MarketingResearchFor

NewProductLaunch: Cisatracurium

ASummerTrainingProject Report

SubmittedinPartialFulfillmentoftheRequirementsforthe Award of

degree of MBA (Finance & Marketing)

2011–2013

Submittedby Guided by

ManishRanjan Singh Ms.RanpreetKaur

 CertificatefromtheCompany/Organization

This is to certify that Aditya Kumar, son of Mr. Subodh kumar Singh Pursuing BBA from
D P G INSTITUTE OF TECHNOLOGY AND MANAGEMENT, Gurugram has
successfully completed the Project Report in our organization on the topic titled,“Marketing
Research for New Product Launch: Cisatracurium” from 1st July to 10th November 2023.
During his project tenure in the organization/company, we found him hard working, sincere
and diligent person and his behavior and conduct was good. We wish him all the best for his
future endeavors.

Signature

SandeepPawar(GroupProductManager)
NameandDesignationoftheGuide

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 Certificate of Originality

This is to certify that the project report entitled “Marketing Research for New Product
Launch: Cisatracurium” Submitted to Maharshi Dayanand University, Rohtak in partial
fulfillment of the requirement for the award of the degree of BBA (Finance & Marketing)is
anoriginal work carried out by Mr. Aditya Kumar ,underthe guidance of Ms. Ranpreet
Kaur. The matter embodied in this project is a genuine work done by Aditya Kumar Singh to
the best of my knowledge and belief and has not been submitted before, neither to this
University nor to any other University for the fulfillment of the requirement of any course of
study.

Signature of the Student SignatureoftheGuide

Designation

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 Certificate

This is to certify that the project titled “Marketing Research for New Product Launch:
Cisatracurium” is an academic work done by “Manish Ranjan Singh” submitted in the
partial fulfillment of the requirement for the award of the Degree of MBA (Finance &
Marketing) from Bharati Vidyapeeth Deemed University, Pune. It has been completed under
the guidance of Ms. Ranpreet Kaur (Faculty Guide) and Mr. Sandeep Pawar (Corporate
Mentor). We are thankful to Abbott India Ltd. for having allowed our student to undergo
project work training. The authenticity of the project work will be examined by the viva
examiner which includes data verification, checking duplicity of information etc. and it may
be rejected due to non fulfillment of quality standards set by the Institute.

Dr.SachinS.Vernekar (Director

IMED)

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 ACKNOWLEDGEMENT

The satiation and euphoria that accompany the successful completion of the project would be
incomplete without the mention of the people who made it possible.

I would like to take the opportunity to thank and express my deep sense of gratitude to my
corporate mentor Mr. Sandeep Pawar and my facultymentor Ms.Sonam Yadav. I am greatly
indebted to both of them for providing their valuable guidance at all stages of the study, their
advice, constructive suggestions, positive and supportive attitude and continuous
encouragement, without which it would have not been possible to complete the project.

I would also like to thank Mr. Rajesh Pandey (Country Manager) who in spite of busy
schedule has co-operated with me continuously and indeed, his valuable contribution and
guidance have been certainly indispensable for my project work.

I am thankful to Mr. Sandeep Pawar for giving me the opportunity to work with Abbott India
Ltd. and learn.

I owe my wholehearted thanks and appreciation to the entire staff of the company for their
cooperation and assistance during the course of my project.

I hope that I can build upon the experience and knowledge that I have gained and make a
valuable contribution towards this industry in coming future.

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 Preface

The objective of the project was “to understand the Neuro Muscular Blocker (NMB) market&
develop the medical positioning for Cisatracurium” for Abbott India Ltd., for that we have to
understand the customer needs (doctors), pricing constraints, response, emotions andbeliefs
regarding the product, so that they can contribute their valuable inputs for introducing the
“Cisatracurium” in India for the company. The objective of this study was to analyze the
clinical practice ofthe availableneuromuscular blockerin Mumbai and Punecitywith respect to
the survey in the best hospitals of the city.

The project was started on 1st of June after knowing all the relevant information regarding the
project, under the guidance of Mr. Sandeep Pawar (Group Product Manager). The first part of
my project involves the study of the Anesthetists’ armamentarium of drugs, Understand the
NMB category & their mechanism of action and Clinical use of NMBs & their place in
therapy. For this I used Internet as a primary source of information for study, also attended a
day with Dr. Amit Arora discussing the topics. Along with the detailed study of NMB
category the study was more focused on Cisatracurium.

Since, the next part of my project was to develop the questionnaire respected to medical
positioning for Cisatracurium and clinical preferences of current NMBs available. Hence, the
detailedstudyprovided mea rough ideain developingquestionnaireand mycorporatementor
guided me in finalizing the questionnaire. For this the questionnaire was prepared which gave
the vague idea about the customers, who were reallyinterested in practicingthe new molecule
and wanted to know about the availability of the molecule in the country. Go through
questionnaire in different hospitals and people in the Pune and Mumbai city. The marketing
research was undertaken for Pune and Mumbai region during one month. The sample size of
the marketing research was taken to be 40. The questionnaire contains various aspects like
their Name, Contact Number, E-mail Id, Hospital Name, NMB preference and Cisatracurium
advantage etc. The final part of the project consists of 15 days of scanning the questionnaire.

Mostimportantpartisanalyzingthe information.

