PROJECT-1 “MARKET ANALYSIS & PERCEPTION ON PRE-PROBIOTICS”
PROJECT-2 “MARKET ANALYSIS & PERCEPTION ON
FERROUS ASCORBATE”

A PROJECT REPORT
Submitted By
GAYATRI .P. PAWAR
Roll No. 35
In Partial Fulfilment For The Award Of The Diploma
Of
PGDM
IN
PHARMACEUTICAL MANAGEMENT
PROJECT GUIDE: INTERNAL GUIDE :
MR .KAPIL.MUDLIAR MRS.SUMANA BOSE
(PRODUCT MANAGER) (FACULTY)
DUPEN LABORITIES PVT. SIESCOMS. S.I.E.S COLLEGE OF MANAGEMENT STUDIES
MAY 2010 - JUNE2010
DECLARATION

I hereby declare that the project work entitled
“MARKET ANALYSIS AND PERCEPTION ON PRE-PROBIOTICS” –PROJECT 1
MARKET ANALYSIS AND PERCEPTION ON LATEST HEMATINIC (FERROUS ASCORBATE+ FOLIC ACID)- PROJECT 2 submitted to SIES COLEGE OF MANAGEMENT STUDIES, NERUL NAVI MUMBAI is a record of an original work done by me under the guidance of Mrs.SUMANA BOSE, Faculty Member,and Dr. Suhas Tambe ,HOD. this project work has not performed the basis for the award of any Degree or diploma/ associate ship/fellowship and similar project if any.

GAYATRI PAWAR

ABSTRACT

The main goal of the report was to investigate about the PRE-PROBIOTICS molecule, its market perception, prescription pattern and the most prescribed and selling brands in Navi Mumbai. This report begins by examining the current prescription rates of Pre-Probiotics in areas from Thane to Turbhe. There is an in-depth survey of statistics which reveals the fact that the Pre-probiotics are prescribed frequently by physicians and is the need of the changing lifestyle of people. The next part of the report talks about different brands, cost and the top selling brands..

In order to determine the extent of awareness on the use of Probiotics among qualified medical practitioners in Navi-Mumbai, a survey was carried out. The survey involved the use of close-ended and open-ended structured questionnaires and 80randomly sampled medical practitioners and 50 retailers. The survey asked about current knowledge on the subject, and provided information to gauge the potential receptivity to using or recommending Pre-Probiotics in patient care.75 medical practitioners responded.

A reasonable proportion of physicians in Navi-Mumbai are familiar with the use of Pre-Probiotics and some have clearly been involved in its prescription for some time. However, I hypothesized that medical practitioners in areas of Ghansoli and turbhe are yet to grasp the concept of using Pre-Probiotics either as health promoting foods or as Bio therapeutic agents for the treatment of diarrhea or urogenital infections. Nevertheless, 76% were in favor of Probiotics and stated they would approve it for health maintenance. The results of the open-ended questionnaire that asked the participants to freely write down any fear, questions and concerns they may have on Probiotics revealed less critical issues that verge on lack of adequate knowledge on the subject. 5% of the participants raised some concerns
.
Ultimately the conclusion of the report is that, Pre-Probiotics is highly effective and generally safe. It substantially maintains the intestinal flora and further improves digestion

ACKNOWLEDGEMENT
Working on this project gave me an insight into the nature and characteristics of doctor a unique customer that sets the pharmaceutical industry apart from the other industries. Needless to say, the project did give me an exposure to this industry, particularly in the field of project management and market research.
I would like to express my gratitude to DUPEN LABORATORIES who gave me the opportunity to complete my summer training.
I would like to thank, Mr. Kapil Mudliar, Product Manager Marketing, who gave me the opportunity to commence the project and had assigned me the project guide.
I would like to extend my gratitude to my project guide Ms.Sanjivni Patil.PMT whose constant vigilance and support have enabled me to successfully complete my project.
I am deeply indebted to my supervisor Dr.Suhas Tambe, HOD and Mrs. SUMANA BOSE, Faculty member also Mrs. ALKA PUROHIT , Placement co-ordinator from SIESCOMS whose help, stimulating suggestions and encouragement helped me throughout the research and in writing of this report.
Especially, I would like to give my special thanks to all the doctors and chemists for giving valuable inputs and allowing me to do a part of the project survey in their clinic
Gratitude to all those who helped me to complete this report.

TABLE OF CONTENTS
LIST OF TABLES SR.NO | PARTICULARS | PAGE No. | 1 | Segmentation of doctors for Pre-probiotics | 20 | 2 | Indications by doctors for Pre-probiotics | 22 | 3 | Available brands of Pre-probiotics | 25 | 4 | Available brands of Ferrous ascorbate+Folic acid combination | 48 | 5 | Segmentation of doctors for Ferrous ascorbate+Folic acid combination | 51 |

LIST OF ILLUSTRATIONS SR.NO | PARTICULARS | PAGE No. | a | No of doctors-proj-1 | 20 | b | Prescription rate for Pre-probiotics | 21 | c | No of doctors prescribing Pre-probiotics | 21 | d | Indications for Pre-probiotics | 23 | e | Brands preferred for Pre-probiotics | 24 | f | Combination preferred for Pre-probiotics | 27 | g | Dosage form and gender for Pre-probiotics | 28 | h | Age | 29 | I | age | 29 | J | Dosage for Pre-probiotics | 30 | K | Source of information for Pre-probiotics | 31 | L | Information required by doctors for Pre-probiotics | 32 | m | Side effects rates for Pre-probiotics | 33 | n | Top selling brands by retailersfor Pre-probiotics | 34 | o | Non prescription analysis of retailers | 35 | p | Source of information to the retailers for Pre-probiotics | 36 | q | Prescription rate for ferrous ascorbate=folic acid | 52 | r | Indication by doctors for ferrous ascorbate=folic acid | 53 | s | Brand preference by doctors for ferrous ascorbate=folic acid | 54 | t | Combination preference by doctors for ferrous ascorbate=folic acid | 55 | u | Side- effects analysis by doctors for ferrous ascorbate=folic acid | 56 | v | Dosage form and gender analysis among doctors for ferrous ascorbate=folic acid | 57 | w | Dosage form and gender analysis among doctors for ferrous ascorbate=folic acid | 57 | x | Period of therapy for ferrous ascorbate=folic acid | 58 | y | Information required for ferrous ascorbate=folic acid | 59 | z | Top selling brands among retailers for ferrous ascorbate=folic acid | 60 | zi | Source of information required by retailer for ferrous | 61 |
LIST OF CHAPTERS: PROJECT-1 S.NO | PARTICULARS | PAGE NO. | 1. | INTRODUCTION | | | 1.1 | ORGANISATION PROFILE | 1 | | 1.2 | MARKET ANALYSIS | 3 | | 1.3 | OBJECTIVE | 4 | | 1.4 | SCOPE | 4 | | 1.5 | LIMITATION | 4 | | 2. | MOLECULE PROFILE | | | 2.1 | PROBIOTICS | 5 | | 2.2 | PREBIOTICS & SYNBIOTICS | 7 | | 2.3 | MECHANISM OF ACTION | 9 | | 2.4 | CLINICAL APPLICATIONS | 10 | | 2.5 | SAFETY | 14 | | 2.6 | DOSAGE | 14 | | 2.7 | PRESENTATION | 14 | | 2.8 | FACTS ABOUT PROBIOTICS | 15 | | 3. | CONCEPTUAL FRAMEWORK | 16 | 4. | RESEARCH DESIGN & METHODOLOGY | 18 | 5. | RESEARCH FINDINGS | | | 5.1 | DOCTORS SURVEY | 20 | | 5.2 | RETAILERS SURVEY | 34 | | 6. | RECOMMENDATION | 37 | 7 | LIMITATIONS | 38 | 8 | CONCLUSION | 39 | 9 | BIBILOGRAPHY | 40 |

