DESSERTATION REPORT

ON

STUDY OF NUTRACEUTICAL MARKET PRODUCT

(CH-BALANCE) IN MEERUT and BULANDSHAHAR

SUBMITTED IN PARTIAL FULFILLMENT OFDEGREE OF

MASTER OF BUSINESS ADMINISTRATION

SUBMITTED BY: Samiullah Khan

UNDER MENTORSHIP OF: Dr.Reshma Nasreen

MBA (PHRMA) 4th SEM

DEPARTMENT OF MANAGEMENT, FMITJAMIA HANDARD

NEW DELHI

LIST OF CONTENTS

ACKNOWLEDGEMENT

DECLARATION

EXECUTIVE SUMMARY

INTRODUCTION

LITRATURE REVIEW

RESEARCH METHODOLOGY

DATA COLLECTION

QUESTIONNAIRE

DATA INTERPRETATION AND ANALYSIS

LIMITATIONS OF THE STUDY

CONCLUSION OF THE STUDY

RECOMMENDATIONS OF THE STUDY

BIBILOGRAPHY

ACKNOWLEDGEMENT

I would like to thank my mentor Dr.Reshma Nasreen for all the help rendered to me during

the project work and going out of way to help me with each and every aspect of project.

I wish to express my gratitude to Mr. V. K. Arora, Regional Sales Manager , Sritech

Pharma for his valuable guidance and suggestions which has saved me from many pitfalls

during the course of my study.

I would like to thank all PHYSICIANS for their support and help which made whole project

the learning experience of life time.

I would also like to thank my Family for their moral as well as financial support during the

study.

DECLARATION

The Project entitled “Prescription Pattern of General Physician in Western Uttar

Pradesh’’ is an original piece of work and which was carried out under the supervision of

Mr. V. K. Arora, Regional Sales Manager , Sritech Pharma and under the guidance of

Dr.Reshma Nasreen , Department of Management ,Jamia Hamdard .

I further declare that this project work is based on my original work and no part of this

project has been published or submitted to anybody.

SAMIULLAH KHAN

MBA (PM) 4th SEM

D/O MANAGEMENT

JAMIA HAMDARD

NEW DELHI - 110062

EXECUTIVE SUMMARY

The Indian Pharmaceutical Industry today is in the front rank of India’s science-based industries with wide ranging capabilities in the complex field of drug manufacture and technology. It ranks very high in the third world, in terms of technology, quality and range of medicines manufactured. From simple headache pills to sophisticated antibiotics and complex cardiac compounds, almost every type of medicine is now made indigenously. 

Indian Pharma Industry boasts of quality producers and many units approved by regulatory authorities in USA and UK. International companies associated with this sector have stimulated, assisted and spearheaded this dynamic development in the past 53 years and helped to put India on the pharmaceutical map of the world. Cholesterol is a waxy steroid of fat that is manufactured in the liver or intestines to produce hormones and cell membranes and transported in the blood plasma of all mammals. It is an essential structural component of mammalian cell membranes, where it is required to establish proper membrane permeability and fluidity. In addition, cholesterol is an important component for the manufacture of bile acids, steroid hormones, and Vitamin D. Cholesterol is the principal sterol synthesized by animals, but small quantities are synthesized in other eukaryotes, such as plants and fungi. It is almost completely absent among prokaryotes, which include bacteria. Although cholesterol is an important and necessary molecule for mammals, high levels of cholesterol in the blood can clog arteries and potentially is linked to diseases such as heart disease

The research was conducted on GENERAL PHYSICIAN in Meerut and Bulandshahar. The research was conducted on 20 Physicians in the two cities .The questionnaire mainly includes the questions related to prescribing behavior of Cardiologist and factors affecting their prescription pattern. Most of the Cardiologist were overloaded with work and participated casually in the research work. The Cardiologist use to attend between 20-40 everyday. The Patients suffered from various factors and cholesterol is one of the major sources of diseases. Around 35%-60% of the cardiac patients suffered problem due to cholesterol. Rosuvas was most prescribed anti-cholesterol drug among cardiologist. Regular detailing of drugs by Medical Representatives and better quality Products plays an important role in shifting brand loyalty of Cardiologist. Most of the Cardiologist did not trust Herbal Drugs. Only few of them trust herbal substitute for cholesterol. Cardiologists were not aware of the ch-balance of Amway.The anti-cholesterol drugs have very huge market and its herbal substitute can be money making machine if proper strategies are employed.

