Under The Skin

Populations across the world are paying the price for development in form of functional issues in every organ system, but the skin pays the heaviest price as it is the first point of contact for every possible microbe or toxin. Aashruti Kak writes about what drives the dermatology market

The human skin, being the largest organ in the human body, provides protection, regulates temperature, resists dissolution, controls evaporation and and much more than one can imagine. However, due to its diverse nature, and the fact that is it the most 'taken for granted' organ, it is also a rich habitat for microbes. So whenever it malfunctions or is under unavoidable attack, that is where dermatology steps in.

Market potential

"Research for psoriasis and cosmetological applications of drugs is already underway in some Indian companies like Lupin and Piramal." Dipta Chaudhury Sr. Consultant - Pharma & Biotech Practice South Asia and Middle East, Frost & Sullivan

“The global dermatology market was estimated at $19 billion in 2008, and the Indian dermatology market was estimated at $513 milion in 2010. The dermatology market is quite vast, ranging from prescription to over the counter medicines. This includes both treatment for skin disorders, including burns, fungal infections,wounds, and conditions like eczema, psoriasis etc, to cosmetic dermatology with products like Botox, Latisse, Juvederm, etc. The potential for both the streams is massive,” says Dipta Chaudhury, Senior Consultant-Pharma and Biotech Practice, South Asia and Middle East, Frost & Sullivan. “The importance of skin has increased in recent years. With successful surgery, treatment of surgical scars and other wounds has become an equally important area. Patients today are willing to pay for-state-of-the-art treatments and companies can continue to tap into this highly lucrative market by carving out their niche in the overall derma segment,” she adds.

"The need to look young, double income no kids (DINK) families, more females in the corporate sectors add to the factors supporting growth in the segment." Nitin Ambre Sr. Gen. Manager - Sales & Mktg., Ajanta Pharma

As per IMS dataset MAT-Mar, 2011, the Indian derma market has grown by 14.8 per cent over the last year. The market shows promise, considering the fact that there is rising disease awareness in derma related indications and the fact that there is a higher propensity of population at large willing to treat the disease. In the derma segment, NDDS research is a great opportunity as it enhances compliance and drug delivery of the existing formulations. Nitin Ambre, Senior General Manager-Sales and Marketing, Ajanta Pharma believes that although dermatology (medical or aesthetic) is not going to provide life saving therapies but it will definitely have a role in making people looking young, therefore, it will have a long term impact in the field of R&D.

Drivers and restraints

"There are no real threats that the segment is facing. In fact there are several opportunities which are being exposed, especially in the area of aesthetic and skin care segment." Farida Hussein Sr. Vice President (Mktg.), USV

“There are no real threats that the segment is facing. In fact there are several opportunities which are being exposed, especially in the area of aesthetic and skin care segment,” informs Farida Hussein, Senior Vice President - Marketing, USV.

The derma market depends a lot upon the type of products, while cosmetic dermatology can be considered as a luxury. However, for treatment related products, the market is directly dependent upon the number of patients who can afford the treatment, says Chaudhury, “Basic treatments for skin related disorders are always in demand, however, since most medical spending in India is mainly out-of-pocket, the drug sales can be expected to be higher in metros and tier II cities than in all rural areas as well. With an increase in pollution, stress and poor nutrition, many skin disorders have become more common in India, and that will definitely drive the market”.

Cosmetic dermatology is also expected to grow in tier I and II cities with increasing spending power and the high aspirational value. However, the cost of drugs may be the main barrier for growth of the high profit segment of dermat drugs. She explains, “While antibiotic and anti-fungal segments of derma products are in constant demand, they are also of low value and highly priced in nature. The drugs propelling the market are cosmetic derma brands like Botox, Juvederm and Latisse, which are priced high and not available to the larger population. This may make it difficult for the segment to show very fast growth.”

Ambre adds increased awareness, the need to look young, double income no kids (DINK) families, more females in the corporate sectors add to the factors supporting growth in the segment. However, according to him, restraints are that the number of qualified cosmetologists across the country is very less compared to our population.

