Express Pharma

Safeguarding the golden years

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Geriatric care and health management raises unique social, economic, and clinical challenges in India. From a pharma perspective, tackling their medication needs for complex health issues require special attention to protect their sunset years

Japan, the country with the highest number of old people, is also home to 117-year-old Nabi Tajima of Japan, now the oldest living person in the world whose age has been documented. He took over this slot from Violet Brown, another 117-year-old from Japan who died recently, on September 15, 2017. Yet, we have a contender from India as well. Almost a year back, Swami Sivananda from Varanasi claimed to be 120 years old and was in the process of applying for the Guinness World Record. Thus, lifespans in India too have increased significantly and thereby so has the number of older people in the country.

According to United Nations estimates, India has the largest youth population, but a report released by the Ministry of Statistics also reveals that the number of citizens over the age of 60 jumped 35.5 per cent — from 7.6 crores in 2001 to 10.3 crores in 2011.

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Utkarsh Palnitkar

The growing number of senior citizens in India have also created the need for healthcare methods which are suited for this population. Speaking in his personal capacity, As Utkarsh Palnitkar, Partner and Head, Infrastructure, Government and Healthcare, Life Sciences KPMG India points out, “India’s population is expected to grow from 1.32 billion in 2016 to 1.51 billion by 2030, an increase of 14 per cent. This is likely to, in turn, lead to a growing elderly population (aged 60 years above) which is projected to rise from 121 million in 2016 to 190 million by 2030, an increase of 56.2 per cent. This demographic shift will serve as a key driver for the demand of medicines in the country.”

Special attention for senior citizens

This necessitates the need for specially designed medication and treatment protocols to suit the needs of this population. There are several factors that need to be considered during formulation of medicines, drug delivery and treatment of the geriatric population. Palnitkar informs, “The prevalence of chronic disease in the geriatric patient population such as asthma and heart disease are more prevalent amongst Indian men, whereas ailments like arthritis, hypertension, cataract and diabetes are more prevalent amongst women. India’s epidemiological profile would, thus, become increasingly favourable for pharma companies as the burden imposed by chronic diseases grows.”

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Nishant Vaidya

Nishant Vaidya, Senior Product Manager, Bliss GVS Pharma also states, “The major concern for the elderly population are, loco motor disabilities, irritable bowel syndrome, heart diseases, skin disorders and mental disorders due to ageing brain.”

So, how do we handle the special and specific needs of this special population?

Depicting the Indian scenario, Palnitkar informs, “In India, elderly patients have a traditional mind-set and prefer conventional formulations such as oral and injectable. Doctors also find it challenging to explain the administration of suppositories and pessaries to elderly patients. Hence, promoting these dosage forms would be an ambitious task for pharma companies.”

However, Nishant Vaidya highlights the challenges and shortcomings in the traditional and conventional dosage and delivery methods and states, significance of identifying disease profiles and states, “In elderly population, pharmacokinetics are strongly influenced by co-morbidity, polypharmacy or impaired organ functions. Though oral formulation is widely accepted in the Indian market, these dosage formulations come with their own set of problems when used in elderly population.”

Are suppositories the