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Perception Mapping

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Diabetes patients overview in India

*source: http://mdrf-eprints.in/90/1/Epidemiology_of_type_2.pdf

Top Companies in the Anti-Diabetics Segment value viz.(Rs.)
RANK COMPANY MAT 02/2012 VALUE (Cr.)
3,703 492 304 224 183

MKT SHARE%
100 17.9 11.1 8.2 6.7

VALUE GROWTH%
23.2 18 22 24 15

Anti-Diabetic 1. 2. 3. 4. ABBOTT USV SANOFI-AVENTIS SUN

5.

ELI LILLY

114

4.2

11

Top Selling Brands in the Anti-Diabetics Segment value viz. (Rs.)
RANK BRAND
COMPANY THERAPEUTIC CLASS
Insulin

MAT 02/2012 VALUE(Cr.)

1. 2. 3. 4. 5.

HUMAN MIXTARD 30/70 LANTUS GLYCOMET-GP NOVOMIX 30 GALVUS MET

ABBOTT
S.A. USV ABBOTT NOVARTIS

226 105 101 96 72

Insulin
Glimep.+met. Insulin Vildagliptin+met.

Top performing brands of IPM in antidiabetics category (Unit Viz.)
RANK BRAND COMPANY
THERAPEUTIC CLASS
Glimep.+met.

MAT 02/2012 units (Lac.)
460

1.

GLYNASE-MF

USV USV

2.
3. 4. 5.

GLYCOMET
DAONIL GLYCIPHAGE GLUCORED

Glimep.+met
Glibenclamide Metformine Glibenclamide+met.

408
311 281 268

S.A.
F-I

SUN

Top performing combinations in oral antidiabetics category (Value Viz.in Rs.Cr.)
RANK DRUGS & COMBINATION
1. 2. 3. 4. 5. GLIM.+MET. DPP4 INHI. & COMB. PIOGLI.+MET.+GLIM. GLIMEPRIDE METFORMIN

MAT02/2008
157.62 0.00 80.04 135.89 102.25

MATMATMATMAT02/2009 02/2010 02/2011 02/2012
217.80 15.40 115.61 153.87 122.42 307.46 103.23 167.95 176.78 149.63 417.66 210.31 232.90 203.39 177.54 567.43 373.58 324.22 226.03 211.46

6. 7. 8.
9 10

GLICLAZIDE + MET. VOGLIBOSE GLIBENCLAM. + MET.
PIOGLITAZONE PIOGLI.+ MET.

113.84 25.47 64.26
70.04 43.81

116.54 41.74 68.68
71.80 44.44

129.61 77.79 75.31
76.33 56.21

135.34 106.90 80.34
78.94 65.60

147.28 135.96 88.78
84.95 71.62

Top performing combinations in oral antidiabetics category (Unit Viz. in Lac.)
RANK DRUGS & COMBINATIONS MAT-02/2008 MAT-02/2009
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. METFORMIN GLIM.+MET. GLIPIZIDE + MET. PIOGLI.+MET.+GLIM. GLIMEPRIDE GLIBENCLAMIDE + MET. GLIBENCLAMIDE GLICLAZIDE + MET. VOGLIBOSE PIOGLITAZONE 834.37 464.48 512.16 157.12 384.03 452.54 597.79 334.79 44.25 235.55 928.35 602.91 569.85 225.16 421.63 452.2 509.92 335.12 72.55 238.12

MAT-02/2010
1049.11 799.16 593.75 321.31 475.47 449.84 479.04 363.68 143.69 243.69

MAT-02/2011
1187.78 1046.56 631.84 444.75 519.29 441.78 450.69 368.13 199.34 242.35

MAT-02/2012
1328.7 1309.89 683.79 622.77 542.92 462.41 427.17 386.34 253.25 251.55

11.
12. 13. 14. 15.

GLIPIZIDE
DPP4 INHI. & COMB. GLICLAZIDE PIOGLI.+ MET. ACARBOSE

271.71
0 171.14 116.82 73.74

266.39
6.84 167.16 114.92 75.97

237.82
48.43 170.53 131.82 73.05

237.9
103.77 169.91 149.07 67.9

228.05
184.5 167.92 159.74 63.54

Overview of Brands in DPP-IV inhibitors market in INDIA
Brand name
GALVUS MET JANUMET
JANUVIA GALVUS

Company
Novartis MSD
MSD novartis

Molecule vildagliptin & metformin sitagliptin & metformin sitagliptin vildagliptin

Strength vildagliptin 50mg; metformin 500mg sitagliptin 500mg; metformin 500mg sitagliptin 100mg vildagliptin 50mg

