Cipla

Life care

Medico-marketing module

Cipla
Life care

Let us talk pride, lets talk Rabicip

Recognition

Loved
Priority

Rabicip

10% Cont.

Success

Cipla
Life care

Our learning objectives today

How common is ARD (Acid Related Disorder)?
Types of ARD and how it happens?
Opportunity for our brand
Market scenario
Molecular Unique Selling Proposition (USP)
Brand USP
In clinic situations and conversion tips
Our objective for coming months

Cipla
Life care

Symptoms of Acid Related Disease

Heartburn
Feeling of abnormal
slow digestion

Nausea

ARD

Stomach discomfort
pain

Excessive burping
belching

Abdominal
bloating.

Early satiety

Acid regurgitation

NOT VERY UNCOMMON

95%
Lifetime
60-70%
Month
5-10%
Daily

Cipla
Life care

FireBurningPain

Affects quality of life

Significant work days loss and long term
treatment
Hospitalization as 25% of peptic ulcers
develop complications
Definitely Not A Pleasurable Experience

Cipla
Life care

Lets understand
Acid Related Disorders

Cipla
Life care

Parts of Gastro Intestinal System

Cipla
Life care

Mechanism of Acid Secretion

Cipla
Life care

What Is the Optimal Gastric PH for healing

pH 4

Ulcer healing above 4

pH > 5 to 7 For hemostasis: blood clotting and

platelet aggregation
pH > 7

Optimal for preventing ulcer

rebleeding

Cipla
Life care

Acid Related Disorders: Types

Gastritis

Acute, Chronic

Duodenitis
GERD (Gastroesophageal Reflux disease)
Peptic Ulcer disease
Hypersecretory conditions

Gastric ulcer, Duodenal

ulcer
Zollinger Ellison
syndrome

Cipla
Life care

The Medicines
Antacids
Prostaglandins e.g. Misoprostol
H2-receptor Antagonists
Cimetidine,Famotidine,Ranitidine

Proton Pump inhibitors

Omeprazole,Pantoprazole,Lansoprazole,
Esomeprazole, Rabeprazole

Cipla
Life care

Who Treats
Typical gastro intestinal
symptoms.. Indigestion,Pain in the
abdomen, loss of appetite, gas,
abdominal distention etc

General practitioner or
Gastroenterologists

GERD asthma, Chronic cough

Chest physician

Non cardiac chest pain

Drug induced ulcers

Stress ulcers

Opportunity Everywhere

Cardiologist

Orthopaedician
Surgeons and
Intensivists

Cipla
Life care

Point need to remember Till Now

Acid related disorder and types

Who treats acid related disorders

How PPI is better than H2 RA

Cipla
Life care

Acid Related Disorders

Focus on the Hospital
Setting

Cipla
Life care

Acid Suppression in Critical Care Settings

1. Bleeding acid peptic disease

Accounts for > 150000 hospitalisations and 8-12000
deaths per year.
2. Stress induced mucosal injury
Usually seen in ICU patients.
3. Acid Inhibition During Surgery
4. Severe Reflux Esophagitis

Cipla
Life care

Point need to remember Till Now

Indication for Rabicip I.V.

Cipla
Life care

Molecular
USP

Cipla
Life care

Are All PPIs (Oral,i.V.) The Same

NO

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Life care

Pharmacodynamic Differences

Activation

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Life care

Pharmacodynamic Differences (Cont.)

Proton Pump Inhibition After One Dose

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Life care

Pharmacodynamic Differences (Cont.)

Metabolism

Genetic polymorphism
Inter-patient variability
Fast or slow metabolisers

Cipla
Life care

Pharmacodynamic Differences (Cont.)

Unique Property

Enhances gastric mucin secretion

Cipla
Life care

Molecular USP
Fastest activation among all PPIs
100% inhibition of Proton Pump in just 5 minutes
Increases gastric mucin secretion by 41%
Greter antisecretory effect over a 24hr period than any other PPI
Efficacy of Rabeprazole is not affected by genetic
polymorphism
Minimum drug to drug interactions

Cipla
Life care

Point need to remember Till Now

Molecular USP of Rabicip.

Cipla
Life care

Market

Cipla
Life care

Key Insights - Anti-ulcerant Market

Doctors prefer newer PPIs (especially Pantoprazole &

Rabeprazole)
Constant hammering I.e brand reminder is the need of
the hour

Cipla
Life care

The Market
Total market = 415 Cr
Growth = 9 %
Players = 200 +

138 Cr
6%

Omeprazole

118 Cr
14%

Pantoprazole

109 Cr
18%

Rabeprazole

27 Cr
-2%
Esome

23 Cr
-14%

Lansoprazole

Cipla
Life care

Know your competitor

Omeprazole

Pantoprazole

Rabeprazole

Omez (DRL)

Pantocid (SUN)

Razo (DRL)

Ocid (ZYC)

Pantodac (ZYC) Rablet (Lupin)

Protoloc (USV)

Pan (AK)

Rekool(ALMB)

Ometab (INT)

Pantop (ARIS)

Happi (GR)

Ocid DSR (ZYC) Pantium (INT)

Rabeloc (ZYC)

Brands for retailing : All Rabeprazole and

highlighted omeprazole &
pantoprazole brands

Cipla
Life care

What Competitors Are Doing

In clinic

PDA, DMC, Gifts

Academic

Journals (Am J Gas. Sun, Endoscopy

clinic - Cadila)
Books Sun, Cadila
Updates - (Recent advances in
Gastroenterology Alkem)

Special activity

GET cool with REKOOL, Letter campaign

(FDC)

