Marketing Research For

New Product Launch: Cisatracurium

A Summer Training Project Report

Submitted in Partial Fulfillment of the Requirements for the

Award of degree of MBA (Finance & Marketing)

2011 – 2013

Submitted by Guided by

Manish Ranjan Singh Ms. Ranpreet Kaur

2 | P a g e

Certificate from the Company/Organization

This is to certify that Manish Ranjan Singh, son of Dr. Satyendra Narayan Singh Pursuing

MBA from Institute of Management and Entrepreneurship Development, Pune has

successfully completed the Project Report in our organization on the topic titled,

“Marketing Research for New Product Launch: Cisatracurium” from 1st June to 10

th

August 2012. During his project tenure in the organization/company, we found him hard

working, sincere and diligent person and his behavior and conduct was good. We wish him all

the best for his future endeavors.

Signature

Sandeep Pawar (Group Product Manager)

Name and Designation of the Guide

3 | P a g e

Certificate of Originality

This is to certify that the project report entitled “Marketing Research for New Product

Launch: Cisatracurium” Submitted to Bharati Vidyapeeth Deemed University, Pune in

partial fulfillment of the requirement for the award of the degree of MBA (Finance &

Marketing) is an original work carried out by Mr. Manish Ranjan Singh, under the guidance

of Ms. Ranpreet Kaur. The matter embodied in this project is a genuine work done by

Manish Ranjan Singh to the best of my knowledge and belief and has not been submitted

before, neither to this University nor to any other University for the fulfillment of the

requirement of any course of study.

Signature of the Student Signature of the Guide

Designation

4 | P a g e

Certificate

This is to certify that the project titled “Marketing Research for New Product Launch:

Cisatracurium” is an academic work done by “Manish Ranjan Singh” submitted in the

partial fulfillment of the requirement for the award of the Degree of MBA (Finance &

Marketing) from Bharati Vidyapeeth Deemed University, Pune. It has been completed under

the guidance of Ms. Ranpreet Kaur (Faculty Guide) and Mr. Sandeep Pawar (Corporate

Mentor). We are thankful to Abbott India Ltd. for having allowed our student to undergo

project work training. The authenticity of the project work will be examined by the viva

examiner which includes data verification, checking duplicity of information etc. and it may

be rejected due to non fulfillment of quality standards set by the Institute.

Dr. Sachin S. Vernekar

(Director IMED)

5 | P a g e

ACKNOWLEDGEMENT

The satiation and euphoria that accompany the successful completion of the project would be

incomplete without the mention of the people who made it possible.

I would like to take the opportunity to thank and express my deep sense of gratitude to my

corporate mentor Mr. Sandeep Pawar and my faculty mentor Ms. Ranpreet Kaur. I am greatly

indebted to both of them for providing their valuable guidance at all stages of the study, their

advice, constructive suggestions, positive and supportive attitude and continuous

encouragement, without which it would have not been possible to complete the project.

I would also like to thank Mr. Rajesh Pandey (Country Manager) who in spite of busy

schedule has co-operated with me continuously and indeed, his valuable contribution and

guidance have been certainly indispensable for my project work.

I am thankful to Mr. Sandeep Pawar for giving me the opportunity to work with Abbott India

Ltd. and learn.

I owe my wholehearted thanks and appreciation to the entire staff of the company for their

cooperation and assistance during the course of my project.

I hope that I can build upon the experience and knowledge that I have gained and make a

valuable contribution towards this industry in coming future.

Manish Ranjan Singh, BVDU, IMED

PUNE

Name of the Student Signature

6 | P a g e

Preface

The objective of the project was “to understand the Neuro Muscular Blocker (NMB) market

& develop the medical positioning for Cisatracurium” for Abbott India Ltd., for that we have

to understand the customer needs (doctors), pricing constraints, response, emotions and

beliefs regarding the product, so that they can contribute their valuable inputs for introducing

the “Cisatracurium” in India for the company. The objective of this study was to analyze the

clinical practice of the available neuromuscular blocker in Mumbai and Pune city with respect

to the survey in the best hospitals of the city.

The project was started on 1st of June after knowing all the relevant information regarding the

project, under the guidance of Mr. Sandeep Pawar (Group Product Manager). The first part of

my project involves the study of the Anesthetists’ armamentarium of drugs, Understand the

NMB category & their mechanism of action and Clinical use of NMBs & their place in

therapy. For this I used Internet as a primary source of information for study, also attended a

day with Dr. Amit Arora discussing the topics. Along with the detailed study of NMB

category the study was more focused on Cisatracurium.

Since, the next part of my project was to develop the questionnaire respected to medical

positioning for Cisatracurium and clinical preferences of current NMBs available. Hence, the

detailed study provided me a rough idea in developing questionnaire and my corporate mentor

guided me in finalizing the questionnaire. For this the questionnaire was prepared which gave

the vague idea about the customers, who were really interested in practicing the new molecule

and wanted to know about the availability of the molecule in the country. Go through

questionnaire in different hospitals and people in the Pune and Mumbai city. The marketing

research was undertaken for Pune and Mumbai region during one month. The sample size of

the marketing research was taken to be 40. The questionnaire contains various aspects like

their Name, Contact Number, E-mail Id, Hospital Name, NMB preference and Cisatracurium

advantage etc. The final part of the project consists of 15 days of scanning the questionnaire.

Most important part is analyzing the information.

Manish Ranjan Singh Signature

7 | P a g e

Index

1. CHAPTER 1: Introduction……………………………………………..9-30

1.1. Overview of the Industry………………………………………………..10 1.1.1. Pharmaceutical Industry in India

1.2. Company Profile……………………………………………………...…12 1.2.1. About the Company 1.2.2. Corporate Overview Fact sheet 1.2.3. Vision 1.2.4. Dedication 1.2.5. Strategy 1.2.6. The Work Culture 1.2.7. The Abbott Brand Promise

1.3. Company History…………………………………………………….…18 1.3.1. Early Decades 1.3.2. Late 1960s and Early 1970s: Diversification and Crises 1.3.3. Late 1970s through 1980s: Emphasizing R&D, Nutritionals, Diagnostic

Equipment 1.3.4. 1990s and beyond: New Drug Introductions and Acquisitions 1.3.5. Recognition 1.3.6. Key dates 1.3.7. Abbott India Ltd. History

1.4. Competition Overview………………………………………………….30

2. CHAPTER 3: Research Methodology………………………………...31-36

2.1. Objective and Scope of Study…………………………………………..32 2.1.1. Objective of the Study

2.1.2. Scope of the Study

2.1.3. Managerial Usefulness of the Study

2.1.4. Types of Research and Research design

2.2. Research Methodology………………………………………………….33

2.3. Research Design………………………………………………………...34

2.4. Sample Design…………………………………………………………..34

2.4.1. Sample Size

2.4.2. Sampling Method

2.4.3. Sample Type

2.5. Data Collection Method…………………………………………….…..35

2.6. Limitation Of the Study………………………………………………....36

8 | P a g e

3. CHAPTER 2: Conceptual Discussion…………………….…………..37-43

3.1. About Product: Cisatracurium………………………………………….38

3.2. Current Issues/News……………………………………………………39

4. CHAPTER 4: Data Analysis……………………………………..……44-69

4.1. Methods and Techniques of Data Analysis…………………………….45

4.1.1. Data Analysis Concept

4.1.2. Data Analysis Process

4.2. Detail Analysis……………………………………………………….....47

5. CHAPTER 5: Findings, Conclusion & Suggestions……………….....70-74

5.1. Interpretation…………………………………………………………....71

5.2. Findings………………………………………………………….……...72

5.3. Conclusion………………………………………………………..……..73

5.4. Suggestions……………………………………………………….…..…74

6. CHAPTER 6: Appendix & Bibliography…………………………….75-80

6.1. Sample Questionnaire……………………………………………….….76

6.2. Abbreviation & Notations………………………………………….…...79

6.3. Bibliography……………………………………………………….…....80

9 | P a g e

CHAPTER 1

Introduction

10 | P a g e

Overview of the Industry

“The Indian pharmaceutical industry is a success story providing employment for

millions and ensuring that essential drugs at affordable prices are available to the vast

population of this sub-continent.”

Richard Gerster

Pharmaceutical Industry in India

The Pharmaceutical industry in India is the world's third-largest in terms of volume and stands

14th in terms of value.

The government started to encourage the growth of drug manufacturing by Indian companies

in the early 1960s, and with the Patents Act in 1970. However, economic liberalization in 90s

by the former Prime Minister P.V. Narasimha Rao and the then Finance Minister, Dr.

Manmohan Singh enabled the industry to become what it is today. This patent act removed

composition patents from food and drugs, and though it kept process patents, these were

shortened to a period of five to seven years.

The lack of patent protection made the Indian market undesirable to the multinational

companies that had dominated the market, and while they streamed out. Indian companies

carved a niche in both the Indian and world markets with their expertise in reverse-

engineering new processes for manufacturing drugs at low costs. Although some of the larger

companies have taken baby steps towards drug innovation, the industry as a whole has been

following this business model until the present.

The Indian pharmaceutical sector has come a long way, being almost non-existent before

1970 to a prominent provider of healthcare products, meeting almost 95 per cent of the

country's pharmaceuticals needs. The Industry today is in the front rank of India’s science-

based industries with wide ranging capabilities in the complex field of drug manufacture and

technology. It ranks very high in the third world, in terms of technology, quality and range of

medicines manufactured. From simple headache pills to sophisticated antibiotics and complex

cardiac compounds, almost every type of medicine is now made indigenously.

11 | P a g e

Playing a key role in promoting and sustaining development in the vital field of medicines,

Indian Pharma Industry boasts of quality producers and many units approved by regulatory

authorities in USA and UK. International companies associated with this sector have

stimulated, assisted and spearheaded this dynamic development in the past 53 years and

helped to put India on the pharmaceutical map of the world.

The Indian Pharmaceutical sector is highly fragmented with more than 20,000 registered units

with severe price competition and government price control. It has expanded drastically in the

last two decades. There are about 250 large units that control 70 per cent of the market with

market leader holding nearly 7 per cent of the market share and about 8000 Small Scale Units

together which form the core of the pharmaceutical industry in India (including 5 Central

Public Sector Units). These units produce the complete range of pharmaceutical formulations,

i.e., medicines ready for consumption by patients and about 350 bulk drugs, i.e., chemicals

having therapeutic value and used for production of pharmaceutical formulations.

Following the de-licensing of the pharmaceutical industry, industrial licensing for most of the

drugs and pharmaceutical products has been done away with. Manufacturers are free to

produce any drug duly approved by the Drug Control Authority. Technologically strong and

totally self-reliant, the pharmaceutical industry in India has low costs of production, low R&D

costs, innovative scientific manpower, strength of national laboratories and an increasing

balance of trade.

The number of purely Indian pharma companies is fairly low. Indian pharma industry is

mainly operated as well as controlled by dominant foreign companies having subsidiaries in

India due to availability of cheap labour in India at lowest cost. Most pharma companies

operating in India, even the multinationals, employ Indians almost exclusively from the

lowest ranks to high level management. Mirroring the social structure, firms are very

hierarchical. Homegrown pharmaceuticals, like many other businesses in India, are often a

mix of public and private enterprise. Although many of these companies are publicly owned,

leadership passes from father to son and the founding family holds a majority share.

