIYAR
Mr. 49 M DIABETES HIGH
MANISH LIPID
KUMAR
JAIN
Mrs. 57 F CARDIAC
VANDANA
SHRIVASTA
VA
Mr. 48 M CARDIAC SMOKING
PRASHANT
TIWARI
Mr. P.D. 51 M CARDIAC HIGH B.P.,
PAHUJA SMOKING
Mr. J.K. 58 M CARDIAC HIGH B.P. DIABETES
YADAV

ANALYSIS AND INTERPRETATION:

NUMBER OF PATIENT OF DIFFERENT AGE SUFFERING FROM

CARDIAC AND DIABETES:
FEMA CARDI DIABET
AGE MALE LE AC ES
31-40 9 5 12 2
41-50 15 1 14 2
51-60 12 4 15 1
61-70 3 0 3 0
71-80 0 1 1 0

INTERPRETATION: Here in this pie and bar graph it shows that the female of different
age in particular area suffering from cardiac and diabetes.
INTERPRETATION:

Here in this pie and bar graph it shows that the male of different age suffering from
cardiac and diabetes

INTERPRETATION: Here in this graph 43% are suffering from cardiac and 7% are
suffering from diabetes in the total population of age between 31-40yrs..

INTERPRETATION: Here in this graph 44% are suffering from cardiac and 6% are
suffering from diabetes in the total population of age between 41-50yrs.
INTERPRETATION:

Here in this graph 47% are suffering from cardiac and 3% are suffering from diabetes in
the total population of age between 51-60yrs.

INTERPRETATION: Here in this graph 50% are suffering from cardiac and 0% is
suffering from diabetes in the total population of age between 61-70yrs

INTERPRETATION:

Here in this graph 50% are suffering from cardiac and 0% is suffering from diabetes in
the total population of age between 71-80yrs

Total patient Male and Female suffering from cardiac and diabetes
INTERPRETATION: In this graph it shows different ages of persons suffering from
cardiac and diabetes.

Scope of study:
By the help of patient survey report we can easily find out the average of particular area
suffering from cardiac and other chronic disease, with this report we reduce the cardiac
problem of patients by proper diagnosing and treatment by various technology such as
“By-pass surgery, By pacemaker or by medicines prescribed by the cardiologist”

Limitation of study:
Unawareness of patients regarding to there health
Lack of knowledge
Unavailability of past data

Facts and findings:

• Depending upon my questionnaire I got that many person don’t know about the
risk factor of there disease and its symptoms.
• According my study I found that the patients who is in between the age of 60-80
yrs have less chance of curing from cardiac disease because of there weak
heart which can’t be operated or transplanted or by having By-pass surgery.
• By having survey is the best hedging instrument which reduce the heart attack of
person due to awareness of there disease and by treatment through best
cardiologist.

ANALYSIS:
By having survey I analyze that person suffering from cardiac disease is more in the
particular area in Bhiwadi in comparison to person suffering from Diabetes or other
chronic disease.
CONCLUSION:
Through my study I reached to the point that the Male cardiac patients are more in
comparison to female in that particular area of BHIWADI. Some of the persons of that
area are also suffering from other chronic disease which is less in comparison to
cardiac.

Recommendation and suggestion

Patient should be check up regularly in time to time by there cardiology doctor.
Medicine should be taken by the patients in prescribe time.
Proper healthy food should be taken by the patient

INTERPRETATION: In this graph it shows the patient of different age suffering from
cardiac disease in particular area in BHIWADI.
INTERPRETATION: In this graph it shows that patients suffering from cardiac as well
as his/ her Risk Factor and Other Chronic illness.
APPENDIX
 PATIENTS HEALTHY QUESTIONNAIRE:
DATE:

NAME:

AGE:

SEX:

ADDRESS: ………………………………………………………………………………………

……………………………………………………………………………………………………

……………………………………………………………………………………………………
…

MOBILE NO. .……………………………….

TELEPHONE NO…………………………..

RISK FACTOR (Tick those present)

Diabetes M, High BP, Family H/O, High Lipid, Smoking

Other Chronic Illness if any:

Medicines:

Family Dr’s name:

Survey by: Varun Kumar Referred by: Dr.S.K.Chugh

Biocon Ltd.
 BIBLIOGRAPHY:

1. www.google.co.in

2. www.scribd.com

3. www.biocon.com

4. Research methodology (Harper W. Boyd, C.R. Kothari)

5. Marketing research and report preparation by- N.K. MALHOTRA

6. http://www.henrystewart.com/conferences/january2005/N05655/
programme.html