Understanding the consumer's perspective on the future of healthcare is the key to envisioning the future of pharma itself!

While there occurs a lot of ideation & speculation within the industry domain on the future of healthcare & an outlook on pharma variously from 2020 through to 2050, I always still felt there is a crying need for pharmaceutical industry to understand the consumer's perspective on what healthcare scenario should be like in future - This is critical considering the hitherto quintessential 'practitioner-dependent' healthcare consumer is changing rapidly & is looking at an 'iterative' role for himself rather than wanting to being 'prescribed' health literally & figuratively.

While not exactly an average consumer, the pharmaceutical professionals themselves represent a sample population of aware individual consumers whose opinion I believe will give me a much valuable insight into what an increasingly knowledgeable healthcare consumer is looking forward to with respect to health & wellness in 2025 & hence I have decided to reach out to them primarily, to start with & pick some brain.

Through the various forums I have access to, I have already sent out multiple requests to multitudes of individuals to spare a a few minutes of their precious time to fill in the HEALTH 2025 survey as a consumer. I of course will be greatly pleased to have an outlook from the 'non-pharma' aware consumers too & invite the same to provide their valuable input.

The outcome of my small effort looks promising with the total initial responses already reaching 100 across the globe even as I type this post - Not bad at all, considering the survey's been open for only 20 hours now. 

Very soon I will be back to share the results of the above survey & postulate, however minimal, on a few useful trends & indicators.

Wish me good luck folks!

Cipla Ventures - What's the real story Gen-3?

Greed for quality & comprehension makes one less effective & less productive.........
........... Stash away those cudgels people, this is NOT about pharmaceutical manufacturing, this IS about my realization after a month of sub-par blogging that resulted in my number of posts going low (just one article to be precise in June 2013!) and the number of views I get per a month hitting the nadir! - A promise to myself... will try to type out a few "casually turned out" articles every now n then, instead of generating it through my oft employed time-consuming approach of Mull-it-over-for-a-week-Type-it-on-Word-Edit-it-as-though-HBR-were-publishing-it-and-finally-Paste-it-on-the-blog....... Spontaneity ain't dead yet!

Now the REAL topic...

The recent news of Cipla charting new course to achieve a $5 billion revenue in next ten years caught my attention & got me thinking.... Not because a 10 year objective as this is anything novel, but the simultaneous creation of a dedicated investing arm Cipla Ventures, towards this vision, is what interests me. 

Now again, what's so novel about corporate venture capital? its's been around for some time and the trend is bound to catch-on with whichever company that's sitting on surplus cash reserves jumping into the fray if not anything else, as someone said (Super LP??) for the blood & gore and the adrenalin rush that venture investing & enterprise incubation gives.

What interests me is.... 

........ the brief agenda of this arm of Cipla, as reported by Economic times, that says will "weigh the prospect of investing in companies from start-up hubs like Boston and London among other places, in areas such as biotechnology, medical devices and new chemical entity

What interests me is.... 

....... the expansive & prophetic way in which the new CEO Subhanu Saxena says "Out of the five or six bets I place, only two or three need to pay off"

What interests me is.... 

....... what is this "pay off" for which Cipla is ready to take "sensible risk", a novel term for a generic Indian company that has taken the traditionally low risk option of staying close to the home turf?

What interests me is.... 

...... what key takeaway Saxena is walking away with from Novartis & bringing to Cipla?

Let me be clear, I am not insinuating anything unethical here nor I am attaching ulterior motives to a darn-clear writing-on-the-wall business opportunity, all I am doing is trying to get to the heart of matter as to what will Cipla gain eventually through these investments..