PROJECT - 2 S.NO | PARTICULARS | PAGE NO. | 1. | INTRODUCTION | | | 1.1 | MOLECULE PROFILE | 45 | | 1.2 | INDICATIONS & CLINICAL USE | 46 | | 1.3 | MARKET ANALYSIS | 48 | | 1.4 | OBJECTIVE | 49 | | 1.5 | SCOPE | 49 | | 1.6 | LIMITATION | 49 | | 2. | RESEARCH DESIGN & METHODOLOGY | 50 | | 3 | RESEARCH FINDINGS | | | 3.1 | DOCTORS SURVEY | 51 | | 3.2 | RETAILERS SURVEY | 60 | | 4. | RECOMMENDATION | 62 | 5. | LIMITATIONS | 63 | 6. | CONCLUSION | 64 | 7 | BIBLIOGRAPHY | 65 |

APPENDIX Annexure-1 | QUESTIONNAIRE FOR PROJECT-1 | 41-42 | Annexure-2 | QUESTIONNAIRE FOR PROJECT-2 | 66-67 |

1. INTRODUCTION

1.1 ORGANISATION PROFILE Dupen Laboratories was established in 1976 to manufacture pharmaceutical products. The company specialize in production of myriad formulations in tablet, capsule and oral liquid forms. They are a SSI unit catering to the needs of well-known multi-national companies. They have two manufacturing plants, in Vapi and Silvassa, that are easily accessible from Mumbai. Both these plants are in a well-developed industrial area with all the infra-structural facilities that are required. Dupen Laboratories, is experienced in the production of quality pharmaceutical products and trust meeting the manufacturing needs of national and multinational pharmaceutical companies. | Using their knowledge and experience they have branched into the niche market of oral health care and now manufacture and market their own brand of dental care products. This is a rapidly expanding market and they feel that they can contribute to providing good dental care to our customers. Currently, they produce alcohol-free mouthwash, mouth ulcer gel, gel for bad breath and a tooth gel for hypersensitive teeth. They are soon going to add many more new products to this range.Their people are their key strength. People with experience, who respond quickly to innovation in the industry, stay ahead of the competition. They are continually trained and kept abreast on the current practice in technology, GMP, and quality assurance. | | | | Dupen laboratories, have the expertise in manufacturing quality pharmaceuticals for almost 3 decades.. The reputed companies outsource their products for toll manufacturing on basis of transfer price or loan license terms. They have been praised for | their efficiency and timely delivery of finished goods. And are confident of their ability to provide quality manufacturing services to their clients. |
Products:
Generic Formulations:
Antibiotics/ Antibacterials: Antiulcerants/Antacids: 1. Co – Trimozol S. S. 1. Dumotin - 20 2. Co – Trimozol D. S. 2. Dumotin - 40 3. Duprox – 250 3. Duprox - TZ 4. Duprox – 500 4. Duflox - TZ 5. Duflox – 100 5. Cyclora 6. Duflox – 200 6. Orol 7. Duflox – OZ 8. M’pclox 9. Moxycol
Dermatology: Anti – Inflammatory: 1. Derma’Q 1. Ibutrex 2. Sisul 2. Dilora 3. V’ Soft 3. Dilin Gel 4. Nepozin

* Freshora Oral Care Range: Cuticura Skin Care: 1. Senso Freshora 1. Adhibit 2. FB Freshora 2. Calene 3. Mouthwash Freshora 3. Mumet 4. Mugel Freshora 4. Mutop 5. SensoRinse 5. Dango 6. Gumpen 6. ZicBic 7. Eveday 7. Piglow 8. CNBC 8. Scarnish 9. Paintol 9. Dulimus 10. B- Mine 10. Dulimus Forte

* NewAge Care: 1. MetaPower Capsules 2. MetaPower Suspensions 3. Q- NXT Softgel 60mg & 120 mg

1.2 MARKET ANALYSIS
The term probiotic means "for life" and it is currently used to name bacteria associated with beneficial effects for humans and animals. They are nutritional supplements and when ingested in sufficient amount confer bacterial health effects.
The global probiotics market is estimated to grow at a CAGR of around 13% from 2009-2014 and Europe and Asia would be occupying the maximum market share by the end of 2014. The US Probiotics market is undeveloped, but in near future anticipated to provide a good opportunity for the growth of Probiotics market.
Synbiotic market was $15 Billion in 2008 , a 13% increase over 2007. Annual growth of 22.6% until 2015 in India is expected

Aging population, rising cases of gastrointestinal disease and rising consumer consciousness for health-related issues is driving the growth of the Probiotics market. Probiotics claim to improve the immune system of the body which becomes another important driver for the growth of the probiotics market.

1.3 OBJECTIVE: The objective of the survey was to understand the market perception about Pre-probiotics from the doctors and retailers. * To study the market potential of Pre-probiotics. * To know the preference of doctors towards the combination of pre-probiotics. * To analyse the leading brands in Pre-probiotics. * To observe the frequently observed indications treated by pre-probiotics

1.4 SCOPE :
The scope of the survey is limited to the areas of Navi Mumbai (Thane to Turbhe)

1.5 LIMITATION:
The sample size chosen may not be enough to give a true representation of the total population

2 .MOLECULE PROFILE

2.1 PROBIOTICS
The usefulness of Probiotics as a treatment option has not been The buzz surrounding probiotics has become a roar.1 Probiotics (healthful bacteria), Prebiotics (that provide food for probiotics) and Synbiotics (the combination of Prebiotics and Probiotics) are hot areas in research, clinical practice and the commercial global marketplace.

Probiotics are live microbes that can be formulated into many different types of products, including foods, drugs, and dietary supplements. Species of Lactobacillus and Bifidobacterium are most commonly used as Probiotics, but the yeast Saccharomyces cerevisiae and some E. coli and Bacillus species are also used as Probiotics. Lactic acid bacteria, including Lactobacillus species, which have been used for preservation of food by fermentation for thousands of years, can serve a dual function by acting as agents for food fermentation and, in addition, potentially imparting health benefits. Strictly speaking, however, the term “Probiotic” should be reserved for live microbes that have been shown in controlled human studies to impart a health benefit. Fermentation of food provides characteristic taste profiles and lowers the pH, which prevents contamination by potential pathogens. Fermentation is globally applied in the preservation of a range of raw agricultural materials (cereals, roots, tubers, fruit and vegetables, milk, meat, fish etc.).
In addition to lactic acid, many Probiotic strains also produce hydrogen peroxide as lactoperoxidase. They are also capable of producing acetic acids, lipopolysaccharides, peptidoglycans, superantigens, heat shock proteins and bacterial DNA-all in precise proportion to nourish each other, inhibit challengers and/or benefit the host.
These types of antimicrobial tools also give Probiotics the ability to counter the mighty H. pylori bacterium, which is known to be at the root of a majority of ulcers. In fact, H. pylori inhibition has been observed in studies on L. acidophilus DDS-1, L. rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii and Bifidobacterium

Colony Forming Units in Probiotics:
As per Probiotics definition the live microorganisms that are administered have to be in adequate amounts to confer a health benefit to the host. Clinical bodies have used Probiotic levels of above 1 billion to 10 billion or above. According to Earl Mindell, an internationally recognized expert on nutrition, healthy persons should take 2 to 5 billion Colony Forming Units (CFUs) of Probiotics a day and those with GI conditions can take up to 10 billion CFUs per day. In acute Diarrhea, lactobacillus is most effective at the dose of 10 billion CFUs per day. For prescription Probiotics, the current daily intake recommended by the Natural Health Products Directorate of Canada is 5-10 billion CFUs per day. The Ideal Properties of Probiotics : * nonpathogenic * genetically stable * resistant to acid * capable of survival, proliferation and metabolic activity at the target site * high stability * viability at high populations * antagonistic towards pathogenic bacteria * resistant to bile * immunostimulator * able to exert clinically documented health benefits.