Packing
10 14
10 14

Price
198 308
299 270

Launch date
2009/05 2008/12
2008/04 2008/08

JALRA
ONGLYZA JALRA-M ZOMELIS ISTAVEL ISTAMET

USV
BMS USV Piramal SPI SPI

vildagliptin saxagliptin vildagliptin 50mg saxagliptin 50mg

14
14 10 14 7 &10 14

270
532 198 270

2009/01
2010/04 2009/12 2010/04

vildagliptin & metdformin vildagliptin sitagliptin phosphate sitagliptin & metformin

vildagliptin 50mg; metformin 500mg vildagliptin 50mg sitagliptin 100mg sitagliptin 500mg; metformin 500mg

209 & 299 2011/11 resp. 308 2011/11

Top 10 Brands in DPP-IV inhibitors market (Value Rs.viz.)
Rank
1

Brand name
GALVUS MET

MAT 02/2012 val (cr)
72

Grth %
19

2
3 4 5

JANUMET
JANUVIA GALVUS JALRA

61
57 48 41

16
15 13 11

6
7 8 9

ONGLYZA
JALRA-M ZOMELIS ISTAVEL

37
33 8 6

10
1 2 1

10

ISTAMET

3

1

Top 10 Brands in DPP-IV inhibitors market (Unit viz.)
MAT 02/2012 Rank
1
2 3 4 5

Brand name
GALVUS MET
JANUMET JANUVIA GALVUS JALRA-M

unit (lac.)
45.77
25.97 24.96 23.02 21.38

unit Grth %
24.81
14.08 13.53 12.48 11.59

6
7 8 9 10

JALRA
ONGLYZA ZOMEL ZOMELIS ISTAVEL

19.72
9.03 6.85 3.95 2.42

10.69
4.90 3.72 2.14 1.31

DPP-IV Inhibitors market scenario: Region viz (Rs.) (INDIA)

REGION
DELHI

MAT-02/2009 (lac.)
71

MAT-02/2010 MAT-02/2011 MAT-02/2012 (lac.) (lac.) (lac.)
1,402 3,269 5,240

MUMBAI
CALCUTTA CHENNAI HYDERABAD BANGALORE

157
52 287 210 253

1,087
413 1,126 977 394

2,164
1,289 1,436 1,257 854

4,337
2,304 2,042 1,844 1,289

LUDHIANA
AHMEDABAD PUNE LUCKNOW KANPUR

1
18 1 6 22

21
174 63 72 112

384
490 218 291 168

1,236
824 606 513 339

JAIPUR
NAGPUR VIJAYWADA AGRA

6
5 7 3

84
68 40 351

282
216 171 218

337
328 286 244

Region
DELHI MUMBAI CALCUTTA CHENNAI HYDERABAD BANGALORE LUDHIANA

MAT-02/2009 MAT-02/2010 Unit (th.) Unit (th.)
33 71 24 126 92 109 1 8 1 3 3 2 3 9 2 684 520 205 507 432 175 10 84 30 33 39 30 19 51 164

MAT-02/2011 Unit (th.)
1,692 1,106 627 670 575 380 155 227 118 134 126 99 90 75 122

MAT-02/2012 Unit (th.)
2,768 2,158 1,108 955 827 572 539 341 326 236 159 154 144 139 136

AHMEDABAD PUNE LUCKNOW JAIPUR NAGPUR VIJAYWADA KANPUR AGRA

Promotional Strategies of Top Brand

GALVUS CV safety, Islet Enhancement Efficacy advancement

JANUVIA 1st line add-on drug to metformin & Highest Rx worldwide

ONGLYZA Extra help, Extra control

Market research particulars
• Research Type: Conclusive Research • Research Class: Problem Identification and Problem Solving research • Research Instrument: Questionnaire • Technique of data collection: In-Depth personal interview, probing is done whenever required • Sampling Technique: Convenient Technique & Area sampling • Sample Size: 158 Physicians & 160 Chemist • Target Respondent: Specialty Covered: Endocrinologist, Diabetologist, Cardiologist MD (Med), MBBS physician who have good diabetes practice • Data Collection Period: 13/6/12 to 19/7/12 • Target Area: Nasik, Jalgaon, Chandigarh, Ambala
PLACE NO.OF PHYSICIANS NO. OF CHEMIST Open ended question SHOP Close ended (Multiple Choice) 40 40 40 40 2 8

NASIK
JALGAON CHANDIGARH AMBALA

41
42 40 35

Tabular Rating Questions
Preference Ranking Question

2
1

Q1. Please mention which molecule do you generally prescribe for newly detected Type 2 Diabetes Mellitus (DM) patients? a) Gliptins b) Metformin c) Glimepiride d) Glinide e) Glitazone

Data Obtained:

WEST REGION
80
70 60 50 40 30 20 10 0

NORTH REGION
80

77 64

72

70

60
50 40

47

24

30 20

16 0 1

0

0

10 0

• As per analysis 30% Physicians use Gliptins in west region and 20% Physicians use Gliptins in North region for newly detected DM.