The total Indian production constitutes about 13 per cent of the world market in value terms

and, 8 per cent in volume terms. The per capita consumption of drugs in India, stands at

US$3, is amongst the lowest in the world, as compared to Japan- US$412, Germany- US$222

and USA- US$191.

12 | P a g e

Company Profile

About The Company

Abbott Laboratories is a Chicago-based global, diversified (multi-division)

pharmaceuticals and health care products company. It has 90,000 employees and operates in

over 130 countries. The company headquarters are in Abbott Park, North Chicago, Illinois.

The company was founded by Chicago physician, Dr. Wallace Calvin Abbott in 1888. In

2011, Abbott had over $38.9 billion in revenue. Abbott Laboratories is one of the major

multinational company in the pharmaceutical industry. Abbott, is a company that focuses on

turning science into caring – ABBOTT, A Promise for Life. For more than a century, Abbott

Laboratories has been working to advance health care for people around the world. Founded

in 1888 by a young Chicago physician, Dr Wallace Calvin Abbott, Abbott Laboratories has

evolved into a diversified health care company that discovers, develops, manufactures and

markets innovative products and services. Products and services of Abbott, span the

continuum of care from prevention and diagnosis, to treatment and cure. Abbott today is a

global, diversified health care company devoted to the discovery, development, manufacture

and marketing of pharmaceutical, diagnostic, nutritional and hospital products.

Abbott extends this commitment with a strong presence in India as it has grown and evolved

its operations in India over many decades. The products encircle life from newborns to ageing

adults. Abbott has built expertise and leadership in primary care therapeutic areas like

Gastroenterology and Paincare. Our specialty areas include Neuroscience, Metabolics and

Hospital Care. Abbott serves the needs of Indian consumers with products backed by science

and R&D. It has locally developed brands like Digene, Cremaffin, Epilex, Zolfresh and

Obimet. Abbott has also brought global products including Brufen, Prothiaden, Ganaton,

Sevorane, Thyronorm and Leptos to Indian consumers. Abbott’s pioneering products like

Survanta help infants. As of 2010, Abbott India Ltd. tops the list of publicly listed life science

companies in India and the revenue generated in the year 2011 is the highest than any other

pharmaceutical company doing business in the country.

Abbott India, today has strong brand equity and commands esteem in the market place. To

reach the customer, Abbott India has a network of 18 distribution points, which cater to

11,000 stockists and 70,000 retailers. Behind Abbott India’s success, is a team of competent,

13 | P a g e

committed people, driven by the principles of Value Based Management, and aided by strong

alliances and partnerships.

Abbott India Limited, provides healthcare solutions through its four business units:

1. Primary Care - which markets products in the areas of Pain Management,

Gastroenterology, with well-known brands like Brufen, Digene, Cremaffin.

2. Specialty Care - Metaboloics & Urology provides solutions in the areas of Thyroid,

Obesity, Diabetes and Benign Prostratic Hyperplasia.

3. Specialty Care - Neuroscience has a varied portfolio, with specialty products in the

Neurology and Psychiatric segments.

4. Hospital Care - offers products in the field of anesthesiology and neonatology namely

Forane, Sevorane and Survanta.

The company has over 1000 employees and a state-of-the-art formulation plant at Verna in

Goa. The manufacturing locations are designed to produce quality, high volume formulations

using cost efficient processes. The plant has well equipped laboratories and trained personnel

to ensure international standards of quality at each step of the manufacturing process.

The company has in-house development and medical teams to undertake product and clinical

development tailored to the needs of the Indian market.

Abbott provides quality health care worldwide by creating healthcare solutions, which directly

affects the life of the common man.

14 | P a g e

Corporate Overview Fact Sheet

Founded in 1888 by Chicago physician Dr. Wallace C. Abbott, Abbott has emerged as one of

the world's most diverse health care companies. The company has approximately 91,000

employees worldwide serving customers in more than 130 countries. Abbott ranks No. 71 on

the FORTUNE 500 and is headquartered in north suburban Chicago, USA. Abbott India Ltd.

ranks No. 1 in India in top performing pharmaceutical company.

Primary Businesses

Medical Products – Key lines of business include vascular, laboratory and molecular

diagnostics, diabetes care, vision care and animal health.

Nutritionals – Abbott offers a variety of nutrition products for infants, children, active

adults and patients with special dietary needs.

Pharmaceuticals – Includes global patented pharmaceuticals and investigative

compounds and indications in development, and established pharmaceuticals.

Areas of Expertise:

Pharmaceuticals Medical Products Nutritional Products

Anesthesia

Anti-infectives

Cardiovascular

Immunology

Metabolics

Neuroscience

Oncology

Pain Care

Renal Care

Virology

Animal Health

Diabetes Care

Diagnostics

Hematology

Molecular

Point of Care

Vascular

Pediatric Nutrition

Healthy Living

Medical Nutrition

15 | P a g e

Fast Facts Abbott

Chairman and CEO: Miles D. White

Corporate Headquarters: North suburban Chicago, Illinois, USA

Stock Exchange Listing: New York [ABT: NYSE]

Number of Employees: Approximately 91,000 worldwide

2011 Revenue: $38.9 billion

2011 R&D Investment: $4.1 billion

Pharmaceutical

Research Centers:

Abbott Park and North Chicago, Illinois, USA

Worcester, Massachusetts, USA

Ludwigshafen, Germany

Countries Where

Products are Sold: More than 130

Key 2011 Financial Measures

Revenue: $38.9B

Net Income: $4.7B

R&D Investment: $4.1B

Dividend: 39 years of consecutive increases

16 | P a g e

Vision

To be the world’s premier health care company

Dedication

To employees, customers, shareholders, suppliers and the public

Strategy

Value Based Management is our integral philosophy, directed towards maximizing long-term

cash flow and shareholder value through:

Focus on the Company's core profitable segments to build up our position as one of

the leading pharmaceutical companies;

Investments in information technology to improve planning and control of operation;

Increased investments in Human Resources Training & Development to upgrade and

broaden the skill base of the organization in consonance with changing needs;

Build flexible cost-efficient manufacturing base through a balanced mix of in-house

and contract manufacturing

Our Basic Principle

Respect people: Our people are our strength

The Work Culture

Abbott India is an equal opportunity employer and provides a congenial and professional

work environment for all its employees, with great emphasis on teamwork. We stimulate

innovation, encourage calculated risk taking and accept mistakes as a part of the learning

process.

We encourage experiential learning, and believe in clear delegation of authority and

acceptance of personal accountability. We value the involvement of our colleagues in bringing

the best to our organization in a spirit of understanding, trust and appreciation of cultural

differences. We are open to discussing alternative views and build on constructive feedback.

17 | P a g e

The Abbott Brand Promise

A Promise for Life

Turning Science into Caring

We are here for the people we serve in their pursuit of healthy lives. This has been the way of

Abbott for more than a century – passionately and thoughtfully translating science into lasting

contributions to health.

Our products encircle life, from newborns to aging adults, from nutrition and diagnostics

through medical care and pharmaceutical therapy.

Caring is central to the work we do and defines our responsibility to those we serve:

We advance leading-edge science and technologies that hold the potential for significant

improvements to health and to the practice of health care.

We value our diversity – that of our products, technologies, markets and people – and believe

that diverse perspectives combined with shared goals inspire new ideas and better ways of

addressing changing health needs.

We focus on exceptional performance – a hallmark of Abbott people worldwide – demanding

of ourselves and each other because our work impacts people's lives.

We strive to earn the trust of those we serve by committing to the highest standards of quality,

excellence in personal relationships, and behavior characterized by honesty, fairness and

integrity.

We sustain success – for our business and the people we serve – by staying true to key tenets

upon which our company was founded over a century ago: innovative care and a desire to

make a meaningful difference in all that we do.

The promise of our company is in the promise that our work holds for health and life.

18 | P a g e

Company History

In 1888 at the age of 30, Dr. Wallace C. Abbott, an

1885 graduate of the University of Michigan, founded the

Abbott Alkaloidal Company. At the time he was a practicing

physician and owned a drug store. His innovation was the

use of the active part of a medicinal plant, generally

an alkaloid (morphine, quinine, strychnine, and codeine),

which he formed into tiny pills which he called “dosimetric

granules.” This was successful since it allowed more

consistent and effective dosages for patients.

Abbott Laboratories is one of the oldest and most successful pharmaceutical companies in the

United States. While about 30 percent of annual revenues come from the sale of

pharmaceuticals--including Abbott's flagship drug, the antibiotic Biaxin--the company has a

higher profile in the area of nutritionals, where its products include leading infant formula

brands Similac and Isomil and a leading adult nutritional brand, Ensure. Abbott is also a top

manufacturer of medical diagnostic equipment, with an emphasis on blood analyzers and the

detection and monitoring of infections and diseases. The firm's hospital products unit

produces electronic and injectable drug-delivery systems, intravenous solutions and supplies,

anesthetics, and products used in critical care settings. Abbott's annual research and

development budget exceeds $1 billion, with areas of emphasis including AIDS/antivirals,

anti-infectives, diabetes, neuroscience, oncology, pediatric pharmaceuticals, urology, and

vascular medicine.

Early Decades

Abbott Laboratories has its origin in the late 19th century in a small

pharmaceutical operation run from the kitchen of a Chicago physician named Wallace Calvin

Abbott. As did other physicians of the time, Dr. Abbott commonly prescribed morphine,

quinine, strychnine, and codeine--all of which were liquid alkaloid extracts--for his patients.

Because they existed only in a liquid form, these drugs were prone to spoilage over time,

mitigating their effectiveness as treatments. In 1888, Dr. Abbott heard that a Belgian surgeon

19 | P a g e

had developed alkaloids in solid form. Alkaloid pills soon became available in Chicago, but

Dr. Abbott was dissatisfied with their quality, and he decided to manufacture his own.

Dr. Abbott began to advertise his products to other doctors in 1891. So successful was his

business that he eventually sold shares to other doctors and incorporated his operation in 1900

as the Abbott Alkaloidal Company. By 1905, annual sales had grown to $200,000. Ten years

later, the company changed its name to Abbott Laboratories. During World War I, Abbott's

company was essential to the medical community, as several important drugs, manufactured

exclusively by German companies, were no longer available in the United States. Abbott

developed procaine, a substitute for the German novocaine, and barbital, a replacement for

veneral.

After the war, Abbott continued to concentrate on the research and development of new drugs.

In 1921, the company established a laboratory in Rocky Mount, North Carolina, which

developed a number of new drugs, including sedatives, tranquilizers, and vitamins. Even after

Dr. Abbott's death that year, the company continued to invest heavily in new product

development and aggressive marketing campaigns. The company went public in 1929 with a

listing on the Chicago Stock Exchange. Two years later, Abbott expanded outside the United

States for the first time with the establishment of an affiliate in Montreal, Canada.

DeWitt Clough was named president of the company in 1933, ending a period of somewhat

stale communal leadership. A more dynamic character than any since Dr. Abbott, Clough is

best remembered for the inauguration of the company magazine, What's New? The

publication had such a positive impact on worker morale and public opinion that several of

Abbott's competitors started similar publications. In 1936 Abbott began its long-term

association with anesthetics when it introduced sodium pentothal, which had been developed

by Abbott scientists Ernest Volwiler and Donalee Tabern (who in 1986 were named to the

U.S. Inventors Hall of Fame for this discovery).