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 Index
1. CHAPTER1: Introduction.......................................................................9-30
Overviewofthe Industry............................................................................10
PharmaceuticalIndustryin India
CompanyProfile........................................................................................12
About the Company
CorporateOverviewFact sheet
Vision
Dedication
Strategy
TheWork Culture
TheAbbottBrand Promise
CompanyHistory......................................................................................18
EarlyDecades
Late1960s and Early1970s: DiversificationandCrises
Late1970sthrough1980s:EmphasizingR&D,Nutritionals,Diagnostic
Equipment
1990sandbeyond:New DrugIntroductionsandAcquisitions
Recognition
Key dates
AbbottIndiaLtd. History
CompetitionOverview..............................................................................30

2. CHAPTER3:ResearchMethodology......................................................31-36
ObjectiveandScopeofStudy......................................................................32
ObjectiveoftheStudy
Scopeof theStudy
ManagerialUsefulnessoftheStudy
TypesofResearch andResearchdesign
ResearchMethodology..............................................................................33
Research Design.......................................................................................34
SampleDesign...........................................................................................34
SampleSize
SamplingMethod
SampleType
DataCollectionMethod.............................................................................35
LimitationOftheStudy...............................................................................36

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3. CHAPTER2:ConceptualDiscussion......................................................37-43
AboutProduct:Cisatracurium...................................................................38
CurrentIssues/News.................................................................................39

4. CHAPTER4:DataAnalysis.....................................................................44-69
MethodsandTechniquesofDataAnalysis...................................................45
DataAnalysis Concept
DataAnalysis Process
DetailAnalysis..........................................................................................47

5. CHAPTER5:Findings,Conclusion&Suggestions..................................70-74
Interpretation............................................................................................71
Findings....................................................................................................72
Conclusion................................................................................................73
Suggestions...............................................................................................74

6. CHAPTER6:Appendix& Bibliography................................................75-80
SampleQuestionnaire...............................................................................76
Abbreviation&Notations..........................................................................79
Bibliography.............................................................................................80

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CHAPTER 1
Introduction

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 Overviewofthe Industry

“The Indian pharmaceutical industry is a success story providing employment for

millionsandensuringthatessentialdrugsataffordablepricesareavailabletothevast
population of this sub-continent.”
RichardGerster

PharmaceuticalIndustryinIndia
ThePharmaceuticalindustryinIndiaistheworld'sthird-largestintermsofvolumeandstands 14th in
terms of value.

Thegovernmentstarted to encourage the growth of drug manufacturing by Indian companies in

the early 1960s, and with the Patents Act in 1970.However, economic liberalization in 90s by
the former PrimeMinister P.V. Narasimha Raoandthe then FinanceMinister,Dr. Manmohan
Singhenabled the industry to become what it is today. This patent act removed
compositionpatentsfrom food and drugs, and though it kept process patents, these were
shortened to a period of five to seven years.

The lack of patent protection made the Indian market undesirable to the multinational
companies that had dominated the market, and while they streamed out. Indian companies
carved a niche in both the Indian and world markets with their expertise in reverse-
engineering new processes for manufacturing drugs at low costs. Although some of the larger
companies have taken baby steps towards drug innovation, the industry as a whole has been
following this business model until the present.

The Indian pharmaceutical sector has come a long way, being almost non-existent before1970
to a prominent provider of healthcare products, meeting almost 95 per cent of the country's
pharmaceuticals needs. The Industry today is in the front rank of India’s science- based
industries with wide ranging capabilities in the complex field of drug manufacture and
technology. It ranks very high in the third world, in terms of technology, quality and range of
medicines manufactured. From simple headache pills to sophisticated antibiotics and complex
cardiac compounds, almost every type of medicine is now made indigenously.

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Playing a key role in promoting and sustaining development in the vital field of medicines,
Indian Pharma Industry boasts of quality producers and many units approved by regulatory
authorities in USA and UK. International companies associated with this sector have
stimulated, assisted and spearheaded this dynamic development in the past 53 years andhelped
to put India on the pharmaceutical map of the world.

The Indian Pharmaceutical sector is highlyfragmented with more than 20,000 registered units
with severeprice competition and government price control. It has expanded drasticallyin the
last two decades. There are about 250 large units that control 70 per cent of the market with
market leader holding nearly 7 per cent of the market share and about 8000 Small Scale Units
together which form the core of the pharmaceutical industry in India (including 5 Central
Public Sector Units). These units produce the complete range of pharmaceutical formulations,
i.e., medicines ready for consumption by patients and about 350 bulk drugs, i.e., chemicals
having therapeutic value and used for production of pharmaceutical formulations.

Following the de-licensing of the pharmaceutical industry, industrial licensing for most of the
drugs and pharmaceutical products has been done away with. Manufacturers are free to
produce any drug duly approved by the Drug Control Authority. Technologically strong and
totallyself-reliant, thepharmaceutical industryin Indiahas low costs ofproduction, low R&D
costs, innovative scientific manpower, strength of national laboratories and an increasing
balance of trade.

The number of purely Indian pharma companies is fairly low. Indian pharma industry is
mainly operated as well as controlled by dominant foreign companies having subsidiaries in
India due to availability of cheap labour in India at lowest cost. Most pharma companies
operating in India, even the multinationals, employ Indians almost exclusively from thelowest
ranks to high level management. Mirroring the social structure, firms are very hierarchical.
Homegrown pharmaceuticals, like many other businesses in India, are often a mix of public
and private enterprise. Although many of these companies are publicly owned, leadership
passes from father to son and the founding family holds a majority share.