Introduction

Cholesterol is a waxy steroid of fat that is manufactured in the liver or intestines to produce

hormones and cell membranes and transported in the blood plasma of all mammals.[2] It is an

essential structural component of mammalian cell membranes, where it is required to

establish proper membrane permeability and fluidity. In addition, cholesterol is an important

component for the manufacture of bile acids, steroid hormones, and Vitamin D. Cholesterol

is the principalsterol synthesized by animals, but small quantities are synthesized in

other eukaryotes, such as plants and fungi. It is almost completely absent among prokaryotes,

which include bacteria. Although cholesterol is an important and necessary molecule for

mammals, high levels of cholesterol in the blood can clog arteries and potentially is linked to

diseases such asheart disease.

The name cholesterol originates from the Greek chole- (bile) and stereos (solid), and

thechemical suffix -ol for an alcohol. François Poulletier de la Salle first identified

cholesterol in solid form in gallstones, in 1769. However, it was only in 1815 that

chemist Eugène Chevreulnamed the compound "cholesterine"

Since cholesterol is essential for all animal life, it is primarily synthesized from simpler

substances within the body. However, high levels in blood circulation, depending on how it

is transported within lipoproteins, are strongly associated with progression of atherosclerosis.

For a person of about 68 kg (150 pounds), typical total body cholesterol synthesis is about 1

g (1,000 mg) per day, and total body content is about 35 g. Typical daily additional dietary

intake in the United States is 200–300 mg. The body compensates for cholesterol intake by

reducing the amount synthesized.

Cholesterol is recycled. It is excreted by the liver via the bile into the digestive tract.

Typically about 50% of the excreted cholesterol is reabsorbed by the small bowel back into

the bloodstream. Phytosterols can compete with cholesterol reabsorption in the intestinal

tract, thus reducing cholesterol reabsorption.

Function

Cholesterol is required to build and maintain membranes; it modulates membrane

fluidity over the range of physiological temperatures. The hydroxyl group on cholesterol

interacts with the polar head groups of the membrane phospholipids and sphingolipids, while

the bulky steroid and the hydrocarbon chain are embedded in the membrane, alongside

the no polar fatty acid chain of the other lipids. In this structural role, cholesterol reduces the

permeability of the plasma membrane to protons (positive hydrogen ions) and sodium ions.

Within the cell membrane, cholesterol also functions in intracellular transport, cell signaling

and nerve conduction. Cholesterol is essential for the structure and function of

invaginated caveolae and clathrin-coated pits, including caveola-dependent and clathrin-

dependent endocytosis. The role of cholesterol in such endocytosis can be investigated by

using methyl beta cyclodextrin (MβCD) to remove cholesterol from the plasma membrane.

Recently, cholesterol has also been implicated in cell signaling processes, assisting in the

formation of lipid rafts in the plasma membrane. In many neurons, a myelin sheath, rich in

cholesterol, since it is derived from compacted layers of Schwann cell membrane, provides

insulation for more efficient conduction of impulses.

Within cells, cholesterol is the precursor molecule in several biochemical pathways. In the

liver, cholesterol is converted to bile, which is then stored in the gallbladder. Bile contains

bile salts, which solubilize fats in the digestive tract and aid in the intestinal absorption of fat

molecules as well as the fat-soluble vitamins, Vitamin A, Vitamin D, Vitamin E,

and Vitamin K. Cholesterol is an important precursor molecule for the synthesis of Vitamin

D and the steroid hormones, including the adrenal glandhormones cortisol and aldosterone as

well as the sex hormones progesterone, estrogens, and testosterone, and their derivatives.

Some research indicates that cholesterol may act as an antioxidant.

Dietary sources

Animal fats are complex mixtures of triglycerides, with lesser amounts of phospholipids and

cholesterol. As a consequence, all foods containing animal fat contain cholesterol to varying

extents. Major dietary sources of cholesterol include cheese, egg yolks, beef, pork,poultry,

and shrimp.

Human breast milk also contains significant quantities of cholesterol.

The amount of cholesterol present in plant-based food sources is generally much lower than

animal based sources. In addition, plant products such as flax seeds and peanuts contain

cholesterol-like compounds called phytosterols, which are suggested to help

lower serumcholesterol levels.

