c



   

  

  

    

u




  
 OVERVIEW
¢ Company profile
¢ Overview of epilepsy
¢ Literature review
¢ Research methodology
¢ Data analysis and finding
¢ Conclusion and suggestion
¢ Recommendation
 Company profile

¢ ‘

„
 
 is our goal. We give our first thoughts to
patients and their families and contribute to increasing their
benefits.
¢ ‘


 
 
Eisai is a responsible, focused, efficient, innovative and solution-
oriented pharmaceutical company. This vision is designed to
provide the overall direction for our company. It describes what we
need to continue succeeding in the future, based on changes in
the marketplace and our capabilities.
 Company history

¢ Eisai Inc. is a U.S. pharmaceutical subsidiary of Tokyo-based Eisai

Co. Ltd. a research-based 
 
 company that
discovers, develops and markets products throughout the world.
Established in 1995.
¢ Eisai Inc. began marketing its first product in the United States in
1997 and has rapidly grown to become an integrated
pharmaceutical business with sales of approximately $3.9 billion in
fiscal year 2009 (year ending March 31, 2010).
¢ Headquartered in Woodcliff Lake, New Jersey, we are dedicated to
a tradition of genuine concern for people and are driven by the
desire to meet the diverse health care needs of patients and their
families and caregivers.
 Overview of epilepsy
¢ The words "epilepsy" and "epileptic" are of Greek origin and have
the same root as the verb "epilambanein," which means "to seize"
or "to attack." Therefore, epilepsy means seizure, while epileptic
means seized.
¢ In the modern understanding of epilepsy, it should not be
considered a disease. Rather, it is a symptom indicating a medical
condition in the brain that causes a potential for recurrent seizures.
¢ The condition of epilepsy has many causes and the kinds of
seizures that occur can vary widely.
¢ The word epilepsy is actually a descriptive term. It takes into
account an individual's risk of recurrent seizures. However, when
people are suffering from meningitis and have a seizure, they would
not be considered to have epilepsy unless they had a seizure after
the meningitis resolved.
¢ In this case, these individuals have a risk for recurrent seizures and,
hence, epilepsy.
¢ If an individual over time does not have any seizures off
medications, then it could be said that epilepsy has resolved or
gone into remission.
¢ In terms of treatment of epilepsy


  were the first

successful medicine for epilepsy, from the 1850s onwards,
abolishing attacks in some, and diminishing them in number or
violence in most others.
¢ They started to be displaced only after the introduction of
Ä


, first prescribed in 1912. Barbiturates continue to be

one of the effective treatments, although further understanding of
the underlying mechanisms have led to the development of
alternative modern anticonvulsant drugs those that potentiate or
imitate the inhibitory neurotransmitter GABA, or stabilize the
neuronal cell membrane, and thus prevent excessive
 Type of epilepsy
¢ Ô






Generalized epileptic seizures occur when electrical abnormalities

exist throughout the brain. A partial seizure does not involve the
entire brain. A partial seizure begins in an area called an epileptic
focus, but may spread to other parts of the brain and cause a
generalized seizure.
 Cont͙
¢ u 



¢ Simple partial seizures do not spread from the focal area where
they arise. Symptoms are determined by the part of the brain
affected. The patient usually remains conscious during the seizure
and can later describe it in detail.
 Cont͙
¢ þ
 


A distinctive smell, taste, or other unusual sensation (aura) may

signal the start of a complex partial seizure, Complex partial
seizures start as simple partial seizures, but move beyond the focal
area and cause loss of consciousness.
 à





¢ u


 


  

Sridharan R, Murthy BN. 2009, Apollo Hospitals, Institute for Research in Medical
Statistics, Indian Council of Medical Research, Chennai, Madras.
¢ Based on the total projected population of India in the year 2001,
the estimated number of people with epilepsy would be 5.5 million.
Based on a single study on the incidence of epilepsy, the number of
new cases of epilepsy each year would be close to half a million.
Because rural population constitutes 74% of the Indian population,
the number of people with epilepsy in rural areas will be
approximately 4.1 million, three fourths of whom will not be getting
any specific treatment as per the present standard.
¢ m     þ 
  