The total Indian production constitutes about 13 per cent of the world market in value terms
and, 8 per cent in volume terms. The per capita consumption of drugs in India, stands atUS$3,
is amongst the lowest in the world, as compared to Japan- US$412, Germany- US$222 and
USA- US$191.

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 CompanyProfile

AboutTheCompany

Abbott Laboratoriesis a Chicago-based global, diversified (multi-division)

pharmaceuticalsandhealth careproducts company. It has 90,000 employees and operates in
over 130 countries. The company headquarters are in Abbott Park, North Chicago, Illinois.
The company was founded by Chicago physician, Dr. Wallace Calvin Abbott in 1888. In
2011, Abbott had over $38.9 billion in revenue. Abbott Laboratories is one of the major
multinational company in the pharmaceutical industry. Abbott, is a company that focuses on
turning science into caring – ABBOTT, A Promise for Life. For more than a century, Abbott
Laboratories has been working to advance health care for people around the world. Foundedin
1888 by a young Chicago physician, Dr Wallace Calvin Abbott, Abbott Laboratories has
evolved into a diversified health care company that discovers, develops, manufactures and
markets innovative products and services. Products and services of Abbott, span the
continuum of care from prevention and diagnosis, to treatment and cure. Abbott today is a
global, diversified health care company devoted to the discovery, development, manufacture
and marketing of pharmaceutical, diagnostic, nutritional and hospital products.

Abbott extends this commitment with a strong presence in India as it has grown and evolved
its operations in India over manydecades. The products encircle lifefrom newborns to ageing
adults. Abbott has built expertise and leadership in primary care therapeutic areas like
Gastroenterology and Paincare. Our specialty areas include Neuroscience, Metabolics and
Hospital Care. Abbott serves the needs of Indian consumers with products backed by science
and R&D. It has locally developed brands like Digene, Cremaffin, Epilex, Zolfresh and
Obimet. Abbott has also brought global products including Brufen, Prothiaden, Ganaton,
Sevorane, Thyronorm and Leptos to Indian consumers. Abbott’s pioneering products like
Survanta help infants. As of 2010, Abbott India Ltd. tops the list of publicly listed life science
companies in India and the revenue generated in the year 2011 is the highest than any other
pharmaceutical company doing business in the country.

Abbott India, today has strong brand equity and commands esteem in the market place. To
reach the customer, Abbott India has a network of 18 distribution points, which cater
to11,000stockistsand70,000retailers.BehindAbbottIndia’ssuccess,isateamofcompetent,

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committed people, driven bythe principles of Value Based Management, and aided by strong
alliances and partnerships.

Abbott India Limited,provideshealthcaresolutionsthroughitsfourbusinessunits:

1. PrimaryCare-whichmarketsproductsintheareasofPainManagement, Gastroenterology,
with well-known brands like Brufen, Digene, Cremaffin.

2. Specialty Care - Metaboloics & Urology provides solutions in the areas of

Thyroid,Obesity, Diabetes and Benign Prostratic Hyperplasia.

3. SpecialtyCare - Neuroscience has a varied portfolio, with specialty products in

theNeurology and Psychiatric segments.

4. Hospital Care-offersproductsinthefieldofanesthesiologyandneonatologynamely
Forane, Sevorane and Survanta.

The company has over 1000 employees and a state-of-the-art formulation plant at Verna in
Goa. The manufacturing locations are designed to produce quality, high volume formulations
using cost efficient processes. The plant has well equipped laboratories and trained personnel
to ensure international standards of quality at each step of the manufacturing process.

The company has in-house development and medical teams to undertake product and clinical
development tailored to the needs of the Indian market.

Abbottprovidesqualityhealthcareworldwidebycreatinghealthcaresolutions,whichdirectly
affects the life of the common man.

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CorporateOverviewFactSheet

Founded in 1888 by Chicago physician Dr. Wallace C. Abbott, Abbott has emerged as one of
the world's most diverse health care companies. The company has approximately 91,000
employees worldwide serving customers in more than 130 countries. Abbott ranks No. 71 on
theFORTUNE500 and is headquartered in north suburban Chicago, USA. Abbott India Ltd.
ranks No. 1 in India in top performing pharmaceutical company.

PrimaryBusinesses
 Medical Products– Key lines of business include vascular, laboratory and molecular
diagnostics, diabetes care, vision care and animal health.
 Nutritionals– Abbottoffersavarietyofnutritionproductsforinfants,children,active adults
and patients with special dietary needs.
 Pharmaceuticals–Includesglobalpatentedpharmaceuticalsandinvestigativecompounds
and indications in development, and established pharmaceuticals.