Total fat intake, especially saturated fat and trans fat, plays a larger role in blood cholesterol

than intake of cholesterol itself. Saturated fat is present in full fat dairy products, animal fats,

several types of oil and chocolate. Trans fats are typically derived from the partial

hydrogenation of unsaturated fats, and do not occur in significant amounts in nature. Trans

fat is most often encountered in margarine and hydrogenated vegetable fat, and consequently

in many fast foods, snack foods, and fried or baked goods.

A change in diet in addition to other lifestyle modifications may help reduce blood

cholesterol. Avoiding animal products may decrease the cholesterol levels in the body not

only by reducing the quantity of cholesterol consumed but also by reducing the quantity of

cholesterol synthesized. Those wishing to reduce their cholesterol through a change in diet

should aim to consume less than 7% of their daily caloriesfrom animal fat and fewer than

200 mg of cholesterol per day.

It is debatable that a diet, changed to reduce dietary fat and cholesterol, can lower blood

cholesterol levels, (and thus reduce the likelihood of development of, among others, coronary

artery disease leading to coronary heart disease), because any reduction to dietary cholesterol

intake could be counteracted by the organs compensating to try to keep blood cholesterol

levels constant. Also pointed out is the experimental discovery that in the diet, ingested

animal protein can raise blood cholesterol more than the ingested saturated fat or any

cholesterol. Moreover, the benefits of a diet supplemented with plant sterol esters has been

questioned.

Synthesis

All animal cells manufacture cholesterol with relative production rates varying by cell type

and organ function. About 20–25% of total daily cholesterol production occurs in the liver;

other sites of higher synthesis rates include the intestines, adrenal glands, and reproductive

organs. Synthesis within the body starts with one molecule of acetyl CoA and one molecule

of acetoacetyl-CoA, which are dehydrated to form 3-hydroxy-3-methylglutaryl CoA (HMG-

CoA). This molecule is then reduced to mevalonate by the enzyme HMG-CoA reductase.

This step is the regulated, rate-limiting and irreversible step in cholesterol synthesis and is

the site of action for the statin drugs (HMG-CoA reductase competitive inhibitors).

Mevalonate is then converted to 3-isopentenyl pyrophosphate in three reactions that

require ATP. This molecule is decarboxylated toisopentenyl pyrophosphate, which is a key

metabolite for various biological reactions. Three molecules of isopentenyl pyrophosphate

condense to form farnesyl pyrophosphate through the action of geranyl transferase. Two

molecules of farnesyl pyrophosphate then condense to form squalene by the action

of squalene synthase in the endoplasmic reticulum. Oxidosqualene cyclase then cyclizes

squalene to formlanosterol. Finally, lanosterol is then converted to cholesterol.

Konrad Bloch and Feodor Lynen shared the Nobel Prize in Physiology or Medicine in 1964

for their discoveries concerning the mechanism and regulation of cholesterol and fatty acid

metabolism.

Regulation of cholesterol synthesis

Biosynthesis of cholesterol is directly regulated by the cholesterol levels present, though

the homeostatic mechanisms involved are only partly understood. A higher intake from food

leads to a net decrease in endogenous production, whereas lower intake from food has the

opposite effect. The main regulatory mechanism is the sensing of intracellular cholesterol in

the endoplasmic reticulum by the protein SREBP(sterol regulatory element-binding protein 1

and 2).In the presence of cholesterol, SREBP is bound to two other proteins: SCAP (SREBP-

cleavage-activating protein) and Insig1. When cholesterol levels fall, Insig-1 dissociates

from the SREBP-SCAP complex, allowing the complex to migrate to the Golgi apparatus,

where SREBP is cleaved by S1P and S2P (site-1 and -2 protease), two enzymes that are

activated by SCAP when cholesterol levels are low. The cleaved SREBP then migrates to the

nucleus and acts as a transcription factor to bind to the SRE (sterol regulatory element),

which stimulates the transcription of many genes. Among these are the low-density

lipoprotein (LDL) receptor and HMG-CoA reductase. The former scavenges circulating LDL

from the bloodstream, whereas HMG-CoA reductase leads to an increase of endogenous

production of cholesterol. A large part of this signaling pathway was clarified by Dr. Michael

S. Brown and Dr.Joseph L. Goldstein in the 1970s. In 1985, they received the Nobel Prize in

Physiology or Medicine for their work. Their subsequent work shows how the SREBP

pathway regulates expression of many genes that control lipid formation and metabolism and

body fuel allocation.