Q2.Please, Rank your preference on a scale of 1-5 (1-Poor, 2Average, 3-Good, 4-V.Good, 5-Excellent) for different medications with respect to various attributes.
Metformin DPP-IV Inhi. Sulfonylureas α-gluco. Inhi.

Safety Efficacy Availability Patient Compliance Cost of drug

Data Obtained:

Attribute 1: SAFETY
NORTH REGION
5.00 4.50
4.50

WEST REGION
5.00 4.50
4.53

4.00
3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi. 3.88 3.69 3.67

4.00 3.50 3.00 2.50 2.00 1.50
3.34 3.29 3.21

1.00 0.50
0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

• After metformin DPP-IV inhibitors are considered as safer than other. Sulfonylurea cause more Hypoglycemia, in term of safety it is ranked back at 3rd position

Data Obtained:

Attribute 2: Efficacy
NORTH REGION
5.00 4.50 4.59

WEST REGION
5.00 4.50 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi. 3.94 3.83 3.41 4.52

4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 3.53

3.52
3.08

0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

• DPP-IV inhibitors are considered as second most efficacious molecule among all categories • This attribute is required to most effectively communicate to physicians because Efficacy is 2nd most preferred parameter for physician to Rx anti-diabetics

Data Obtained:

Attribute 3: Availability
NORTH REGION
5.00 4.50

WEST REGION
5.00

4.50
4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00 Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

4.39 3.83
3.51 3.10

4.00

4.32

3.50
3.00

3.49
2.96 3.07

2.50
2.00

1.50
1.00

0.50
0.00 Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

• DPP-IV Inhibitors class scores lowest among all classes, Many physicians said they want to try Vildagliptin and other molecules but, their availability is major issue for them

Data Obtained:

Attribute 4: Patient Compliance
NORTH REGION
4.00 3.50 3.79

4.50 4.00 3.50 3.00 4.06

WEST REGION

3.00
3.17 3.33 3.07 2.50 2.00 2.83 2.95

2.50
2.00 1.50 1.00 0.50 0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

2.64

1.50
1.00 0.50 0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

• DPP-IV Inhibitors class is ranked lower as compare to metformin & sulfonylureas in patient compliance. Many physicians said poor compliance is due to high cost of medication

Data Obtained:

Attribute 5: Cost of Drug
NORTH REGION
4.00 3.50 3.16 3.80 3.28

WEST REGION
4.00

3.50
3.00 2.50 2.00 1.50 1.00 0.50 0.00

3.72

3.00
2.50

2.32

2.00 1.99

1.50 1.24
1.00 0.50
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

1.11

0.00
Metformin DPP-IV inhibitors Sulfonylureas α-gluco.inhi.

• DPP-IV Inhibitors has lowest value among all classes as well as among all parameters of DPP-IV Inhibitors in terms of cost of therapy. High cost of therapy hinders prescription pattern of physicians, even in the posh areas of city this problem is prevailing

Average cost per tablet therapy
Class Metformin Sulfonylurea Glitazone α-gluco. Inhi. Glinides Total cost of above all categories DPP-IV Inhibitors Average Cost/tab 1.31 3.95 5.42 10.84 10.84 32.36 26.85

Q3. How is your experience about DPP-IV Inhibitors (Gliptins) in your clinical practice? 1. Good 2. Very good 3. Average 4. Not up to mark

Data Obtained:

WEST REGION
4%
Good Very Good

NORTH REGION
4% 18%
Good Very Good Average Not up to mark

13%

48%

Average Not up to mark

55% 23%

35%

• On an average 35 % & 23% Physicians said their experience about DPP-IV inhibitors are Very good in West region and North region respectively.

Q4. Please mention when will you prescribe DPP-IV inhibitors when HbA1c level is: a. 6.5-7.0 b. 7.0-7.5 c. 7.5-8.0 d.>8.0

Data Obtained:

WEST REGION
6.5-7.0 7.0-7.5 7.5-8.0 >8.0

NORTH REGION
6.5-7.0 7.0-7.5 7.5-8.0 >8.0

35%
65%

26%

5%

69%

• On an average 65 % & 69% of physicians use DPP-IV inhibitors at 7.5-8.0 HbA1c level in West region and North region. So, It shows that Physicians do not start DPP-IV inhibitors at starting level of Diabetes.