2.2 PREBIOTICS AND SYNBIOTICS

Prebiotics are dietary substances (mostly consisting of nonstarch polysaccharides and oligosaccharides poorly digested by human enzymes) that nurture a selected group of microorganisms living in the gut. They favor the growth of beneficial bacteria over that of harmful ones.
Unlike probiotics, most prebiotics are used as food ingredients—in biscuits, cereals, chocolate, spreads, and dairy products, for example. Commonly known prebiotics are: * Oligofructose * Inulin * Galacto-oligosaccharides * Lactulose * Breast milk oligosaccharides

Lactulose is a synthetic disaccharide used as a drug for the treatment of constipation and hepatic encephalopathy. The prebiotic oligofructose is found naturally in many foods, such as wheat, onions, bananas, honey, garlic, and leeks. Oligofructose can also be isolated from chicory root or synthesized enzymatically from sucrose.
Fermentation of oligofructose in the colon results in a large number of physiologic effects, including: * Increasing the numbers of bifidobacteria in the colon * Increasing calcium absorption * Increasing fecal weight * Shortening gastrointestinal transit time * Possibly, lowering blood lipid levels

The increase in colonic bifidobacteria has been assumed to benefit human health by producing compounds to inhibit potential pathogens, by reducing blood ammonia levels, and by producing vitamins and digestive enzymes.

The Ideal Properties of Prebiotics : * should be a non-digestible food ingredient * should be principally an oligosaccharide * neither be hydrolysed nor be absorbed in the upper part of the GI tract * should reduce the gut pH * should promote the growth and activity of probiotics * beneficially affects the host health * must be selectively fermented so that it is able to alter the colonic microflora towards a healthier composition e.g. by increasing number of saccharolytic species & reducing putrefactive microorganisms * improves conditions associated with both constipation and diarrhea. * should be principally an oligosaccharide

2.22 SYNBIOTICS refer to nutritional supplements combining probiotics and prebiotics in a form of synergism, hence synbiotics. Probiotics are not stimulated by prebiotics, which would mean symbiosis. As probiotics are mainly active in the small intestine and prebiotics are only effective in the large intestine, the combination of the two may give a synergistic effect The Ideal Properties of Synbiotics : * should be an ideal combination of probiotics with prebiotics * should exhibit synergistic relationship between viable beneficial bacteria and their selective substrate. * prebiotic compound should selectively favors the probiotic compound e.g. FOS in combination with probiotics such as B. infantis, B. longum etc. * should produce additive or synergistic effect.

2.3 MECHANISMS OF ACTION

Prebiotics affect intestinal bacteria by increasing the numbers of beneficial anaerobic bacteria and decreasing the population of potentially pathogenic microorganisms (Fig. 3). Probiotics affect the intestinal ecosystem by stimulating mucosal immune mechanisms and by stimulating nonimmune mechanisms through antagonism/competition with potential pathogens These phenomena are thought to mediate most beneficial effects, including reduction of the incidence and severity of diarrhea, which is one of the most widely recognized uses for probiotics. Probiotics reduce the risk of colon cancer in animal models, probably due to their role in suppressing the activity of certain bacterial enzymes that may increase the levels of procarcinogens, but this has not been proven in humans. Well-designed, randomized clinical studies are still required in order to define the role of probiotics as therapeutic agents in inflammatory bowel disease
Alleged health effects of probiotics
Intestinal effects Relieve effects, promote recovery from diarrhea
(rotavirus, travelers’ and antibiotic-induced) Produce lactase, alleviate symptoms of lactose intolerance and malabsorption Relieve constipation Treat colitis
Immune system effects Enhance specific and nonspecific immune response Inhibit pathogen growth and translocation Stimulate gastrointestinal immunity Reduce chance of infection from common pathogens (Salmonella, Shigella)
Other effects Reduce risk of certain cancers (colon, bladder) Detoxify carcinogens Suppress tumors Lower serum cholesterol concentrations Reduce blood pressure in hypertensives Treat food allergies Synthesize nutrients (folic acid, niacin, riboflavin, vitamins B6 & B12) Increase nutrient bioavailability Improve urogenital health Optimize effects of vaccines (e.g. rotavirus vaccine, typhoid fever vaccine)
2.4 CLINICAL APPLICATIONS
Colon cancer
The SYNCAN study tested the effect of oligofructose plus two probiotic strains in patients at risk of developing colonic cancer. The results of the study suggest that a synbiotic preparation can decrease the expression of biomarkers for colorectal cancer.

Diarrhea
Treatment of acute diarrhea:
It has been confirmed that different probiotic strains (see Table 8), including L. reuteri ATCC 55730, L. rhamnosus GG, L. casei DN-114 001, and Saccharomyces cerevisiae (boulardii) are useful in reducing the severity and duration of acute infectious diarrhea in children. The oral administration of probiotics shortens the duration of acute diarrheal illness in children by approximately 1 day.

Antibiotic-associated diarrhea: (AAD)
In antibiotic-associated diarrhea, there is strong evidence of efficacy for S. boulardii or L. rhamnosus GG in adults or children who are receiving antibiotic therapy. Recent research has indicated that L. casei DN-114 001 is effective in hospitalized adult patients for preventing antibiotic-associated diarrhea and C. difficile diarrhea.

Radiation-induced diarrhea:
There is inadequate research evidence to be certain that VSL#3 (Lactobacillus casei, L. plantarum, L. acidophilus, L. delbrueckii, Bifidobacterium longum, B. breve, B. infantis, and Streptococcus thermophilus) is effective in the treatment of radiation-induced diarrhea.

Eradication of Helicobacter pylori
Several lactobacilli and bifidobacterial strains, as well as Bacillus clausii, appear to reduce the side effects of antibiotic therapies and improve patient compliance. Several strains were effective in decreasing side effects, but did not have effects on the eradication rate. A recent meta-analysis of 14 randomized trials suggests that supplementation of anti–H. pylori antibiotic regimens with certain probiotics may also be effective in increasing eradication rates and may be considered helpful for patients with eradication failure. There is currently insufficient evidence to support the concept that a probiotic alone, without concomitant antibiotic therapy, would be effective. In summary, there is literature suggesting that certain probiotics may be helpful as adjuvant therapy with antibiotics in the eradication of H. pylori infection.

Allergy
The strongest evidence is for the prevention of atopic dermatitis when certain probiotics are administered to pregnant mothers and newborns up to 6 months of age. However, a recent clinical trial did not confirm these results. With regard to the treatment of allergic disease, a few well-designed studies have provided evidence that specific probiotic strains can be effective in the treatment of a subset of patients with atopic eczema. Little is known about the efficacy of probiotics in preventing food allergy.