Cholesterol synthesis can be turned off when cholesterol levels are high, as well. HMG CoA

reductase contains both a cytosolic domain (responsible for its catalytic function) and a

membrane domain. The membrane domain functions to sense signals for its degradation.

Increasing concentrations of cholesterol (and other sterols) cause a change in this domain's

oligomerization state, which makes it more susceptible to destruction by the proteosome.

This enzyme's activity can also be reduced by phosphorylation by an AMP-activated

proteinkinase. Because this kinase is activated by AMP, which is produced when ATP is

hydrolyzed, it follows that cholesterol synthesis is halted when ATP levels are low. Plasma

transport and regulation of absorption

Cholesterol is only slightly soluble in water; it can dissolve and travel in the water-based

bloodstream at exceedingly small concentrations. Since cholesterol is insoluble in blood, it is

transported in the circulatory system within lipoproteins, complex discoidal particles which

have an exterior composed of amphiphilic proteins and lipids whose outward-facing surfaces

are water-soluble and inward-facing surfaces are lipid-soluble; triglycerides and cholesterol

esters are carried internally. Phospholipids and cholesterol, being amphipathic, are

transported in the surface monolayer of the lipoprotein particle.

In addition to providing a soluble means for transporting cholesterol through the blood,

lipoproteins have cell-targeting signals that direct the lipids they carry to certain tissues. For

this reason, there are several types of lipoproteins within blood called, in order of increasing

density,chylomicrons, very-low-density lipoprotein (VLDL), intermediate-density

lipoprotein (IDL), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). The

more cholesterol and less protein a lipoprotein has the less dense it is. The cholesterol within

all the various lipoproteins is identical, although some cholesterol is carried as the "free"

alcohol and some is carried as fatty acyl esters referred to as cholesterol esters. However, the

different lipoproteins contain apolipoproteins, which serve as ligands for specific receptors

on cell membranes. In this way, the lipoprotein particles are molecular addresses that

determine the start- and endpoints for cholesterol transport.

Chylomicrons, the least dense type of cholesterol transport molecules, contain apolipoprotein

B-48, apolipoprotein C, and apolipoprotein E in their shells. Chylomicrons are the

transporters that carry fats from the intestine to muscle and other tissues that need fatty acids

for energy or fat production. Cholesterol which is not used by muscles remains in more

cholesterol-rich chylomicron remnants, which are taken up from the bloodstream by the

liver.

VLDL molecules are produced by the liver and contain excess triacylglycerol and cholesterol

that is not required by the liver for synthesis of bile acids. These molecules

contain apolipoprotein B100 and apolipoprotein E in their shell. During transport in the

bloodstream, the blood vessel cleave and absorb more triacylglycerol from IDL molecules,

which contain an even higher percentage of cholesterol. The IDL molecules have two

possible fates: Half are into metabolism by HTGL, taken up by the LDL receptor on the liver

cell surfaces and the other half continue to lose triacylglycerols in the bloodstream until they

form LDL molecules, which have the highest percentage of cholesterol within them.

LDL molecules, therefore, are the major carriers of cholesterol in the blood, and each one

contains approximately 1,500 molecules of cholesterol ester. The shell of the LDL molecule

contains just one molecule of apolipoprotein B100, which is recognized by the LDL

receptorin peripheral tissues. Upon binding of apolipoprotein B100, many LDL receptors

become localized in clathrin-coated pits. Both the LDL and its receptor are internalized

by endocytosis to form a vesicle within the cell. The vesicle then fuses with a lysosome,

which has an enzyme called lysosomal acid lipase that hydrolyzes the cholesterol esters.

Now within the cell, the cholesterol can be used for membrane biosynthesis or esterified and

stored within the cell, so as to not interfere with cell membranes.

Synthesis of the LDL receptor is regulated by SREBP, the same regulatory protein as was

used to control synthesis of cholesterol de novo in response to cholesterol presence in the

cell. When the cell has abundant cholesterol, LDL receptor synthesis is blocked so that new

cholesterol in the form of LDL molecules cannot be taken up. On the converse, more LDL

receptors are made when the cell is deficient in cholesterol. When this system is deregulated,

many LDL molecules appear in the blood without receptors on the peripheral tissues. These

LDL molecules are oxidized and taken up by macrophages, which become engorged and

form foam cells. These cells often become trapped in the walls of blood vessels and

contribute to artherosclerotic plaque formation. Differences in cholesterol homeostasis affect

the development of early atherosclerosis (carotid intima-media thickness). These plaques are

the main causes of heart attacks, strokes, and other serious medical problems, leading to the

association of so-called LDL cholesterol (actually a lipoprotein) with "bad" cholesterol.

