rabicip & i.v
TRANSCRIPT
CiplaLife care
Medico-marketing module
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Let us talk pride, lets talk Rabicip
Rabicip Success
Recognition
LovedPriority
10% Cont.
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Our learning objectives today
How common is ARD (Acid Related Disorder)?
Types of ARD and how it happens?
Opportunity for our brand
Market scenario
Molecular Unique Selling Proposition (USP)
Brand USP
In clinic situations and conversion tips
Our objective for coming months
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Symptoms of Acid Related Disease…
ARD Abdominal bloating.
Stomach discomfortpain
Heartburn
Acid regurgitation
Nausea
Early satiety Excessive burpingbelching
Feeling of abnormal slow digestion
95%Lifetime
60-70%Month
5-10%Daily
NOT VERY UNCOMMON
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Fire…Burning…Pain
Affects quality of life
Significant work days loss and long term treatment
Hospitalization as 25% of peptic ulcers develop complications
Definitely Not A Pleasurable Experience
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Lets understandAcid Related Disorders
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Parts of Gastro Intestinal System
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Mechanism of Acid Secretion
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What Is the Optimal Gastric PH for healing
pH 4 Ulcer healing above 4
pH > 5 to 7 For hemostasis: blood clotting and platelet aggregation
pH > 7 Optimal for preventing ulcer rebleeding
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Acid Related Disorders: Types
Gastritis Acute, Chronic
Duodenitis
GERD (Gastroesophageal Reflux disease)
Peptic Ulcer diseaseGastric ulcer, Duodenal ulcer
Hypersecretory conditions Zollinger Ellison syndrome
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Antacids
Prostaglandins e.g. Misoprostol
H2-receptor Antagonists
Cimetidine,Famotidine,Ranitidine
Proton Pump inhibitors
Omeprazole,Pantoprazole,Lansoprazole,
Esomeprazole, Rabeprazole
The Medicines
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Opportunity Everywhere
Who Treats
Typical gastro intestinal symptoms.. Indigestion,Pain in the abdomen, loss of appetite, gas, abdominal distention etc
General practitioner or Gastroenterologists
GERD asthma, Chronic cough Chest physician
Non cardiac chest pain Cardiologist
Drug induced ulcers Orthopaedician
Stress ulcers Surgeons and Intensivists
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Point need to remember Till Now
Who treats acid related disorders
Acid related disorder and types
How PPI is better than H2 RA
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Acid Related Disorders Focus on the Hospital
Setting
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Acid Suppression in Critical Care Settings
1. Bleeding acid peptic disease
Accounts for > 150000 hospitalisations and 8-12000 deaths per year.
2. Stress induced mucosal injury
Usually seen in ICU patients.
3. Acid Inhibition During Surgery
4. Severe Reflux Esophagitis
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Point need to remember Till Now
Indication for Rabicip I.V.
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Molecular USP
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Are All PPIs (Oral,i.V.) The Same
NO
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Pharmacodynamic Differences
Activation
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Proton Pump Inhibition After One Dose
Pharmacodynamic Differences (Cont.)
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Metabolism
• Genetic polymorphism
• Inter-patient variability
• Fast or slow metabolisers
Pharmacodynamic Differences (Cont.)
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Unique Property
Enhances gastric mucin secretion
Pharmacodynamic Differences (Cont.)
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Molecular USP
Fastest activation among all PPIs
100% inhibition of Proton Pump in just 5 minutes
Increases gastric mucin secretion by 41%
Greter antisecretory effect over a 24hr period than any other PPI
Efficacy of Rabeprazole is not affected by genetic
polymorphism
Minimum drug to drug interactions
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Point need to remember Till Now
Molecular USP of Rabicip.
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Market
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Key Insights - Anti-ulcerant Market
Doctors’ prefer newer PPI’s (especially Pantoprazole & Rabeprazole)
Constant ‘hammering’ I.e brand reminder is the need of the hour
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The Market
Total market = 415 Cr
Growth = 9 %
Players = 200 +
138 Cr6%
118 Cr14%
109 Cr18%
27 Cr-2%
23 Cr-14%
Omeprazole Pantoprazole Rabeprazole Esome Lansoprazole
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Know your competitor
Omeprazole Pantoprazole Rabeprazole
Omez (DRL) Pantocid (SUN) Razo (DRL)
Ocid (ZYC) Pantodac (ZYC) Rablet (Lupin)
Protoloc (USV) Pan (AK) Rekool(ALMB)
Ometab (INT) Pantop (ARIS) Happi (GR)
Ocid DSR (ZYC) Pantium (INT) Rabeloc (ZYC)
Brands for retailing : All Rabeprazole and highlighted omeprazole &
pantoprazole brands
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What Competitors Are DoingIn clinic PDA, DMC, Gifts
Academic Journals (Am J Gas. – Sun, Endoscopy clinic - Cadila)
Books – Sun, Cadila
Updates - (Recent advances in Gastroenterology – Alkem)
Special activity GET cool with REKOOL, Letter campaign (FDC)
Sponsorship Academic
CME Cadila, Sun, Intas
Gastro club Sun
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Targets - Rabicip
Audience− Gastros, Cons./Chest Phy, Gen. Surgeons, Ortho &
Top GPs
Molecules− Pantoprazole,Omeprazole & other brands of
Rabeprazole
Indications− GERD / Reflux Esophagitis− Acid peptic disorders− Drug induced gastritis
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Pricing and Packaging
Rabicip 20 (15’s) – Rs. 48.58
Rabicip 10 (15’s) - Rs. 34.13
Presentation
Sale pack: Strip of 15 tablets
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Point need to remember Till Now
Name of my competitors.