Michael R. Trimble, 2010 National Hospital for Nervous Diseases and Institute of
Neurology, London, England
Alterations of cognitive function are separate from disturbances of
behaviour seen in association with epilepsy Maximal impairments
are seen in patients receiving polytherapy: rationalization of
polytherapy improves cognitive abilities. Studies in children and
adults have allowed differentiation of the effects of various
commonly used antiepileptic agents. Maximal cognitive deficits are
seen with. phenytoin, while phenobarbital and sodium valproate
induce moderate disturbances, and carbamazepine seems relatively
free from such toxicity.
¢ þ!  
‘


 m


à


¢ Claude Remy Centre Medical la Teppe, Tain l'Hermitage, France Correspondence
to Centre Medical La Teppe, 26600 Tain l'Hermitage, France.
¢ CLB is an effective antiepileptic drug (AED) in most varieties of
seizures and epilepsies for both short-term and long-term
treatment. Tolerability of CLB is satisfactory, better than for
conventional benzodiazepines. CLB has no significant interaction
with other drugs.
¢ ‘

þ 
Ô

"

 ‘



¢ "

# 
$ %  
   
þ 

u %&''( College of
Physicians and Surgeons, Columbia University, New York.
¢ Randomized clinical trials form the basis for evidence-based
decision making about best treatment options, but they rarely
compare active therapies making decisions difficult,
 Research Methodology
¢ m
To understand the treatment modalities by Neurologists for
epilepsy treatment
¢ !)


¢ m

 !





 
 

  
 !


 


¢ m  $
 

   



 !
! 
¢ m  !


!


  
    $
 % 




 
 
¢ "
 
¢ Sample contained Neurologists from hospitals (private and
government) from Delhi region
¢ Sample location: Delhi, 20 hospitals, Delhi region selected as
secondary analysis showed a treatment gap and potential for
company expansion.
¢ Sample Size: 50 doctors.
¢ 

  
 
¢ þ 
Ú consisting of well structured questionnaire that would
be common to all doctors. More precisely, 
 


 
where descriptive information or factual data would be used.
¢ u   
¢ Structured questionnaire for the doctors.
¢ 2



 As the questionnaire is self
administrated one, the survey will be simple and user friendly
words used in questionnaire will be readily understandable to all
doctors. Also technical jargons will be avoided to ensure that there
is no confusion for doctors in responding.
¢ "
  
¢ Internet, Published journals and reports, if available, are used to
avail the already available data on research related to the topic
 à‘m‘*"

¢ The number of doctors available in each hospital in Neuro

department are less therefore the sample size was small
¢ The questionnaire was conclusive so in-depth analysis could not be
done and doctors own views about the drugs to be used could not
be explored.
 m‘mm*mà ""

1. + 


  

 

$,

|
 |

20 30 - 50 50- 70 >70

2%

8%
30%

60%

FINDINGS:
Maximum doctors (more than half of total doctors consulted) are
visited by around 30 to 50 patients per week.
¢ 2. ð 
 !



 



 ,
| | | 
children young middle age old age

34 42

14 8

¢ FINDINGS:
Maximum patients of epilepsy where found to children, closely
followed by old age people where as young and middle age people
are less affected by epilepsy.
¢ Î. ð  





,
    
idiopathic generalized partial

10%
28%

62%

¢ FINDINGS:
¢ Most people (more than half of total) suffer from generalized type
of epilepsy, while idiopathic (unknown cause) is rare.
¢ M. ð   

 





,
|     
40%

20%
10% 8% 8%
6% 6%

¢ FINDINGS:
¢ Maximum doctors prescribed a combination of phenobarbitone and
phenytoin as most preferred drugs followed by use of phenytoin
single.
¢ r ð -   
 !
 