Also, HDL particles are thought to transport cholesterol back to the liver for excretion or to

other tissues that use cholesterol to synthesize hormones in a process known as reverse

cholesterol transport (RCT). Having large numbers of large HDL particles correlates with

better health outcomes. In contrast, having small numbers of large HDL particles is

independently associated with atheromatous disease progression within the arteries.

Metabolism, recycling and excretion

Cholesterol is susceptible to oxidation and easily forms oxygenated derivatives known

as oxysterols that can be formed by three different mechanisms, autoxidation, oxidation

secondary to lipid peroxidation and by cholesterol metabolizing enzymes. A great interest in

oxysterols arose when it was shown that they exerted inhibitory actions on cholesterol

biosynthesis, a finding that subsequently became known as the “oxysterol hypothesis”.

Additional roles for oxysterols in human physiology include their participation in bile acid

biosynthesis, their function as transport forms of cholesterol and as regulators of gene

transcription.

Cholesterol is oxidized by the liver into a variety of bile acids.[30] These in turn

are conjugated with glycine, taurine, glucuronic acid, or sulfate. A mixture of conjugated and

non-conjugated bile acids along with cholesterol itself is excreted from the liver into the bile.

Approximately 95% of the bile acids are reabsorbed from the intestines and the remainder

lost in the feces. The excretion and reabsorption of bile acids forms the basis of

the enterohepatic circulation which is essential for the digestion and absorption of dietary

fats. Under certain circumstances, when more concentrated, as in the gallbladder, cholesterol

crystallises and is the major constituent of most gallstones,

although lecithin and bilirubin gallstones also occur less frequently

Treatment

There are several types of lipid lowering drugs. Some are better at lowering LDL cholesterol, some at reducing triglyceride levels and some help raise HDL cholesterol, the good cholesterol.

Statins

Statins are also known as HMG-CoA reductase inhibitors. They are the most effective drugs in lowering LDL cholesterol. They

inhibit HMG-CoA reductase (3-hydroxy-3-methylglutaryl coenzyme A reductase) an enzyme involved in the synthesis of cholesterol,

especially in the liver. Decreased cholesterol production leads to an increase in the number of LDL membrane receptors, which increases

clearance of LDL cholesterol from circulation.

Brand Name Generic Name

Altocor, Mevacor lovastatin

Crestor rosuvastatin

Lescol fluvastatin

Lipitor atorvastatin

Pravachol pravastatin

Zocor simvastatin

Baycol (withdrawn August 2001) cerivastatin

Fibrates

Fibrates are regarded as broad-spectrum lipid lowering drugs. Their main action is to decrease triglyceride levels but they also tend

to reduce LDL cholesterol and help to raise HDL cholesterol. Mechanism of action is not well established. Apparently it decreases

plasma levels of triglycerides by decreasing their synthesis. Also reduces plasma levels of VLDL cholesterol by reducing its release into

the circulation and increasing catabolism.

Brand Name Generic Name

Antara, Lipofen, Tricor,Triglide fenofibrate

Atromid-S clofibrate

Lopid gemfibrozil

Cholesterol Absorption Inhibitors

This is a new class of antihyperlipidemic drugs. It works by reducing the absorption of dietary cholesterol, through the intestines.

Brand Name Generic Name

Zetia ezetimibe

Bile Acid Sequestrants (also known as Anion-Exchange Resins)

Bile acid sequestrants reduce serum cholesterol levels. They cause no change or sometimes even cause a slight increase in

trigylceride concentrations and are therefore not suitable for patients with elevated triglyceride levels. After oral administration, they are

not absorbed but bind to bile acids in the intestine and prevent their reabsorption. The bound complex is insoluble and is excreted in the

faeces. Decrease in bile acid leads to an increase in hepatic synthesis of bile acids from cholesterol. Depletion of cholesterol from the

liver increases LDL receptor activity, which removes LDL cholesterol from the blood.