Sponsorship

Academic

CME

Cadila, Sun, Intas

Gastro club

Sun

Cipla
Life care

Targets - Rabicip

Audience

Gastros, Cons./Chest Phy, Gen. Surgeons, Ortho &

Top GPs

Molecules

Pantoprazole,Omeprazole & other brands of

Rabeprazole

Indications

GERD / Reflux Esophagitis

Acid peptic disorders

Drug induced gastritis

Cipla
Life care

Pricing and Packaging

Rabicip 20 (15s) Rs. 48.58

Rabicip 10 (15s) - Rs. 34.13

Presentation

Sale pack: Strip of 15 tablets

Cipla
Life care

Point need to remember Till Now

Name of my competitors.
Target specialty and indication for me

Cipla
Life care

How Do We Tackle Competition

Cipla
Life care

Conversion Aid Cum Brand Reminder

Frequency / Qty In every 2 month / 4-5
Audience - Gastros, Cons.Phy (Selected)
Must communicate:
Reviews 27 of the top general and specialty
medical journals to keep clinicians up to date on
the most important research appearing in the
literaturer
Only Cipla is authorized to provide this
valuable (Rs. 700 / copy) journal to the doctor

Cipla
Life care

Conversion Aid Cum Brand Reminder

Frequency / Qty In every 3 month
Audience Only Gastros
Must communicate:
Provides comprehensive information on a
single topic, hence highly respected
worldwide
Only Cipla is authorized to provide this
valuable (Rs. 4000 / copy) journal to the
doctor

Cipla
Life care

Lets Practice

Input handling GCNA, Journal watch

How to emphasize on importance?

How to take commitment for support?

Some common practices (Pre announcement,
Prior appointment)

Cipla
Life care

Additional Support

Interesting & innovative literature (DMC, 4 pager)

Gifts

Cipla
Life care

Brand
USP

Cipla
Life care

Brand USP
1.3 minutes
Our strong campaign on activation time

Product services
Revolutionize Hep B mgmt. (1st time in India- Lamivudine, Adefovir,
Lansoprazole, Hydrocortison foam)

Academic services - GCNA,, Journal watch

Personal touch - Visit, Activity, Need based sampling

Cipla
Life care

In clinic
Situations

Cipla
Life care

How Do We Convert Pantoprazole Prescribers

Pantoprazole

Rabicip

Winner

Activation time is 4.6 mins.

Just 1.3 mins.

Rabicip

Just 20% inhibition of proton pump in 5

mins.

100%

Rabicip

Anti-secretory effect is moderate

Significantly higher Rabicip

Increase in intra-gastric pH (2.2) is

moderate

(3.4) significantly
higher

Metabolism affected by CYP2C19 enzyme Unaffected

Rabicip
Rabicip

Cipla
Life care

How Do We Convert Omeprazole Prescribers

Omeprazole
Activation time is 2.8 mins.

Rabeprazole
Just 1.3 mins.

Only 47% inhibition of proton pump 100% inhibition of proton pump in

in 5 mins.
5 mins.
Inadequate acid suppression over 24 Adequate & sustained acid
hrs.
suppression
Anti-secretory effect is moderate

Significantly higher

Only 32% patients got complete

heartburn relief on day 1

As high as 65% patient got

complete heartburn relief on day 1

Cipla
Life care

Targets Rabicip I.V.

Hospital Doctors
All ICUs, ICCUs, SICUs and Intensivists
All doctors attached to Gastroenterology, Surgery and
Medicine department
Trade Doctors
Gastroenterologists
General Surgeons / Gastro Surgeons
Cons. Physicians
All doctors attached to Polyclinics / Nursing Homes

Cipla
Life care

Pricing and Packaging

Price:
Rabicip I.V. 20 mg- Rs 60.99
Presentation:
Each 10 ml vial contains Rabeprazole
Sodium for Injection 20mg with 5ml of
sterile water for injection.

Cipla
Life care

A COMPARISON WITH PANTOPRAZOLE I.V.

Rabicip IV

Pantoprazole IV

IV 20 mg 6 hourly in upper
80 mg stat followed by 8
gastrointestinal bleed , 20 mg OD mg/hr, i.e. 272 mg/day
all other indications
100% inhibition of proton pump
at 32 min even in presence of
blood in stomach

49% inhibition of proton

pump at 342 min if pH 5.1 due
to presence of blood

pH > 6 for 100% of 24 hr at 20

mg 6 hourly

Median pH 2.2 for 24 Hr at 40

mg IV OD. Wide variation
even at 272 mg/d infusion

Cipla
Life care

Rabicip I.V
Similar efficacy why change ?
Talk about slow on set of action when blood in the
stomach, follow with genetic polymorphism.
Pantoprazole is better
Acknowledge individual opinion, give reference, request
to try your brand
Rate
Dont encourage beyond the stipulated norm, seek
BM participation for entry

Cipla
Life care

Lets Revisit the Highlights

Rabicip- An Ace Mover

Benefits

Feature
Starts action in just 1.3 mins

Cipla
Life care

Fastest onset of action amongst all other PPIs

Complete inhibition of Proton Pump in just 5 mins.

Sustained acid suppression over 24 hours
No inter patient variability
Only PPI to increase gastric mucin secretion
Significantly increases intra- gastric Ph
Not metabolised by CYP 450 enzyme system

Rapid relief of symptoms

Day & Night acid control
More predictable effect
Succesfully prevents reccurence
of ulcers
Greater anti- secretory effect
Least drug- drug interaction

Cipla
Life care

The coming months with

Rabicip

Cipla
Life care

Will you be there?

Territory

Avg.YPM

Gr%

Shrikaulam

1504

12

Bhimabharan

1428

23

Sikar

1295

295

Tiruvalla

1140

22

Kolar

1051

74

Cipla
Life care

Believe in you

With will
you can
write the
future