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ShareCipla and Mankind Pharma are engaged in a big battle for supremacy in the Indian oral contraceptives market. Over the past few months, I-pill and Unwanted-72, the two companies' brands, respectively, have gained more brand recall than many other fast moving consumer products. So much so, these may be the most-advertised pharmaceutical brands in India, ahead of commonly sold drugs such as Saridon, Aspirin and Coldarin.
For many years, Cipla banked on cheap prices of its highly rated pharmaceutical products to shore up its topline, but for the last ten years, Mankind Pharma is playing the same strategy that Cipla applied against its rivals, capturing every prescription possible through aggressive trade channel schemes and capitalising on better rapport with the doctors.
Mankind's traditional bastion in North India is being swept with Unwanted and the ads aired at high frequency act as an effective vehicle to prod Indian women to experience the product.
Marketing of drugs over the counter is assuming a new meaning from the olden times when major industry associations unsuccessfully jostled with government officials to get commonly used products routed through the direct-to-consumer marketing approach and spread out their distribution chains from chemists to lakhs of provision stores. Despite many industry representations assuring the safety of the commonly used drugs, the regulators have stopped short of allowing free access to the medicines.
The government could have done more in terms of proactive controls. The age-old Drugs and Magic Remedies Act, 1954 refers to objectionable ads pertaining to a list of product categories including talisman or mantra, or any other charm, as magic remedies. There are, however, no steps to curb ads that may induce people to go for products that may not be clinically effective or safe.
On hundreds of television channels, viewers are bombarded with glossy ads that claim to cure complicated diseases through use of magically effective divine stones. Others promote tea leaves that treat diabetes effectively. Are these ads within the limits of government provisions? Is it fair on the part of the government to watch this unbridled spread of wrong information passively? The jury is out.
We all know that Crocin does not need a prescription at the counter, but nowhere has the Indian government permitted its sale without prescription. Though criticised by the industry, that approach is ideal for the Indian market. It may not be true for Crocin since paracetamol is tolerated well in the human body, but chances of adverse reactions due to some other stronger drug cannot be glossed over.
Our population is too gullible to the claims and counter-claims made by companies.
In India, we are still not aware of the provisions of adverse drug reaction reporting. Unlike doctors in the West, medical experts are not proactive or are keen to follow up with patients to know how drugs behave over a longer period of time. The concept of post-marketing surveillance is non-existent and we have seen how approved complex cancer products have been ordered to be withdrawn within months of their launch.
We cannot be sure if a patient may have suffered due to the side effects of a product and if the thousands of products swamping the Indian market are safe. Multiple state regulators approving products make the process of identifying unscrupulous manufacturers even tougher, almost impossible to trace.
While Cipla and Mankind fight tooth and nail, some are asking if the Indian consumer is being made to pay a price for cutthroat corporate warfare. Is it right to promote contraceptive products through sensitive mass media such as television?
Given the fact that medical awareness in India is nowhere compared with the West, we may be dealing with an extremely critical situation.
At the same time, the two companies cannot be directly faulted for unlawful promotion. Cipla, for one, has clearly put on its literature, website and on the ads that these are emergency contraceptive interventions, implying that this may not be for regular use but that fine print often gets hidden in the high-decibel ads.
At this stage, it may be difficult to re-examine the whole issue since it is assumed that the government may have reviewed the situation much before giving the due permission. But the drug regulator could look at overhauling its monitoring systems. Though that won't help prevent indiscriminate use of critical medicine, the entire system will be more accountable for products as sensitive as medicines.
Pillman is an executive closely linked to the global pharma industry.
