Emerging markets are much more heterogeneous place compared to regulated markets like the US and EU. Regulatory norms, application of intellectual property rights, disease pattern, and market size vary considerably between developing countries.
All this means that market access strategy, portfolio management strategy would be quite different for these markets.
In emerging and for emerging markets
The truth is that there is no way to compare emerging markets with markets like the US. In many emerging markets, pharmaceutical manufacturing is dominated by mid and small-cap companies. These companies primarily specialize in producing off-patent branded generics. Some of these countries have quite a robust local pharmaceutical market like India, Brazil, or Russia.
In emerging markets, even the scope of intellectual property rights varies. For example, 46 least developed countries simply qualify for drug patents waiver. Some of these countries, like Bangladesh, have a healthy pharma market and local production.
To complicate things further, many countries like India or Russia may provide drug patent waivers for certain life-saving drugs on humanitarian grounds. Just take the example of Remdesivir. In 2020, the Russian supreme court backed a local manufacturer granting it the right to produce the patented drug.
Biologics aren't as prominent in emerging markets
It is true that as per all the projections, biologics will continue to gain traction. Biological pharma products are going to revolutionize the way diseases are treated. However, in most emerging markets, small molecules will continue to dominate in the foreseeable future. For example, even in nations like China, less than 10% of patients with colorectal cancer are treated with biologics compared to 55% in the US.
Further, there are regulatory challenges in the field, as countries are still identifying a pathway for biosimilars.
Additionally, there is also a difference between the disease pattern between developed markets and emerging markets. All these factors, along with the most vital factor, which is the country's financial capabilities, it appears that small molecules would continue to remain considerably relevant in emerging markets.
Despite all the challenges and ambiguities, considerable growth is expected in emerging markets. Therapeutic areas like diabetes, oncology, anti-infectives, cardiovascular, and nervous system would be the growth drivers.
Below are some of the molecules that have good perspectives in emerging markets. Fortunately, these molecules are either already off-patent in some markets or losing their protection in the next few years:
· Rivaroxaban (Xarelto): Belongs to a new class of blood thinners that are far safer than warfarin. It is mainly indicated for the prevention of deep vein thrombosis and pulmonary emboli. It is also prescribed to prevent blood clots in those diagnosed with atrial fibrillation or after specific surgical procedures. It has a global market of above 1 billion USD. Still, more importantly, experts estimate that it has a total scope of 6 billion USD.
The only thing to watch out for when going forward with this particular molecule is the country's prescription habits. In some countries, its sister molecule apixaban is more successful.
· Apixaban (Eliquis): This molecule has similar indications to rivaroxaban and is also indicated to prevent blood clots. However, it is generally regarded as even safer than rivaroxaban, with an even lesser risk of major bleeding. In some of the emerging markets, it has a much greater share than rivaroxaban. This molecule is already 9 billion USD strong globally.
· Canagliflozin (Invokana): This is a second-line treatment of diabetes. It is the first of the SGLT2 inhibitors to be approved in the US. These drugs work...
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