Brand Name Generic Name

Colestid, Flavored Colestid colestipol

Questran, Questran Light cholestyramine

Welchol colesevelam

Nicotinic Acid Group

Niacin (also known as Nicotinic acid) is limited by its side effects especially vasodilatation. In doses of 1.5 to 3 g daily it lowers both cholesterol and triglyceride concentrations by inhibiting synthesis. It also increases HDL cholesterol.

Brand Name Generic Name

Niacor niacin

Fish Oil

Fish oil preparations are used to lower very high triglyceride levels in the blood.

Brand Name Generic Name

Lovaza, Omacor omega-3-acid ethyl esters

Combination Drug Therapy

Niacin and ezetimibe are available in combination with statins, as single dose forms.

Brand Name Generic Name

Advicor niacin/lovastatin

Simcor niacin/simvastatin

Brand Name Generic Name

Vytorin ezetimibe/simvastatin

Other Drugs

Ispaghula Husk, a form of soluble fibre, can be used as an adjunct to a lipid lowering diet in patients with mild to moderate hypercholesterolemia. It probably acts by reducing reabsorption of bile acids: plasma triglycerides remain unchanged.

Probucol, has been shown to reduce both LDL and HDL cholesterol levels. It is not available in U.S. but is available in Canada under the following brand names, Bifenabid, Lesterol, Lorelco, Lurselle, Panesclerina, and Superlipid.

Outlook (Prognosis)

If you are diagnosed with high cholesterol, you will probably need to continue lifestyle changes and drug therapy throughout your life. Periodic monitoring of your blood levels is necessary. Reducing high cholesterol levels will slow the progression of atherosclerosis.

Possible Complications

Possible complications of high cholesterol include:

Atherosclerosis Coronary artery disease Stroke Heart attack or death

Lipitor

In 2006, Pfizer’s Lipitor (atorvastatin) generated global revenues of $13.6bn, making it the best selling drug in pharmaceutical history. The blockbuster medicine has single-handedly driven the overall revenue margins of the cardiovascular segment, as this area continues to dominate the pharmaceutical market. Despite the maturing status of Lipitor, the drug has repeatedly maintained steady growth over the past 5 years, crowding out the yearly revenues of other lipid-regulating blockbuster drugs: Merck& Co’s Zocor and Zetia, Astrazeneca’s Crestor, Abbott’s Tricor and Bristol Myers Squibb’s Pravacol.

However, as Lipitor’s blockbuster revenue is seriously threatened by imminent patent expiration in some of the drug’s largest markets such as the US, Japan and the UK, there is significant unrest between Pfizer’s key stakeholders about the future of the drug. Principally, amongst the heightened Lipitor topics are the imminent exposure of the $1 billion annual drug sales or more, as well as the fast expanding generic market in which India’s Ranbaxy is a dominant force. 

Off the immediate entry of Ranbaxy’s generic Lipitor, in key markets, the legal challenges surrounding the number one drug have set a new benchmark for pharmaceutical companies protecting branded products. Industry observers predict that Pfizer’s crises are far from over, as the high revenue streams of Lipitor will experience significant challenges before the commencement of the next decade.

Moreover, Pfizer’s lack of success to replace Lipitor with Torcetrapib has escalated the company’s near-term battles besides the ever-tighter regulatory hurdles, reduced R&D efficiency and increased competition, creating formidable therapeutic challenges as healthcare payers influence pricing. Nevertheless, there are strong drivers of growth including unmet therapeutic needs, the rising incidence of multiple diseases, ageing populations, the rising living standards and fast-developing geographical markets. The future of Lipitor is therefore vitally important to Pfizer, especially in this uncertain period of economic changes and pressures. 

This report includes detailed five-year forecasts over the period 2008-2013, and features 10

and 15-year forecasts to help you understand the medium-term prospects for these markets.

Literature review

1. Drugs for cholesterol

Author: Hans.A.Mathew

Publication: Gield&van publication, 2006

Finding of this report states that Statins are the most preferred anti –cholesterol drugs.

Statins are combined with other drugs

Statins are followed by Fibrates as anti- cholesterol drugs.

2. Hidden truth about cholesterol lowering drugs

Author: Sidney M. Wolfe, Larry D. Sasich, Rose-Ellen Hope

Publication: inset Publication

Finding of this report states that

Prescription drugs are not only way to lower cholesterol.

There are many ways to control cholesterol apart from FDA approved drugs.

Diet control and proper exercise regime can also help in reducing cholesterol.