During World War II, Abbott once again played an important role in battlefield and hospital

healthcare. By this time, American pharmaceutical companies such as Abbott were much less

dependent on Germany's companies, particularly the IG Farben--a conglomeration of the

world's most advanced drug manufacturers. After the war, much of the IG Farben's research

was turned over to American manufacturers. Abbott, however, had little to gain from this

information; it was already a worthy competitor on its own.

20 | P a g e

After the departure of DeWitt Clough in 1945, Abbott shifted its attention to the development

of antibiotics. The company developed the antibiotic erythromycin, which, introduced under

the brand names Erythrocin and E.E.S. in 1952, constituted a significant portion of Abbott's

prescription drug sales for several decades--even after the expiration of its 17-year patent.

Sales of the drug increased dramatically when it was found to be an effective treatment for

Legionnaire's disease.

Abbott stumbled onto a lucrative new product when one of its researchers accidentally

discovered that a chemical with which he had been working had a sweet taste. The chemical, a

cyclamate, could be used as an artificial sweetener. Initially, from 1950, it was marketed to

diabetics, but in the 1960s, as Americans became more health and diet conscious, it was

increasingly used as a sugar substitute in a wide variety of foods.

In 1964 Abbott completed the first major acquisition in company history when it purchased

Columbus, Ohio-based M & R Dietetic Laboratories. M & R was the manufacturer of Similac

baby formula and over the succeeding decades, as the company's Ross Products Division,

formed the basis for Abbott's market-leading infant and adult nutritionals business.

Late 1960s and Early 1970s: Diversification and Crises

By the mid-1960s, Abbott had gone several years without a major

breakthrough in research, and none was projected at any time in the immediate future. Then,

in 1967, Edward J. Ledder was named president of the company. He advocated a reduction in

Abbott's emphasis on pharmaceuticals by diversifying into other fields. In the years that

followed, Abbott introduced an array of consumer products, including Pream nondairy

creamer, Glad Hands rubber gloves, Faultless golf balls, and Sucaryl, the cyclamate sugar

substitute. In an effort to ensure the success of Abbott's consumer product line, Ledder placed

Melvin Birnbaum, a highly experienced and able manager he had hired away from Revlon, in

charge of the division. Ledder's policy of diversification laid the groundwork for more flexible

corporate strategies. No longer exposed exclusively within the pharmaceuticals market,

Abbott was able to cross-subsidize failing operations until they could be rehabilitated.

Despite this flexibility, Abbott soon realized new obstacles to its growth. The company's

hospital products competed in a limited, institutional market. New drugs had greater profit

margins but were subject to government approval procedures that kept companies waiting for

21 | P a g e

several years before they could market their discoveries. Consumer products, on the other

hand, involved more expensive marketing and generated less profit than pharmaceuticals.

Unable to increase profits without substantial risk, Abbott's management decided to maintain

the strategies that were in place.

Cyclamate sales had grown so dramatically that by 1969 they accounted for one-third of

Abbott's consumer product revenues--or about $50 million. The increasing popularity of

cyclamates as an ingredient in diet foods, however, led the Food and Drug Administration

(FDA) to conduct an investigation of possible side effects from their overuse. The FDA's

research was widely criticized as 'fragmentary' and 'fatally flawed,' but it was nonetheless

used as evidence that cyclamates were carcinogenic. The market collapsed in August 1970

when the FDA banned domestic sales of cyclamates. Abbott, which overnight had suffered the

loss of one of its most profitable operations, protested the ban, but was unable to reverse the

decision. Although the company continued to petition the FDA, subsequent studies confirmed

that metabolization of cyclamates can lead to chromosome breakage and bladder cancer.

Less than a year after cyclamates were banned, Abbott was forced to recall 3.4 million bottles

of intravenous solution. The bottles were sealed with a varnished paper called Gilsonite,

which, it was discovered, harbored bacteria. The contamination was discovered only when

healthcare workers noticed and then investigated the high incidence of infection in patients

who had been administered Abbott's intravenous solutions. The Center for Disease Control

linked the contaminated solutions to at least 434 infections and 49 deaths. With sales down

from $17.9 million to $3 million, Abbott's share price began to fall. Abbott moved quickly to

replace its Gilsonite seals with synthetic rubber, but the company was unable to regain its

leadership of the intravenous market. Litigation resulted in the company eventually pleading

no contest to a charge of conspiracy and paying a $1,000 fine.

Late 1970s through 1980s: Emphasizing R & D, Nutritionals, Diagnostic Equipment

The crises of the early 1970s left the company's upper echelon of management

weakened and vulnerable to criticism. Although Edward Ledder was recognized for the

success of his diversification program (and largely excused for his inability to prevent either

the cyclamate ban or the intravenous solution crisis), conditions were obviously ripe for the

expression of talent by a new manager. Robert Schoellhorn, a veteran of the chemical

industry, was just such a manager. His efforts as a vice-president in the hospital products

22 | P a g e

division at Abbott resulted in a revenue increase of 139 percent for that division between 1974

and 1979. He correctly predicted that the next most profitable trend in healthcare would be

toward cost-effective analysis and treatment. Schoellhorn was later promoted to president and

chief operating officer of the company. Meantime, in 1977 Abbott entered into a joint venture

with Takeda Chemical Industries, Ltd. of Japan called TAP Pharmaceuticals Inc. for the

codevelopment and comarketing of pharmaceuticals.

Abbott Laboratories registered an annual sales growth rate of 15.5 percent and an earnings

growth rate of 16.5 percent by 1979. This expansion was attributed by financial analysts to the

company's increased productivity, reduced costs, expansion into foreign markets, and greater

involvement in hospital nutritionals and diagnostic testing equipment. The company also

introduced three new drugs in 1979: Depakene, an anticonvulsant; Tranxene, a mild

tranquilizer; and Abbokinase, a treatment for blood clots in the lungs. All three products were

the direct result of the company's increased investment in research and development in the

mid-1970s.Utilizing its knowledge of intravenous solution production, vitamin therapy, and

infant formula, Abbott developed a comprehensive nutritional therapy program to speed the

recovery of hospital patients and thereby reduce medical care costs. In the 1980s, as many as

65 percent of all hospital patients suffered from some form of malnutrition, so Abbott was

highly successful in marketing their program. Another advantage of adult nutritional products

was that they had a place in the growing home care market.

Abbott had similar success marketing its lines of diagnostic equipment. Electronic testing

devices developed by Abbott proved more accurate than manual procedures. In order to

strengthen the technical end of its diagnostic equipment research, Abbott hired two top

executives away from Texas Instruments to head the division.

Robert Schoellhorn, who advanced to chairperson and chief executive officer in 1979,

continued to emphasize investment in pharmaceutical research and development in the 1980s.

Seven new drugs introduced in 1982 accounted for 17 percent of sales in 1985. Foreign

operations also remained extremely important to Abbott, and the company had more than 75

foreign subsidiaries and manufacturing facilities in more than 30 countries. Schoellhorn

continued to support Ledder's original diversification policy. The introduction of Murine eye-

care products and Selsun Blue dandruff shampoo served to expand the domestic consumer

product line and promised to provide earning stability in the event of a downturn in any of the

company's other markets.

23 | P a g e

Schoellhorn was also credited with promoting Abbott's emphasis on diagnostic equipment,

especially blood analyzers. These devices were increasingly used to detect legal and illegal

substances in the bloodstream. Abbott led the trend, developing the first diagnostic tests for

Acquired Immune Deficiency Syndrome (AIDS), in 1985, and hepatitis. The company's

'Vision' blood analyzer fit on a desktop and performed 90 percent of typical blood tests within

eight minutes. By the end of the 1980s, sales of blood analysis devices represented a billion-

dollar business, and medical diagnostic products (at $2.3 billion per year) constituted nearly

half of Abbott's annual sales. Meanwhile, in the pharmaceuticals arena, Abbott in 1987

received FDA approval for a new drug called Hytrin for the treatment of hypertension. Hytrin

was approved in 1993 for the treatment of noncancerous enlarged prostate.

Schoellhorn was widely praised as the driving force behind Abbott's phenomenal growth

during the 1980s--sales nearly tripled, profits doubled, and the pharmaceutical company rose

to 90th from 197th on Fortune's list of the world's top 500 companies. The leader's aggressive

management style, however, often led to conflict. Over the course of the 1980s, three

presidents--James L. Vincent (1981); Kirk Raab (1985); and Jack W. Schuler (1989)--quit. In

December 1989, Abbott's board of directors unseated Schoellhorn, who in turn sued the

company for his job. Abbott accused Schoellhorn of misappropriation of company assets and

'fraudulent conduct,' adding that the former CEO exercised stock options worth $9.3 million

within days of his release. Schoellhorn was succeeded by Vice-Chairman Duane L. Burnham.

1990s and Beyond: New Drug Introductions and Acquisitions

Unlike many of its competitors (including Merck, SmithKline Beecham, and

Eli Lilly), Abbott did not acquire a drug distribution manager in the early 1990s. Instead, the

company plowed funds into research and development. R & D outlays rose from 5.2 percent

of sales in 1982 to more than 10 percent of sales by 1994--by the latter year, R & D

expenditures neared $1 billion. That year marked the company's 23rd consecutive earnings lift

and helped Abbott's stock hold its value better than most competitors in the uncertain

healthcare environment of the early 1990s.

Among key developments in the early 1990s was the introduction in 1991 of clorithromycin,

an antibiotic developed as a successor to Abbott's erythromycin. Marketed in the United

States under the name Biaxin, clorithromycin was useful in the treatment of common upper

respiratory ailments such as the flu as well as other types of infections. It quickly became

24 | P a g e

Abbott's flagship pharmaceutical--eventually achieving $1 billion in annual sales--remaining

so into the early 21st century.

New product introductions continued in the middle years of the decade. In 1994 Abbott

introduced sevoflurane, an inhalation anesthetic that soon gained popularity because of its

wide range of uses. The following year, TAP, the joint venture with Takeda Chemical,

received FDA approval for Prevacid, an ulcer treatment (sales of Prevacid reached $1.3 billion

by 1998). In 1996 FDA clearance was granted for Norvir, a protease inhibitor for the

treatment of HIV and AIDS.

Despite these R & D successes, Abbott's earnings were failing to increase at the high-double-

digit rate that they had in the 1980s, and the company was beginning to face the risk of being

gobbled up by a larger rival in the rapidly consolidating healthcare industry of the 1990s.

Shrugging off the conservative management of the early 1990s, Abbott moved aggressively in

the second half of the decade to expand via acquisition and thereby stave off being acquired

itself. In 1996 Abbott bolstered its diagnostics division through the $867 million purchase of

MediSense, Inc., a Waltham, Massachusetts-based maker of blood-testing devices for

diabetics. This was the company's first major deal since the 1964 acquisition of M & R

Dietetic Laboratories. In 1997 Abbott spent about $200 million for certain intravenous

product lines of Sanofi Pharmaceuticals, Inc., the U.S. unit of France's Sanofi S.A. Included in

this deal was Carpujet, an injectable drug-delivery system based on preloaded, single-dose

syringes. Also in 1997, Abbott suffered a potential setback when Takeda Chemical did not

renew a ten-year contract that gave Abbott the right of first refusal to distribute Takeda's new

drugs in the United States via the TAP venture. Takeda had decided to set up its own sales and

marketing organization in the United States. By this time TAP was generating annual sales in

excess of $2 billion, primarily from the marketing of Prevacid and Lupron, a prostate-cancer

drug.