Two theories that strike me right away are as follows;

i) TOOL FOR NEGOTIATION:  

The multiple niche stakes & thereby the 'possible' control on the licensing /sale of the pipeline candidates & technologies of the portfolio companies in the NCE, Biotechnology & Diagnostic space will potentially help Cipla negotiate/ barter generic deals with the big pharma companies whose drugs Cipla is/ will/ would aggressively pursue to market in the US & European markets

Will this fly...? despite the generous window of hit-miss offered by Saxena, this is an opportunity completely out in the ether & my guess is as good as Cipla's :-)

ii) EXIT PREPPING OF FOUNDER PROMOTERS: 

Before I am clobbered for suggesting India's most nationalistic  private pharmaceutical company would sell-out, let me remind that no one's above liquidity & no company is unattainable in this corporate game. Let's also remember that the new leadership of Cipla is, surprise, surprise.... of all places, from Novartis, the bête noire of Cipla in many a litigation?? - Let's also remember that the new leadership of Cipla in US & EU is Ex-Teva... the generic behemoth that can make big-ticket acquisitions every now and then (read: $6.5 billion Cephalon; $7.5 billion Barr et al..)

Will this fly...? Of course it'll - the lure is the access to a 1.24 billion strong Indian market.

Anymore theories? 

A start-up messed up at its foundation OUGHT TO be fixed!

The celebrated venture investment guru Peter Thiel postulated a law that says "a start-up messed up at its foundation cannot be fixed" - Bruce Booth attempted a commentary of this law in the context of Biotech ventures through his blog post titled 'Foundings Matter: Thiel’s Law Applied To Biotech' - While Bruce's application of Thiel's law is based on a tacit agreement of the postulation, I believe this can be argued differently, as indicated by some campus talk here...

Below is my comment against the article by Bruce Booth, wherein I agreed and disagreed with the author in two independent contexts....

My comment:
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It bugs me no end just how little the VC & PE literati out there ever attempts to explain all those lurid, smart theories in the context of biotech enterprises instead of solely building case-studies out of super-achieving IT start-ups that brought-in bags of cash to the VCs very early into its life cycle. This peculiar penchant among the authors for avoidance of anything called biotech enterprise I feel is owing to a general investor impatience for acknowledging the veracity of any investment that can’t be cashed out profitably within 3-5 years & thereby not showcased as a text-book case of intelligent investing. While otherwise is a decently thought-provoking & stimulating book, “Venture Capitalists at Work: How VCs identify and build billion dollar successes” by Tarang Shah is one such recent addition to my list of disappointing treatise.

Peter Thiel too probably isn’t greatly different after all, since a lot of the wisdom he’s been postulating is validated only within the narrow context of IT start-ups - Your effort Bruce, at ‘pharmifying’ the ‘Thiel’s law’ is thus a very welcome diversion.

None of the mess-ups you listed right from ‘un-reproducible science’ to ‘inappropriate capitalization’ can be contested as inconsequential in any which way & together these six make a great check-list for the entrepreneur on how not to go wrong initially & for a full-fledged due diligence by the VC either at the initial funding or an informal, abbreviated review prior to subsequent funding rounds. I however am struggling a little bit to accept that the DNA can’t ever be repaired once messed up – isn't disruptive innovation, which inherently amounts to re-coding the DNA of the enterprise /or enterprise's innovation/ business model, an accepted strategy now?

In the June 2013 issue of HBR, Rita Gunther McGrath (Author of “The End of Competitive Advantage”) talks on how the current day enterprise scenario is all about moving away from the conventional ‘Sustainable competitive advantage’ model and instead moving towards “Transient competitive advantage’ – Biotechs' that operate within an ever evolving, dynamic clinical scenario I believe can’t really base their strategy on sustainable competitive advantage & have to necessarily adapt, quickly & efficiently to the transient competitive advantage model & this may necessitate periodic re-coding of the enterprise DNA - What I quote here is what pretty much you and others said earlier regarding the need of emergence of ‘lean-start-ups’.

So instead of trying overtly to ensure all loose ends are tied-up upfront (…including the phantom scenarios!) & showcase a supposedly fine-tuned enterprise DNA to the VCs, the start-up would do good to expand the scope of the business plan to incorporate a well thought through set of situation-appropriate pivots & an alternate disruptive innovation model or two.