Hepatic encephalopathy
Prebiotics such as lactulose are commonly used for the prevention and treatment of this complication of cirrhosis. Minimal hepatic encephalopathy was reversed in 50% of patients treated with a synbiotic preparation (four probiotic strains and four fermentable fibers, including inulin and resistant starch) for 30 days.

Immune response
There is suggestive evidence that several probiotic strains and the prebiotic oligofructose are useful in boosting the immune response. Indirect evidence has been obtained in studies aimed at preventing acute infectious disease (nosocomial diarrhea in children, influenza episodes in winter) and studies that tested antibody responses to vaccines.

Inflammatory bowel disease (IBD)
Pouchitis:
There is good evidence for the usefulness of probiotics in preventing an initial attack of pouchitis (VSL#3), and in preventing further relapse of pouchitis after the induction of remission with antibiotics. Probiotics can be recommended to patients with pouchitis of mild activity, or as maintenance therapy for those in remission.

Ulcerative colitis:
The probiotic E. coli Nissle strain may be equivalent to mesalazine in maintaining remission of ulcerative colitis. There is inadequate research evidence to be certain that other probiotic preparations are effective in ulcerative colitis.

Crohn’s disease:
Studies of probiotics in Crohn’s disease have been disappointing, and a recent Cochrane systematic review concluded that there is no evidence to suggest that probiotics are beneficial for maintenance of remission in Crohn’s disease.

Irritable bowel syndrome (IBS)
Several studies have demonstrated significant therapeutic gains with probiotics in comparison with placebo. A reduction in abdominal bloating and flatulence as a result of probiotic treatments is a consistent finding in published studies; some strains may ameliorate pain and provide global relief (B. infantis 35624) in addition. Lactobacillus reuteri may improve colicky symptoms within one week of treatment, as shown in a recent trial with 90 breastfed babies with infantile colic. In summary, there is literature suggesting that certain probiotics may improve the principal symptoms in persons with IBS.

Lactose malabsorption
Streptococcus thermophilus and Lactobacillus delbrueckii subsp. bulgaricus improve lactose digestion and reduce symptoms related to lactose intolerance

Necrotizing enterocolitis
Clinical trials have shown that probiotic supplementation reduces the risk of necrotizing enterocolitis in preterm neonates of less than 33 weeks’ gestation. A systematic review of randomized controlled trials also indicated a reduced risk of death in probiotic treated groups. In summary, there is strong support for the use of certain probiotic strains in preterm infants.

2.5SAFETY
A review outlining the safety of current probiotic compounds has been published. Probiotic have achieved a ‘ generally regarded as safe’ (GRAS) status. Rare reports of infection such as fungemia and bacteremia in immunocompromised patients.Pregnant women and nursing mothers should use probiotic supplements only if recommended by their physicians.

2.6 DOSAGE
Healthy person should take 2-5 billion CFUs (colony stimulating units) of probiotics a day and those with GI conditions can take up to 10 billion CFUs per day. In acute infectious diarrhea, lactobacillus is most effective at a dose of 10 billion CFUs during the first 48 hours, which translates to 5 billion CFUs per day. For prescription probiotics, the current daily intake recommended by the Natural Health Products directorate (NHPD) of Canada is 5-10 billion CFU’S per day.

2.7PRESENTATION:
Capsules and Sachets of Probiotc + Prebiotic combination(Pro-wel) and Probiotic alone (Darolac) are commercially available.
Benefits offered by Probiotic & Prebiotic Combination Formula are :- * Maximum Colony Forming Units (CFUs) :- ensure complete action. * Fructooligosaccharide (FOS):- offers nutrition to the probiotics & normal intestinal flora. * Acid – resistant cells :- reach intestine in full force. * Freezed-dried & nitrogen-flushed cells :- offers excellent stability. * Vegetable capsules :- ensure universal appeal.

2.8 FACTS ABOUT PROBIOTICS * Most probiotic supplements are destroyed in the stomach-99% of unprotected probiotics are destroyed when exposed to stomach acid for 60 minutes, that average time food spends in the stomach.

* Many probiotics require special Scare or they can be destroyed. High temperatures, high oxygen levels moisture and direct light can destroy them

* Shelf life. Probiotics do not have a long shelf life in their active form. In most cases refrigeration is required to maintain the shelf life.

* Prebiotics are needed as nourishment for the probiotic bacteria so they can survive, grow and colonize the bowels. A good probiotic formula would include Fructo-oligosaccharides or FOS as a prebiotic. FOS's pass safely through the stomach and small intestine and act to stimulate the growth of probiotic's and bifidobacteria in the large intestine by fermenting and creating ideal conditions for microflora colonization

* Yeast is a big problem in modern culture due to the processed foods we consume daily. Probiotic's do an effective job of cleaning up excess yeast growth. Having yeast cell wall destroying enzymes included in a probiotic is also an added bonus.

3 CONCEPTUAL FRAMEWORK
A perception study is a survey, or series of surveys, that assesses the market’s opinions of a target company’s: * Service performance * Brand image * Competitive positioning * Degree to which it is meeting customers’ needs
The survey is typically a combination of: * A standardized “quantitative” survey * “Qualitative” one-on-one interviews (by telephone or in person)
Additionally, it may be preceded by a series of focus groups and ideally conducted on either a regular or periodic basis.
Benefits
A standardized questionnaire provides: * Reduced costs * Faster time to prepare the survey for distribution * A comparison of the market’s perceptions of a firm's clients to industry norms
A correlation analysis: * Provides the ability to identify the perceptions that most relate to competitive superiority and positive word of mouth * Is less biased and more predictive than asking “importance” of various items * Reduces questionnaire length, increasing participation rates
A perception study provides: * Reduced costs of sales by improving the likelihood of repeat business * An understanding of what aspects of the relationship/service are most important to the client’s decision to hire a general contractor

* An understanding of how well the firm is performing on the aspects of importance to the client * A foundation for developing process improvements designed to improve performance on selected aspects of their service * Baselines of performance against which follow-up surveys can track improvements and changes in service delivery * A competitive advantage for securing and maintaining customers

4. RESEARCH DESIGN

4.1 approach towards the project

Before going into the details of the methodology it is important to understand the overall approach. The project went through several stages where each stage has some process to be undertaken and had a defined deliverable.

STAGE-1 Understanding the need & objective of the study.

STAGE-2 Developing the Research Design & applying the research methodology, which includes the mode of data collection (questionnaires).

STAGE-3 Data analysis and submitting the report.

4.2 Methodology 4.12 Type of research: Exploratory 4.13 Type of data: Primary data & Secondary data

4.3 Data collection method: Data is collected through structured questionnaire. For this project I have used primary data which was collected through the use of structured QUESTIONNAIRE. The questionnaire contained both open ended as well as close ended questions and also verbally questions were asked to the respondent when need arise during the survey. The data was collected the data personally by getting questionnaire filled up from chosen doctors and retailers,
Secondary data was also used , which were collected through
a) Internet
b) Management books

4.4 Sampling: Non-Probability convenience sampling. 4.5 Sample size: 50 Retailers & 75 Doctors. 4.6 Sampling unit: General Physicians, Dentists, ENT & Gynaecologists. 4.7 Data analysis technique: Quantitative

5. RESEARCH FINDINGS
Survey and its Interpretation:
The no. of sample respondents were 75 Doctors, & 50 Retailers in the areas of Navi-Mumbai from Thane to Turbhe

5.1 DOCTOR’S SURVEY:

SEGMENTATION | No.OF DOCTORS | GENERAL PHYSICIANS | 44 | DENTISTS | 15 | ENT | 4 | PAEDIATRICIAN | 2 | GASTROENTEROLOGIST | 2 | GYNAECOLOGISTS | 8 | TOTAL | 75 |
1

Figure [ 1 ] a

* Doctor, do you prescribe Prebiotics and probiotics? b c

INTERPRETATION: 76% of the doctors were aware about pre-probiotics and were frequently prescribing pre-probiotics. The awareness about the pre-probiotics is good among the doctors.100% of the GP’s covered were prescribing Pre-probiotics. The Dentists and the Gynaecs were rarely prescribing as the awareness among them is less and needs to be improved.