By 1997 Abbott had doubled its sales and earnings since Burnham had taken over from the

ousted Schoellhorn. In early 1998 Burnham announced that he would retire in 1999. At the

beginning of that year, Miles D. White, who had been a senior vice-president in charge of the

diagnostics division, took over as CEO. Later in 1999, White was named chairman as well.

During the leadership transition period in 1998, Abbott acquired Murex Technologies

Corporation, a maker of diagnostics products, for $234 million. During 1999, Abbott's

appetite for growth increased exponentially with the announcement in June of a deal to

25 | P a g e

acquire ALZA Corporation for $7.3 billion in stock. ALZA was a leading producer of

advanced drug-delivery systems and had a solid pipeline of new pharmaceuticals under

development. The Federal Trade Commission (FTC), however, raised antitrust concerns about

the merger, and when the two sides were unable to reach an agreement with the FTC, they

called off the merger in December. Another possible factor in the collapse of the deal was the

decline in Abbott's stock price following the company's agreement in November to pull 125

types of medical-diagnostic test kits off the U.S. market and to pay a $100 million civil

penalty to the U.S. government. Since 1993 the FDA had been issuing warnings to Abbott

regarding quality control deficiencies at its test kit plants, with the market withdrawal and

payment of the fine being the outcome of this process. The FDA also cited poor

manufacturing controls as the reason for its halting the sales of Abbott's clot-dissolving agent

Abbokinase in early 1999.

In the meantime, Abbott managed to complete two smaller acquisitions in 1999. It acquired

Perclose, Inc., a maker of sutures used to close arteries during angioplasty procedures, for

about $600 million in stock. Abbott also paid $217 million in cash to Glaxo Wellcome Inc. for

five anesthesia products. In January 2000 Abbott sold its agricultural products business to

Sumitomo Chemical Co., Ltd. Abbott was now for the first time in decades a pure healthcare

firm. Abbott in April of that year began marketing Biaxin XL, a new once-daily formulation

of its flagship Biaxin antibiotic. The FDA in September 2000 granted expedited approval to

Kaletra, a second-generation AIDS medication developed by Abbott. Kaletra had the potential

to overtake the top AIDS drug, Pfizer Inc.'s Viracept, because it had fewer side effects. It also

appeared that patients did not develop resistance to Kaletra over time, as happened with most

other AIDS drugs, including Viracept. Then in December 2000 Abbott launched another

attempt at a major acquisition when it reached an agreement to acquire the Knoll

Pharmaceutical Co. unit of German chemical giant BASF AG for $6.9 billion in cash. Once

again, Abbott's aim was to bolster its product pipeline, and Knoll had at least one potential

blockbuster in a drug called D2E7, an experimental rheumatoid arthritis treatment. Knoll's

existing products included Meridia, an obesity drug with annual sales of about $400 million,

and Synthroid, a $150 million thyroid drug.

In 2010, Abbott Laboratories acquired Piramal Healthcare Ltd.’s branded generic-medicine

unit in India for $3.72 billion, making it the country’s biggest drug maker and tapping into a

market expected to more than double by 2015. Abbott said it will pay $2.12 billion upfront

and $400 million annually for four years from 2011 for the unit, which sells retail-ready

26 | P a g e

pharmaceuticals in India, Sri Lanka and Nepal. The Abbott Park, Illinois-based company will

pay cash for the transaction, expected to close in the second half of 2010.

The acquisition is the second-largest takeover in India’s health-care industry and gives Abbott

a 7 percent stake in the $8 billion Indian pharmaceutical market. The move fits into Abbott’s

strategy of broadening its business beyond brand-name pharmaceuticals in the U.S. and

Europe, where sales are slowing because of generics competition and pricing pressure from

governments.

In India, the pharmaceutical market is expected to increase as much as 16 percent a year

through 2014, according to IMS Health Inc. The $300 billion U.S. market will grow at a

slower rate of 3 percent to 6 percent over the same period, said IMS. The slower growth in the

U.S. and Europe has Abbott and other drug maker turning toward developing countries to

increase sales. Tokyo-based Daiichi Sankyo Co. bought 64 percent of Ranbaxy Laboratories

Ltd., India’s largest drug maker, for about 488.7 billion yen ($5.45 billion) in 2008, the

biggest takeover in the South Asian nation’s pharmaceutical industry, and Pfizer Inc. has been

licensing products from Indian generic-drug maker Aurobindo Pharma Ltd.

Recognition

FORTUNE: Among "Most Admired Companies," 1984-present

Barron's: Listed No. 29 in 2012 ranking of world's 100 most respected companies

Barron's: Miles White among world’s 30 "Most Respected CEOs" four straight years

Dow Jones Sustainability Index: Listed among world leaders in economic,

environmental and social performance seven straight years

Scrip:2011 award for Leadership in Corporate Social Responsibility

The Deal magazine: Most Admired Corporate Dealmaker in health care four straight

years

Working Mother: "100 Best Companies for Working Mothers" 11 straight years

DiversityInc: "50 Best Companies for Diversity" nine straight years

Science and The Scientist magazines: Recognized as a top employer for scientists

for many years

Honored for workplace leadership in more than 25 countries

27 | P a g e

Key Dates:

1888 Dr. Wallace Calvin Abbott begins manufacturing alkaloid pills

1900 Abbott incorporates his firm as Abbott Alkaloidal Company

1915 Company changes its name to Abbott Laboratories.

1929 Abbott goes public with a listing on the Chicago Stock Exchange

1936 Company introduces the anesthetic sodium pentothal

1952 Company launches a new antibiotic, Erythrocin

1964 Abbott acquires M & R Dietetic Laboratories, maker of Similac baby formula

1967 New president Edward J. Ledder begins a diversification into consumer products,

including Sucaryl, a cyclamate sugar substitute.

1970 FDA bans the sale of cyclamates

1971 Abbott is forced to recall 3.4 million bottles of intravenous solution

1977 Company forms joint venture with Takeda Chemical Industries, Ltd. of Japan

called TAP Pharmaceuticals Inc.

1985 Abbott develops the first diagnostic test for AIDS.

1987 Abbott's Hytrin is approved by the FDA for the treatment of hypertension.

1991 Clorithromycin, an antibiotic, is introduced.

1996 Abbott acquires MediSense, Inc., a maker of blood-testing devices for diabetics

1999

Abbott agrees to acquire ALZA Corporation for $7.3 billion but the deal later

collapses; Abbott agrees to pay a $100 million fine relating to quality control

problems at its medical test kit plants; suture maker Perclose, Inc. is acquired.

2000 FDA approves the AIDS drug Kaletra; Abbott agrees to acquire the Knoll

Pharmaceutical Co. unit of BASF AG for $6.9 billion in cash.

Abbott India Ltd. History

Company was originally incorporated on August 22, 1944 under the

Companies Act, 1913 as Boots Pure Drug Company (India) Limited. Its name was then

changed to The Boots Company (India) Limited on November 1, 1971, thereafter to Boots

Pharmaceuticals Limited on January 1, 1991. On October 31, 1995 the name was changed to

Knoll Pharmaceuticals Limited, thereafter to Abbott India Limited on July 1, 2002.

28 | P a g e

1944: All shares issued to Boots Pure Drug Co., Ltd. Only 5 shares issued for cash

1963: 2,00,000 shares issued to the present Company

1965: The Company was incorporated on 15th December

On 19th October, the Company entered into a technical collaboration agreement

with Boots Pure Drug Co. Ltd., England

In December, 2,00,000 shares issued to public (prem. Rs 13 per shares).

1969: 25,000 shares issued at par to L.I.C., U.T.I. and I.C.I.C.I. on conversion of 5%

debenture holdings

1976: The Company undertook to set up a new chemical plant at Ahmednagar, a

backward area in Maharashtra, for the manufacture of Ibuprofen from the basic

stage in technical collaboration with its parent company. Ibuprofen is a raw

material of Boots original research

1977: 1,48,150 Right Equity shares issued to Indian shareholders (prem. Rs 3.50 per

shares: prop. 2:9)

1979: 2,66,050 Bonus shares issued in prop. 1:3

1983: The Company issued 1,70,000-15% non-convertible debentures of Rs 100 each.

These debentures were redeemed on 5th October, 1990 at a premium of Rs 5 per

debenture

The Company also issued 4,27,290 No. of Equity shares of Rs 10 each at a

premium of Rs 45 per share as rights to resident Indian equity shareholders

The object of rights issue and offer for sale was to reduce the holding of Boots

Company PLC, England in the Company from 53% to 40%.

1984: 13,58,520 Bonus equity shares issued in prop.3:5

1986: 4,27,280 new equity shares were offered as Rights to the resident Indian equity

shareholders at a premium of Rs 45 per shares

1987: The Company received a letter of intent for both the products and the expansion

capacity of Ibuprofen was being implemented

40,50,000 bonus equity shares issued in prop. 1:1

1988: The Company undertook a project to set up a new formulation factory at Jejuri in

Pune district

1989: A number of new products, namely Brufen Junior Syrup, Chota Strepsils Icy,

Optrex Eye Lotion, Highly Purified Insulins and Nausidome were launched during

the year

29 | P a g e

1994: Products such as Novopen, Human mixtard, Mixtard penfills were launched

Beem Healthcare Ltd., Lenbrook Pharmaceuticals Ltd. and Valencia

Pharmaceuticals Ltd are the subsidiaries of the Company

1995: It is proposed to change the name of the company to Knoll Pharceuticals Ltd.

effective 31st October, name was changed to Knoll Pharmaceuticals Ltd.

1997: The Company has acquired the product Epilex for a total consideration of Rs 9.90

crores. The product is used in the treatment of epilepsy

The new Goa plant of Knoll Pharmaceuticals, a part of the BASF group, has been

set up. BASF India has also set up two state-of-the-art plants to manufacture

speciality dyes and dispersons in Mangalore and these were commissioned.

1998: Lupharma GmbH, a wholly-owned subsidiary of Knoll AG of Germany, had made

a public offer for acquisition of a further 11 percent holding in Knoll Pharmaceut-

icals in order to take its stake up to 51 percent from the current levels of 40 percent

1999: Beem Healthcare which was engaged in marketing of consumer brands has been

merged with Knoll with effect with July 1998

Knoll Pharma has entered into a three-way pact with the Gujarat-based Torrent

Pharmaceuticals and Danish giant, Novo Nordisk, in the anti-diabetes segment

2000: The Company has entered into a agreement with Kalpataru Homes for the

assignment of the leasehold

Ranbaxy Laboratories Ltd has entered into an agreement with Knoll Pharmaceutic-

als Ltd to market the latter's leading brands in select overseas markets

2001: Lupharma UK Holding One Ltd., a wholly-owned subsidiary of Lupharma GmbH

has proposed to acquire 82,62,000 shares i.e. 51 per cent of the share capital of

Knoll Pharmaceuticals from Lupharma Gmbh

2002: Knoll Pharmaceuticals, the maker of popular painkiller Brufen, has changed its

name to Abbott India following global takeover of Knoll's majority stakeholder -

German firm BASF Pharma - by US drug major Abbott Laboratories

2003: Mr V D Narkar, Director of Abbott India Ltd, has resigned with effect from June

19, 2003

Mr.Ashok Dayal is appointed as Additional Director of the company

Scheme of amalgamation of Lenbrook Pharmaceuticals (a wholly owned subsidi-

ary of the company) with the company

2008: Abbott India Ltd has informed that the Board of Directors of the Company at its

meeting held on February 14, 2008, has appointed Mr. Thomas Dee as the

Additional Director of the Company

2010: Abbott Laboratories bought Piramal Healthcare Ltd.’s branded generic-medicine

unit in India

30 | P a g e

Competition Overview

Competition is mainly from the domestic manufacturers and imports from

China because of the low manufacturing cost. With the new patent regulations the industry

expects to see a major structural shift with the entry of foreign pharmaceutical manufacturers.

