What UPI did to consumers and businesses, UPHI will do to healthcare

The COVID-19 pandemic proved India’s ability as a global vaccine manufacturer, providing safe and affordable vaccines. How can we capitalise on these abilities?

Yes, India has established its prowess in vaccine manufacturing which has been possible due to concerted efforts of the scientific community, the government, and the private sector. Even before the pandemic surged in India, the Indian pharma industry contributed to 62 per cent of the global demand for vaccines. However, with the COVID-19 vaccine, we have lived up to not only being the “archetype of frugal innovation” but manufacturing at scale, but with exceptionally faster turnaround and great efficiency. The digitisation effort through the Co-Win app enabled implementation, equitable distribution and consumer guidance of availability, next doses and helped in governance on infection control mechanisms (vaccine passport as one may want to call it) the scale and speed of which the world had not seen before.

India can play a huge role towards creating “vaccine equity” by providing access to countries or regions such as Africa, Latin America which are facing acute shortages of these vaccines. Adult immunisation/vaccination could be also another way to capitalise on these abilities. Given the younger population in the country, spread of communicable diseases more so after the pandemic and the lack of healthcare accessibility in the hinterland, this could be a cost-effective strategy towards primary care for public health. With concerted efforts from government, public and private enterprises this could be realised.

Pharma companies in India are still not self-sufficient in APIs and the increasing number of COVID cases in China has already resulted in price hikes and shortages of certain key starting materials and APIs. What can be done to speed up the implementation of schemes like the PLI initiative to scale up API capability?

The current PLI scheme has an outlay of close to one billion dollars with an aim to substitute 90 per cent of API import and develop API sufficiency for domestic and become suppliers to the world. While the long-term objectives of the scheme are robust there has been a low to moderate response with only a few companies in the top tier and at the bottom getting a go at it. The key is to open again and expand, attract more investment from the middle market where a lot of players can be encouraged to come in and shape a global play. This will help get more players in and drive the cause. The last couple of years have seen PEs’ interest in the area and will remain an interesting space to watch. At hand is not only reducing cost but also an entire China plus one global opportunity which we can encash with backward integration in API.

Pharma companies in India have always been price warriors but the branded generics space is today crowded with competition from other nations like Vietnam etc. How can India’s pharma sector move up the value chain, into segments like biologics, speciality pharma etc? What will be the investments that need to be made and a realistic timeline to see success?

The investment must be in R&D and innovation space to move up the value chain and become a “value-driven” industry from a volume-driven industry. This may require setting up an overarching regulatory body and central body to financing from all government bodies, exploring new models for financing R&D to increase private investments and make funds available for high-risk/long-term projects. We are already seeing partnerships with academia by the industry. ImmunoAct (a Laurus Labs investee company) is a Delhi IIT initiative on CarT cell therapy heralding India‘s arrival in cell and gene therapy. Immuneel and other innovator start-ups will lead India’s foray into this.

Perhaps there are more models to look at like one in the Massachusetts Life Sciences Innovation ecosystem. Also, to establish a strong innovation ecosystem, the role of the government in terms of encouragement and instituting an RLI is being actively considered by the DoP and pushed by the industry. The industry will do well to join hands to mobilise action with the government.

COVID-19 was a huge disrupter to the pharma supply chain and procurement practices. How can pharma companies deploy technology to prevent and resolve such challenges?

The major challenge which the pharma industry faced during Covid times was the inability to capture external data in real-time and synthesise it into actionable and visual insights to enable rapid and better decision-making. To enable improvement across the value chain, moving from linear and serial monoliths to an interconnected network of digital supply networks to enable end-to-end visibility, collaboration, responsiveness, agility and optimisation will be key. Complicated as it may seem this is being attempted and soon to be a reality by the Govt of India through ABDM under the aegis of the NHA. It is predicted what UPI did to consumers and businesses, UPHI (under ABDM) will do to healthcare consumers and the industry.

Pharma companies must leverage Industry 4.0 practices, IOT and sensors. The ability to create data lakes and provide analytics will be key. AI tools can mine and analyse data from multiple sources to detect patterns and potential anomalies to generate demand forecasts and identify potential disruptions like Covid-19. Using these early indications, possible preventive actions can be identified driving better decision-making and action.

