Securing the top position generally held by anti-diabetic and cardiovascular medicines, the drug for chronic lung diseases, Foracort, now holds the top spot in the Indian pharmaceutical market. According to data by research firm IQVIA, Cipla’s Foracort showed the highest growth among the top 40 brands in the Indian pharma market, with Cipla’s Budecort closely behind in January.
“Among the top 10 brands, Foracort has shown the highest growth followed by Budecort for the month," said the monthly report released by IQVIA for January. Data shows that Foracort is the topmost brand with 83 crores of sales and a monthly growth of 20 per cent.
Foracort is an inhaler which is a respiratory medication primarily used to treat asthma symptoms and chronic obstructive pulmonary disease (COPD). It shows a shift in the acceptance of inhalers, as in the past, there was a fear associated with the use of inhalers. Budecort is a steroid which is used to treat and prevent the symptoms of asthma such as wheezing and shortness of breath.
The IQVIA’s official spokesperson, Swati Chaudhary, told News18 that the category of respiratory drugs has started growing “substantially post-COVID, potentially owing to changes in environmental conditions and increasing pollution levels across various regions".
Since November, Foracort has maintained its leading position, possibly attributed to the onset of the winter season along with air pollution, both known to exacerbate respiratory illnesses. Otherwise, the inhaler brand keeps fluctuating to different ranks, but among the top 10 brackets. For instance, in October, broad-spectrum antibiotic Monocef was leading the charts, followed by antibiotic Augmentin. Foracort held the third position.
INHALERS ARE THE LARGEST CATEGORY
According to Chaudhary, senior director of commercial business, South Asia, IQVIA, the top 40 brands in the Indian pharmaceutical market commonly feature categories such as diabetes, anti-infectives, proton pump inhibitors (PPI), pain management and respiratory therapies.
“Monthly analysis reveals that chronic therapy areas like diabetes and cardiovascular exhibit more stable performance," she said.
The data shows that the “asthma and COPD market" contributes 44 per cent to the overall respiratory market – the highest compared to any other category such as cough and cold and anti-histamine medications.
Chaudhary’s analysis also pointed out that inhalers are the top-selling category under the asthma and COPD category medications. “Within asthma and COPD, inhalation preparations is the largest category with 55% contribution. It has grown at 18% year-on-year and 14% CAGR in the last five years."
BLAME COVID, AIR POLLUTION & MORE
The trend indicated by the market data also aligns with the observation of doctors in their clinical practice.
Sample this: Dr Navneet Sood, senior consultant, pulmonology at New Delhi-based Dharamshila Narayana Suprspeciality Hospital, told News18 that he has been seeing many more people coming to him with “breathing problems".
“This increase started before COVID-19, but it got worse afterwards. Covid-19 made us pay more attention to respiratory issues, but it’s not the only reason for the rise. There are a few reasons why more people are having trouble with their breathing. One big reason is air pollution."
WHAT OTHER EXPERTS SAY
“Respiratory medicine’s ascent to becoming a primary category among medicine brands in India can be attributed significantly to heightened awareness among the general public, particularly in the post-Covid era," said Dr Ravi Shekhar Jha, head of the department, pulmonology, Fortis Escorts Hospital, Faridabad.
Another health expert, Dr Rajeev Jayadevan, believes that the trend is possibly highlighting one of the health concerns faced by many people post Covid. “Numerous individuals are experiencing persistent coughing that persists despite trying various remedies, persisting for months even after the initial infection."
He linked a study which found that the more you get infected with Covid-19, with or without knowledge, the chances of developing chronic lung diseases such as asthma increases. “Post-infection, the airways become hypersensitive. This could be further triggered by rising air pollution."
A significant study conducted by Christian Medical College, Vellore, found lingering lung damage after Covid-19, affecting lung function, exercise capacity and quality of life.
The study titled ‘Impact of post-COVID-19 lung damage on pulmonary function, exercise tolerance and quality of life in Indian subjects’ said that the Indian population showed more symptoms and lung impairment compared to other studies, highlighting the significant impact of post-Covid-19 lung damage on health and well-being.
ACCEPTANCE OF INHALERS IN INDIA
Foracort inhaler leading the charts indicates a notable change in India’s attitude towards inhaler usage. According to Dr Maninder Dhaliwal, an expert in paediatric pulmonology, the surge in the sale of Foracort, has both a positive and negative side to it.
“Foracort is an inhaler medicine. It is good that the public is now recognizing allergies and asthma as a disease which has increased the acceptance of these respiratory medicines which are given through inhalers."
He said this shows that “improved recognition and a decrease in stigma" associated with the use of inhalers will help in better control of these conditions.
“At the same time, increased use is concerning as it implies that there is a noticeable surge in these conditions both in big and small cities largely due to rising air pollution and environmental disruption caused by humans."
In children, he said that there was a surge in respiratory infections causing fever, cough and bronchospasm. “While fever is short-lived, cough remains for a longer time owing to pollution, irritation and possible gradual change in the body’s response over the years." Such a phenomenon may have also contributed to the use of increased inhalational medicines over the years.
Senior consultant, pediatric ICU and paediatric pulmonology, Dhaliwal warned that “breathing clean air is more urgent now than ever."
“The lungs are the one delicate organ in the human body in which we have limited ability for protection against the increasing insults from the environment. If we continue to neglect lung health, we stand to compromise on it and will continue to invest more in respiratory medications, like it is happening now."
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