Demand for drugs to ease Covid-19 symptoms surged during the pandemic even as growth for other categories slowed or contracted. Except for one—cardiac therapy.
Sales of cardiac medicines on an average grew 12.1% year-on-year in the last eight months, according to data cited by Nomura. Anti-infectives, excluding Covid-related drugs such as Favipiravir and Remdesivir, contracted 10%.
The cardiac segment displaced anti-infectives as the leading therapy in India in July and has stayed ahead. According to an October report by Motilal Oswal, its market share measured by moving annual turnover rose to 13.6% compared to 13% for anti-infectives.
The cardiac segment has been growing faster than the market for years amid an ageing population and lifestyle changes. The World Health Organization estimates that by 2030, cardiovascular diseases would be responsible for more than 35% deaths in India compared to 25% in 2016, with ischemic heart disease and stroke responsible for more than 80% of this burden.
While average sales of cardiac therapy drugs grew 2 percentage points faster than the industry in each of the last four years, volumes increased at 6%, twice the pace for the rest of the market, according to data from All Indian Origin Chemists & Distributors. Analysts see the category-leading growth in the future as well.
Lupin Ltd., Cipla Ltd., Glenmark Pharmaceuticals Ltd., Torrent Pharma Ltd. and Sun Pharmaceutical Industries Ltd. are the top five drugmakers by market share in the cardiac segment.
HDFC Securities sees the cardiac segment remaining a dominant therapy for the next 10-15 years and gain 300-400-basis-points share. Lupin, Glenmark, JB Chemicals, and Cipla are likely to gain market share among listed drugmakers, it said.
Lupin, Cipla and Glenmark, in emailed responses to BloombergQuint, said they view it as a long-term opportunity outgrowing the market. Cipla cited anticoagulant and heart failure therapies as key drivers.
Rajeev Sibal, president, India region formulations at Lupin, said increasing disease burden and a better healthcare system will create a bigger opportunity.
India’s Rising Burden Of Chronic Diseases
While changing lifestyles increased India’s chronic disease burden, people with hypertension, diabetes and other such ailments were more vulnerable to Covid-19. According to a July report of the World Heart Federation, as much as 73% Covid-19 deaths in India are linked to diabetes, hypertension, cardiovascular and respiratory diseases.
There are 79 million diabetics and 200 million individuals suffering from hypertension in India, two of the key conditions linked to heart ailments, according to the American College of Cardiology June 2020 study. That, however, may not reflect the full scale of India’s burden of cardiovascular diseases.
While an ageing population is contributing more, availability of healthcare and diagnostic services and mandatory health checks as part of employment is also helping identify cases.
India still has a large population that is undiagnosed and so cardiac therapies will continue to drive growth over the long term, said Vishal Manchanda, research analyst at Nirmal Bang Securities.
According to Sibal of Lupin, cardiovascular diseases are considered the No. 1 cause of mortality in India. “This can be attributed to our genetic predisposition, lifestyle, stress and food habits,” he said.
In the next few years, the company expects demand to continue for medications to manage cholesterol, high blood pressure, and drugs required for management of heart attack, stroke and heart failure, Sibal said. “The next wave of demand could be for targeted therapies such as monoclonal antibodies.”
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