Summer Internship Project Report

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

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 10th

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 2|Page

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

3|Page

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)

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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

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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 6|Page

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

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

1.2.Company 1.2. Company Profile……………………………………………………...…12 1.2.1. 1.2.2. 1.2.3. 1.2.4. 1.2.5. 1.2.6. 1.2.7.

About the Company Corporate Overview Fact sheet Vision Dedication Strategy The Work Culture The Abbott Brand Promise

1.3.Company 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 1.4.Competition Overview………………………………………………….30 2. CHAPTER 3: Research Methodology………………………………...31-36

2.1.Objective 2.1. Objective and Scope of Study…………………………………………..32 2.1.1. 2.1.2. 2.1.3. 2.1.4.

Objective of the Study Scope of the Study Managerial Usefulness of the Study Types of Research and Research design

2.2.Research 2.2. Research Methodology………………………………………………….33 2.3.Research 2.3. Research Design………………………………………………………...34 2.4.Sample 2.4. Sample Design…………………………………………………………..34 2.4.1. Sample Size 2.4.2. Sampling Method 2.4.3. Sample Type

2.5.Data 2.5. Data Collection Method…………………………………………….…..35 2.6.Limitation 2.6. Limitation Of the Study ………………………………………………....36

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

3.1.About 3.1. About Product: Cisatracurium………………………………………….38 3.2.Current 3.2. Current Issues/News……………………………………………………39 4. CHAPTER 4: Data Analysis……………………………………..……44-69

4.1.Methods 4.1. Methods and Techniques of Data Analysis Analysis…………………………….45 4.1.1. Data Analysis Concept 4.1.2. Data Analysis Process

4.2.Detail 4.2. Detail Analysis……………………………………………………….....47 5. CHAPTER 5: Findings, Conclusion & Suggestions……………….....70-74

5.1.Interpretation 5.1. Interpretation…………………………………………………………....71 5.2.Findings 5.2. Findings………………………………………………………….……...72 5.3.Conclusion 5.3. Conclusion………………………………………………………..……..73 5.4.Suggestions 5.4. Suggestions……………………………………………………….…..…74 6. CHAPTER 6: Appendix & Bibliography …………………………….75-80

6.1.Sample 6.1.Sample Questionnaire……………………………………………….….76 6.2.Abbreviation 6.2. Abbreviation & Notations………………………………………….…...79 6.3.Bibliography 6.3. Bibliography……………………………………………………….…....80

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CHAPTER 1  Introduction

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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 reverseengineering 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.

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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. 11 | P a g e

Company Profile About The Company Abbott Laboratories is a Chicago-based global, diversified dive rsified (multi-division) (multi-d ivision) 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,

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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.

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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



Animal Health



Pediatric Nutrition



Anti-infectives



Diabetes Care



Healthy Living



Cardiovascular



Diagnostics



Medical Nutrition



Immunology



Hematology



Metabolics



Molecular



Neuroscience



Point of Care



Oncology



Vascular



Pain Care



Renal Care



Virology

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Fast Facts Abbott Chairman and CEO:

Miles D. White

Corporate Headquarters: North suburban Chicago, Illinois, USA Stock Exchange Listing:

New York [ York [ABT: NYSE] 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

R&D Investment: $4.1B

Net Income: $4.7B

Dividend: 39 years of consecutive increases

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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.

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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.

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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 p art of a medicinal plant, p lant, generally gen erally 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 18 | 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.

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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 20 | 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 21 | 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 eyecare 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. 22 | 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 billiondollar 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 23 | 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-doubledigit 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 24 | 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 25 | 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 26 | 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.

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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 non-convertib le 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

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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 Pharmaceuticals 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 Pharmaceuticals 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 subsidiary 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 29 | 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

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CHAPTER 2  Research Methodology

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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 nonnumerical 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

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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 ti me 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.

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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.

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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.

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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.

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CHAPTER 3 Conceptual Discussion

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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 neuromuscular-b locking 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. 38 | 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  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."

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"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 specia lty therapeutic areas such as Hepatitis C, immunology, chronic chro nic 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) 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 40 | 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."

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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

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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.

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CHAPTER 4  Data Analysis

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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.

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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 possibl e 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 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 o n just one variable vari able is obviously obviousl y 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.

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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:

Preference Preference of NMB in Clinical Practice

16%

Atracurium

19% 65%

Vecuronium Rocuronium

Chart 1: Most Commonly Prefered NMB agent in Clinical Practice

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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.

Preference Preference of NMB in Clinical Practice (Mumbai Region)

21% Atracurium

11% Vecuronium

68% Rocuronium

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

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Preference Preference Of NMB in Clinical Practice (Pune Region)

9% Atracurium

33% 58%

Vecuronium Rocuronium

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.