There are five government-owned companies the Indian public sector. These companies are

the Indian Drugs and Pharmaceuticals, Hindustan Antibiotics Limited, Bengal Chemicals and

Pharmaceuticals Limited, Bengal Immunity Limited and Smith Stanistreet Pharmaceuticals

Limited. Some of the major Indian private companies are Alembic Chemicals, Aurobindo

Pharma, Ambalal Sharabhai Limited, Cadila Healthcare, Cipla, Dr. Reddy’s, IPCA

Laboratories, Jagsonpal Pharma, J.B. Chemicals, Kopran, Lupin Labs, Lyka Labs, Nicholas

Piramal, Ranbaxy Labs, Matrix Laboratories, Orchid Chemical and Pharmaceuticals, Sun

Pharmaceuticals, Ranbaxy Laboratories, Torrent Pharma, TTK Healthcare, Unichem Labs,

and Wockhardt. The foreign companies in India include Abott India, Astra Zeneca India,

Aventis Pharma India, Burrough-Wellcome, Glaxo SmithKline, Merck India, Novartis, Pfizer

Limited, and Wyeth Ledele India.

Top 10 Publicly Listed Life Science companies in India, as of 2011

Rank Company Name Revenue 2011(USD million)

1 Abbott India Ltd. 1348.51

2 Ranbaxy 1327.56

3 Dr. Reddy's Laboratories 1178

4 Lupin Ltd 929.84

5 Aurobindo Pharma 865.19

6 Dabur 700.3

7 Sun Pharmaceutical 673.99

8 Cadila Healthcare 629.45

9 Jubilant Life sciences 561.03

10 GlaxoSmithKline Pharmaceuticals Ltd 475.8

31 | P a g e

CHAPTER 2 Research Methodology

32 | P a g e

OBJECTIVE & SCOPE OF STUDY

Objective of the Study

The main objective to conduct this research is to understand the Neuromuscular Blocker

(NMB) market & develop the medical positioning for new product launch i.e. Cisatracurium

Primary Objective

To study and understand the concept and process of marketing research.

To understand and get the concept of Marketing of Pharmaceutical products

To get the practical implication of the process involved in any product launch

Scope of the Study

The project scope involves the study of the Anesthetists’ armamentarium of drugs.

Understand the Neuromuscular Blocker (NMB) category, their mechanism of action and

clinical use of NMBs & their place in therapy. The project scope also involves the finding of

clinician preferences in current NMBs available with the marketing research and developing a

medical positioning for Cisatracurium from the above collected data.

Managerial Usefulness of the Study

This study helps to understand marketing research basic terminologies & different strategies

for different market situation

Types of Research and Research Design

Quantative Research- Quantitative research generates numerical data or

information that can be converted into numbers. Only measurable data are being

gathered and analyzed in this type of research.

Qualitative Research- Qualitative Research on the other hand generates non-

numerical data. It focuses on gathering of mainly verbal data rather than

measurements. Gathered information is then analyzed in an interpretative manner,

subjective, impressionistic or even diagnostic

33 | P a g e

Research Methodology

A questionnaire was prepared to gauge the awareness of new molecule in customer.

Survey has been done out of the company covering a wide cross-section of the

industry.

The question was presented in one to one interview with each of the respondents.

Responses of the concerned persons had been thoroughly analyzed.

Conclusions had been arrived at using the response of the concerned persons and not

on questionnaire alone.

Generally speaking, doctors are most reserve persons on the planet and they are not flattered

by attention and this sometimes overcomes any inhibitions so that matters quite secret are

paraded before the observer with seeming abandon. At other times, particularly where an issue

has been the subject of recent press attention, the shutters go up and there is no way in. All

you can do in such circumstances is to give up and try something else likely to be more

productive - you haven't the time to spend on lengthy negotiation. Crucial to the business of

initially gaining access is the whole matter of assurances of confidentiality, anonymity, etc,

which I consider below. Your stance, once granted access, depends on how much of an active

participant you want to be in the arena you are observing - the more obviously committed you

are to one particular stance or ideology the more others will take this into account when

revealing their thoughts or their actions to you.

In this context the questionnaire was not a fully fledged one and was made with an intention

of getting the main information as doctors don’t have that much time to spare and also a long

questionnaire may irritate them. So the questionnaire used in my research was really crisp and

was aimed at getting the required information in the least time, also the questionnaire was

used for primary purpose only.

34 | P a g e

Research Design

Research design specifies the methods and procedures for conducting a particular study. A

research design is the arrangement of conditions for collection and analysis of the data in a

manner that aims to combine relevance to their search purpose with economy in procedure.

Research design is broadly classified into three types as:

Exploratory Research Design

Descriptive Research Design

Causal Research Design

Descriptive Research Design

Descriptive research studies are those studies which are concerned with described the

characteristics of particular individual. In descriptive as well as in diagnostic studies, the

researcher must be able to define clearly, what he wants to measure and must find adequate

methods for measuring it along with a clear cut definition of population he want to study.

Since the aim is to obtain complete and accurate information in the said studies, the procedure

to be used must be carefully planned. The research design must make enough provision for

protection against bias and must maximize reliability, with due concern for the economical

completion of the research study.

SAMPLE DESIGN

A Sample Design is a definite plan for obtaining a sample from a given population. It refers to

the technique to the procedure adopted in selecting items for the sampling designs are as

below:

SAMPLE SIZE

The sample size has been 40 doctors. Conclusions had been arrived at using the response of

the questionnaire.

SAMPLING METHOD

In this marketing research project, I am using Random sampling method.

SAMPLE TYPE

Area Sampling, and the area of sampling is Mumbai & Pune.

35 | P a g e

Data Collection Method

Primary Data: - Primary data means data that are collected by different techniques

like questionnaire, Depth interview, Survey, Schedules etc. In this project, primary

data has been collected by the means of questionnaire.

Secondary Data: - Secondary data means data that are already available i.e.: they

refer to the data which have already been collected and analyzed by someone else.

Usually published data are available in: Various publications of the central, state/local

governments or foreign governments, technical and trade journals etc. The secondary

data involved in this project has been gathered from the medical journals, literatures

and internet.

36 | P a g e

Limitation of the Study

The sample area and sample size has been limited due to time constraint.

Doctors (respondents) are reluctant for their feedbacks & opinions, and authenticity of

their statements can’t be verified too.

All the observation and recommendation will be made on the feedback obtained from

survey.

37 | P a g e

CHAPTER 3 Conceptual Discussion

38 | P a g e

About The Product

NIMBEX® (Cisatracurium besylate)

NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal muscle relaxant for

intravenous administration. Compared to other neuromuscular blocking agents, it is

intermediate in its onset and duration of action. Cisatracurium besylate is one of 10 isomers of

atracurium besylate and constitutes approximately 15% of that mixture.

Abstract

Cisatracurium is a neuromuscular-blocking drug or skeletal muscle relaxant in the category of

non-depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to facilitate

endotracheal intubation and to provide skeletal muscle relaxation during surgery or

mechanical ventilation. It is a bisbenzyltetrahydroisoquinolinium agent with an intermediate

duration of action.

It is the R-cis, R'-cis isomer of atracurium besilate and is approximately 3-fold more potent

than the mixture of isomers that constitute the parent drug. The ED95 for cisatracurium

besilate (dose required to produce 95% suppression of twitch response to nerve stimulation) in

adults is 0.05 mg/kg during N2O/O2 opioid anaesthesia. As for atracurium besilate, the

primary route of elimination of cisatracurium besilate is by spontaneous degradation.

Cisatracurium besilate is not associated with dose-related histamine release (at bolus doses of

< or = 8 x ED95) and, consistent with this, has demonstrated cardiovascular stability in both

healthy patients (< or = 8 x ED95) and those with coronary artery disease (< or = 6 x ED95).

In clinical trials, cisatracurium besilate has been used successfully to facilitate intubation (at 2

to 4 x ED95) and as a muscle relaxant during surgery and in intensive care. Compared with

vecuronium, cisatracurium besilate was associated with a significantly faster recovery after

continuous infusion in patients in intensive care. Relative to atracurium besilate, cisatracurium

besilate has a lower propensity to cause histamine release is more potent but has a slightly

longer onset time at equipotent doses. It also offers a more predictable recovery profile than

vecuronium after prolonged use in patients in intensive care. Thus, comparative data provide

some indication of the potential of cisatracurium besilate as an intermediate-duration

neuromuscular blocking agent but further comparisons with other like agents are required to

define precisely its relative merits.

39 | P a g e

Current Issue/News

March 21, 2012

Abbott Selects AbbVie as New Name for Future Research-Based Pharmaceutical

Company

Company Remains on Track for Separation into Two Publicly Traded Global Health

Care Companies by End of 2012

Abbott Park, Illinois (NYSE: ABT) — Abbott today announced that AbbVie [pronounced

Abb-vee] will be the name of the new, independent research-based pharmaceutical company it

expects to launch by the end of 2012.

The naming of the new company is the latest milestone in the process that began in October

2011, when Abbott announced it would separate into two publicly traded companies, one in

diversified medical products and the other in research-based pharmaceuticals. AbbVie, the

research-based pharmaceutical company, will include Abbott’s current portfolio of leading

proprietary pharmaceuticals and biologics. The diversified medical products company, which

will retain the Abbott name, will consist of Abbott’s existing diversified medical products

portfolio, including its branded generic pharmaceutical, devices, diagnostics and nutritional

businesses. Both companies will be global leaders in their respective industries.

Miles D. White will remain chairman and CEO of Abbott. Richard A. Gonzalez, currently

executive vice president, Global Pharmaceuticals, will become chairman and CEO of AbbVie.

The name is derived from a combination of Abbott and "vie," which references the Latin root

"vi" meaning life.

"The beginning of the name connects the new company to Abbott and its heritage of

pioneering science," said Mr. Gonzalez. "The 'vie' calls attention to the vital work the

company will continue to advance to improve the lives of people around the world."

40 | P a g e

"With a powerful family of products and a continued focus on breakthrough innovations

targeting some of the most critical medical needs, AbbVie will be positioned to deliver

market-leading performance and better health for patients," said Mr. White.

The research-based pharmaceutical company has nearly $18 billion in annual revenue today

and will have a sustainable portfolio of market-leading brands, including Humira, Lupron,

Synagis, Kaletra, Creon and Synthroid. An attractive pipeline of innovative R&D assets – in

important specialty therapeutic areas such as Hepatitis C, immunology, chronic kidney

disease, women's health, oncology and neuroscience – will help drive future growth.

The AbbVie logo and graphic identity will be unveiled when the new company is launched.

May 03, 2012

Abbott Announces Collaboration with Syngene to Open First Nutrition R&D

Center in India

Mumbaiand Bangalore, India — Abbott (NYSE: ABT), one of India's largest health care

companies, today announced plans to establish its first nutrition research and development

center in the country in collaboration with Syngene, India's leading contract research

organization. The Abbott Nutrition R&D Center in India will focus on the development of

science-based, affordable nutrition products for the country and enable the expansion of

Abbott's nutrition product portfolio there.