3. Lipitor , the thief of memory

Author: Duane Graveline

Publication: jack Publication

Finding of this report states that

The author has discussed about the memory loss and other problems faced by user of Lipitor and other statins.

The author has discussed in detail about all the harmful effects of statins.

The author has emphasized about a herbal replacement of statins.

The author has backed most of his claims with the help of relevant data.

4. Amway : The cult of free enterprises

Author: Duane Graveline

Publication: jack Publication

Finding of this report states that

The history of Amway The brief description about its competitor and strategies. The detail about its products.

Research Methodology

STUDY REQUIREMENT – The product research of CH-balance in Meerut and Bulandshahar

OBJECTIVE

To study the ground realities of nutraceutical business in semi urban cities. To study the nutraceutical prescribing Pattern of physicians in Meeerut and

buandshahar (U.P.) To study the details of marketing strategies employed by different

nutraceutical companies in order to tap the urban market.

SUB OBJECTIVE

To study and observe the different aspects of nutraceutical marketing in India.

To study and analyze the different marketing trends in semi urban market.

To study and observe the psychological aspect of prescribing behavior of General Physicians..

Scope of the research

The research will provide an in-depth analysis of existing trends in nutraceutical business.

The research will provide different aspects of prescribing behavior of General Physicians in terms of nutraceuticals.

It will help neutraceutical marketers to design new marketing model and strategies to penetrate Pharma market.

Research Design

There is a huge array of alternative research designs that can satisfy research objectives. The key is to create a design that enhances the value of the information obtained, whilst reducing the cost of obtaining it.

Marketing research can be classified one of three categories:

1. Exploratory research2. Conclusive research :

a) Descriptive researchb) Causal research

These classifications are made according to the objective of the research. In some cases the research will fall into one of these categories, but in other cases different phases of the same research project will fall into different categories.

1. Exploratory research has the goal of formulating problems more precisely, clarifying concepts, gathering explanations, gaining insight, eliminating impractical ideas, and forming hypotheses. Exploratory research can be performed using a literature search, surveying certain people about their experiences, focus groups, and case studies. When surveying people, exploratory research studies would not try to acquire a representative sample, but rather, seek to interview those who are knowledgeable and who might be able to provide insight concerning the relationship among variables. Case studies can include contrasting situations or benchmarking against an organization known for its excellence. Exploratory research may develop hypotheses, but it does not seek to test them. Exploratory research is characterized by its flexibility.

2. Conclusive research is the research design which leads us to conclusion. It is classified into:

a) Descriptive research.b) Causal research

a) Descriptive research is more rigid than exploratory research and seeks to describe users of a product, determine the proportion of the population that uses a product, or predict future demand for a product. As opposed to exploratory research, descriptive research should define questions, people surveyed, and the method of analysis prior to beginning data collection. In other words, the who, what, where, when, why, and how aspects of the research should be defined. Such preparation allows one the opportunity to make any required changes before the costly process of data collection has begun.There are two basic types of descriptive research: longitudinal studies and cross-sectional studies. Longitudinal studies are time series analyses that make repeated measurements of the same individuals, thus allowing one to monitor behavior such as brand-switching.

However, longitudinal studies are not necessarily representative since many people may refuse to participate because of the commitment required. Cross-sectional studies sample the population to make measurements at a specific point in time. A special type of cross-sectional analysis is a cohort analysis, which tracks an aggregate of individuals who experience the same event within the same time interval over time. Cohort analyses are useful for long-term forecasting of product demand.

b) Causal research seeks to find cause and affect relationships between variables. It accomplishes this goal through laboratory and field experiments.

Research Design Used in the Project-

Descriptive format of conclusive research.

Data Collection Sampling Procedure: 350 General Physician Practitioners

Primary data: It was collected through well structured questionnaire from General Medical Practitioners. The questionnaire design was such that it Motivated the respondents to cooperate, become involved, and provide complete, Honest and accurate answers.

Secondary Data: it includes information obtained from literature review, articles in the Newspapers, magazines and internet.

Data Presentation-it is based on statistical analysis of the feedbacks obtained.

DATA ANALYSIS

How Many numbers of cardiac patients are attended by you everyday?

Findings:1. About half of the Cardiologist admitted examining up to 20 patients daily.

2. Around 40% of the Cardiologist admitted examining between 20-40 patients.

3. Only 14% of them said their patients number exceeds 40 per day.

How many percentage of heart patients have cholesterol related problems?