Areasof Expertise:

Pharmaceuticals Medical Products Nutritional Products

 Anesthesia  Animal Health  PediatricNutrition

 Anti-infectives  DiabetesCare  Healthy Living
 Cardiovascular  Diagnostics  MedicalNutrition
 Immunology  Hematology
 Metabolics  Molecular
 Neuroscience  Pointof Care
 Oncology  Vascular
 PainCare
 RenalCare
 Virology

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FastFacts Abbott

ChairmanandCEO: MilesD. White

CorporateHeadquarters: NorthsuburbanChicago,Illinois,USA

StockExchange Listing: NewYork[ABT:NYSE]

Numberof Employees: Approximately91,000worldwide

2011 Revenue: $38.9 billion

2011R&DInvestment: $4.1 billion

Pharmaceutical AbbottParkandNorthChicago,Illinois,USA
ResearchCenters: Worcester, Massachusetts, USA
Ludwigshafen, Germany

Countries Where
Morethan 130
ProductsareSold:

Key2011FinancialMeasures

Revenue:$38.9B R&DInvestment:$4.1B
NetIncome:$4.7B Dividend:39yearsofconsecutive increases

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Vision
Tobetheworld’spremierhealthcarecompany

Dedication
Toemployees,customers,shareholders,suppliersandthepublic

Strategy

Value Based Management is our integral philosophy, directed towards maximizing long-term
cash flow and shareholder value through:

 FocusontheCompany'score profitable segmentstobuildupourpositionasone of the

leading pharmaceutical companies;

 Investmentsininformationtechnologytoimproveplanningandcontrolofoperation;

 Increased investments in Human Resources Training & Development to upgrade and

broaden the skill base of the organization in consonance with changing needs;

 Build flexible cost-efficient manufacturing base through a balanced mix of in-

houseand contract manufacturing

OurBasic Principle

Respectpeople: Ourpeople areour strength

TheWorkCulture

Abbott India is an equal opportunity employer and provides a congenial and professionalwork
environment for all its employees, with great emphasis on teamwork. We stimulate
innovation, encourage calculated risk taking and accept mistakes as a part of the learning
process.

We encourage experiential learning, and believe in clear delegation of authority and

acceptanceofpersonalaccountability.Wevaluetheinvolvementofourcolleaguesinbringing the
best to our organization in a spirit of understanding, trust and appreciation of cultural
differences. We are open to discussing alternative views and build on constructive feedback.

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 TheAbbottBrand Promise
APromiseforLife

TurningScienceinto Caring

We are here for the people we serve in their pursuit of healthylives. This has been the wayof
Abbott for more than a century – passionately and thoughtfullytranslating science into lasting
contributions to health.

Our products encircle life, from newborns to aging adults, from nutrition and diagnostics
through medical care and pharmaceutical therapy.

Caringis central to the work wedo and defines ourresponsibilityto thosewe serve:

We advance leading-edge science and technologies that hold the potential for significant
improvements to health and to the practice of health care.

We value our diversity – that of our products, technologies, markets and people – and believe
that diverse perspectives combined with shared goals inspire new ideas and better ways of
addressing changing health needs.

We focus on exceptional performance – a hallmark of Abbott people worldwide – demanding

of ourselves and each other because our work impacts people's lives.

Westriveto earnthetrust ofthoseweservebycommittingto thehighest standardsofquality,

excellence in personal relationships, and behavior characterized by honesty, fairness and
integrity.

We sustain success – for our business and the people we serve – by staying true to key tenets
upon which our company was founded over a century ago: innovative care and a desire to
make a meaningful difference in all that we do.

Thepromise ofourcompanyis in the promisethatour work holdsforhealth and life.

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 CompanyHistory

In 1888 at the age of 30, Dr. Wallace C. Abbott, an

1885 graduate of theUniversity of Michigan, founded the
Abbott Alkaloidal Company.Atthetimehewas a practicing
physician and owned a drug store. His innovation was the
useoftheactivepartofa
medicinalplant,generallyanalkaloid(morphine,quinine,strych
nine,andcodeine), which he formed into tiny pills which he
called “dosimetric granules.” This was successful since it
allowed more consistent and effective dosages for patients.

Abbott Laboratories is one of the oldest and most successful pharmaceutical companies in the
United States. While about 30 percent of annual revenues come from the sale of
pharmaceuticals--including Abbott's flagship drug, the antibiotic Biaxin--the company has a
higher profile in the area of nutritionals, where its products include leading infant formula
brands Similac and Isomil and a leading adult nutritional brand, Ensure. Abbott is also a top
manufacturer of medical diagnostic equipment, with an emphasis on blood analyzers and the
detection and monitoring of infections and diseases. The firm's hospital products unitproduces
electronic and injectable drug-delivery systems, intravenous solutions and supplies,
anesthetics, and products used in critical care settings. Abbott's annual research and
development budget exceeds $1 billion, with areas of emphasis including AIDS/antivirals,
anti-infectives, diabetes, neuroscience, oncology, pediatric pharmaceuticals, urology, and
vascular medicine.

Early Decades
Abbott Laboratories has its origin in the late 19th century in a small
pharmaceutical operation run from the kitchen of a Chicago physician named Wallace Calvin
Abbott. As did other physicians of the time, Dr. Abbott commonly prescribed morphine,
quinine, strychnine, and codeine--all of which were liquid alkaloid extracts--for his patients.
Because they existed only in a liquid form, these drugs were prone to spoilage over time,
mitigatingtheireffectivenessastreatments.In1888,Dr.AbbottheardthataBelgiansurgeon
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had developed alkaloids in solid form. Alkaloid pills soon became available in Chicago, but
Dr. Abbott was dissatisfied with their quality, and he decided to manufacture his own.

Dr. Abbott began to advertise his products to other doctors in 1891. So successful was his
business that he eventuallysold shares to otherdoctors and incorporated his operation in 1900
as the Abbott Alkaloidal Company. By 1905, annual sales had grown to $200,000. Ten years
later, the company changed its name to Abbott Laboratories. During World War I, Abbott's
company was essential to the medical community, as several important drugs, manufactured
exclusively by German companies, were no longer available in the United States. Abbott
developed procaine, a substitute for the German novocaine, and barbital, a replacement for
veneral.