Competitive landscape

Some global companies active in the market include Nycomed (Takeda), Allergan, Galderma, Valeant, Sanofi Aventis, Intendis, J&J, GSK, Roche, etc. Indian companies include Nicholas Piramal (now Abbott India), J&J India, Ranbaxy, Zydus Cadila, Glenmark Pharma, Lupin, etc.

According to IMS dataset MAT-Mar, 2011, the top five therapeutic sub segments are topical corticosteroids, emollients and protectives, anti-fungals, topical anti-infectives, antiseptics, and anti acne products. “Of course Ajanta Pharma and some other small companies also have good volumes in certain areas, but they operate with different business modules. Recently launched successful brands are triple combo demelanising agents like melacare/skinlite, antidandruff shampoo, topical immunomodulators,” says Ambre. “And there are many more in pipeline as well,” he adds.

Hussein informs, “Successful drugs in the global market are Benzaclin (SNF), Differin (Galderma), and Retin A (J&J). Top five derma companies in India are GSK, Glenmark, Ranbaxy, Abbot and Win Medicare. GSK leads the market with a growth rate of 24 per cent (MAT April 2011) which is more than the market growth itself. Successful brands in India are Betnovate, Candid and Suncros.”

According to her, derma products contribute to 3.9 per cent of USV sales. In the therapeutic area, USV has topical Clindamycin (Erytop) for the treatment of acne, Derobin for management of psoriasis and they contribute upto 2.3 per cent of the USV sales. In the area of skin care and aesthetics, we have Sebamed range of products that contribute upto 1.6 per cent to the USV sales. “We have a tie up with Sebapharma, a German company specialising in skin care. They have a global presence and their skin care products are all formulated at the skin pH of 5.5. We are also actively looking for meaningful tie-ups in the area of aesthetics and therapeutics which will complement the skin care basket from Sebamed,” reveals Hussein.

Ranbaxy also has a strong presence in topical steroids, anti-fungals, anti-infective, acne management, emollients and aesthetic dermatology (anti-aging, sun protection). “In our quest to be a leading player in the derma segment, we constantly evaluate opportunities, especially to introduce new products in unrepresented markets. Luliconazole is our latest in-licensed brand in the anti-fungal market. Amexidil (hair loss) is another popular brand available in the area of new delivery system,” says a Ranbaxy spokesperson.

A futuristic view

Chaudhury believes that the Indian dermatology market is poised for growth. “At its current growth rate we expect the trend to continue, with growth at around 20 per cent over the next three to four years. The segment is still not highly crowded, as it has few players, but it has immense potential in the Indian market. Over the counter (OTC) products are also large segments in the market, and will propel growth. Due to importance of patents, Indian companies can also look at licensing some innovator products for the Indian market.” While the treatment of skin related disorders remains the primary segment for derma, the sector driving growth will be cosmetic dermatology since it is of high value. “Research for psoriasis and cosmetological applications of drugs is already underway in some Indian companies like Lupin and Piramal,” she adds.

There exists a high potential for R&D in the derma market, especially since most of the agents take care of the signs and symptoms and not the underlying cause of the disorders, except for infective disorders, says Hussein. She further says, “In the aesthetic or skin care market, there is a high potential to do research in the field of aging and hyper-pigmentation. And with the entry and success of premium priced skin care products in India coupled with increase in the number of interventions and aesthetic procedures conducted in the country, along with the fact that many dermatologists are now taking higher training in aesthetic dermatology, the dermatology market will grow at a rate more than 25 per cent year-on- year.”

Ambre agrees to the fact that the future of dermatology market has huge potential as the total number of dermatologists have almost doubled in last five years, and that clinical dermatology will remain the mainstay, whereas aesthetics/cosmetology segment will prosper even in the rural areas because of increased awareness and availability of knowledgeable/skilled doctors. “The key areas will be psoriasis, eczema, hair nutrition, facial upliftment, peels and fillers to name few, with Ajanta taking the lead always. Many companies are jumping into the field of cosmetology and more research and advancement will be seen in painless dermal procedures,” he says.

aashruti.kak@expressindia.com