Express Pharma

Contraception portfolio to continue to be important given the unmet medical need

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Bayer Zydus Pharma is committed to focus on working with the relevant stakeholders to enhance its presence in gynaecological therapies in India. Manoj Saxena, MD – Bayer Zydus Pharma, reveals more

What are the health issues faced by women which are unique to India, due to socio-economic reasons, genetic disposition, etc?

Women in India face numerous health challenges throughout their lives from puberty to menopause, and even beyond that.

Issues like malnutrition, poor reproductive and maternal health are dominant among women in India. The World Bank Data 2015 reports that nearly 45,000 maternal mortality cases in India are due to causes related to childbirth every year accounting to about 17 per cent of such deaths globally. The lack of knowledge on proper family spacing through the appropriate use of contraceptives is a major challenge in India, while gynaecological issues like Polycystic Ovary Syndrome (PCOS), menstrual disorders and endometriosis are also on rise in our country. These issues not only impact the physical health of women but also affect their overall well-being, hampering their quality of life.

According to Indian Human Development Survey 2012 about 79.8 per cent of women need permission to visit a health centre either from a senior male or female member in the family. This indicates the lack of empowerment among women to make decisions related to their health. Literacy plays an important role in understanding and addressing health concerns. With a low female literacy rate at 68.4 per cent, reported in  the National Family Health Survey 2015-16 (NFHS-4), there is still an unmet need to increase the level of awareness on health issues among women in India in order to encourage earlier intervention and proper management

Which are the three to four segments within women healthcare where Bayer has chosen to specialise in?

With almost nine decades of experience, Bayer is a pioneer in the field of women’s health. The first studies on female hormones were initiated by Bayer in the 1920s. Since then, we have come a long way – from developing the first Combined Oral Contraceptive pill (Anovlar ) to pioneering research in intrauterine contraception systems.

Bayer is committed to delivering science for a better life by advancing a portfolio of innovative treatments. Women’s health including family planning and menopause management has been in the centre of Bayer’s gynaecology franchise for many years. Today, our research efforts focus on finding new treatment options for gynaecological diseases with a high medical need such as uterine fibroids and endometriosis, which affect a large number of women in our society. In India, our women’s healthcare business focusses on three areas: contraception, menopause management and gynaecology. We recently launched Visanne in India for treatment of endometriosis. This marks a considerable step forward in managing this chronic, debilitating disease.

What have been the disease trends in this therapeutic segment?

The recent National Family Health Survey 2015-16 (NFHS-4) released in 2018 showed that 47 per cent of the married women between 15-49 years did not use any method of contraception. Another recent study of postpartum unintended pregnancies published in 2016, has revealed that 88 per cent of them end in induced abortions1. The low use of contraceptive methods is attributed to the lack of information on the available options and apprehensions about their use. Some of the major roadblocks in decision making on the contraceptive use are the social barriers and the patriarchal system of society which does not encourage discussion of the topic with family and elders.

In gynaecology diseases,  two in five adolescents and one in five adult women in India are likely to suffer from PCOS 2. These are higher than the global numbers of one in 10 women suffering from PCOS. Similarly, from about 17 crore women with endometriosis in the world, around 2.6 crore women (in reproductive age-group) are in India.3 These prevailing health challenges deteriorate the quality of life for women impacting their physical and emotional well-being.

Are there enough cost effective treatment options in India in these disease areas?

There are various cost effective treatment options available in India The cost of opting for contraception is affordable in India. In fact it is lesser in comparison to dealing with an unplanned pregnancy.

Bayer continues to make some of its well-researched, innovative and modern therapies available in India and they are priced according to the value they offer to patients. I must say the treatment options in India are on par with the treatments offered to women in developed countries.

Given that India is a price sensitive market, under insured and that the average woman tends to prioritise her family’s health rather than her own, most women health conditions go undiagnosed until too late. For instance, breast and cervical cancers are not detected until in the 3rd/ 4th stages. How can we address these challenges?

The announcement of the Universal Health Cover by the government in the recent budget is a positive step to make healthcare accessible. This may help address the financial burden for the patients. There is also a need for continuous awareness initiatives to educate and inform women about the health issues, which would help them in early diagnosis and treatment.

There is still a stigma attached to discussing issues like menstrual hygiene, infertility issues, contraception etc. How can pharma companies build awareness around these areas in a responsible manner?