* In which indications do u prescribe prebiotics/probiotics?

INDICATIONS DOCTORS | IBS | IBD | DIARRHOEA | AAD | POST-OPERATIVE CONDITION | STOMATITIS | GP’S | * | * | * | * | | * | DENTISTS | | | | | * | * | ENT | | | | * | * | * | GYNAECS | | | | * | * | | GASTRO | * | * | * | * | * | * | PAEDIATRICIAN | | | * | * | | | 2

d INTERPRETATION: As per the survey, 36 GP’s prescribed pre-probiotics for treating diarrhea, 14 for IBS,38 for treating AAD , 2 for treating IBD. Dentists and ENT preferred antibiotics to treat stomatitis (5)and in post-operative conditions(8). Also in some cases for the treatment of AAD(7). Gynaecs prescribed pre-probiotics rarely only in post-operative conditions and depending on the dose of antibiotics, to treat AAD
Gastroenterologists gave an in depth feedback on pre-probiotics. The information given by these doctors was very much fruitful and gave more knowledge about the indications on which pre-probiotics can be given. According to Gastroenterologists, pre-probiotics are given in many indications like IBS, IBD, Traveller’s diarrhea, diverticular disease, gastroenteritis, Stomatitis, AAD, lactose intolerance, and colon cancer

Paediatrician prescribed pre-probiotics for treating diarrhea and AAD.

* Which brands do you prescribe?Why?

e

BRANDS AVAILABLE Sr. No. | BRANDS | COMPANY | PRICE (In Rs.) | Content | 1. | Vibact | USV Ltd. | Plain - 78.15 DS- 139 | 10 Caps 10 Caps | 2. | Vizylac | Unichem | 16.70 | 10 Caps | 3. | Bifilac | Tablets India Ltd. | 132.60 78.45 | Sachets ( 5*3 ) 10 Caps | 4. | Becelac | Dr. Reddy’s lab | | | 5. | Ecoflora | Tablets India Ltd. | | | 6. | Neutrolin B | Okasa Pharma Pvt . Ltd | 18.94 11.43 | 1 Bottle 10 Cap | 7. | Flora BC. | Mankind | 24 16.50 | 1 Bottle 10 Cap |
3

INTERPRETATION:
In the competitive analysis it was found that the most prescribed brands were Vibact Flora BC, NeutrolinB. The prime reasons for these brands running more successfully was that Vibact and Vibact DS was admired for their good reputation and efficacy. This brand is well reputed and contains efficient quantum of required pre-probiotic species.
Flora BC of Mankind was the most prescribed brand in areas of Ghansoli to turbhe since it is very economical as compared to other brands. Mankind has its prime focus on rural areas. It is very much affordable and easily available.
Neutrolin B was mostly prescribed by Dentists and gynaecologists since it contains multivitamins in addition to lactobacillus species.
Thus it was found that Vibact was top selling brand since it was well promoted and the name was easily recalled by the doctors.
Each doctor prescribes more than 1 brand. May be they trust more than 1 brand or according to the conditions of the patients and the contents offered by the product varied their response

* Do you always prescribe in combinations?

f

INTERPRETATION
According to the survey, 67% of the doctors preferred combination of prebiotics and probiotics over individual molecule because of greater efficacy and supportive treatment. As probiotics are mainly active in the small intestine and prebiotics are only effective in the large intestine, the combination of the two may give a synergistic effect.
Some doctors says that they prefer prescribe it after antibiotic therapy as antibiotics kill the microbes and pre-probiotic flourish the intestinal microbial flora so they do not recommend antibiotic along with pre-probiotic as they think that antibiotic would inhibits its action. They prefer co-prescribe pre-probiotic along with other drug treatment after antibiotic therapy

* Doctor consideration of dosage form,age and gender g h

i INTERPRETATION * For age 1 to 12 yrs- Out of 75 doctors, 53% prefer giving sachets, 45%prefer giving syrups, and 2% do not prefer to prescribe it. * For age 12 to 55 yrs- 35% doctors prefer capsules, 33% prefer sachets , 22% prefer tablet and 10% prefer sother dosage form. * For age 55 yrs and above- 53% doctors prefer prescribing capsules, 8% prefer syrups, 39% prefer tablets .
Children are the one, who mostly gets diarrhea due some infections, so doctors mostly prefer giving either sachets or syrup, so that it would be easy to swallow. It also gives instant relief due to better bioavailability. Adult or geriatric patient of age above 55, for them it is easy to swallow the tablet form of the drug so for doctors mostly prescribe either capsule or syrup.

* Which dosage forms do you prescribe?

j

INTERPRETATION: Majority of the doctors preferred BID for better efficacy.
Prescription of the pre-probiotic drugs is mostly seen depending on the severity of the condition of the patient. It varies patient to patient according to the doctors.

* Sources of information for pre/probiotic product k
INTERPRETATION
Most of the doctors gets to know about the brands available in the market through Medical Representative of the respective company. Very few doctors find knowledge about the pre-probiotic combination in any of the medical books. They mostly come to know through Med. Reps or the Internet.

* Do you need more information on prebiotics/probiotics?

l

INTERPRETATION The results showed that 85.2% of the respondents were familiar with the term pre-probiotics, and 76% indicated that they would like more information on the subject. There is need for more promotion and better awareness on Pre-probiotics.
The dentists are not much aware of this term and hence need to be made aware as they also majorly prescribe pre-probiotics. Doctors raised issues on lack of availability of information about the subject.

* According to you. What measures should be taken to improve awareness?

INTERPRETATION: To access such data, 64.5% preferred medical textbooks, while only 27.4% indicated peer reviewed medical journals. Nevertheless, 76% were in favor of probiotics and stated they would approve it for health maintenance.

* Are there any side effects of consuming prebiotics/probiotics? m

INTERPRETATION Up to 11% of the participants raised some concerns bordering on the safety and receptivity of Probiotics products among the prospective users. 89% of the respondents said that pre-probiotics are usually safe and well tolerated. Few raised some concerns related to its side-effects like constipation and hypersensitivity.

5.2 RETAILER’S SURVEY
SAMPLE SIZE:50 * Can you tell me the top brands for prebiotics+probiotics combination? n
INTERPRETATION:
According to the survey, the top 3 brands of PREBIOTICS-PROBIOTICS combination are: 1st VIBACT- USV 2nd FLORA BC Mankind 3rd NEUTROLIN B Okasa Pharma Pvt . Ltd

* What is the monthly sales for prebiotics-probiotics combination?
INTERPRETATION: Average sales is 10-15 strips per month

* Which category of doctors prescribe prebiotics-probiotics combination?