Afterthewar,Abbottcontinuedtoconcentrateontheresearchanddevelopmentofnewdrugs. In
1921, the company established a laboratory in Rocky Mount, North Carolina, which
developed a number of new drugs, including sedatives, tranquilizers, and vitamins. Even after
Dr. Abbott's death that year, the company continued to invest heavily in new product
development and aggressive marketing campaigns. The company went public in 1929 with a
listing on the Chicago Stock Exchange. Two years later, Abbott expanded outside the United
States for the first time with the establishment of an affiliate in Montreal, Canada.

DeWitt Clough was named president of the company in 1933, ending a period of somewhat
stale communal leadership. A more dynamic character than any since Dr. Abbott, Clough is
best remembered for the inauguration of the company magazine,What's New?The publication
had such a positive impact on worker morale and public opinion that several of Abbott's
competitors started similar publications. In 1936 Abbott began its long-term association with
anesthetics when it introduced sodium pentothal, which had been developed by Abbott
scientists Ernest Volwiler and Donalee Tabern (who in 1986 were named to the U.S.
Inventors Hall of Fame for this discovery).

During World War II, Abbott once again played an important role in battlefield and hospital
healthcare. By this time, American pharmaceutical companies such as Abbott were much less
dependent on Germany's companies, particularly the IG Farben--a conglomeration of the
world's most advanced drug manufacturers. After the war, much of the IG Farben's research
was turned over to American manufacturers. Abbott, however, had little to gain from this
information; it was already a worthy competitor on its own.

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After the departure of DeWitt Clough in 1945, Abbott shifted its attention to the development
of antibiotics. The company developed the antibiotic erythromycin, which, introduced under
the brand names Erythrocin and E.E.S. in 1952, constituted a significant portion of Abbott's
prescription drug sales for several decades--even after the expiration of its 17-year patent.
Sales of the drug increased dramatically when it was found to be an effective treatment for
Legionnaire's disease.

Abbott stumbled onto a lucrative new product when one of its researchers accidentally
discoveredthatachemicalwithwhichhehadbeen workinghadasweettaste.Thechemical,a
cyclamate, could be used as an artificial sweetener. Initially, from 1950, it was marketed to
diabetics, but in the 1960s, as Americans became more health and diet conscious, it was
increasingly used as a sugar substitute in a wide variety of foods.

In 1964 Abbott completed the first major acquisition in company history when it purchased
Columbus, Ohio-based M & R Dietetic Laboratories. M & R was the manufacturer of Similac
baby formula and over the succeeding decades, as the company's Ross Products Division,
formed the basis for Abbott's market-leading infant and adult nutritionals business.

Late1960sandEarly1970s:DiversificationandCrises

By the mid-1960s, Abbott had gone several years without a majorbreakthrough

in research, and none was projected at any time in the immediate future. Then,in 1967,
Edward J. Ledder was named president of the company. He advocated a reduction in Abbott's
emphasis on pharmaceuticals by diversifying into other fields. In the years that followed,
Abbott introduced an array of consumer products, including Pream nondairy creamer, Glad
Hands rubber gloves, Faultless golf balls, and Sucaryl, the cyclamate sugar substitute. In an
effort to ensure the success of Abbott's consumer product line, Ledder placed Melvin
Birnbaum, a highly experienced and able manager he had hired away from Revlon, in
chargeofthedivision. Ledder'spolicyofdiversificationlaidthegroundworkformoreflexible
corporate strategies. No longer exposed exclusively within the pharmaceuticals market,Abbott
was able to cross-subsidize failing operations until they could be rehabilitated.

Despite this flexibility, Abbott soon realized new obstacles to its growth. The company's
hospital products competed in a limited, institutional market. New drugs had greater profit
marginsbutweresubjecttogovernmentapprovalproceduresthatkeptcompanieswaitingfor

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several years before they could market their discoveries. Consumer products, on the other
hand, involved more expensive marketing and generated less profit than pharmaceuticals.
Unable to increase profits without substantial risk, Abbott's management decided to maintain
the strategies that were in place.

Cyclamate sales had grown so dramatically that by 1969 they accounted for one-third of
Abbott's consumer product revenues--or about $50 million. The increasing popularity of
cyclamates as an ingredient in diet foods, however, led the Food and Drug Administration
(FDA) to conduct an investigation of possible side effects from their overuse. The FDA's
research was widely criticized as 'fragmentary' and 'fatally flawed,' but it was nonethelessused
as evidence that cyclamates were carcinogenic. The market collapsed in August 1970
whentheFDAbanneddomesticsalesofcyclamates.Abbott,whichovernighthadsufferedthe loss of
one of its most profitable operations, protested the ban, but was unable to reverse the decision.
Although the companycontinued to petition the FDA, subsequent studies confirmed that
metabolization of cyclamates can lead to chromosome breakage and bladder cancer.