My two Rappen*

*on a business trip in Switzerland at the time of posting this article

Shouldn't all pharmaceutical professionals too take the Hippocratic Oath?

The news about the generic drug maker Ranbaxy Labs pleading guilty to felony charges related to drug safety and its acceptance of $500 million in civil and criminal fines created an unprecedented buzz in the world-wide web. The most incisive piece by far appears to be “the epic inside story of long-term criminal fraud at Ranbaxy.....” By Katherine Eban on CNN Money.

No horror story is complete without its share of seedy alleys, murky dealings & closed cup-boards that contain multitudes of hidden skeletons - this too has. Even as all the digging is indeed required towards a total expose’, the associated spill/ shoot-out of emotional rhetoric is threatening to harm the still-early but the strong trend of genericization of global medicare.

Can we raise above the rhetoric of branded drugs v/s generic drugs; first-world v/s third-world & address the core issue of why medical frauds happen & what can be done to plug these? 

My Comment on the above article:

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A very compelling narrative & an alarmingly scary proposition…. 

I fully agree with the majority opinion here that the consequences of a fraud this big should be equally big for the company in question. But again, I also endorse the opinion of a few others like Sam Werbalowsky, Dan Miller et al who have pointed out that Ranbaxy isn't a standalone case in the shameful history of pharmaceutical frauds & that the focus should be on ethical business of all Pharma & not just the generic players as Ranbaxy – It is important to underscore this particular aspect at this juncture since the tone & tenor of this otherwise brilliant piece makes it prone to being construed as a platform for demonizing the generic medicine vis-a-vis' branded drugs. 

A quick look at the list of infamy here & here establishes that the common thread running through all is the disturbing trend of the best-of-the-organizations taking a call of preferring earnings over ethics at critical decision points. Another common aspect among all is the seeming complicity of a vast number of employees at all levels of the organization to misrepresenting a fact or manipulating an outcome. This shows that the problem is not just at the top decision making levels but is endemic at all levels of hierarchy & there’s this shocking apathy all through to what amounts to ethical behavior of an average worker/ employee in a pharmaceutical organization.

Given the complete insulation of an average pharmaceutical employee to the consumer-end of the spectrum & hence insulation from the consequences of any wrong-doing, I'm a little sceptical as to what will motivate these people to be vigilantes of public health & safety at their work place, pardon my cheekiness here, whether or not that involves whistle-blower benefits – THIS apparent lack of ownership of public health & safety in pharmaceutical manufacturing world is what I believe is the real core problem.

While there may be much creative reasoning & some complex solutions to the above core problem, I’d like to keep it simple & say that the reason is a lack of any formal sensitization of a pharmaceutical industry worker prior to or during his/ her employment on her/ his own accountability to public health & safety in general & the solution I hence propose is to instil this accountability in all pharmaceutical employees by way of a Hippocratic Oath that unfortunately is currently merely confined to medical practitioners & decreasingly so.

Food for thought.

Ref: my earlier post at:

http://vishrasayan.blogspot.in/2013/03/factors-influencing-global-prospects.html

Nobody’s saying no to India’ – phew, that’s a relief...

The survey of a few global LPs by VCCircle that was intended to understand 'what a LP wants from Indian PE managers" but actually feels like "why a global LP wouldn't want to put his best bucks in Indian PE" threw up some expected & some strange surmises, but nevertheless makes an interesting read –

The link to the article is below & below that is a repro' of my own comment on the article;

http://www.vccircle.com/news/general/2013/05/20/what-do-limited-partners-want-indian-private-equity-fund-managers-results

My comment:

---------------------------------

Interesting surmises!

What makes the takeaways less validated however is the lack of disclosure or at least a categorization of the LPs surveyed**. This gap I felt more acutely for a few like the question # 9 the response pictorial of which indicates that 50% of LPs surveyed will put money in PE/ VCs that're focused on investing in growth-stage enterprises – this averaged-out response doesn't allow one to assess if this is the response of each LP sub-set falls within this range or if some LP sub-sets deviate from the mean significantly.