INTERPRETATION: * Gynaecologists(Rarely) * General Practioner

* Are pre-probiotics given OTC? o INTERPRETATION Only few consumers purchase pre-probiotic on non prescription basis as they may have prescribed previously with the pre-probiotic by their doctor

* Sources of information for pre/probiotic product

p

INTERPRETATION- 47 chemist gets aware about the brands available in the market through medical representatives. And 41 chemists get aware from the doctor’s prescription because med. Reps. of the respective company promote their brands to the doctor and doctor in return if find competent and effective enough, they prescribe them.

6.RECOMMENDATIONS

* Introduce proven products at an affordable price; * Use various educational tools, including peer reviewed publications, media, seminars, university courses * Introduce the concepts and explain advantages and limitations of these products * Generate awareness among the doctors of rural areas and most preferably among the dentists. * Taste of the sachets for children consumption should be improved * Aggressive marketing through field force is a must. * The concepts and the various indications in which Pre-probiotics can be used should be conveyed efficiently to the doctors. * New efficient species of bacteria other than the existing ones can be tried out.

7.LIMITATIONS * The interviwer bias was a major limitation in the research. There could have been difference between the information generated and the information interpretated by the respondents. * The research was carried out in parts of Navi-Mumbai. The primary data collected may not be a representative of other geographical areas. * Sample size of 75 may not reflect the same results of actual size. * Some doctors had the policy of not to entertain such surveys, so their opinions could not be known

8.CONCLUSION The advent of probiotics and the discovery that they colonise the human GI tract has thrown light on another symbiotic, man and his gut flora. With research underway there has been tremendous growth in the field of probiotics. They are strengthening their roles in the reduction of antibiotic associated diarrhea, management of rotavirus diarrhea, and diarrhea due to various causes; showing positive effect in the management of lactose intolereance; irritable bowel syndrome, inflammatory bowel disease; and are being researched in various non-gastrointestinal disease. These effects can be seen with a daily intake of 5-10 billion CFUs of probiotics per day. Prebiotics, with their potential to increase the activity of probiotics, are also being increasingly used in preparations containing probiotics. Synbiotics as they are called are metamorphosing from little known entities to well-known agents helpful in the maintenance of good health. It is now become imperative that the clinicians assimilate knowledge about probiotics & prebiotics, and use them for the benefit of their patients. The alarming increase of inappropriate use of antibiotics and bacterial resistance, makes Probiotics, Prebiotics & Synbiotics very necessary to lead a healthy life. Although this survey was probably biased in favour of giving probiotic advice, more than 50% response to the idea of giving prebiotrics-probiotics combination has reached the tipping point in general practice

9.BIBLIOGRAPHY

I got the information and data from the following mentioned books and websites. Net reference: * www.pubmed.com * www.medicinenet.com * www.google.com

* www.wikipedia.co

* www.cimsasia.com
Book reference: * K. D. Tripathi, 2004, Essential of medical pharmacology. Jaypee Brothers Medical Publishers Pvt. Ltd., New Delhi. * Mach T (November 2006). "Clinical usefulness of probiotics in inflammatory bowel diseases". Journal of Physiology and Pharmacology: an Official Journal of the Polish Physiological Society 57 Suppl 9: 23–33. * Yan F, Polk DB (November 2006). "Probiotics as functional food in the treatment of diarrhea". Current Opinion in Clinical Nutrition and Metabolic Care 9 (6): 717–21 * Naresh. K. Malhotra, 2007,Marketing research .5th edition, published by Pearson Education, USA * Philip Kotler, Marketing Management Edition-13th.

APPENDIX
QUESTIONNAIRE FOR DOCTORS 1. Doctor, do u prescribe prebiotics/probiotics? Yes NO 2. In which indications do u prescribe prebiotics/probiotics? i. ____________________________________ ii. ____________________________________ iii. ____________________________________

3. How often do you get patients for main indications of prebiotics/probiotics?
____________________

4. Which brands do you prescribe?Why? iv. ___________________________________________________ v. ___________________________________________________ vi. ___________________________________________________

5. Do you always prescribe in combinations?

_________________________________________________________ 6. Which dosage forms do you prescribe?
_________________________________________________________
7 Do you need more information on prebiotics/probiotics? Yes NO
8.According to you. What measures should be taken to improve marketing? ___________________________________________________________
9 Are there any side effects of consuming prebiotics/probiotics? ________________________________________________________
CLASSIFICATION DATA OF DOCTOR:
Name: - Gender (M/F):-
Years of Practice: - Specialization:-
Area: - Cell No:-

QUESTIONNAIRE FOR RETAILERS 1. Are you aware of prebiotic/probiotic products? Yes NO 2. Can u tell me some brands of prebiotics/probiotics?
___________________
___________________
___________________
3. What is the monthly sales for pre/probiotics?
____________________

4. Are the pre/probiotic products given as OTC? Yes NO 5. Which doctors prescribe pre/probiotics?
____________________
____________________ 6. Would you need more information on Pre/probiotics Yes NO
7 Sources of information for pre/probiotic product MR Magazine journals Books Others, if any
CLASSIFICATION DATA OF RETAILER:
Retailers Name Contact:
Shop’s Name:
Area Card/Stamp:

PROJECT 2
MARKET PERCEPTION AND ANALYSIS OF FERROUS ASCORBATE-FOLIC ACID COMBINATION

ABSTRACT

The main goal of the report was to investigate about the Ferrous ascorbate + Folic acid combination, its market perception, prescription pattern and the most prescribed and selling brands in Navi Mumbai. This report begins by examining the current prescription rates of Ferrous ascorbate + Folic acid combination in areas from Belapur to Panvel. There is an in-depth survey of statistics which reveals the fact that the Ferrous ascorbate + Folic acid combination is the most selling molecule and is the need of the changing lifestyle of people.

A reasonable proportion of physicians in Navi-Mumbai are familiar with the use of Ferrous ascorbate + Folic acid combination and majority have clearly been involved in Ferrous ascorbate + Folic acid combination prescription for long time. However, I hypothesized that some medical practitioners are yet to grasp the concept of using Ferrous ascorbate + Folic acid combination

In order to determine the extent of awareness on the use of Ferrous ascorbate + Folic acid combination among qualified medical practitioners in Navi-Mumbai, a survey was carried out. The survey involved the use of close-ended and open-ended structured questionnaires and 55 randomly sampled medical practitioners and 50 retailers. The survey asked about current knowledge on the subject, and provided information to gauge the potential receptivity to using or recommending Ferrous ascorbate + Folic acid combination in patient care.50 medical practitioners responded. The results showed that 100% of the respondents were familiar with the term Ferrous ascorbate + Folic acid combination, and 76% indicated that they would like more information on the subject. The top selling brand for this combination involved Orofer XT of Emcure , following this were Feronia of Zuventis, C-Pink of Wanbury and so on.

Ultimately the conclusion of the report is that, Ferrous ascorbate + Folic acid combination is highly effective and generally safe.

1.INTRODUCTION

1.1 MOLECULE PROFILE

* Ferrous ascorbate, a synthetic molecule of ascorbic acid and iron, is indicated in the treatment of iron deficiency anemia. * Vitamin B9 (folic acid and folate inclusive) is essential to numerous bodily functions ranging from nucleotide biosynthesis to the remethylation of homocysteine. The human body needs folate to synthesize DNA, repair DNA, and methylate DNA as well as to act as a cofactor in biological reactions involving folate.[3] It is especially important during periods of rapid cell division and growth. Both children and adults require folic acid to produce healthy red blood cells and prevent anemia. Folate and folic acid derive their names from the Latin word folium (which means "leaf"). Leafy vegetables are a principal source, although in Western diets fortified cereals and bread may be a larger dietary source. * Ferrous ascorbate and folic acid combination is mainly used in the treatment of the iron deficiency anemia.

