Interview: GSK India's Playbook For Vaccines Dominance

Anju Ghangurde @ScripAnjuG

Deft pricing and effective physician engagement appear to have helped shape GSK's sustained dominance in the Indian self-pay vaccines market. GSK Pharmaceuticals India managing director, Annaswamy Vaidheesh, takes Scrip through some of the strategies at play including the sharp recalibration in the price of Synflorix and how the British multinational is harnessing digital technology to stay "close" to its customers.

GlaxoSmithKline Pharmaceuticals Ltd. has been a leader in the self-pay vaccines segment in India for over a decade and the firm's top management indicates that timing the launch right, a "dedicated and trained" field force and "good insight" about pricing have been vital in staying ahead of competition.

"It's very easy to launch a new product which has got great value to add and skim it at the higher end, whereas GSK has always adopted an approach of access to medicines as a fundamental driver. So we've always had India-specific prices. That is a very important lesson for companies….how to get your pricing right," Annaswamy Vaidheesh, GlaxoSmithKline Pharmaceuticals' vice president South Asia and managing director India, told Scrip.

GSK is the number one vaccines company in the self-pay segment in India with a market share of 35% according to IMS data for June 2016 and over a dozen vaccines in its portfolio. GSK India's vaccine business reported revenues of over INR4bn in FY2015-16.

Market sources note the "high" per capita per month of GSK's vaccines sales team – some estimates suggest revenues generated run into more than INR10m ($149,120) per executive annually – though GSK suggested that productivity was not necessarily the only indicator of the team's prowess.

"[The sales team] know exactly what a customer wants; they don't waste a doctor's time and always go with something to add value to the doctor's practice by way of bringing latest knowledge/information, continuously asking what the company can do better. That has made a difference….it’s a unique, very powerful organization," Vaidheesh explained.

At the end of 2013, GSK had announced that from January 2015 globally no customer-facing GSK sales professionals or their managers would be financially incentivized based on individual sales targets.

The British multinational has also invested in significant market development activity in India – direct-to-consumer initiatives and HCP [health care professional] education, among other efforts.

"It's a combination of multiple factors that has helped us have leadership status in the market for many years," Vaidheesh said.

Digital Technology

The GSK boss also noted that the company was harnessing the power of digital technology to reach out and develop its customer base.

GSK launched the VIP [vaccination and immunization practices] symposia last year, primarily to leverage the use of digital media to webcast global speakers to over 100 locations across India.

"We reached out to almost 2,000-plus HCPs through a single webcast. That really makes a lot of difference to pediatricians who are hungry for knowledge, want to update themselves," Vaidheesh said.

Among other efforts, GSK has also conducted disease awareness campaigns through digital platforms such as YouTube, while in-clinic the firm leverages the use of iPads – rolled out with Veeva as platform support. Last year GSK selected Veeva Systems Inc as its multichannel CRM [customer relationship management] partner.

"This comprehensive use of digital technology has helped us to be very close to customers and also the optimal use of their knowledge to take care of patients."

INTERVIEW: A Revolution At GSK India

By Anju Ghangurde 28 Apr 2016

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Read the full article here

Products And Prices

GSK India has reaped significant gains and expanded access with its calibrated pricing approach for certain products. (Also see "Watch The Indian Respiratory Space: Cipla, GSK At Work " - Scrip, 13 Aug, 2015.)

GSK had previously lowered prices of its pneumococcal conjugate vaccine (PCV), Synflorix, by around 40% – a move that the top brass indicated had gone "a long way" in improving access to the product.

Before the launch of Synflorix in 2011, more than 100,000 children received PCVs but this figure increased to 500,000 in 2014 and by the end of this year nearly 800,000 children are expected to receive PCVs, GSK India said.

"Synflorix is a star for sure," Vaidheesh said.

GSK has also conveyed its interest in supplying the Indian government with the pneumococcal vaccine.

Globally, Médecins Sans Frontières (MSF) has called for a reduction in the price of a full course of Synflorix to $5 per child for all developing countries. GSK, in April this year, though explained that this was significantly below its cost of goods and would mean that it makes a loss on every dose of vaccine it delivered at that price. The latest position on MSF's request could not immediately be ascertained.

Currently, Synflorix is the market leader in India and has a volume share of around 63%. Details on competitor Pfizer Inc.'s Prevenar-13 share in India could not immediately be ascertained. MSF has opposed the patent on Prevenar-13 in India. (Also see "India Prevenar 13 Patent Challenge Closely Watched As Test Case" - Pink Sheet, 12 Aug, 2016.)

Novartis Products

Another product, Rabipur, the rabies vaccine from Novartis' stable and now part of GSK's portfolio, also appears to have strengthened its presence in India. The product's ranking has risen 36 places as per April 2016 data from AIOCD AWACS, the market research agency that tracks retail sales.

Vaidheesh said that that while the GSK team could take credit for the product's strong performance "to some extent", there have been severe supply constraints of other rabies vaccines in recent years that have helped boost its performance.

"Rabipur has got great brand equity and it's an excellent fit for the GSK portfolio with a larger vaccine dedicated field force," he said. The rabies vaccine is also exported to China from the Indian facility.

The change of hands for products like Rabipur follows a global deal in 2014, under which Novartis AG decided to divest its vaccines business to GSK, while GSK, in turn, transferred its oncology products to Novartis; the two companies also announced plans to combine their over-the-counter and consumer healthcare businesses in a joint venture. (Also see "Novartis Revamps, Buys GSK Cancer Drugs, Sells Animal Health To Lilly" - Pink Sheet, 22 Apr, 2014.)

Another Novartis product, Quinvaxem is also now marketed by GSK's India vaccine team, though there have been certain supply challenges. "Once our supply situation improves we should be able to go in a big way for Quinvaxem," Vaidheesh said.

Both GSK and Novartis sell vaccines for diphtheria, tetanus and pertussis (DTP) in India: the former sells a trivalent DTPa vaccine (Infanrix) and a booster vaccine (Boostrix) in India, while Novartis sells the DTPw pentavalent vaccine (Quinvaxem). Both firms had earlier submitted to the Competition Commission of India (CCI) that the monovalent and multivalent vaccines belong to different product markets and therefore, the trivalent and pentavalent vaccines are not substitutable. (Also see "Indian competition regulator clears Novartis-GSK transactions" - Scrip, 24 Dec, 2014.)

GSK has also recently launched Priorix Tetra, a combined measles, mumps, rubella and varicella vaccine, in phases in India and Vaidheesh maintains that the initial response has been "fantastic".

"We are going in phases; there are different segments that customers would like to use it in combination… right now we are in the evaluation stage."

The meningitis vaccine, Menveo, is also in the launch pipeline and the Indian arm hopes to "get it by the next year".