Real-Time Location System in distribution channels will provide insight to track and trace, in real-time, the movement of goods and packages from the suppliers, manufacturers, warehouses and hubs to the end customer preventing any major disruptions. This will reveal logistics supply market details helping in reducing lead times and providing dynamic freight prices.

Life sciences companies have been forced to speed up the digitisation process across functions during the COVID years. What have been the early wins/advantages of deploying such technologies?

On the supply side, the ability of Indian pharma to meet the demands of meds during the pandemic in an agile and timely manner was indeed a showcase event to the world. This is due to the digitisation of operations and supply chain which started a few years ago. The pandemic has only accelerated this journey and Indian pharma companies are only intensifying their digital transformation across, R&D, manufacturing, supply chain and customer-facing areas. Many Indian companies are investing in process excellence to build a digital layer on top.

On the demand side, service providers and doctors’ access to patients through e-consult, e-commerce players offering new, one-stop-shop for concierge services like diagnostics, meds, consultation and at-home services have now come to stay as new business models. Lifesciences companies are now partnering with service providers to improve patient experience and help improve outcomes beyond the pill initiatives, as pharma calls them.

Availability of longitudinal patient records, IOMT and wearables have all led to better patient data being available and pharma companies are using real-world evidence and data to bring new and repurpose existing meds for unmet needs and indications. In the coming time, more and more targeted and personalised therapy will be a realm of the ordinary as the benefits of data and analytics come to the fore.

Pharma companies have been the target of data theft and ransomware. What is the way forward towards a sustainable digital evolution for pharma companies, while protecting the vast data created during R&D, clinical trials etc?

The recent incidences at IPCA, Intas, Arti Drugs and AIIMS impacting operations and publishing confidential data on the dark web have really bought the issue facing global pharma closer home. While connectedness has enormous value, it also poses certain risks. To share data, it is important to build trust in the ecosystem and ensure that other parties’ data security and tools support digital use authorisations, traceability, and control.

Much of that is currently a major unmet need across the sector. Governance structures, policies, and privacy practices must be sufficiently robust to address the ethical, and legal issues associated with collecting, storing, and sharing sensitive health data. Furthermore, as connectivity becomes more important in pharma and healthcare, regulators will continue to emphasise the importance of privacy, consent and data security.

India’s reputation as the ‘pharmacy of the world’ is being threatened by quality concerns such as deaths linked to cough syrups reportedly containing solvents contaminated with ethylene glycol and diethylene glycol. How can India counter these challenges?

This is a paradox India has always had to live with. Insufficient control despite having great capability. There is an urgent need for measures to improve quality control and assurance mechanisms that govern all products Small, Medium and Large Enterprises as regards quality. The Ayushman Bharat Digital Mission (ABDM) by the National Health Authority has in its remit to index drugs that are produced in India through a registry which allows for easy identification (QR Codes) and traction of all drugs produced in India along with other anti-counterfeit measures.

While these are necessary steps, speed is of the essence. More so if we are striving to move up the value chain with clear regulatory standards, vigilance, and approval mechanisms around new forms of therapy, rare diseases, first-in-class therapies and conduction of clinical trials early stage and Phase 3. With the digitisation of protocols and the ability to measure patients’ data in real time, we would be able to build transparency and credibility in the eyes of the world.

Many pharma companies in India are entering the nutraceuticals sector but how can they differentiate themselves from the herd?

Nutrition is a great opportunity for Indian-branded generic pharma. Nutrition is becoming attractive as it offers a differentiated opportunity, less regulated and with more freedom to innovate and drive channel growth and consumer loyalty. The pandemic has also given a boost to self-care, impacting consumption, and immunity boosters and dietary supplements make it more attractive now. This is further evident in the transactions of nutraceutical companies in the M&A space that we are witnessing and PE money aiding newer, and pharma naïve entrepreneurs get into the fray.

New forms like gummies, jellies and soft gels and easy availability through D2C e-commerce platforms have given companies direct access to the consumer and open to creating loyalty and move with the life cycle of the consumer. Further connected commerce gives the ability to build brands digitally and makes marketing more efficient as opposed to traditional cost-intensive channels and sales force.

Further PLI scheme in Nutra is on the anvil driven by the Nutra task force and will bring in more players and establish India as a nutraceutical destination. The jury is out on whether Indian Pharma can replicate their pill and vaccine success to become nutraceutical suppliers to the world. The pie awaiting is a $650 billion market by 2030[1].

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