Early awareness is required on these topics among both men and women. We need to overcome the social barriers and be open to discuss contraception, and gynecological issues which concern women’s health and society at large. Most of women depend on peers and the Internet as the source of information. It is important to guide them towards the right sources of information. As a healthcare innovator, pharmaceutical companies can play a responsible role in educating women and men and helping them make the right choices.

Globally, Bayer has identified this cause and supports initiatives like the World Contraception Day (WCD) that takes place on September 26th every year. This annual worldwide campaign centres on the vision where every pregnancy is wanted. Since the last 10 years, WCD has been celebrated around the world with a mission to improve awareness of contraception and to enable young people to make informed choices on their sexual and reproductive health.

Bayer in India has also introduced the #Bareyourpain campaign to create awareness and encourage women to come out and speak up about endometriosis or period-related pain, instead of suffering in silence.

In another initiative, Bayer has supported the development of the guidelines for disease management of PCOS and menstrual disorders. These guidelines serve as the standard of treatment and care and help healthcare practioners determine the right treatment options that benefit patients.

The government has some schemes dedicated to women’s health. How can pharma companies like Bayer collaborate with the government to maximise resources and amplify awareness?

Bayer Zydus Pharma closely works with Federation of Obstetric and Gynaecological Societies of India (FOGSI) on various campaigns to create awareness on women’s health. We have conducted about 75 programmes in colleges last year to educate young girls on the PCOS and its management. We are open to evaluating projects which could benefit women and society.  As part of our Corporate Societal Engagement (CSE) initiative – Discovering Hands, Bayer is empowering visually impaired women by training them to detect signs of breast cancer. In another project, Bayer is also working to provide low cost sanitary pads to rural women and girls in and around Hyderabad.

Empowerment of women is one of the pillars of our CSE initiatives and we are also contributing to this cause though our expertise and offerings in women’s healthcare.

How does Bayer Zydus’ women healthcare (WHC) leadership position differ from its peers, globally as well as in India?

Bayer is a pioneer in the research of women’s health, be it in the development of its first oral birth control pill or its highly effective intrauterine contraceptive systems or research in areas of endometriosis and PCOS.  Bayer has always led the way.

Our long-standing history and expertise in women’s health is trusted among the healthcare community. It is the quality of our products and promise they deliver that makes us a trusted partner. We are in a leadership position in most of the women’s health products in the represented market.

What is the revenue share of the WHC business? What is the strategy to grow the WHC business?

The pharma business sales were € 16.4 billion in 2016 and we have invested € 4.4 in research and development. Our portfolio in Women’s Healthcare contributed significantly to our overall business.

Bayer Zydus Pharma is committed to focus on working with the relevant stakeholders to enhance its presence in gynaecological therapies in India.  The launch of Visanne is a milestone in this direction. The contraception portfolio will continue to be important for us given the unmet medical needs in contraception in India. We will stay committed to the cause of women’s health and empower women to make informed choices in taking care of their health and well-being.

What are the promising leads in the research pipeline in the WHC segment? What are the future disease trends in this therapeutic segment?

Today, our research efforts focus on finding new treatment options for gynaecological diseases with a high medical need such as uterine fibroids and endometriosis, which affect a large number of women in our society. The gynaecology pipeline at Bayer includes several investigational compounds in various stages of preclinical and clinical development. Together, these projects reflect the company’s approach to research, which prioritises targets and pathways with the potential to alter the way that gynecological diseases are treated.

As an example our research pipeline comprises Vilaprisan – a novel oral treatment of uterine fibroids currently in Phase III clinical development as well as for endometriosis in Phase II.

Will 2018 see any new launches in the WHC segment? Do give some details.

Bayer Zydus Pharma has recently launched Visanne in India for the treatment of endometriosis. This extended long-term oral therapy is specifically developed for women with endometriosis. Visanne has been proven to benefit patients in many countries and is currently available for Indian women suffering from pain due to endometriosis.

We are committed to improving the health and well-being of women and their families by contributing to better disease awareness to drive early diagnosis and by bringing to women safe, effective and tolerable treatments for diseases afflicting women.

References:
1. Hooda R. et.al. International Journal of Reproductive Medicine Volume 2016, Article ID 7695847
2. Fertility Science and Research Journal of the Indian Fertility Society in 2014,
3. Bendigeri T,  Warty N, Sawant R et.al. Endometriosis: Clinical Experience of 500 Patients from India. The Indian Practitioner. July 2015; 68(7):34-40.

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