through Dr Sanjiv Kumar
President of Indian Academy of Public Health and Indian Patient Alliance Group,
Former Senior Advisor at UNICEF and Former Director at IIHMR
India has made substantial progress in health, with life expectancy dropping from 32 years in 1947 to almost 70 years in 2017, with many communicable diseases falling and infant and child mortality rates falling substantially. and kindergarten. However, many areas of concern remain in health care. With the increase in non-communicable diseases, India is home to around 22.2 million chronic obstructive pulmonary diseases and 35 million chronic asthma patients. The country is known as the diabetes capital of the world with 11.8 percent prevalence of the disease. India accounts for 27 percent of the global TB burden with a 26 percent detection and treatment gap. Over 10 percent of the Indian population suffer from common mental illnesses and the number of children per 100,000 people who die due to environmental factors is highest in India among the BRIC countries at 248.14. These numbers highlight the critical need to redefine patient care in the country, and this can only be achieved by adopting new approaches in healthcare, including innovative breakthroughs in the pharmaceutical industry.
Innovation in pharmaceutical medicine often occurs as a series of progressive advancements in safety and efficacy over existing treatments, resulting in significant improvements in patient care. While some new drugs become the firsts of a new therapeutic class, the vast majority represent new members of an existing class with significant differences, for example in terms of impact on pharmacological properties, metabolism, dosage regimens. and administration systems. These differences can significantly benefit patients enabling successful treatment.
Refining breakthrough drugs for better patient outcomes
Often a distinction is made between âbreakthroughsâ and âincrementalâ innovation in the pharmaceutical industry. Cutting-edge innovation in healthcare is defined as the development of a new class of drugs, while incremental innovation refers to the development of new drugs within an existing therapeutic class. For example, 63 percent of drugs on the World Health Organization‘s Essential Medicines List are follow-up drugs. Progressive innovation offers several benefits for the individual patient and for public health in general, both in terms of improving adherence and treatment outcomes and reducing costs.
Drive incremental innovation to manage the burgeoning disease burden
Gradual improvements can be as important to improving treatment outcomes as breakthroughs. There are advantages to having a variety of drugs available in a therapeutic class. The world is moving towards precision medicine to provide the most suitable individualized treatment for a patient. Because one size does not fit all, different patients with the same symptoms react differently to the same medicine. Having multiple alternative treatments available in the same classroom allows physicians to meet the needs of each patient. This is essential in the management of various illnesses such as depression, where some patients respond to certain medications only in one.
Incremental innovations in drugs may be more efficient than first-in-class and more advanced drug delivery systems, for example replacing an injection with a tablet or vice-versa or the innovation of a medicine that should be taken once a day rather than more frequently. This improves compliance and provides greater convenience. Take for example, for patients with chronic heart failure and chronic stable angina we now have once daily tablets such as ivabradine which helps in more convenient dosing as patients no longer have need to take the drug twice a day.
Patients are more likely to stick to their regimen if they can select their treatment based on simplified administration and better patient compliance with better dosage. For example, tablets prescribed for bipolar disorder, epilepsy, and to prevent migraine headaches are large in size because they are available in 500 mg and 1000 mg formats, making it difficult for some patients to swallow. Thanks to progressive innovations and years of scientific research, there are now smaller tablets that make swallowing easier, help patients stick to their medications, improve health outcomes and improve quality of life.
The availability of therapeutic alternatives leads to security of supply, which is particularly critical in the event of a shortage and withdrawal from the market. In 2016, for more than a decade, India experienced a shortage of 270 molecules of onco to fight the growing cancers in India.
The success of incremental innovation hinges on several enabling factors, including access to a skilled workforce, finance and a conducive policy environment. The goal of any pharmaceutical industry is to improve the effectiveness of existing drugs and to save lives. To achieve this, India must invest more in research and development (R&D) which represents 0.7% of GDP since 2014, much lower than other emerging economies where it is between 1 and 1.5% of GDP. GDP. Moreover, to provide quality universal healthcare to its citizens, the introduction of enabling policies that will encourage manufacturers to bring incremental innovation in the Indian pharmaceutical industry is the need of the moment.
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