Final frontier: Big Pharma plans to turn rural India into a cash cow

First, foreign food brands flooded India with chips, cookies and soft drinks that fundamentally changed the nation’s eating habits. Now, Big Pharma wants to cash in on an upsurge in cases of diabetes and heart disease in the country’s most distant corners.

Global pharmaceutical companies, from Indianapolis-based Eli Lilly & Co. to Switzerland’s Novartis AG, are heading into smaller cities and rural areas to learn about the healthcare needs of about 70 per cent of the population. These remote regions of the developing world are the final frontier for the international drug industry.

In the farming village of Thana Kalan outside New Delhi – where buffalo roam narrow streets and the scent of cow dung used for fuel hangs faintly in the air – Ajit Singh had never heard of diabetes. That was until community health workers showed up at the door and warned him and his wife they were at high risk of it.

The Singhs were part of a free door-to-door screening program funded by Eli Lilly, which is among the world’s biggest makers of diabetes medicines. Even though families like theirs might only start off with cheap generic drugs the hope is that they will be more likely to shift to pricier brands as their incomes rise. And if Big Pharma can figure out a way to serve these patients while turning even a slim profit, the sheer numbers could mean a huge payout down the road.

“Companies are interested in taking a longer-term stance and understanding the characteristics of these markets and positioning themselves in a way that could help them down the line capture market share,” said Sebastien Mazzuri, a director with consulting firm FSG, who specializes in developing pharmaceutical markets.

Foreign Brands
India’s two decades of economic growth has attracted consumer brands such as Coca-Cola Co. and Unilever. Rising incomes have powered increased motor vehicle ownership and also greater demand for processed foods. Active lifestyles were replaced by sedentary ones. In recent years, the country has been home to about 69 million diabetics, according to the International Diabetes Federation. China has about 110 million diabetes patients.

Over the last five years, virtually all the growth in the volume of medicines sold globally has been in the largest developing markets, while the developed world stagnated, according to a report last year by Quintiles IMS Holdings Inc. Among the fastest growing were China and India.
Chinese spent $116.7 billion on medicine in 2016, a figure that could reach as much as $170 billion in 2021. Spending in India is forecast to grow at an even faster rate-from $17.4 billion to as high as $3 ..

In rural India and China, where health-care access ranges from spotty to non-existent, there are almost 1.5 billion people, many of whom have never been tested for cholesterol levels, diabetes or heart disease.

The Lilly-funded pilot program that screened Singh, run by the non-profit Public Health Foundation of India, sends community health workers house to house in two mid-sized Indian cities and the surrounding countryside with tablet computers programmed to screen people for diabetes and hypertension. It also raises awareness of the diseases and is training local health workers to better diagnose and treat them.