Doctor’s prospective and marketing aspect * The ferrous form offers rapid absorption 3 times greater than any other form. Hence doctors prefers the combination of the ferrous ascorbate with the folic acid rather than the ferrous sulfate or any other ferrous form * Doctor prescribes the combination for some conditions which are as follows 1. Iron deficiency anemia 2. Rapid growth and development 3. Metabolic diseases 4. Post surgical convalescences 5. Pregnancy and lactation 6. Dietary insufficiency 7. Chronic and acute blood loss

1.2 INDICATIONS AND CLINICAL USES: Ferrous ascorbate, a synthetic molecule of ascorbic acid and iron, is indicated in the treatment of iron deficiency anemia. A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. Iron is an essential trace mineral in human nutrition. It is involved in the entire process of respiration, including oxygen transport and electron transport. The principal goal of respiration is the production of biologic energy.
Compositions comprising ferrous ion and an ascorbate have a synergistic effect on cartilage development. Therapeutic compositions comprising ferrous ion and an ascorbate are therefore useful in the treatment of osteoarthritis.

Folic acid, sometimes called folate, is a B vitamin (B9) found mostly in leafy green vegetables like kale and spinach, orange juice, and enriched grains. Folic acid is a B vitamin. It is used in our bodies to make new cells. Adequate concentrations of folate, vitamin B12, or vitamin B6 may decrease the circulating level of homocysteine, an amino acid normally found in blood. There is evidence that an elevated homocysteine level is an independent risk factor for heart disease and stroke. The evidence suggests that high levels of homocysteine may damage coronary arteries or make it easier for blood clotting cells called platelets to clump together and form a clot. However, there is currently no evidence available to suggest that lowering homocysteine with vitamins will reduce your risk of heart disease. Clinical intervention trials are needed to determine whether supplementation with folic acid, vitamin B12 or vitamin B6 can lower your risk of developing coronary heart disease. The NORVIT trial suggests that folic acid supplementation may do more harm than good.

The most common neural tube defects are spina bifida (an incomplete closure of the spinal cord and spinal column), anencephaly (severe underdevelopment of the brain), and encephalocele (when brain tissue protrudes out to the skin from an abnormal opening in the skull). All of these defects occur during the first 28 days of pregnancy - usually before a woman even knows she's pregnant.
That's why it's so important for all women of childbearing age to get enough folic acid
Some evidence associates low blood levels of folate with a greater risk of cancer. Folate is involved in the synthesis, repair, and functioning of DNA, our genetic map, and a deficiency of folate may result in damage to DNA that may lead to cancer. Several studies have associated diets low in folate with increased risk of breast, pancreatic, and colon cancer. However, associations between diet and disease do not indicate a direct cause. Researchers are continuing to investigate whether enhanced folate intake from foods or folic acid supplements may reduce the risk of cancer.
In a 3-year trial on 818 people over the age of 50, short-term memory, mental agility and verbal fluency were all found to be better among people who took 800 micrograms of folic acid daily—twice the current RDA—than those who took placebo. Folate is necessary for fertility in both men and women. In men, it contributes to spermatogenesis. In women, on the other hand, it contributes to oocyte maturation, implantation, placentation, in addition to the general effects of folic acid and pregnancy. Therefore, it is necessary not to receive insufficient amounts through the diet, in order to avoid subfertility

1.3 MARKET ANALYSIS

India is the anaemia capital of the world as patients do not continue the medication on account of high incidence of GI irritations in the existing ferrous ascorbate brands
Indian market for haematinic products is at around Rs 900 crore, which is growing at 13 per cent annually. Of this, the ferrous ascorbate market is around Rs 190 crore and growing at 35 per cent.

BRANDS AVAILABLE PRODUCT NAME | COMPANY | PACK SIZE | PRICE(RS) | OROFER XT | EMCURE | 10 | 59 | FERONIA XT | ZUVENTIS | 10 | 62.55 | C-PINK | WANBURY | 10 | 59.5 | FOLVITE | WYETH | 5 mg x 30's | 62.9 | SOLUFER | ALKEM | 10 | 51) |
4

1.4 OBJECTIVE:

* The objective of the survey was to understand the market perception about Ferrous ascorbate + Folic acid combination from the doctors and retailers. * To study the market potential of Ferrous ascorbate + Folic acid combination * To know the preference of doctors towards the combination of Ferrous ascorbate + Folic acid combination. * To analyse the leading brands in Ferrous ascorbate + Folic acid combination. * To observe the frequently observed indications treated by Ferrous ascorbate + Folic acid combination

1.5 Scope :
The scope of the survey is limited to the areas of Navi Mumbai (Belapur to Panvel)

1.6 Limitation:
The sample size chosen may not be enough to give a true representation of the total population

2 RESEARCH DESIGN:

Before going into the details of the methodology it is important to understand the overall approach. The project went through several stages where each stage has some process to be undertaken and had a defined deliverable.
STAGE-1 Understanding the need & objective of the study.

STAGE-2 Developing the Research Design & applying the research methodology, which includes the mode of data collection (questionnaires).

STAGE-3 Data analysis and submitting the report.

2.1 METHODOLOGY Type of research: Exploratory
Type of data: Primary data & Secondary data

Data collection method: Data is collected through structured questionnaire. For this project I have used primary data which was collected through the use of structured QUESTIONNAIRE. The questionnaire contained both open ended as well as close ended questions. The data was collected the data personally by getting questionnaire filled up from chosen doctors and retailers,
Secondary data was also used , which were collected through
a) Internet
b) Management books
c)ORG-IMS data ( 2009 ) Sampling: Non-Probability convenience sampling. Sample size: 50 Retailers & 75 Doctors. Sampling unit: General Physicians, Dentists, ENT & Gynaecologists. Data analysis technique: Quantitative

3 RESEARCH FINDINGS

Survey and its Interpretation:
The no. of sample respondents were 50 Doctors, & 50 Retailers in the areas of Navi-Mumbai from Belapur to Panvel.

3.1 DOCTOR’S SURVEY:

SEGMENTATION | No.OF DOCTORS | GENERAL PHYSICIANS | 25 | GYNAECOLOGISTS | 25 | TOTAL | 50 |
5

* Doctor, do you prescribe Ferrous ascorbate + Folic acid combination? q INTERPRETATION: As per the survey, 98% of the doctors were fquently prescribing Ferrous ascorbate + Folic acid combination to their patients.

* In which indications do u prescribe Ferrous ascorbate + Folic acid combination?

r

INTERPRETATION:
According to the survey, 100% GP’s and 100% Gynaecologists preferred Ferrous ascorbate + Folic acid combination for treating Anemia.
Gynaecs mostly(100%) prscribed during Pregnancy and lactation and also in cases of Weakness
GP’s prescribed also in conditions of Weakness, iron deficiency and some also prescribed in Ulcers .

* Which brands do you prescribe?Why?

s

INTERPRETATION: In the competitive analysis, Orofer XT was the leading brand as it was majorly prescribed by both GP’s and Gynaeacs. Orofer XT was preferred due to good reputation and efficient marketing. Following, Orofer XT were other brands like Feronia of Zuventis which was equally preferred by both GP’s and Gynaeacs.
In some cases, depending on the patient’s condition doctors preferred plain Folic acid tablets. The most prescribed brand for these conditions was Folvite. Folvite of Wyeth was majorly prescribed by GP’s in cases of Anemia and dietary deficiency.
C-Pink of Wanbury had better prescription than Orofer earlier, however the current scenario showed declined Rx for C-Pink. Currently C-Pink was mainly prescribed by Gynaecologists.
Other brands like Solufer , Solgar, Hema plex and Haemaze Forte suspension of VHB Life Sciences generated less prescriptions.