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90%

77%

80%

74%

70% 60%

55%

50% 40% 30%

22%

23%

20%

16%

16% 10%

7%

10% 0% Atracurium

Vecuronium

Rocuronium

< 30 % of Consumption 30 - 60 % of Consumption > 60 % of Consumption

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 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. c ategory. 

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. 50 | 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-

1

2

3

4

5

35%

30%

13%

13%

9%

-

9%

17%

48%

26%

Safety

52%

39%

5%

4%

-

Recovery Time

9%

13%

52%

13%

13%

Potency

4%

9%

13%

22%

52%

tics in an ideal NMB

Onset of Action Duration of Action

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

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

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%

tics in an ideal NMB

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.

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

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%

tics in an ideal NMB

With respect to above table it can be concluded that, 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 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.

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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:

Onset Of Action Atracurium 6%

Rocuronium 44%

Pancuronium 3%

Succinylcholine 47%

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

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Duration Of Action Succinylcholine 3% Pancuronium 22%

Rocuronium 17%

Vecuronium 25%

Atracurium 33%

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

Recovery Time

Rocuronium 22%

Succinylcholine 6% Cisatracurium 5%

Atracurium 67%

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

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Safety

Rocuronium 19%

Cisatracurium 11%

Vecuronium 28% Atracurium 42%

Chart 8: Best positioning of NMB with 'Safety'

Potency Pancuronium 8% Vecuronium 33%

Atracurium 14%

Rocuronium 42% Succinylecholine 3%

Chart 9: Best positioning of NMB with 'Potency'

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70% 60% 50%    s    r    o    t    c    o    D     f    o

40% 30%

   %

20% 10% 0% Atra Atracu currium

Rocur ocuron oniiu m

Vecuroniu m

Succinylch oline

Pancuroni um

Cisatracuri um

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%

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. 57 | 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.

< 30 minutes Surgery Procedure Procedure Vecuronium 3% Rocuronium

Succylincholine 5%

5%

Atracurium 87%

Chart 11: Preference of NMB in 60 minutes Surgery Procedure Pancuronium 3%

Atracurium 32% Rocuronium 39%

Vecuronium 26%

Chart 13: Preference of NMB in >60 minutes GA procedures

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INFERENCE 

From the above chart, it is evident that 87% doctors prefer Atracurium in 60 minute surgery. Only 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

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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

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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:

Need of Reversal Agent in GA Procedures

21%

Yes

No

79%

Chart 14: Distribution of Doctors t hat prefer Reversal Agent

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100%

16%

16%

24%

90% 80%

63%

70% 60%

92% 50% 84% 40%

84%

76%

30% 37%

20% 10%

8% 0% Atracurium

Rocuronium

Vecuronium

Y es

#Cisatracurium

Succinylcholine

NO

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

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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.

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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:

24%

Different NMB

76% Same NMB Agent

0%

10%

20 %

30 %

40 %

50 %

60 %

70 %

80%

% of Doctors Using Same NMB

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.

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Different Combination of NMB which doctors prefer:

Succinylcholine

Atracurium/Vecuronium/Rocuroni Atracurium/Vecuronium/Rocuronium/Pancuroniu um/Pancuronium m

 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

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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)

Most Vital Characteristics of Cisatracurium

47% A

16%

B C D

18%

E

3%

13%

F

3%

Chart 17: Distribution of most vital characteristics of Cisatracurium

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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)

Clinical use of Cisatracurium in GA Procedures 8% 11% 41%

A B

16%

C D

24%

E

Chart 18: Distribution of clinical opinion about Cisatracurium in GA procedures

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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.

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CHAPTER 5  Findings, Conclusion  And Suggestions

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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.

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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.

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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’ ‘safet y’ is the t he 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.

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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.

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‘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.

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Cisatracurium is considered to perform better in Kidney & Renal patients. Thus, this market should be targeted prior to expansion of any other area.

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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.

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CHAPTER 6  Appendix & Bibliography Bibliography

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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 procedures 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 Onset of action

Preference

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 76 | P a g e

4. Kindly mention the dosage protocol you follow for each of the following NMB agents. Intubation (mg/kg)

NMB

Maintenance (mg/kg)

st

1 maintenance (Time in min)

nd

2

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 No. of Vials Strength

Reason for the Choice

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. Reversal Agent? NMB Agents Yes

What % of Procedures?

No

Remarks if any?

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?

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8. According to you, which of the following is the most vital characteristic of the Cisatracurium?

a. b. c. d.

More potent than available NMB agents Less risk associated with the molecule Very Less histamine release than Atracurium 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

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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

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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

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www.wiki-meds.com

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www.druglib.com

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en.wikipedia.org



www.abbott.co.in



www.abbott.com

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