Findings:1. Above 40%of the cardiologist admitted that more then 60% of heart patients have

cholesterol related problems.

2. It shows that cholesterol is the major problem behind heart problems.

Which drugs among you prescribe for cholesterol?

Findings:

1. The market in meerut and bulandshahar was dominated by ranbaxys rosuvas.2. It was followed by world famous , Pfizers LIPITOR 3. Hamdards lipo tab and Himalayas shuddha gugglu was least prescribed in this catogery.

Your opinion about Herbal drugs for cholesterol control?

Findings:

1. Only 12% of the cardiologist admitted prescribing herbal medicines for cholesterol control and find them good as compare to conventional alternatives.

2. Around 1/3 of doctors interviewd said that the herbal cholesterol drugs are of average quality and they prescribe them some times.

3. Majority of them admitted not prescribing herbal drugs.

5. Do you prescribe CH-Balance for cholesterol reduction?

Findings:

1. Only 12% of the cardiologist admitted they know ch balnce and use it some time.2. Around 24% admitted knowing ch-balance but did not prescribe them.3. Majority of them admitted not knowing the product.

Conclusion of the study

Indian nutraceutical market is growing @ 40% The prescribing behavior of General Physician plays an important role in

Nutraceutical Marketing. Most of the doctors use to attend up to 20 patients. The patients were mainly suffered from complications related to cholesterol. The doctors were prescribing the Rosuvas of Ranbaxy,followed by pfizers star

product Lipitor. The herbal and nutraceutical market covers very less percentage of anti cholesterol

drugs. Most of the cardiologist didn’t prescribe herbal substitute of rosuvas because of fear

of quality of herbal products. Ch – Balance is the product of Amway. Amway is world famous network marketing company. Ch- balance has very little penetration in anti-cholesterol market. Only few doctors know the product and very few of them try to prescribe it. Internet Promotion of Ch-balance can be used as a powerful tool for promoting

Pharma Products. The nutraceutical marketing in semi – urban cities has huge potential and will be

money making machines for pharmaceutical & other marketing companies if proper strategies and marketing model is employed.

Limitations of the study

India is inhabited by people of different culture, religion and traditions.

The language and tradition changes here after every 10 km. Any kind of research on Indian population and its buying behavior cannot be accurate

because of its diverse population with more diverse living style and culture. This is the reason why many market model and strategies employed by several

companies in India did not yield expected result. The Product research on the Ch balance was done on cardiologist from Meerut ,

Bulandshahar (Uttar Pradesh). The culture and tradition of western U.P may match the tradition and culture of other

Hindi speaking state but it differs from south India or north east states or other non-Hindi states.

So, the conclusion or findings of research may vary if done on a district of south India or any non-Hindi state.

The questionnaire does not include any question to measure the psychological behavior of rural practitioner.

So, the result may not be as accurate due to lack of measurement of psychological behavior of rural prescriber.

The findings of the research are not sufficient to formulate any new rural marketing model or strategy because :

a) The questionnaire is only confined to prescribing aspect of rural practitioner.

b) The questionnaire does not include any question to measure the psychological aspect of rural practitioners.

c) The questionnaire does not include any question related to demography of region.

d) The samples of the research were confined to one region of country.

Bibliography

1. Pradhan, B.Suresh (2001). Nutraceutical Marketing. First Edition, Sage Publication: New Delhi

2. Lambert M Surhone, Miriam T Timpledon, Susan F Marseken (2010). Herbal & natural products Marketing , DMS Publication 4 th Volume : 1123-1149

3. E. M. Kolassa (2007). Elements of Pharmaceutical Pricing, GMV Publication

: 212-276

4. Stuart .P.Slatter (1992).Compettition and Marketing Strategies in Nutaceutical Industry , CBS Publication : 34-22

5. Eric Laat , Frank A. G. Windmeijer, Rudy C. Douven, Netherlands. Centraal Planbureau (2003) : How does Nutraceutical Marketing influence doctors Prescribing behavior ,Memade Publication : 346-389

6. Aslam .siraj (2009) : Prescribing pattern and Drug usuage : DMV Publication

: 12-997. en.wikipedia.org/wiki/ Nutraceutical  

8. www.parry nutraceuticals .com/  

9. www.divis nutraceuticals .com

10.naturalsecrets.com