“Prescription behavior of doctors in nebulisation therapy”.

By- LAVA KUMAR SINGH

CHANDRAMANI KUMAR SINGH
 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 segment
1. Respiratory segment
2. Vitalis
3. Nurture
4. Critical care
5. Life care
6. Lusenta
7. Espisility
8. Quadra
9. Uro- 1
10. Externa
11. Forsighy
12. Omni care
13. Hiv dis.
 Respiratory segment
• It is divided into five teams
• Team 1
• Team 2(Asthma)
• Team 3 COPD
• Team 4 PAED.ASTHMA
• Team 5 ACUTE ASTHMA &COPD
 Asthma
Asthma 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 Asthma
2.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
& COPD
Antibiotics

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 TOTAL
RESPONDENT RESPONDANT
S S
PATNA 100 (50%)
DARBHANGA 41 (20.5%) 200
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
 SPECIALISATION OF DOCTOR

Specializati %age total

on of
doctors
physician 21.5
Chest 9 200
specialist (100%)
Paed. 12
Heart spl. .5
others 57
prescription behavior of doctor’s in inhalation
therapy
 
company whose drug is
prescribed by doctor’s for
inhalation–
 
prescribed % of share
company
Cipla 81.5
Lupin 3
Samarth 2
pharma
others .5%
Don’t prescribe 10%
nebulisation
prescription behavior of doctor’s in
nebulisation therapy

Doctor %age
prescribing
nebulisation
therapy
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 No. of
nebulizers respondents
doctor is having
1 16
2 15
3 2
4 13
Don’t know 154
total 200
Average no. of patients
nebulised per day
 
 Reason for not using
nebulisation therapy-
Reason for not  %of
using nebulizers respondents
Not affordable 6%
Unaware about 14%
nebulizers
Some are already 80%
using this therapy &
some Could not
give exact reason
Handling of nebulizer-
 Preference by doctor in
nebulisation therapy
Preference by % of
doctor respondents
Repulse 58 %
Respiratory 8%
solution
others 34 %
 preference of repulse and
respiratory solution by the
specialization of doctor’s;
 
Specializ Prescribi Prescribi Other total
ation of ng ng mode of
doctor repulse Respiratotreatmen
ry t
solution
Physician 8% 1.5% 12% 21.5
Chest 5% 0.5% 3.5% 9
specialist
Pediatrics 9.5 1.5 1% 12
Heart .5% 0 0 0.5
specialist
*others 35% 4.5% 17.5% 57
total 58% 8% 34% 100%
Bronchodilator used in
nebulizer
Sale of bronchodilator by the
type of chemist
Bronch Doctor Floating
Total
Odilator Centered
shop
chemist

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,l 16.5 % 13.5 % 30 %

evo,ipra)

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