. * Doctor which other ferrous salt combination with folic acid you prescribe? How ferrous ascorbate is different than ferrous sulfate and other salt?
Interpretation: Very few doctors responded to this question. Majority of the doctors were in favour of Ferrous ascorbate and Floic Acid combination. This combination gives rapid absorption than any other form. In some cases doctor prescribed Ferrous fumarate or ferric ammonium citrate (DEXORANGE).

* Do you always prescribe in combination?

t
INTERPRETATION: More than 50% of the doctor responded that the prescription of combination depends on patient’s history and condition.
29% of the medical practioners preferred combination as it gave better and rapid absorption.
A few of them (17%) prescribed plain Folic acid for treating Anemia.

* Are there any side effects of Ferrous ascorbate + Folic acid combination? u

INTERPRETATION: According to the survey, 70% of the respondents said that Ferrous ascorbate + Folic acid combination is generally safe and has no side – effects.
Some doctors,27% responded about some issues of constipation, nausea and vomiting.
A very few of them observed side effects in some patients.
Thus, overall this combination is well tolerated and hence prescribed often.

* Which dosage form do you prescribe for FERROUS ASCORBATE+FOLIC ACID combination?

v

w
INTERPRETATION
Mostly doctors do not prescribe ferrous Ascorbate- Folic Acid for children as they generally do not find child with lack of iron in the body. Only if there is a child with severe anemia then they prescribe it. Adult or geriatric patient of age above 55, for them it is not easy to swallow the tablet form of the drug therefore doctors mostly prescribe syrup or recommend IV (Intravenous Administration). 80% of the patients for the anemic conditions are females.
Prescription of the Ferrous Ascorbate –folic acid combination is mostly to women because it is seen that women are mostly seen anemic and also depending on the severity of the condition of the patient. It varies patient to patient according to the doctors.

* For how long do you prescribe FERROUS ASCORBATE+FOLIC ACID combination? x
INTERPRETATION Period of therapy- 83% doctors prescribe 30 days therapy, 37 %doctors prescribe 90 days treatment, 76 %doctors prescribe more than 90 days treatment but it is mostly for the pregnant women.
Dose frequency for a day- All of the targeted 100 doctors prescribe 1 tablet per day. Sometimes it also depends on severity of the condition of the patient.

* Do you need more information on Ferrous ascorbate + Folic acid combination?

y

INTERPRETATION Athough 98% of the doctors are prescribing and are well aware about the comination , 54% suggested better availability of literature and awareness on the efficacy of combination is required.

3.2 RETAILER’S SURVEY
SAMPLE SIZE:50

* CAN YOU TELL ME THE TOP BRANDS FOR FERROUS ASCORBATE + FOLIC ACID COMBINATION?

z
INTERPRETATION As per the retailers survey the top selling brand for the above combination are
1.OROFER XT- EMCURE
2.FERONIA - ZUVENTIS
3 FOLVITE - WYETH

* Which category of doctors prescribes FERROUS ASCORBATE + FOLIC ACID combination? INTERPRETATION: 1 Gynaecologists 2.General practicioner * WHAT IS THE MONTHLY SALES FOR FERROUS ASCORBATE + FOLIC ACID combination?
INTERPRETATION: Average sales is 10-15 strips per month

zi

INTERPRETATION 48 chemist gets the information about the brands available in the market through medical representatives. And 37 chemists get it from the doctor’s prescription because med. Reps. of the respective company promote their brands to the doctor and doctor in return if find competent and effective enough, they prescribe them.

4 RECOMMENDATIONS

* Ferrous ascorbate combined with folic acid has quite good awareness among the doctors, however more emphasis can be done to promote the benefits of this combination. * Emphasis should be done to promote the molecule to the GP’s as they get large number of patients * Price is not an issue and is affordable. * Benefits of the combination need to be explained to the doctors.

5 LIMITATIONS

* The interviwer bias was a major limitation in the research. There could have been difference between the information generated and the information interpretated by the respondents. * The research was carried out in parts of Navi-Mumbai. The primary data collected may not be a representative of other geographical areas. * Sample size may not reflect the same results of actual size. * Some doctors had the policy of not to entertain such surveys, so their opinions could not be known

6 CONCLUSION

Iron deficiency is the most common and widespread nutritional disorder in the world. It is affecting a large number of children

and women in developing countries and it is the only nutrient deficiency which is also significantly prevalent in industrialized countries. Iron deficiency anemia is affecting more than 30% of the world’s population.

More than 50% of the doctors are into the practice of prescribing FERROUS ASCORBATE+ FOLIC ACID combination. This hematinic market has great potential as hematinics are now becoming the need of the changing life style due to the wide spread nutritional disorder.

Major players in this segment, as per the survey are Emcure – Orofer –XT, Zuventis-Feronia and many more. The combination is generally safe and well tolerated. This combination has various benefits over other and hence better scope .

7 .BIBLIOGRAPHY

I got the information and data from the following mentioned books and websites.

Net reference: * www.pubmed.com * www.medicinenet.com * www.google.com * www.wikipedia.com * www.cimsasia.com

Book reference: * K. D. Tripathi, 2004, Essential of medical pharmacology. Jaypee Brothers Medical Publishers Pvt. Ltd., New Delhi * Naresh. K. Malhotra, 2007,Marketing research .5th edition, published by Pearson Education, USA * Philip Kotler, Marketing Management Edition-13th.

APPENDIX
QUESTIONNAIRE FOR DOCTORS 1. Doctor, do u prescribe ferrous ascorbate + folic acid? Yes NO 2. In which indications do u prescribe ferrous ascorbate+folic acid? i. ___________________ ii. ___________________ iii. ___________________

3. How often do you get patients for main indications of ferrous ascorbate+folic acid?
____________________

4. Which dosage form do u prescribe?
___________________________________________________________________

5. Which brands do you prescribe?Why/ iv. ____________________ v. ____________________ vi. ____________________

6. Do you always prescribe in combination?Why?
___________________________________________________________________
7. Are there any side-effects of this combination?
__________________________________________________________
8. Is there any change needed in this combination? Yes NO

9. Sources of information for ASCORBATE+FOLIC ACID? MR Magazine journals Books Others, if any

10 .Is there enough literature available on ferrous ascorbate+folic acid? Yes NO
CLASSIFICATION DATA OF DOCTOR:
Name: Cell No :
Years of Practice: Specialization:
Area: Card/Stamp
QUESTIONNAIRE FOR RETAILERS 7. Are you aware of FERROUS ASCORBATE+FOLIC ACID? Yes NO 8. Can u tell me some brands of ASCORBATE+FOLIC ACID?
___________________
___________________
___________________
9. What is the monthly sales for ASCORBATE+FOLIC ACID?
____________________

10. Is ASCORBATE+FOLIC ACID combination given as OTC? Yes NO 11. Which doctors prescribe ASCORBATE+FOLIC ACID?
____________________
____________________
____________________
12. Would you need more information on ASCORBATE+FOLIC ACID? Yes NO
7 Sources of information for ASCORBATE+FOLIC ACID? MR Magazine journals Books Others, if any
CLASSIFICATION DATA OF RETAILER:
Retailers Name Contact:
Shop’s Name:
Area Card/Stamp: