Online pharmacies in India $18 billion market set to grow to $55 billion by 2020, are they even legal?

New Delhi: It’s a $18 billion market set to grow to $55 billion by 2020 and it’s finally beginning to get the kind of attention from investors and entrepreneurs those numbers warrant—despite uncertainty over the legality of the business itself.

The business is online pharmacies, and according to start-up data tracker Tracxn, so far, the sector has attracted $92.6 million funding with over $70 million coming only in 2015.

Almost 31 start-ups were launched last year, with the major chunk of investment announced by Netmeds ($60 million), followed by 1MG ($6 million) and Zigy ($3.2 million).

Investors include IT industry veteran Phaneesh Murthy (in Zigy) and global healthcare fund Orbimed (in Netmeds).

Some of them are no doubt taking heart from the Indian drug controller’s approach. In December, the Drug Controller General of India formed a seven-member panel to look into the issue of online drug sales.

“We are very clear on this issue; we want this technology in the country because our aim is to ensure that patients get quick service and of the right quality. We want to see how the issue can be addressed without compromising on safety. There are chances of abuse of technology as well that we want to plug,” said G.N. Singh, Drug Controller General of India (DCGI).

This is a tricky sector, admits Hemant Bhardwaj, co-founder of Zigy, adding that he and Murthy hired three law firms in 2014 just to ascertain if the business was legal.

“It is largely about the interpretation of law. The Pharma Act had no clarity on electronic copy of a prescription. However, the IT Act says that any digital copy of a document will be valid if there is an original copy which can be presented at the time of verification,” said Bhardwaj, adding that he launched Zigy only after getting a green signal from the law firms.

The company, which runs a marketplace model, doesn’t own a pharma retail licence.

“If you are working as a marketplace, you are working on the licence of one of your vendors. Inventory is not held by the marketplace, it is held by the vendors,” said Bhardwaj.

That’s the same model followed by Netmeds (Netmeds Marketplace Ltd).

“If you look at e-commerce firms such as Flipkart, the bill is generated by WS Retail or other vendors. It is the same philosophy that works here, but in this case, the vendor needs to be an authorized licensed retailer to do so,” said Pradeep Dadha, founder and chief executive officer of Netmeds.

The company has made India Post its logistics partner for delivery.

It works with wholesalers and retailers on a commission basis and sells chronic medicines apart from nutritional products. It sells drugs after receiving a scanned copy of the prescription.

Earlier this month, it also forged partnerships with online doctor booking and consultation sites Lybrate Inc. and Doctor Insta Pvt. Ltd to serve their customers.

Most online pharmacies do not sell Schedule X medicines such as sleeping pills.

Zigy operates across five cities and has tied up with local vendors to comply with the law, which doesn’t allow drugs prescribed in one state to be sold by a pharmacist in another.

With more customers willing to shop online for just about anything, and smartphones facilitating such transactions, the timing is just right for online pharmacies, say entrepreneurs.

“We were waiting for the opportune time. The moment we saw people were buying spinach and okra online, we knew the market was ripe for us,” said Dadha of Netmeds.

And with smartphones, “clicking a picture of the prescription is easy”, said Prashant Tandon, co-founder of 1MG.

Industry experts estimate the market to be generating 3,000-4,000 orders on a daily basis.

The regulator’s positive stance has made companies and investors comfortable with the business models.

“The sector offers great business potential. Online sale of medicines is not a new concept. But in India, till we entered, there were hardly any online pharmacies with serious intent,” said Murthy, former chief executive of iGate Corp.

Much like in e-commerce, discounts are prevalent, although they rarely exceed 20%.

Still, that’s been enough to provoke the strong pharma retail lobby to protest the entry of online pharmacies.

The All India Chemists and Druggists Organization (AICDO) protested in October, accusing online pharmacies of taking away their business by offering deep discounts. The association also claimed that these firms would lead to a deterioration in the quality of medicines as they need to be stocked at specified temperatures.

Online firms, however, have now formed a lobby of their own called the Indian Internet Pharmacy Association (IIPA).

In an attempt to level the playing field, the DCGI issued a fresh circular on 30 December saying that, “the rules do not distinguish between the conventional and over the Internet sale of drugs”.

It, however, added that there will be a “strict vigil” on the online sale of medicines and action would be taken against companies if they are found to be in breach of regulations.

http://www.livemint.com/Companies/EGTOILRRNF0T3J4OfUg9SN/Will-online-pharmacies-work-in-India-and-are-they-even-lega.html

The pill that costs $9,000 in US sells for $70 in Indian Country

And that's just one leukaemia drug. India's generic industry has been producing many such life-saving medicines at a fraction of the global price

The Hyderabad-based Bharat Biotech might be the first to come out with a vaccine for the Zika virus if its efficacy can be proved. If it does succeed, this won't be the first time India has come to the rescue of the world. Indeed, the country's generic medicines are a lifeline for millions not only in low and middle-income countries but also in the developed world. India's generic industry hit global headlines in 2001 when Cipla offered a three-drug cocktail for AIDS at less than a dollar a day , a fraction of the price charged by multinationals. Today, apart from several HIVAIDS drugs, the industry is producing affordable, high quality medicines for several diseases including hepatitis B and C, cancers, drug-resistant TB and asthma. This has been credited to India's patent law, often held up as a model one in preventing the abuse of patent monopolies, and in balancing public interest and the growth of the pharmaceutical industry .

Last month, generic manufacturer Natco announced that it would be supplying daclatasvir, a Hepatitis C drug, to 112 developing countries. In 2013, a medicine to treat hepatitis C, sofosbuvir, hit international headlines for its price -$1,000 per pill. Gram for gram, it cost 67 times the price of gold. The sofosbuivir and daclatasvir combination used for the disease costs almost $150,000 per patient for the 12-week regimen in the US. But in India, it is priced at just $700 or a little over Rs 46,500 per patient for the same regimen. And prices are expected to fall further.

Typically, the price of many expensive patented drugs in European countries like France, Spain or the UK is half of what these cost in the US. In countries like Brazil or South Africa, these are a third or a fifth of the US price. The Indian price is often 1100th. (See box)

BALANCING PATIENT AND PATENT

So how does the Indian generic industry manage to do it? The patent law in India is stringent on what is innovative enough to get a patent. Plus, the crucial section 3(d) in the law, much criticized by multinationals, has prevented "evergreening" -the attempt to patent different aspects and improvements of the same drug to extend the period of patent -a lucrative game for the pharmaceutical business.

Indian courts, too, have played a role. In the case of entecavir for hepatitis B and erlotinib for lung cancer, for instance, instead of blindly handing out injunctions or upholding the validity of patents, the courts ruled in favour of public access to a lifesaving drug. This encouraged companies like Cipla, Ranbaxy and Natco to do a `launch at risk', a term that describes a company deciding to challenge a patent by launching a generic version. This forces the patent-holding company to take them to court, thus testing the validity of the patent granted. Patent oppositions filed by patient groups also spurred the rejection of several frivolous patent claims on cancer, hepatitis and HIV medicines, protecting generic competition.

India's patent law also provides for granting of compulsory licences -under which the government can give a licence to a manufacturer other than the patent holder for a royalty fixed by it -for public health reasons. This can be used where drugs are unavailable or unaffordable. The only compulsory licence granted was in 2012 when the patent office allowed the Indian generic company Natco to market sorafenib, a drug patented by Bayer to treat kidney and liver cancer.This move, upheld by the Supreme Court in December 2014 helped bring down the price by 97%, unimaginable through a price negotiation with the company .

"How long will this continue? We are already feeling the adverse impact of monopoly and limited access to important drugs. If India cannot manufacture newer drugs, how can we be the pharmacy of the world?" asked Dr Yusuf Hamied, of Cipla.

http://timesofindia.indiatimes.com/life-style/health-fitness/health-news/The-pill-that-costs-9000-in-US-sells-for-70-in-India/articleshow/50887471.cms

First mobile pharmacist service offering to 15,000 users

Ireland’s first mobile pharmacist service offering home visits to review prescriptions and arrange a next-day drug delivery now has almost 15,000 members.

The service was launched a year ago by Healthwave, a Dublin-based pharmacy that also offers cheaper mediation with generic drugs.

Under Irish law, customers have to present their prescription to the pharmacist before their drugs can be dispensed. Many people had been travelling long distances to the pharmacy in Dundrum to save an average of 50% on prescription medication. Soon after opening, the pharmacist started offering a nationwide home- delivery service.

The pharmacy operates like a club, with adults paying an annual membership fee of €25. For families, the fee is €60 a year.

Healthwave founder Shane O’Sullivan, who graduated from University College Cork in 2008, said that around 500 people joinedHealthPass every month.

He said members got four free deliveries a year and after that the delivery charge is €5.

He said the pharmacy, which is based in Dundrum Shopping Centre, was expanding rapidly because of the volume of deliveries.

“We now have 35 full-time staff since we launched the delivery service in February 2015,” he said.

Mr O’Sullivan said people in Dublin could expect delivery on the same day with delivery drivers leaving the shop on the afternoon of the same day the prescription was collected.

For anywhere else in the country, Healthwave provides an overnight service.

http://www.irishexaminer.com/ireland/15000-users-for-first-mobile-pharmacy-service-380635.html