Less than a year after cyclamates were banned, Abbott was forced to recall 3.4 million bottles
of intravenous solution. The bottles were sealed with a varnished paper called Gilsonite,
which, it was discovered, harbored bacteria. The contamination was discovered only when
healthcare workers noticed and then investigated the high incidence of infection in patients
who had been administered Abbott's intravenous solutions. The Center for Disease Control
linked the contaminated solutions to at least 434 infections and 49 deaths. With sales down
from $17.9 million to $3 million, Abbott's share price began to fall. Abbott moved quickly to
replace its Gilsonite seals with synthetic rubber, but the company was unable to regain its
leadership of the intravenous market. Litigation resulted in the company eventually pleading
no contest to a charge of conspiracy and paying a $1,000 fine.

Late1970sthrough1980s:EmphasizingR&D,Nutritionals,Diagnostic Equipment

The crises of the early 1970s left the company's upper echelon of management
weakened and vulnerable to criticism. Although Edward Ledder was recognized for the
success of his diversification program (and largely excused for his inability to prevent either
the cyclamate ban or the intravenous solution crisis), conditions were obviously ripe for the
expression of talent by a new manager. Robert Schoellhorn, a veteran of the
chemicalindustry,wasjustsuchamanager.Hiseffortsasavice-presidentinthehospitalproducts
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divisionatAbbottresultedinarevenueincreaseof139percentforthatdivisionbetween 1974 and
1979. He correctly predicted that the next most profitable trend in healthcare would be toward
cost-effective analysis and treatment. Schoellhorn was later promoted to president and chief
operating officer of the company. Meantime, in 1977 Abbott entered into a joint venture with
Takeda Chemical Industries, Ltd. of Japan called TAP Pharmaceuticals Inc. for the
codevelopment and comarketing of pharmaceuticals.

Abbott Laboratories registered an annual sales growth rate of 15.5 percent and an earnings
growthrateof16.5percentby1979.This expansionwas attributedbyfinancialanalyststo the
company's increased productivity, reduced costs, expansion into foreign markets, and greater
involvement in hospital nutritionals and diagnostic testing equipment. The company also
introduced three new drugs in 1979: Depakene, an anticonvulsant; Tranxene, a mild
tranquilizer; and Abbokinase, a treatment for blood clots in the lungs. All three products were
the direct result of the company's increased investment in research and development in the
mid-1970s.Utilizing its knowledge of intravenous solution production, vitamin therapy, and
infant formula, Abbott developed a comprehensive nutritional therapy program to speed the
recovery of hospital patients and thereby reduce medical care costs. In the 1980s, as many as
65 percent of all hospital patients suffered from some form of malnutrition, so Abbott was
highly successful in marketing their program. Another advantage of adult nutritional products
was that they had a place in the growing home care market.

Abbott had similar success marketing its lines of diagnostic equipment. Electronic testing
devices developed by Abbott proved more accurate than manual procedures. In order to
strengthen the technical end of its diagnostic equipment research, Abbott hired two top
executives away from Texas Instruments to head the division.

Robert Schoellhorn, who advanced to chairperson and chief executive officer in 1979,
continued to emphasize investment in pharmaceutical research and development in the 1980s.
Seven new drugs introduced in 1982 accounted for 17 percent of sales in 1985. Foreign
operations also remained extremely important to Abbott, and the company had more than 75
foreign subsidiaries and manufacturing facilities in more than 30 countries. Schoellhorn
continued to support Ledder's original diversification policy. The introduction of Murine eye-
care products and Selsun Blue dandruff shampoo served to expand the domestic consumer
product line and promised to provide earningstabilityin the event of a downturn in anyof the
company's other markets.

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Schoellhorn was also credited with promoting Abbott's emphasis on diagnostic equipment,
especially blood analyzers. These devices were increasingly used to detect legal and illegal
substances in the bloodstream. Abbott led the trend, developing the first diagnostic tests for
Acquired Immune Deficiency Syndrome (AIDS), in 1985, and hepatitis. The company's
'Vision'blood analyzer fit on a desktop and performed 90 percent of typical blood tests within
eight minutes. By the end of the 1980s, sales of blood analysis devices represented a billion-
dollar business, and medical diagnostic products (at $2.3 billion per year) constituted nearly
half of Abbott's annual sales. Meanwhile, in the pharmaceuticals arena, Abbott in 1987
received FDA approval for a new drug called Hytrin for the treatment of hypertension. Hytrin
was approved in 1993 for the treatment of noncancerous enlarged prostate.

Schoellhorn was widely praised as the driving force behind Abbott's phenomenal growth
during the 1980s--sales nearly tripled, profits doubled, and the pharmaceutical company rose
to 90th from 197th onFortune's list of the world's top 500 companies. The leader's aggressive
management style, however, often led to conflict. Over the course of the 1980s, three
presidents--James L. Vincent (1981); Kirk Raab (1985); and Jack W. Schuler (1989)--quit. In
December 1989, Abbott's board of directors unseated Schoellhorn, who in turn sued the
company for his job. Abbott accused Schoellhorn of misappropriation of company assets and
'fraudulent conduct,' adding that the former CEO exercised stock options worth $9.3 million
within days of his release. Schoellhorn was succeeded by Vice-Chairman Duane L. Burnham.

1990sandBeyond:NewDrugIntroductionsandAcquisitions

Unlike many of its competitors (including Merck, SmithKline Beecham, and

Eli Lilly), Abbott did not acquire a drug distribution manager in the early 1990s. Instead, the
company plowed funds into research and development. R & D outlays rose from 5.2 percentof
sales in 1982 to more than 10 percent of sales by 1994--by the latter year, R & D
expendituresneared$1billion.That yearmarkedthecompany's23rdconsecutiveearningslift and
helped Abbott's stock hold its value better than most competitors in the uncertain healthcare
environment of the early 1990s.