Q5. Please mark how frequent you prescribe (Rx) DPP-IV inhibitors on weekly basis? a)0 b) 1-2 c) 3-5 d) 6-7 e) >7

Data Obtained:
Prescriber
14%

WEST REGION
25

non-prescriber
No.of Physicians

20 15 10 5 0 1 to 2 3 to 5 6 to 7 No. of prescriptions/week >7

86%

NORTH REGION
Prescriber non-prescriber
No. of Physicians
25 20 15 10 5 0

100%

1 to 2

3 to 5

6 to 7

>7

No. of Prsriptions/week

Q6. Can you please suggest reason for not prescribing DPP-IV inhibitors? a) Side effects b) Non-availability c) Cost of therapy d) No additional benefits If any other, please mention here: _____________________

Data Obtained:

WEST REGION
4% 17% 4%
Side effects Non-availability

NORTH REGION

Cost of therapy
No additional benefits Other

75%

• Overall 75 % of physicians gives reason as ‘cost of therapy'. As a single tablet of DPP-IV Inhibitors cost around Rs.20 plus this is generally prescribed as add-on therapy so, other drugs cost is also included, overall cost of treatment goes so sky-high making it unattractive to many physicians

Q7. which is the triggering factor for prescribing DPP-IV inhibitors in your practise: a) CME b) seeding trials c) cost reduction d) post marketing surveillance data If any other, please mention here: ______________________

Data Obtained:

WEST REGION
Other Post Marketing Surveillance data Cost reduction Seeding Trials CME
0 10 20 30 40 50 60 70 80

NORTH REGION
Other Post Marketing Surveillance data Cost reduction

Seeding Trials

CME
0 20 40 60 80

• More than 80% Physician said cost reduction is the triggering factor for prescribing. • In North region attention should be given towards both CME and Seeding trials

• 8. Which is your preferred drug amongst DPP-IV inhibitors? a. Vildagliptin b. Sitagliptin c. Saxagliptin d. Other

Data Obtained:

WEST REGION
Vildagliptin sitagliptin Saxagliptin Other
Vildagliptin

NORTH REGION sitagliptin Saxagliptin Other

1% 31%
45%

1%

54%

68%

• On an average 68% & 54% physicians prefer vildagliptin as their choice among DPP-IV Inhibitors in West region and North region resp.

Q9. Rank the following molecules on a scale of 1-5 (1-Poor, 2Average, 3-Good, 4-V.Good, 5-Excellent) for the following DPP-IV Inhibitors?

MEASURES Safety Efficacy Cost Dosing Side-effect profile Availability

Sitagliptin

Vildagliptin Saxagliptin

Data Obtained:
Molecule Sitagliptin Vildagliptin Saxagliptin Safety 3.97 4.13 3.60 Efficacy 4.00 4.255 3.50

West Region Cost 1.57 2.07 1.03 Dosing 3.43 3.49 3.27 Side-effect profile 3.03 3.15 2.89 Availability 2.95 3.17 1.95

North Region Molecule Sitagliptin Vildagliptin Saxagliptin Safety 3.45 3.48 3.09 Efficacy 3.46 3.52 3.03 Cost 1.71 2.07 1.06 Dosing 3.10 3.09 3.10 Side-effect profile 2.93 2.93 2.87 Availability 2.79 2.85 1.84

Q10. What ranking will you give for following drugs used in Diabetes: (1-for highest used drug….5-for least used drug)
Sr.No 1. 2. 3. Vildagliptin Sitagliptin Saxagliptin RANK

Data Obtained:

Area

Vildagliptin

Sitagliptin

Saxagliptin

West region
North region

1.30
1.45

1.95
1.61

3.29
3.41

• Vildagliptin rank for highest used drug in West region & North region. While saxagliptin score least used drug & Sitagliptin rank second in prescribing habit of physicians

Chemist Questionnaire & findings:
Q1. Which is the fast moving brands of DPP-IV inhibitors?
a. Galvus met e.Istavel b.Janumet f.Zomelis c.Onglyza g.Galvus d.Jalra h. Other(_________)

Data Obtained: WEST REGION
9% 17% 6% 17% 14% 20% 22%

NORTH REGION
1%

21%

15% 5%

8%
17%

6%

4%

18%

Gal.met Istavel

Jan.met Zomelis

Onglyza Galvus

Jalra Other

Gal.met Istavel

Jan.met Zomelis

Onglyza Galvus

Jalra Other

Q2. How many strips per week , the above mentioned fast moving brand sold on prescription?
_________________

Data Obtained: WEST REGION
15

15

>15

>15

Strips/week

Strips/week

10 to 15
5 to 10

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...|Consumer’s perception of food quality and its relation to the choice of food | |Master thesis | |Master of Science in Marketing | | | |DEPARTMENT OF MARKETING AND STATISTICS | |HANDELSHØJSKOLEN | |AARHUS UNIVERSITET | | | | | | | | ...

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