“Prescription Behavior of Doctors in Nebulisation Therapy”.

By- LAVA KUMAR SINGH CHANDRAMANI KUMAR SINGH

“Prescription behavior of doctors in nebulisation therapy”.

Special Thanks to:

• Mr. Ramesh kumar singh (BM) Bihar & Jharkhand

• Mr. Amit kumar (MT)• Mr. Ankit kumar(MT)

Dr satyendra soam placement officer(MSM

Cipla caring for life

changing india

, Dr. Khwaja Abdul Hamied

Dr. Khwaja Abdul Hamied

Cipla :

• The Chemical, Industrial & Pharmaceutical Laboratories came in existence in 1935.

• On August 17, 1935, Cipla was registered as a public limited company with an authorised capital of Rs 6 lakhs.

• The search for suitable premises ended at 289, Bellasis Road (the present corporate office) where a small bungalow with a few rooms was taken on lease for 20 years for Rs 350 a month

Milestones• 1935; Dr K A Hamied sets up "The Chemical,

Industrial and Pharmaceutical Laboratories Ltd." in a rented bungalow, at Bombay Central. 

• 1941; As the Second World War cuts off drug supplies, the company starts producing fine chemicals, dedicating all its facilities for the war effort. 

• 1952 Sets up first research division for attaining self-sufficiency in technological development; 

• 1960; Starts operations at second plant at Vikhroli, Mumbai, producing fine chemicals with special emphasis on natural products 

Milestones• 1968; Cipla manufactures ampicillin for the first time

in the country. 

• 1972; Starts Agricultural Research Division at Bangalore, for scientific cultivation of medicinal plants. 

• 1976; Cipla launches medicinal aerosols for asthma

• 1980; Wins Chemexcil Award for Excellence for exports 

• 1982; Fourth factory begins operations at Patalganga, Maharashtra. 

Milestones• 1985; US FDA approves Cipla's bulk drug

manufacturing facilities. 

• 1988; Cipla wins National Award for Successful Commercialisation of Publicly Funded R&D. 

• 1994; Cipla's fifth factory begins commercial production at Kurkumbh, Maharashtra. 

• 1997; Launches transparent Rotahaler, the world's first such dry powder inhaler device now patented by Cipla in India and abroad. The palliative cancer care centre set up by the Cipla Foundation, begins offering free services at Warje, near Pune. 

Milestones

• 2002; Four state-of-the-art manufacturing facilities set up in Goa in a record time of less than twelve months. 

• 2003; Launches TIOVA (Tiotropium bromide), a novel inhaled, long-acting anticholinergic bronchodilator that is employed as a once-daily maintenance treatment for patients with chronic obstructive pulmonary disease (COPD).

• 2005; Set-up state-of-the-art facility for manufacture of formulations at Baddi, Himachal

Pradesh. 

• 2007; Set-up state-of-the-art facility for manufacture of formulations at Sikkim. 

Milestones

IT’S NOT THE END OF JOURNEY

Cipla’s marketing segment1. Respiratory segment2. Vitalis3. Nurture4. Critical care5. Life care6. Lusenta7. Espisility8. Quadra9. Uro- 110. Externa11. Forsighy12. Omni care13. Hiv dis.

Respiratory segment

• It is divided into five teams • Team 1• Team 2• Team 3• Team 4• Team 5

(Asthma)COPD

PAED.ASTHMA

ACUTE ASTHMA &COPD

AsthmaAsthma is a chronic inflammatory lung disease that causes airways to tighten and narrow.often triggered by irritants in the air such as cigarette smoke, asthma flares involve contraction and swelling of the muscles lining the tiny airways.

Asthma

1.Chronic Asthma2.Acute Asthma

Acute Asthma

It is what populary known “dama ka jhatka”In the popular respondent tone

Team 5

ACUTE ASTHMA &COPD• Nebulisation therapy:-

• A small portable machine that is used to administer liquid medication. It converts liquid medication into a “medication mist” that can be inhaled.