Among key developments in the early 1990s was the introduction in 1991 of clorithromycin,
an antibiotic developed as a successor to Abbott's erythromycin. Marketed in the UnitedStates
under the name Biaxin, clorithromycin was useful in the treatment of common upper
respiratoryailmentssuchasthefluaswellasothertypesofinfections.Itquicklybecame
23|Page
Abbott's flagship pharmaceutical--eventually achieving $1 billion in annual sales--remaining
so into the early 21st century.

New product introductions continued in the middle years of the decade. In 1994 Abbott
introduced sevoflurane, an inhalation anesthetic that soon gained popularity because of its
wide range of uses. The following year, TAP, the joint venture with Takeda Chemical,
receivedFDAapprovalforPrevacid,anulcertreatment(salesofPrevacidreached$1.3billion by
1998). In 1996 FDA clearance was granted for Norvir, a protease inhibitor for thetreatment of
HIV and AIDS.

Despite these R & D successes, Abbott's earnings were failing to increase at the high-double-
digit rate that they had in the 1980s, and the company was beginning to face the risk of being
gobbled up by a larger rival in the rapidly consolidating healthcare industry of the 1990s.
Shruggingoffthe conservative management of the early1990s, Abbott moved aggressivelyin
the second half of the decade to expand via acquisition and thereby stave off being acquired
itself. In 1996 Abbott bolstered its diagnostics division through the $867 million purchase of
MediSense, Inc., a Waltham, Massachusetts-based maker of blood-testing devices for
diabetics. This was the company's first major deal since the 1964 acquisition of M & R
Dietetic Laboratories. In 1997 Abbott spent about $200 million for certain
intravenousproductlinesofSanofiPharmaceuticals,Inc.,the
U.S.unitofFrance'sSanofiS.A.Includedin this deal was Carpujet, an injectable drug-delivery
system based on preloaded, single-dose syringes. Also in 1997, Abbott suffered a potential
setback when Takeda Chemical did not renew a ten-year contract that gave Abbott the right of
first refusal to distribute Takeda's new
drugsintheUnitedStatesviatheTAPventure.Takedahaddecidedtoset upitsownsalesand
marketing organization in the United States. By this time TAP was generating annual sales in
excess of $2 billion, primarily from the marketing of Prevacid and Lupron, a prostate-cancer
drug.

By 1997 Abbott had doubled its sales and earnings since Burnham had taken over from the
ousted Schoellhorn. In early 1998 Burnham announced that he would retire in 1999. At the
beginning of that year, Miles D. White, who had been a senior vice-president in charge of the
diagnostics division, took over as CEO. Later in 1999, White was named chairman as well.
During the leadership transition period in 1998, Abbott acquired Murex Technologies
Corporation, a maker of diagnostics products, for $234 million. During 1999,
Abbott'sappetiteforgrowthincreasedexponentiallywiththeannouncementinJuneofadealto
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25|Page
acquire ALZA Corporation for $7.3 billion in stock. ALZA was a leading producer of
advanced drug-delivery systems and had a solid pipeline of new pharmaceuticals under
development.The FederalTradeCommission(FTC),however,raisedantitrustconcerns about the
merger, and when the two sides were unable to reach an agreement with the FTC, they called
off the merger in December. Another possible factor in the collapse of the deal was the
decline in Abbott's stock price following the company's agreement in November to pull 125
types of medical-diagnostic test kits off the U.S. market and to pay a $100 million civilpenalty
to the U.S. government. Since 1993 the FDA had been issuing warnings to Abbott regarding
quality control deficiencies at its test kit plants, with the market withdrawal and payment of
the fine being the outcome of this process. The FDA also cited poormanufacturing controls as
the reason for its halting the sales of Abbott's clot-dissolving agent Abbokinase in early 1999.

In the meantime, Abbott managed to complete two smaller acquisitions in 1999. It acquired
Perclose, Inc., a maker of sutures used to close arteries during angioplasty procedures, for
about$600millioninstock.Abbottalsopaid$217millionincashtoGlaxoWellcomeInc. for five
anesthesia products. In January 2000 Abbott sold its agricultural products business to
Sumitomo Chemical Co., Ltd. Abbott was now for the first time in decades a pure healthcare
firm. Abbott in April of that year began marketing Biaxin XL, a new once-daily formulationof
its flagship Biaxin antibiotic. The FDA in September 2000 granted expedited approval to
Kaletra, asecond-generation AIDS medication developedbyAbbott. Kaletrahad thepotential to
overtake the top AIDS drug, Pfizer Inc.'s Viracept, because it had fewer side effects. It also
appeared that patients did not develop resistance to Kaletra over time, as happened with most
other AIDS drugs, including Viracept. Then in December 2000 Abbott launched another
attempt at a major acquisition when it reached an agreement to acquire the Knoll
Pharmaceutical Co. unit of German chemical giant BASF AG for $6.9 billion in cash. Once
again, Abbott's aim was to bolster its product pipeline, and Knoll had at least one potential
blockbuster in a drug called D2E7, an experimental rheumatoid arthritis treatment. Knoll's
existing products included Meridia, an obesity drug with annual sales of about $400 million,
and Synthroid, a $150 million thyroid drug.