Target specialty and indication for me
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How Do We Tackle Competition
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Conversion Aid Cum Brand Reminder
Must communicate:
Reviews 27 of the top general and specialty medical journals to keep clinicians up to date on the most important research appearing in the literaturer
Only Cipla is authorized to provide this valuable (Rs. 700 / copy) journal to the doctor
Frequency / Qty – In every 2 month / 4-5
Audience - Gastros, Cons.Phy (Selected)
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Conversion Aid Cum Brand Reminder
Must communicate:
Provides comprehensive information on a single topic, hence highly respected worldwide
Only Cipla is authorized to provide this valuable (Rs. 4000 / copy) journal to the doctor
Frequency / Qty – In every 3 month
Audience – Only Gastros
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Lets Practice
How to emphasize on importance?
How to take commitment for support?
Some common practices (Pre announcement, Prior appointment)
Input handling – GCNA, Journal watch
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Additional Support
Interesting & innovative literature (DMC, 4 pager…)
Gifts
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Brand USP
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Product services
Revolutionize Hep B mgmt. (1st time in India- Lamivudine, Adefovir, Lansoprazole, Hydrocortison foam)
1.3 minutes
Our strong campaign on activation time
Academic services - GCNA,, Journal watch
Personal touch - Visit, Activity, Need based sampling
Brand USP
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In clinic Situations
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How Do We Convert Pantoprazole Prescribers
WinnerRabicipPantoprazole
RabicipUnaffectedMetabolism affected by CYP2C19 enzyme
Rabicip100%Just 20% inhibition of proton pump in 5 mins.
RabicipJust 1.3 mins.Activation time is 4.6 mins.
RabicipSignificantly higherAnti-secretory effect is moderate
Rabicip(3.4) significantly higher
Increase in intra-gastric pH (2.2) is moderate
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How Do We Convert Omeprazole Prescribers
Omeprazole Rabeprazole
Activation time is 2.8 mins. Just 1.3 mins.
Only 47% inhibition of proton pump in 5 mins.
100% inhibition of proton pump in 5 mins.
Inadequate acid suppression over 24 hrs.
Adequate & sustained acid suppression
Anti-secretory effect is moderate Significantly higher
Only 32% patients got complete heartburn relief on day 1
As high as 65% patient got complete heartburn relief on day 1
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Hospital Doctors
•All ICUs, ICCUs, SICUs and Intensivists
•All doctors attached to Gastroenterology, Surgery and Medicine department
Trade Doctors
•Gastroenterologists
•General Surgeons / Gastro Surgeons
•Cons. Physicians
•All doctors attached to Polyclinics / Nursing Homes
Targets – Rabicip I.V.
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Price:•Rabicip I.V. 20 mg- Rs 60.99
Presentation:•Each 10 ml vial contains Rabeprazole Sodium for Injection 20mg with 5ml of sterile water for injection.
Pricing and Packaging
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A COMPARISON WITH PANTOPRAZOLE I.V.
Rabicip IVRabicip IV Pantoprazole IVPantoprazole IVIV 20 mg 6 hourly in upper IV 20 mg 6 hourly in upper gastrointestinal bleed , 20 mg OD gastrointestinal bleed , 20 mg OD – all other indications– all other indications
80 mg stat followed by 8 80 mg stat followed by 8 mg/hr, i.e. 272 mg/daymg/hr, i.e. 272 mg/day
100% inhibition of proton pump 100% inhibition of proton pump at 32 min even in presence of at 32 min even in presence of blood in stomachblood in stomach
49% inhibition of proton 49% inhibition of proton pump at 342 min if pH 5.1 due pump at 342 min if pH 5.1 due to presence of bloodto presence of blood
pH > 6 for 100% of 24 hr at 20 pH > 6 for 100% of 24 hr at 20 mg 6 hourlymg 6 hourly
Median pH 2.2 for 24 Hr at 40 Median pH 2.2 for 24 Hr at 40 mg IV OD. Wide variation mg IV OD. Wide variation even at 272 mg/d infusioneven at 272 mg/d infusion
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Rabicip I.V
Rate
Don’t encourage beyond the stipulated norm, seek BM participation for entry
Similar efficacy why change ?
Talk about slow on set of action when blood in the stomach, follow with genetic polymorphism.
Pantoprazole is better
Acknowledge individual opinion, give reference, request to try your brand
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Let’s Revisit the Highlights
CiplaLife careRabicip- An Ace Mover
Feature Benefits
Starts action in just 1.3 mins Fastest onset of action amongst all other PPIs
Complete inhibition of Proton Pump in just 5 mins. Rapid relief of symptoms
Sustained acid suppression over 24 hours Day & Night acid control
No inter patient variability More predictable effect
Only PPI to increase gastric mucin secretion Succesfully prevents reccurence of ulcers
Significantly increases intra- gastric Ph Greater anti- secretory effect
Not metabolised by CYP 450 enzyme system Least drug- drug interaction
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The coming months with Rabicip
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Territory Avg.YPM Gr%
Shrikaulam 1504 12
Bhimabharan 1428 23
Sikar 1295 295
Tiruvalla 1140 22
Kolar 1051 74
Will you be there?
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Believe in you
With will you can
write the future