Asthma

Management of Acute Exacerbations of Asthma & COPDAntibiotics

Bronchodilator

Corticosteroids

Asthma Medicines

Orals

Injectables

Inhalers

Nebulizer Machine

NEBULISER

OUR STUDY

• To identify the market share of CIPLA’S nebulised bronchodilators and corticosteroids molecules in acute respiratory disease.

Research design:-

• descriptive research design.

Methodology:-

• Sampling• Tools of data collection • Tools of data analysis

OUR ANALYSIS

REGION NO.OF RESPONDENTS

TOTAL RESPONDANTS

PATNA 100 (50%)200 DARBHANGA 41 (20.5%)

SAMASTIPUR 25 (12.5%)MUZAFFARPUR 34 (17%)

In our research we included 200 respondents , in which 47.5% were from doctor centered clinics and 52.5% were from floating shops .

Sale of nebulisation drugs

Specialization of doctors

%age total

physician 21.5200(100%)

Chest specialist

9

Paed. 12Heart spl. .5others 57

SPECIALISATION OF DOCTOR

prescription behavior of doctor’s in inhalation therapy 

company whose drug is prescribed by doctor’s for inhalation– 

prescribed company

% of share

Cipla 81.5Lupin 3Samarth pharma

2

others .5%Don’t prescribe nebulisation

10%

prescription behavior of doctor’s in nebulisation therapy

Doctor prescribing nebulisation therapy

%age

Yes 66%No 34%

In Patna 92% doctor’s prescribe nebulisation therapy while in other 3 regions of our research i.e. muzaffarpur , samastipur and darbhanga only 58% doctor’s prefer nubulisation therapy.

Number of nebulizers doctor is having

Number of nebulizers doctor is having

No. of respondents

1 162 153 24 13Don’t know 154total 200

Average no. of patients nebulised per day

Reason for not using nebulisation therapy-

 Reason for not using nebulizers

%of respondents

Not affordable 6 %Unaware about nebulizers

14%

Some are already using this therapy & some Could not give exact reason

80%

Handling of nebulizer-

Preference by doctor in nebulisation therapy

Preference by doctor

% of respondents

Repulse 58 %Respiratory solution

8 %

others 34 %

preference of repulse and respiratory solution by the specialization of doctor’s;

 Specialization of doctor

Prescribing repulse

PrescribingRespiratory solution

Other mode of treatment

total

Physician 8% 1.5% 12% 21.5 Chest specialist

5% 0.5% 3.5% 9

Pediatrics 9.5 1.5 1% 12 Heart specialist

.5% 0 0 0.5

*others 35% 4.5% 17.5% 57 total 58% 8% 34% 100%

Bronchodilator used in nebulizer

Sale of bronchodilator by the type of chemist

BronchOdilator

Doctor Centered chemist

Floating

shopTotal

Duolin 9 % 9 % 18 %

Asthalin 9.5% 6.5 % 16 %

Levolin 0 % 0.5 % 0.5 %

Ipravent 0.5 % 0 % 0.5 %

Other brand 0 % 1 % 1 %

ALL(duo,asth,levo,ipra)

16.5 % 13.5 % 30 %

No response 12 % 22 % 34 %

total 48 % 52 % 100 %

. prescription of corticosteroid by the doctor

Brand of corticosteroid used in nebulizer

Professionly we learnt

• Honesty in profession• Punctuality in job• Calling of the doctors

• Reporting to immediate boss• How to organize doctor’s meeting• How to convince doctors

Bibliography/ references:-

• www.ciplanalanda.com• www.cipla.com• literature on asthma by Steven Dowshen,

MD April 07• BRITISH NATIONAL FORMULARY (2004): No

47 March 2004: Pharmaceutical Press: Oxon•  • BRITISH THORACIC SOCIETY (1997):

Nebuliser Therapy Guidelines: Thorax: 52 suppl 2: S4 – 24

• www.google.com