Abbott selected Syngene – a subsidiary of Biocon, the largest biotech company in India – to

provide a science-based research and innovation team to work closely with Abbott

researchers. More than 50 researchers and scientists will be based at the Abbott Nutrition

R&D Center in India at Biocon Park in Bangalore, which is expected to open in June 2012.

The new R&D center will focus on the development of nutrition products for maternal and

child nutrition and diabetes care. Preventing undernutrition has emerged as one of the most

critical health challenges in India. An estimated 50 percent of Indians (570 million people)

have adequate calorie intake but are not consuming a sufficient level of essential nutrients.1

India also has the world's largest diabetes population, with an estimated 51 million people

41 | P a g e

living with diabetes.2 Among the products being developed for the Indian market are meal

complements for diabetics and pre-diabetics. In addition, the center will address local taste

and texture preferences with new flavors and formulations.

"India is a priority market for investment, growth and innovation," said Robert H. Miller,

Ph.D., divisional vice president, Global R&D and Scientific Affairs for Abbott Nutrition.

"Our strategic collaboration with Syngene will accelerate the design, development and

delivery of science-based, affordable nutrition products in India, for India."

"Health care in India has reached a tipping point as patients seek quality care and products at

affordable prices," said Rehan Khan, managing director, Abbott Nutrition India. "We have

consistently invested in India, and this world-class R&D center will allow us to leverage local

expertise and insights to develop the products we need to successfully expand our portfolio

here."

The nutrition market in India is relatively new and growing steadily. In addition to the

undernutrition and diabetes issues facing India, a rapidly expanding middle class and aging

population are driving increased demand in the country for high-quality, affordable nutrition

products.

"With malnutrition and common chronic diseases at their highest in this region, Abbott and

Syngene have a common vision and commitment to support the development of a healthier

India," said Kiran Mazumdar-Shaw, founder, chairman and managing director, Biocon Group.

"The combined market insights and nutrition science expertise of our two organizations will

enable us to address these immediate needs by developing critically important, innovative yet

affordable nutrition products for the Indian population."

Commenting on the collaboration, Peter Bains, director, Syngene & Clinigene, said, "We are

extremely delighted to partner with Abbott for this synergistic collaboration for its nutrition

business. Our objective will be to develop new products for Abbott's nutrition portfolio. This

symbolizes Syngene's growing capability to offer science-based research and development

solutions across a wide range of life science platforms."

42 | P a g e

About Abbott

Abbott (NYSE: ABT) is a global, broad-based health care company devoted to the discovery,

development, manufacture and marketing of pharmaceuticals and medical products, including

nutritionals, devices and diagnostics. The company employs approximately 91,000 people and

markets its products in more than 130 countries. Abbott currently employs more than 12,000

people throughout India.

About Abbott Nutrition

For more than 85 years, Abbott Nutrition has been developing and marketing science-based

pediatric and adult nutritional products to support the growth, health and well-being of people

of all ages. Abbott offers a variety of nutritional products in India including PediaSure®

(complete, balanced nutrition for children), Similac® (infant milk formula for infants and

children), Mama's Best® (nutritional supplement for pregnant and breastfeeding mothers),

Ensure® (adult nutritionals), Glucerna® (nutrition for people with diabetes) and Prosure®

(nutrition for people with cancer).

About Biocon Limited

Biocon Limited (BSE code: 532523, NSE Id: BIOCON, ISIN Id: INE376G01013) is India's

premier biopharma enterprise focused on innovation to deliver affordable health care solutions

to patients, partners and health care systems across the globe. Established in 1978 by Ms.

Kiran Mazumdar-Shaw, Biocon is committed to reduce therapy costs of chronic diseases like

diabetes, cancer and autoimmune diseases to provide access to affordable treatment to patients

globally. Biocon's key innovations include the world's first Pichia-based recombinant human

Insulin, INSUGEN®, insulin analog Glargine, BASALOG® and India's first indigenously

produced monoclonal antibody, BioMAb-EGFR®, for head & neck cancer. INSUPen® is a

next-generation affordable insulin delivery device introduced in India. With a risk-balanced

business model comprising small molecules, novel molecules, biosimilars, branded

formulations and research services, Biocon has evolved into an emerging global enterprise

serving its partners and customers in over 70 countries.

More information is available at www.biocon.com

43 | P a g e

About Syngene International Limited

Syngene is India's leading contract research organization offering integrated drug discovery

and development services with capabilities in medicinal chemistry, biology, in vivo

pharmacology, toxicology, custom synthesis, process Research and Development, and

formulation development for small and large molecules. Syngene has an expert team of over

1,500 scientists and 1 million sq. ft. of built-up laboratories equipped with state-of-the-art

infrastructure to support the Research and Development programs of global pharma, biotech

and nutrition companies. More information is available at www.syngeneintl.com.

44 | P a g e

CHAPTER 4

Data Analysis

45 | P a g e

METHODS & TECHNIQUES

OF DATA ANALYSIS

Data Analysis Concept

Data analysis is a practice in which raw data is ordered and organized so that useful

information can be extracted from it. The process of organizing and thinking about data is key

to understanding what the data does and does not contain. There are a variety of ways in

which people can approach data analysis, and it is notoriously easy to manipulate data during

the analysis phase to push certain conclusions or agendas. For this reason, it is important to

pay attention when data analysis is presented, and to think critically about the data and the

conclusions which were drawn.

Raw data can take a variety of forms, including measurements, survey responses, and

observations. In its raw form, this information can be incredibly useful, but also

overwhelming. Over the course of the data analysis process, the raw data is ordered in a way

which will be useful. For example, survey results may be tallied, so that people can see at a

glance how many people answered the survey, and how people responded to specific

questions.

In the course of organizing the data, trends often emerge; modeling the data with the use of

mathematics and other tools can sometimes exaggerate such points of interest in the data,

making them easier for the researcher to see. Charts, graphs, and textual writeups of data are

all forms of data analysis. These methods are designed to refine and distill the data so that

readers can glean interesting information without needing to sort through all of the data on

their own.

46 | P a g e

Data Analysis process

Once the necessary data collected, the next task is to aggregate the data in a meaningful

manner. A number of tables are prepared to bring out the main characteristics of the data. The

researcher should have a well thought out framework for processing and analyzing data, and

this should be done prior to the collection.

It includes the following activities:

I. Editing

The first task in data processing is the editing. Editing is the process of examining

errors and omissions in the collected data and making necessary corrections in the

same.

II. Coding

Coding is necessary to carry out the subsequent operations of tabulating and analyzing

data. If coding is not done, it will not be possible to reduce a large number of

heterogeneous data into meaningful categories with the result that the analysis of data

would be weak and ineffective, and without proper focus.

III. Tabulation

Tabulation comprises sorting of the data into different categories and counting the

number of cases that belong to each category. This is also called universal tabulation.

The analysis based on just one variable is obviously meager. Where two or more

variables are involved in tabulation, it is called vicariate or multivariate tabulation.

IV. Analysis

After the all three above steps, the most important step is analysis of the data.

47 | P a g e

DETAIL ANALYSIS

OBJECTIVE 1: NMB Molecule Practiced by Doctors

In the process of market survey, the first thing to determine was to find out the Neuromuscular

Blocker (NMB) preferred by the doctors in their clinical practice. Out of those visited, the

information has been collected and it has been noticed that though most of the Doctors

preferred one or more available NMB molecule.

Hence, in order to find out the actual figure for the preference of the available NMB, the

criteria has been set to find out the actual preference of the NMB by doctors.

This is done by maintaining the criteria for NMB preference by doctors, if the percentage of

consumption of the particular molecule is 50 % or more than only it is counted in the

following chart:

Chart 1: Most Commonly Prefered NMB agent in Clinical Practice

65%

19%

16%

Preference of NMB in Clinical Practice

Atracurium

Vecuronium

Rocuronium

48 | P a g e

INFERENCE

65% of doctors Preferred Atracurim than any other available molecule and their

percentage of consumption ranged above 50% to 90%, some of them were using 100%

only Atracurium

The 2nd

and 3rd

preference by doctors were consecutively Vecuronium and

Rocuronium, with 19% and 16% respectively

Other molecules, like Pancuronium & Succinylcholine too stand in the preferred list of

molecules but their percentage of consumption is too less to be considered in the

above chart.

Chart 2: Preference of NMB in Clinical Practice (Mumbai Region)

68%

11%

21%

Preference of NMB in Clinical Practice (Mumbai Region)

Atracurium

Vecuronium

Rocuronium

49 | P a g e

Chart 3: Preference of NMB in Clinical Practice (Pune Region)

INFERENCE

From the above chart, it is quite obvious that Atracurium is the most preferred

molecule in both Pune & Mumbai Region.

But, another fact noticed here is that Rocuronium is the 2nd

best preferred and

consumed in Mumbai, while it is Vecuronium in the case of Pune.

58%

33%

9%

Preference Of NMB in Clinical Practice (Pune Region)

Atracurium

Vecuronium

Rocuronium

50 | P a g e

Chart 4: % of Distribution % of Consumption of different NMB

INFERENCE

The above Chart gives the clear view of the actual percentage of consumption of each

molecule.

As seen above, Atracurium is the most preferred as well as most consumed molecule

compared to Vecuronium & Rocuronium,

55% of doctors have higher degree of consumption of Atracurium, i.e. - more than

60%. While in the case of both Vecuronium and Rocuronium, only less than 20% of

doctor’s consumption value ranges in the same category.

Again, from the chart it can be easily determined that Vecuronium has edge over the

Rocuronium in terms of consumption which lies between 30-60%.

Pancuronium is no more practiced in the GA procedures. Only one or two cases were

found where Pancuronium is still being practiced, but in very few cases.

Apart from this, Succinylcholine is used in the most of GA procedures, but its use is

mostly restricted to the intubation cases or difficult airway cases.

22%

77% 74%

23%

16%

10%

55%

7%

16%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Atracurium Vecuronium Rocuronium

< 30 % of Consumption

30 - 60 % of Consumption

> 60 % of Consumption

51 | P a g e

OBJECTIVE 2: Characteristics doctors prefer in an ideal NMB

In the process of marketing survey, the most important task was to gather the information

regarding the characteristics which doctors expect in an ideal Neuromuscular Blocker (NMB).

For this a set of characteristics was prepared and while interaction with doctors, they were

asked to number them in accordance to their preference which they consider most important

in the NMB.

After the detailed analysis of the information collected, the following table has been tabulated

to form the facts desired:

Table 1: Percentage of Doctors and their Preference (Mumbai Region)

Preference of Characters-

tics in an ideal NMB 1 2 3 4 5

Onset of Action 35% 30% 13% 13% 9%

Duration of Action - 9% 17% 48% 26%

Safety 52% 39% 5% 4% -

Recovery Time 9% 13% 52% 13% 13%

Potency 4% 9% 13% 22% 52%

With respect to above table it can be concluded that, in Mumbai doctors prefer the following

characteristics in an ideal NMB.

(The list given below is in ascending order)

1. Safety

2. Onset Of Action

3. Recovery Time

4. Duration of Action

5. Potency

52 | P a g e

Table 2: Percentage of Doctors and their Preference (Pune Region)

Preference of Characters-

tics in an ideal NMB 1 2 3 4 5

Onset of Action 14% 36% 7% 29% 14%

Duration of Action 7% 29% 43% 14% 7%

Safety 79% 14% 7% - -

Recovery Time - - 29% 50% 21%

Potency - 22% 14% 7% 57%

With respect to above table it can be concluded that, in Pune doctors prefer the following

characteristics in an ideal NMB.