  

 ï
Most preferred brand of doctors for each of drugs molecule are as
follows.
| |

Phenyto S Epsolin
Fentoin ER 18% 32%
10%

Episol
40%

¢ FINDINGS:
¢ Episol by PIL followed by Epsolin by zydus neuroscience.
¢ 2 ¢ 3

|  || |

Tegretol
 | | | 12%
Episol Plus ze
20%

3 %
Zeptol
24%
Phenytal-30
52% carbatol
Garoin
28% 34%

¢ FINDINGS: ¢ FINDINGS:
¢ Phenytal-30 by Intas ¢ Carbatol by Torrent pharma
pharma
 ¢ 5
¢ 4
 |  
Encorate Epival valparin valrate CR
clonotril epitril ozepam xenotril sl

6%
0% 30%
34%

40% 58%

% 6%

¢ FINDINGS:
¢ FINDINGS:
Ozepam by Innova followed ¢ More than half of brands
closely by Clonotril by Torrent. prescribed was valparin by
Sanofi synthelabo.
 ¢ 7
¢ 6
||
 |
gabantin gabapin neurotin gabalept
lametec
10%
Lamipil
12% 16%
42%
Lamotrol
DT Lamidus
18% DT 32%
60%
10%

¢ FINDINGS:
¢ FINDINGS:
¢ Most prescription are of
¢ Doctors majorly prescribed
gabantin manufactured by
lamidus DT by Zydus
Synero followed by Gabapin by
neuroscience.
Intas pharma
 
.m 

¢ Data collected was organised and analysed to provide

with desired and required information ,concerned with our study.
¢ Most of the doctors get around 30 to 50 patients per week, which
is much lesser as compared to patients of other diseases visited by
other doctors (studied from secondary data). This suggests that
prevalence of this disease is lesser.
Most of the patients of epilepsy are children and also elders.
Occurrence of this disease in young people is uncommon.
Most patients have problem of generalized epilepsy, and
idiopathic being least suggest that causes are generally well
diagnosed by doctors, Because of better and sustained action, a
combination therapy of Phenytoin and Phenobarbitone is most
commonly used by doctors to treat the patients of epilepsy.
 In the combination therapy Phenytal -30 by Intas Pharma is the
major competitor dominating the market.
Phenytoin molecule is mostly sold by Episol brand by Zudus
Neuroscieces
Carbamazepine market is dominated by Carbatol by Torrent
Pharma.
Clonazepam molecule has close competition in two brands vis
Ozepam by Innova followed closely by Clonotril by Torrent
¢ For Valproic acid Sanofi synthelabo dominates the market by more
than half of all other brand combined by brand Valparin.
Lomatrigine a new molecule is majorly prescribed as Lamidus
DT produced by Zydus neuroscience.
¢ For Gabapentin most prescriptions were of Gabantin
manufactured by Synero
 þ   

¢ Epilepsy, one of the most important non communicable
neurological illnesses
¢ is particularly under resourced and undertreated in the developing
worldÚ Epidemiological studies have made it clear that the
magnitude of the problem makes it a public health priority.
¢ Large numbers of people are at risk of morbidity and
mortality, mainly because of difficulties with treatment
infrastructure and the availability of suitable drugs.
¢ However, people with epilepsy need more than drug treatment
because their local cultural context adds a social and economic
burden to the physical burden of their seizures.
¢ The education of health workers, patients, and the wider
community is therefore essential, these approaches may also prove
to be of value in the treatment of other non communicable
diseases, However, in contrast to other chronic non communicable
diseases, such as diabetes and heart disease, there is a high social
burden and stigma attached to epilepsy
¢ Diseases should be re-examined, to discover what lessons have
been learnt and which Approaches may be appropriateÚ four-fifths
of the 50 million people with epilepsy are in developing countries.
¢ People with epilepsy are often socially, educationally and
economically disadvantaged because of their condition.
 þ*m‘*
As it was found that most of the patients of epilepsy were
children, establishment of specialized marketing strategies
targeting doctors who are treating more number of children
could prove beneficial for the company
Since, of the total number of drugs sold, maximum portion is
occupied by a combination therapy of Phenobaribitone and
Phenytoin, production marketing and distribution of these drugs
or combination seems to be area of growth for the company
¢ The study showed that the market of epilepsy is dominated by
companies like Zydus and Intas, which are well established Indian
companies, a study of their marketing strategies would prove
beneficial as it would be specific to epilepsy drugs.
|