I also felt a lot of the questions were overtly leading & that could skew the responses in favor of the inherent bias/ prejudice in the question (for e.g. 10 & 11..)

And yeah, the sliver-lining… It warmed my cockles that LPs have acknowledged of the promise of Healthcare Industry in India & the candid confession that ‘no body’s saying no to India’ – phew, that’s a relief.

**I realize it’s possible this can be done still from the data available OR it has already been done… only I couldn’t see it in the downloaded report.  

Economists often ignore politics says Donald Marron! - wish we all could...

Mahatvakankshi...

That's what I thought I'm becoming when I dared comment on a blog dedicated to Economics!!.... and, on an article dwelling on how economists don't seem to be factoring-in how 'policy decisions might change the future balance of political power' at that!!! - 

Well, here's the link to the article & below's my comment on the same...

http://dmarron.com/2013/05/08/should-economists-pay-more-attention-to-politics/#comment-13844

My comment;

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1. on May 14, 2013 at 8:26 am | ReplyMurali Apparaju

   Of course they should pay attention to politics… 

   The legacy of a theorem & assumption based scenario-building clubbed with the current trend of considering only the mathematical & econometric models as having scientific/ academic rigor I feel made economists predominantly quants… with very less patience and sensitivity towards the uncertainties that can be explained only qualitatively and never numerically……

   Guess some of the lost ART needs to put back in the SCIENCE of Economics 

Will the Indian Mobile makers pay a price for the judicial ambiguity (& their own..) on 'Essential Patents' & FRAND terms?

In his characteristic & incisive style, 'Spicy IP' Prashant Reddy unravels for debate, the ongoing litigation between Ericsson & Micromax Informatics Ltd. after Ericsson sued Micromax (and Mercury Electronics Ltd.) a few months ago for allegedly infringing 8 of its telecom patents for a range of wireless technologies, including 3G, AMR and Edge - read the artcile here @ http://spicyipindia.blogspot.in/2013/05/the-ericsson-micromax-patent-litigation.html 

Looking at the haste in which the Delhi High Court granted an ex-parte interim injunction against Micromax, I cannot but agree with the writer's initial assessment that Indian regulatory apparatus & companies are not geared up for fighting complex & strategic IP litigations.

I however don't share Prashant's (rather gloomy) view that "it is unlikely they (Indian companies) will take the extra-effort to counter-attack Ericsson in a bid to pre-empt future action by other patentees" - like i said earlier in a article of mine, commerce & the promise of it is a good enough reason for any company to learn the ropes of the trade. It also should be understood that, even if it makes immense sense, someone like Micromax may not really be able to go all proactive since they aren't exactly the Apple OR Samsung & their margins, I would expect, will be minimal.

The need is however crystal clear - It's about time Indian regulators, judiciary & indian tech-companies that have to mostly deal with dangerous dampeners like royalty-stacking et al take a crash course in what they need to expect & how they could make strategic litigation a part of their daily lexicon.

below is my comment posted on the above article on Spicy IP;

vishrasayan said...

Excellent insight Prashant!

It appears as though the displaced-vanguards of the mobile technology such as Motorola, Ericsson have re-strategized their revenue generation to monetizing their patents rather than depending on competitive selling :-)

I also see your point about the Indian regulatory, judicial apparatus & the companies themselves prepping way too less on litigations and that's bothersome – this lack of comprehension also resonates with the lack of precise articulation I wrote about some-time ago on my blog… hopefully this will change.

I do agree the potential for royalty-stacking in mobile technology makes it much complex and hence the need for a middle-path, but healthcare too comes with its own complexity of access to latest innovation - I have read your earlier post on compulsory licensing – it appears to me there’s a dichotomy in your justification of premium for innovation (patents) in healthcare and not applying the same yard-stick for the mobile technology…?

1:22 PM