Tying The Loose Ends

By M H Ahssan

Pharma companies in India gear up as swine flu spreads

Aloe vera is known for many things, but not exactly for preventing the spread of new influenza virus strains. But that is exactly what Chennai-based healthcare solutions firm Phyto Specialities is claiming: its capsule blend of herbs tinosporia cordifolia and aloe vera can protect you from swine flu, nothing less.

While the capsule and the claim can be taken with gallons of water — after all, aloe vera boosts immunity, much like Vitamin C — Phyto is the farthest link in a chain of healthcare companies, small and big, who are awaiting the several hundred crore swine flu opportunity.

The pandemic spread by the H1N1 virus has so far taken 63 lives and infected about 3,000 people across the country, according to the health ministry. The pandemic could also take a heavy toll on India’s economy — a study by the World Bank suggests that a mild pandemic would cost India 0.6 per cent of its GDP — even as the country is slowly recovering from the impacts of the global financial meltdown.

The only winner may be the healthcare industry, which has already gained from the paranoia by peddling swine flu kits. In August alone, Delhi-based healthcare firm Religare Wellness sold 60,000 masks and 5,000 disposable gloves, including bulk orders from companies, according to a company spokesperson. A windfall is just around the corner, with the government readying up new orders for generic Tamiflu capsules and swine flu vaccines, and private diagnostic laboratories set to start testing suspected H1N1 patients.

The Virus Money
The government has invited drug manufacturers to submit a new tender for the supply of 20 million capsules of generic Tamiflu, as its stock runs out. Of the 10 million capsules the government had bought earlier, 750,000 have already been distributed to various state health agencies, according to health ministry officials.

An estimated Rs 300 per dose (10 capsules), the drug could fetch pharma companies an order worth Rs 60 crore. Companies such as Hetero Drugs, Cipla, Ranbaxy, Strides Arcolab, Natco Pharma and Swiss pharma major Roche are believed to be in the race.

Further, media reports suggest that the government could also permit retail sales of the drug within a few weeks, which could mean another windfall for pharma companies. “We will launch the drug in the retail market as soon as we can,” says Cipla’s CEO Amar Lulla.

Meanwhile, Panacea Biotec, Bharat Biotech and Serum Institute of India, which have received the virus seed from the US public health agency Centres for Disease Control and Prevention, have started work on a vaccine. But the government and the three companies are yet to finalise an advance purchase agreement for the vaccine, according to Vineet Chawdhry, joint secretary for health in the ministry, who, nevertheless, is confident that a vaccine will be available within five to seven months.

However, there is still no clarity as to when private labs will be able to start testing patients for H1N1 and what approval process they need to follow. “The (Union) government has not issued any orders that prevent private labs from testing. Approvals, if any, would be given by state governments,” says Chawdhry. Last week, the Delhi government allowed four private pathological laboratories in the city — Dr. Lal Pathlabs, Dr. Naveen Dang’s Lab, Auroprobe Lab and Super Religare Laboratories (SRL) — to test samples for the swine flu virus. “The National Institute of Communicable Diseases has inspected our reference lab in Okhla (in Delhi),” says Dr Arvind Lal, chairman and managing director of Delhi-based Dr Lal Pathlabs.

Quest Diagnostic India, another diagnostic firm, also hopes to start testing within five to 15 days. “We will start testing as soon as the government accredits the laboratory and the systems are in place,” says Paul Rust, vice-president and general manager of the company.

The Private Role
While private laboratories may initially test only those samples sent by the government — to support the 18 government labs that are currently conducting the tests — they could also test patients coming directly to their collection centres as well. Sanjeev Chaudhry, CEO of SRL, claims the company could test as many as 1,000 samples a day. At Rs 4,500 per sample, this would translate into monthly revenues of Rs 15.5 crore. SRL also plans to run 10 mobile collection units for door-to-door testing in Delhi.

However, labs will first need to buy swine flu testing kits before they can go ahead with their plans. So far, only California-based Applied Biosystems’s swine flu kit has been approved by the US Food and Drug Administration (FDA) for emergency use. R. Trivedi, head of India operations, Applied Biosystems, says the company is yet to start selling the kit in the country: “We are not importing it, and we have not received any queries on this from Indian companies.”

While Chaudhry of SRL says the firm will opt for Biosystems’s kit, Dr Lal Pathlabs has approached Roche Diagnostics. Roche’s drugs, though, have not yet been approved by the FDA. “It is, however, recommended by several authorities including the WHO,” clarifies Bhuwnesh Agrawal, chairman and managing director of Roche Diagnostics India and South Asia, who declined to disclose the price of the assay.

The state-owned Indian Council of Medical Research is also working on developing a swine flu kit that would cost less than the imported ones. Eventually, the impact of the pandemic on the health of the people, and the country’s economy will depend on how efficiently the government addresses the crisis. Drug making companies and private labs may have a role to play too, but the government needs to ensure that private companies remain part of the solution, rather than contribute to creating more panic.

THE ECONOMIC IMPACT
A pandemic outbreak can cause more damage in developing countries than elsewhere, as these countries have higher population densities. According to a study conducted in 2008 by the World Bank, a mild pandemic could cost a South Asian country such as India 0.6 per cent of its GDP in the first year of the outbreak. A moderate one will cost 2.1 per cent of GDP, while a severe one can claim 4.1 per cent of it.

The hospitality and retail sectors could be hit the hardest. Though hotels in India have not seen a major fall in business so far, restaurants have witnessed a 20 per cent dip in revenues, says Deepak Sharma of the Federation of Hotel and Restaurant Associations of India.

Companies such as Pantaloon Retail have also seen a decline in sales in Maharashtra, where the virus has already claimed 27 lives. The company’s sales are down by 20 per cent and 6 per cent in Pune and Mumbai respectively. “We have seen a marginal decrease in footfall at our Mumbai mall,” admits Dharmesh Jain, group chairman of Nirmal Lifestyle, which develops malls and realty projects.