(The list given below is in ascending order)

1. Safety

2. Onset Of Action

3. Duration of Action

4. Recovery Time

5. Potency

INFERENCE

From the data collected, it can be easily figured out that Safety is the most important

characteristics that doctors seek in any molecule, while Potency is the least important

characteristics in the list.

But, there is variation in the sequence of preference of the characteristics in an ideal

NMB in Mumbai and Pune area

Considering the above facts now the data is further compiled and analyzed to get a real

picture of the preference.

53 | P a g e

Table 3: Overall % of Doctors and their Preference of Characteristics

Preference of Characters-

tics in an ideal NMB 1 2 3 4 5

Onset of Action 27% 32% 11% 19% 11%

Duration of Action 3% 16% 27% 35% 19%

Safety 62% 30% 5% 3% -

Recovery 5% 8% 44% 27% 16%

Potency 3% 13% 14% 16% 54%

With respect to above table it can be concluded that, doctors prefer the following character-

istics in an ideal NMB (the list given below is in ascending order):

1. Safety

2. Onset Of Action

3. Recovery Time

4. Duration of Action

5. Potency

On compilation of entire sample size, it is now clear that Safety is the most important element

in the molecule which doctors values most, followed by Onset of action, Recovery Time,

Duration of Action and last Potency.

Out of the whole sample size, 62% of the sample space considers ‘Safety’ to be most ideal

characteristics in NMB.

54 | P a g e

OBJECTIVE 3: Parameters that best describes the NMB Molecule

The five characteristics that make a molecule an ideal NMB are: Safety, Onset of action,

Recovery time, Duration of action & Potency. Now, another task in the survey is out of these

characteristics which characteristics best describes the available NMB molecule.

For this, simple survey technique of multiple choices has been adapted and after the detailed

analysis of the collected data following output has been derived:

Chart 5: Best positioning of NMB with 'Onset of Action'

Succinylcholine 47%

Rocuronium 44%

Atracurium 6%

Pancuronium 3%

Onset Of Action

55 | P a g e

Chart 6: Best positioning of NMB with 'Duration of Action'

Chart 7: Best positioning of NMB with 'Recovery Time'

Atracurium 33%

Vecuronium 25%

Pancuronium 22%

Rocuronium 17%

Succinylcholine 3%

Duration Of Action

Atracurium 67%

Rocuronium 22% Succinylcholine

6%

Cisatracurium 5%

Recovery Time

56 | P a g e

Chart 8: Best positioning of NMB with 'Safety'

Chart 9: Best positioning of NMB with 'Potency'

Atracurium 42%

Vecuronium 28%

Rocuronium 19% Cisatracurium

11%

Safety

Rocuronium 42%

Vecuronium 33%

Atracurium 14%

Pancuronium 8%

Succinylecholine 3%

Potency

57 | P a g e

Chart 10: Overall % of doctors supporting NMB with its best attribute

INFERENCE

From the above chart the positioning of the molecules can be easily derived.

While considering the Safety aspect of NMB, 42% doctors consider Atracurium as the

safest NMB followed by Vecuronium & Rocuronium.

47% of doctors are with Succinylcholine & 44% of doctors are with Rocuronium, in

terms of onset of action.

In terms of recovery time, 67% of doctors consider Atracurium the best neuromuscular

agent.

With the 42% of doctors supporting Rocuronium, it is considered the most potent

NMB agent.

Most interesting fact came in the study is that, before the launch of Cisatracurium- it

has positioned itself as the safe molecule and also holds a position with good recovery

time.

0%

10%

20%

30%

40%

50%

60%

70%

Atracurium Rocuronium

Vecuronium

Succinylcholine

Pancuronium

Cisatracurium

Onset of Action 6% 44% 0% 47% 3% 0%

Duration Of Action 33% 17% 25% 3% 22% 0%

Recovery Time 67% 22% 0% 6% 0% 5%

Safety 42% 19% 28% 0% 0% 11%

Potency 14% 42% 33% 3% 8% 0%

% o

f D

oct

ors

58 | P a g e

OBJECTIVE 4: Preference of NMB with following Parameters

Though preference of molecule in GA procedures has been determined earlier, it is evident to

find out whether the use of that molecule is independent of surgery duration or not. Hence, the

parameter has been set to find out the desired facts.

All the surgery procedure has been classified into three parts:

­ < 30 minutes

­ 30 - 60 minutes

­ > 60 minutes

In the process of survey, further remarks were collected from doctors for the use of the

molecule. Though no. of vials used for the single surgical procedure couldn’t be determined.

Chart 11: Preference of NMB in <30 minutes GA procedures

Atracurium is the most commonly used molecule in less than < 30 minutes surgery

procedure.

Vecuronium is the least preferred molecule with the above parameters.

Atracurium 87%

Rocuronium 5%

Vecuronium 3%

Succylincholine 5%

< 30 minutes Surgery Procedure

59 | P a g e

Chart 12: Preference of NMB in 30-60 minutes GA procedures

Chart 13: Preference of NMB in >60 minutes GA procedures

Atracurium 58%

Vecuronium 26%

Rocuronium 3%

Pancuronium 13%

30 - 60 minutes Surgey Procedure

Atracurium 32%

Vecuronium 26%

Rocuronium 39%

Pancuronium 3%

> 60 minutes Surgery Procedure

60 | P a g e

INFERENCE

From the above chart, it is evident that 87% doctors prefer Atracurium in <30 minute

surgery while only 58% doctors prefer Atracurium in 30-60 min. surgery procedure.

But, the percentage is quiet low in case of >60 minute surgery. Only 32% doctors

prefer Atracurium in long surgery procedure.

The positioning of Rocuronium is best in terms of long surgery procedures with an

hour or more than that. 39% of doctors prefer Rocuronium over other molecule in >60

minute surgery procedures.

Vecuronium is the second most preferred molecule in the 30-60 minutes surgery

procedure.

Though Pancuronium is very less in clinical practice these days. But still 13% of

doctors prefer it in 30-60 minutes procedures.

From the above facts, it is quite clear that choice of NMB in GA is also dependent of

the surgery duration.

Remarks Sited by Doctors for their Preference of NMB

Succinylcholine

Recovery is complete & good

Pancuronium

Longer acting

Rocuronium

Duration

Safe

Better relaxant

No repetition

Longer duration of action

61 | P a g e

Atracurium

Short Acting, Less recovery time

Short duration & safe

Early and easy Recovery

No histamine release

Best for kidney & liver dysfunction, renal disease

Ultra short acting & self reversal

Good relaxation & cardiostable

Only short acting muscle relaxant available

No residual blockade

Recovery is good

Alter the duration by using in DIP

Adaptable for any duration

Can be used for intubation

Vecuronium

No cardiac effect

Longer duration of action

Intermediate acting

Cardiostable & Potent NMB agent

Top ups needed after some reasonable period

Potency & Safety

62 | P a g e

OBJECTIVE 5: Use of Reversal Agent

Doctors use the reversal agent in all the cases, has been the common belief for years. Hence,

in order to determine the actual fact regarding this it is essential to directly interact with

doctors and collect the needful information. What has been basic motive behind using the

reversal agent?

With all such questions, after the analysis correct fact and figure has been derived:

Chart 14: Distribution of Doctors that prefer Reversal Agent

79%

21%

Need of Reversal Agent in GA Procedures

Yes

No

63 | P a g e

Chart 15: Distribution of NMB Agents with their % of Need of Reversal Agent

Note: - In terms of Cisatracurium, most of the doctors resisted in providing opinions about it

since they weren’t using it. Hence, total sample size is only 16 in the case of Cisatracurium.

Out of which, 63% of doctors believed it don’t any reversal agent.

Reasons for the Need of Reversal Agent as mentioned by Doctors

The patient should be reversed even though it is a self reversal agent, to rule out

residual blockade if any.

There has been common belief that, reverse all patients.

Used to be sure of reversal

Hoffman’s elimination

Just as a safety, major though not mandatory

Cannot avoid reversal

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Atracurium Rocuronium Vecuronium #Cisatracurium Succinylcholine

76% 84% 84%

37%

8%

24% 16% 16%

63%

92%

Yes NO

64 | P a g e

Major findings from the above analysis and chart can be concluded as: -

79% of doctors have a belief that a patient must be reversed, even though if it is a self

reversal agent.

Though, it is not true in the case of Succinylcholine, 92% don’t use any reversal agent

with it.

Compared to Rocuronium & Vecuronium, Atracurium has better positioning as self

reversal agent as only 76% of doctors use reversal if Atracurium has been used in GA.

Rocuronium & Vecuronium stands at similar situation having 84% doctors using

reversal while used in GA.

Most important concept in the analysis came out as, Cisatracurium is considered as

self reversal agent as likes of Succinylcholine.

63% doctors believe it doesn’t need any reversal.

65 | P a g e

OBJECTIVE 6: Determination of Intubation & Maintenance NMB

In the process of marketing survey, it is essential to determine whether doctors prefer the

same Neuromuscular Blocking Agent for intubation as well as in maintenance. The main

purpose of finding this is to know whether doctors use different combination of drugs in

surgical procedure. If yes, what possible combination they follow.

In the course of analysis, it came to notice that not all the doctors use different combination of

molecule. Mostly, the surgery is initiated by using Succinylcholine in intubation and followed

by any other available NMB agent. The finding of analysis is as:

Chart 16: Percentage of Doctors using same relaxant in GA procedures

Since, percentage of doctors using the different NMB molecule in intubation and

maintenance is very low but most of doctors still mix the molecule as per the patient norms.

Mostly, it depends on the type of surgery and the criticality of the case. Availability of

molecule also influences the decision of using the same NMB agent in intubation as well as in

maintenance.

0% 10% 20% 30% 40% 50% 60% 70% 80%

Same NMB Agent

Different NMB

76%

24%

% of Doctors Using Same NMB

66 | P a g e

Different Combination of NMB which doctors prefer:

Succinylcholine Atracurium/Vecuronium/Rocuronium/Pancuronium

Rocuronium Atracurium

Atracurim Vecuronium

Vecuronium Atracurium

From the above facts & feedbacks collected in research process, it can be said mostly

Succinylcholine is used in intubation and continued by any of the muscle relaxant available or

the muscle relaxant of their choice. But, as the above chart shows 76% doctors don’t mix the

molecules in surgery procedures. If Atracurium/Rocuronium is used in intubation than it is

followed by same molecule in maintenance. Only in few cases, Rocuronium is followed by

Atracurium & Atracurium is followed by Vecuronium

67 | P a g e

OBJECTIVE 7: Most Vital Characteristics of Cisatracurium

One of the most important information needed to conceptualize is to determine, what is the

most vital characteristics of the Cisatracurium? The options for this question were:

a. More potent than available NMB agents

b. Less risk associated with the molecule

c. Very less histamine release than Atracurium

d. Among other intermediate acting NMB, it has slower onset of action

Among the choices, the doctors supported for the following choices which according to them

are vital characteristics of the molecule.

A. Only a

B. Only b

C. Only c

D. Both b & c

E. All the three(a, b & c)

F. All the choices(a, b, c & d)

Chart 17: Distribution of most vital characteristics of Cisatracurium

3%

18%

47%

16%

3%

13%

Most Vital Characteristics of Cisatracurium

A

B

C

D

E

F

68 | P a g e

OBJECTIVE 8: Ideal Condition for use of Cisatracurium

With the most vital characteristics of Cisatracurium known to us, thus it is evident to find out

the target market in which it would function smoothly. Hence, it is necessary to find out the

ideal condition for use of Cisatracurium. For this purpose, the GA procedure has been

segmented into three categories:

a. All the GA procedures with duration below 30 min.

b. All the GA procedures with duration between 30-60 min

c. All the GA procedures with above 60 min.

Though, given with only three choices most of the doctors considered Cisatracurium to be

used in all GA procedures. The final analyses of this research concluded with the following

findings:

A. Only a

B. Only b

C. Both a & b

D. Both b & c

E. All of the GA procedures (a, b & c)

Chart 18: Distribution of clinical opinion about Cisatracurium in GA procedures

24%

16%

11% 8%

41%

Clinical use of Cisatracurium in GA Procedures

A

B

C

D

E

69 | P a g e

INFERENCE

From the chart above, it can be derived that:-

­ 41% of doctors out of total sample size, thinks Cisatracurium can be used in all GA

procedures.

­ 24% of doctors feel it will be useful only in GA procedures below 30 minutes of

surgery duration.

­ Rest all has the mix opinion about Cisatracurium.

­ One of the major findings, from the above analysis is that majority of doctors feel it

can be used in all the GA procedures.

Though, Cisatracurium is yet to be launched in India. Hence the initial opinion about the

molecule has positive response from doctors. Some of doctors consider that Cisatracurium is

more useful in Kidney disease patients. One of the other positioning characteristics of

Cisatracurium came in research process is that, few doctors has belief that Cisatracurium may

not require reversal agent as complete recovery is possible out of it.

70 | P a g e

CHAPTER 5 Findings, Conclusion

And Suggestions

71 | P a g e

INTERPRETAION

Abbott Lab’s strength is in its differentiation. Its strength in differentiation comes from the

immense diversity of products the company offers that are considered innovative and unique

compared to products made by competitors. Abbott Labs produces pharmaceutical, medical,

and nutritional products. They are the leading innovators in anesthetics, and diabetes care.

Abbott’s financial performance is consistent with its mission, objectives, and organizational

environment. The company’s vision is “Always at the forefront, always first choice,” and the

company embraces the idea of “focusing on a culture of continuous improvement and a

dedication towards organizational excellence”. This includes the improvement of employees,

products, and the company as a whole. Abbott’s greatest differentiator is in the diverse mix of

their business portfolio. Abbott’s broad line of products and the success of their employees is

what contribute to such high numbers, as well as the company’s ability to produce what

people need throughout the world, medically, pharmaceutically, and nutritionally.

The industry is changing fast. To survive and to prosper involves managing drug pipelines –

as drugs come off patents they no longer bring in enough revenues and must be replaced

quickly by other drugs with durable patents. This means that the companies have to think

ahead, something that sounds easy but involves great risks. Huge sums must be invested in

uncertain in-house research and development and/or must go toward mergers and acquisitions

with other promising companies. Strategic alliances can be used to augment opportunities as

well. As companies develop their new pipelines, they must be mindful of changes caused by

regulations and deregulations in countries all over the globe. The global competitive

environment creates challenges and opportunities for the companies – with equal importance

for the communities in which they reside.

This research offers no new insights into what it takes to build a viable new product launch

but it surely underlines two facts – that it is worth doing in Indian market and that it will

involve retaining and attracting more market share with financial boost that need to take

sizeable financial risks.

72 | P a g e

FINDINGS FROM THE RESEARCH

An important facet of research is “the analysis and positioning of available Neuromuscular

Blocker (NMB), and discuss opinion about the Cisatracurium before the launch in the Indian

market”. Cisatracurium has been available in International market for years, but the

availability of the new molecule in India solely depends on the Abbott Laboratories. Since,

Cisatracurium is licensed to use by Abbott Laboratories.

In terms of the new molecule Cisatracurium, Abbott holds monopoly in the market. But, it is

essential to study the detailed performance of available muscle relaxant in the market, in the

NMB category. This would determine the clinical positioning of Cisatracurium.

From the research, it has been figured out that ‘Safety’ is the most important

characteristics that individual seek in a NMB agent.

Atracurium has been in the top of the list in their clinical practice in any GA

procedures, followed by Rocuronium and Vecuronium. This creates a good market for

Cisatracurium, since most of the doctors consider it as one of the safest molecule in

the NMB category.

Apart from this, use of reversal agent in GA procedure has been very often or

common. Though, the main reason cited for the need to use reversal has been that,

79% of doctors believe the patient must be reversed.

But, it is not true for all the molecules. In terms of Succinylcholine, 92% doctors

believe it doesn’t need any reversal, as it is considered as self- reversal agent. 63% of

doctors have similar belief about Cisatracurium, which gives it competitive advantage

over available NMB agents.

While considering the distribution of GA procedures, it has been found that

Atracurium dominates the market share when it comes to below 30 minutes surgery or

30 – 60 minutes surgery.

But more than 60 minutes surgery is controlled by nearly equal market share of

Vecuronium, Rocuronium & Atracurium. Where, Rocuronium has edge over the other

two.

From the above analysis it is evident that Atracurium is the most preferred molecule

by doctors and also holds larger market share than other competitors.

73 | P a g e

CONCLUSION

The pharmaceutical industry currently represents a highly competitive environment.

Pharmaceutical companies have to operate in a highly regulated environment; the degree of

regulation to a significant extent depends on the country and type of the product. One of the

most important aspects of government regulation for pharmaceutical companies is price

regulation, and different countries have different policies on this issue. As the result of price

control, prices of the same products can significantly differ in different countries.

Abbott Laboratories has been enjoying the long run of its monotonous market in terms of its

product Sevorane. With the new product launch, Cisatracurium it wouldn’t be wrong to say

that company will enjoy the similar situation, if price being the competitive factor.

With the Atracurium occupying the maximum market shares in NMB category, it would be

easy to be replaced by Cisatracurium. Since, it is one of the 10 isomers of original molecule

atracurium besylate. Prior to its launch and clinical use Cisatracurium has been well

positioned as self reversal agent. Hence, it has good positioning in terms of need of reversal

agent. Cisatracurium being one of the safest molecule in the NMB category, it can pick up in

the market quiet well. As in the research it has been found that ‘safety’ is the most important

characteristics that doctor seek in an ideal NMB. Apart from this, majority of doctors has a

belief that it would be essential for all GA procedures.

Hence, it can be considered that the market condition and initial opinion about the product is

ideal for the launch of Cisatracurium.

74 | P a g e

SUGGETIONS

The main challenges for drug companies come from four areas. First, they must deal with

competition from within and without. Second, they must manage within a world of price

controls that dictate a wide range of prices from place to place. Third, companies must be

constantly on guard for patent violations and seek legal protection in new and growing global

markets. Finally, they must manage their product pipelines so that patent expirations do not

leave them without protection for their investment.

Lastly, in terms of Cisatracurium the market development is essential which would help the

company in creating increased market share. For this purpose Abbott India Ltd. should focus

on following:

Cisatracurium being one of the 10 isomers of original molecule atracurium besylate; it

should be market as that way. Its advantages over Atracurium should be counted in its

marketing strategy.

There is a need of self reversal agent in the NMB category, since the Succinylcholine

is only muscle relaxant available hence Cisatracurium should be positioned as self

reversal agent. Most of the individual already believe that it doesn’t need any reversal.

‘Safety’ and ‘Onset of action’ are two most vital characteristics for an ideal NMB

which doctors prefer and Cisatracurium is considered to possess both characteristics.

Thus, it should be counted in the marketing strategy of the product.

Cisatracurium is considered to perform better in Kidney & Renal patients. Thus, this

market should be targeted prior to expansion of any other area.

Abbott Labs’ should launch it India with price being competitive. It will be the best

molecule available in market so if priced competitively it will be picked up like

anything.

75 | P a g e

CHAPTER 6 Appendix & Bibliography

76 | P a g e

Marketing Research (Sample Questionnaire)

Objective: To understand the Neuro Muscular Blocker (NMB) market & develop the medical

positioning for Cis-Atracurium

Name:

Hospital Name:

E-mail:

Ph No.:

1. Kindly mention the NMBs that you use in your clinical practice and the % of GA proced-

ures in which they are used?

NMB Molecule Name Percentage of Consumption

Atracurium

Pancuronium

Vecuronium

Rocuronium

Succinylcholine

2. What are the characteristics you expect to be in an ideal Neuromuscular Blocker (NMB)?

Put the numbering as per your preference.

Parameters Preference

Onset of action

Duration of action

Safety

Recovery time

Potency

3. Among the given parameters, which parameter you consider, best defines the below ment-

ioned NMB? (Kindly mark only one molecule with [√ ], against each parameter)

Neuromuscular

Blocker Agents

Onset of

Action

Duration of

Action

Recovery

Time Safety Potency

Atracurium

Vecuronium

Rocuronium

Succinylcholine

Cisatracurium

Pancuronium

77 | P a g e

4. Kindly mention the dosage protocol you follow for each of the following NMB agents.

NMB Intubation

(mg/kg)

Maintenance

(mg/kg)

1st maintenance

(Time in min)

2nd

maintenance

(Time in min)

Atracurium

Vecuronium

Rocuronium

Succinylcholine

Cisatracurium

Pancuronium

5. Under the following parameters, what is your preference of the NMB molecule? Mention

the quantity of the molecule used along with the reason for the choice.

Surgery

Duration

NMB Agent

Preference

Quantity Used in single Procedure Reason for the

Choice No. of Vials Strength

<30

minutes

30-60

minutes

>60

minutes

6. Do you need to use the ‘Reversal agent’ with the following NMB molecules? If yes, What

is the percentage of surgery procedure in which you have to use ‘reversal agent’?

Also give the remarks for its need of use.

NMB Agents Reversal Agent? What % of Procedures?

Remarks if any? Yes No

Atracurium

Vecuronium

Rocuronium

Succinylcholine

Cisatracurium

Pancuronium

7. Do you use the same agent for intubation and maintenance of neuro muscular blockade? If

No, what are the different combinations of NMBs that you use clinically?

Intubation NMB Maintenance NMB % of procedures?

78 | P a g e

8. According to you, which of the following is the most vital characteristic of the Cisatracu-

rium?

a. More potent than available NMB agents b. Less risk associated with the molecule c. Very Less histamine release than Atracurium

d. Among other intermediate acting NMB, it has slower onset of time

9. Considering the above advantages, which of the following will be the ideal condition for

the use of Cisatracurium?

a. All the GA procedures with duration below 30 min

b. All the GA procedures with duration between 30 – 60 min

c. All the GA procedures with duration above 60 min

Date: - Signature

79 | P a g e

Abbreviations

NMB: Neuro Muscular Blocker

GA: General Anaesthesia

R & D: Research and Development

ABT[NYSE]: ABBOTT[New York Stock Exchange]

E.E.S.: Erythromycin Ethylsuccinate

FTC: Federal Trade Commission

FDA: Food and Drug Administration

80 | P a g e

Bibliography

Reference Books

Marketing Management, Philip Kotler 14th

Edition

Research Methodology, C. R. Kothari Second Edition

Strategic Marketing Management, Richard M. S. Wilson, 3rd

Edition

Medical Journals

Clinical Literatures

Website References

www.generalanaesthesia.info

www.drugs.com

www.wiki-meds.com

www.druglib.com

en.wikipedia.org

www.abbott.co.in

www.abbott.com