In 2010, Abbott Laboratories acquired Piramal Healthcare Ltd.’s branded generic-medicine

unit in India for $3.72 billion, making it the country’s biggest drug maker and tapping into a
market expected to more than double by 2015. Abbott said it will pay $2.12 billion
upfrontand$400millionannuallyforfouryearsfrom2011fortheunit,whichsellsretail-ready

26|Page
pharmaceuticals in India, Sri Lanka and Nepal. The Abbott Park, Illinois-based company will
pay cash for the transaction, expected to close in the second half of 2010.

The acquisition is the second-largest takeover in India’s health-careindustryand gives Abbott a

7 percent stake in the $8 billion Indian pharmaceutical market. The move fits into Abbott’s
strategy of broadening its business beyond brand-name pharmaceuticals in the U.S. and
Europe, where sales are slowing because of generics competition and pricing pressure from
governments.

In India, the pharmaceutical market is expected to increase as much as 16 percent a year

through 2014, according to IMS Health Inc. The $300 billion U.S. market will grow at a
slowerrate of 3percentto6percentover the same period, saidIMS.Theslowergrowthinthe
U.S. and Europe has Abbott and other drug maker turning toward developing countries to
increase sales. Tokyo-based Daiichi Sankyo Co. bought 64 percent of Ranbaxy Laboratories
Ltd., India’s largest drug maker, for about 488.7 billion yen ($5.45 billion) in 2008,
thebiggesttakeoverinthe SouthAsiannation’spharmaceuticalindustry, and Pfizer Inc.hasbeen
licensing products from Indian generic-drug maker Aurobindo Pharma Ltd.

Recognition

 FORTUNE:Among"Most AdmiredCompanies," 1984-present

 Barron's:ListedNo. 29in2012rankingofworld's 100mostrespected companies

 Barron's:MilesWhiteamongworld’s30 "MostRespectedCEOs" fourstraightyears

 DowJonesSustainabilityIndex:Listedamongworldleadersineconomic,
environmental and social performance seven straight years

 Scrip:2011awardfor LeadershipinCorporateSocialResponsibility

 TheDealmagazine:MostAdmiredCorporateDealmakerinhealthcarefourstraight years

 WorkingMother:"100BestCompaniesforWorkingMothers"11straightyears

 DiversityInc:"50 BestCompaniesforDiversity" ninestraightyears

 ScienceandTheScientistmagazines:Recognizedasatopemployerforscientists for
many years

 Honoredfor workplaceleadership inmorethan25 countries

27|Page
KeyDates:

1888 Dr.WallaceCalvinAbbottbeginsmanufacturingalkaloidpills
1900 AbbottincorporateshisfirmasAbbottAlkaloidal Company
1915 Companychangesits name to AbbottLaboratories.
1929 Abbottgoespublicwithalistingon theChicagoStock Exchange
1936 Companyintroduces the anestheticsodium pentothal
1952 Companylaunches a new antibiotic, Erythrocin
1964 AbbottacquiresM&RDieteticLaboratories,maker ofSimilacbabyformula
NewpresidentEdwardJ.Ledderbeginsadiversificationintoconsumerproducts,
1967
including Sucaryl, a cyclamate sugar substitute.

1970 FDAbans thesaleofcyclamates

1971 Abbottisforcedtorecall3.4 millionbottlesofintravenoussolution
CompanyformsjointventurewithTakedaChemicalIndustries,Ltd.ofJapan called
1977
TAP Pharmaceuticals Inc.
1985 Abbottdevelopsthefirstdiagnostictestfor AIDS.
1987 Abbott'sHytrin is approved bytheFDAforthe treatment of hypertension.
1991 Clorithromycin,anantibiotic,isintroduced.
1996 AbbottacquiresMediSense,Inc.,amaker ofblood-testingdevicesfor diabetics
AbbottagreestoacquireALZACorporationfor$7.3billionbutthedeallater
1999 collapses; Abbott agrees to pay a $100 million fine relating to quality control
problemsatitsmedicaltestkitplants;suturemakerPerclose,Inc.isacquired.
FDAapprovestheAIDSdrugKaletra;AbbottagreestoacquiretheKnoll
2000
Pharmaceutical Co. unit of BASF AG for $6.9 billion in cash.

AbbottIndiaLtd.History
Company was originally incorporated on August 22, 1944 under the
Companies Act, 1913 as Boots Pure Drug Company (India) Limited. Its name was then
changed to The Boots Company (India) Limited on November 1, 1971, thereafter to Boots
PharmaceuticalsLimitedonJanuary1,1991.OnOctober31,1995thenamewaschangedto Knoll
Pharmaceuticals Limited, thereafter to Abbott India Limited on July 1, 2002.

28|Page
1944: AllsharesissuedtoBoots PureDrugCo.,Ltd.Only5shares issuedfor cash

1963: 2,00,000sharesissuedtothepresentCompany

1965: TheCompanywas incorporatedon 15th December

On19thOctober,theCompanyenteredintoatechnicalcollaborationagreement with
Boots Pure Drug Co. Ltd., England
In December,2,00,000sharesissuedtopublic(prem.Rs13pershares).
1969: 25,000sharesissuedatpartoL.I.C.,U.T.I.andI.C.I.C.I.onconversionof5% debenture
holdings
1976: The Company undertook to set up a new chemical plant at Ahmednagar, a
backwardareainMaharashtra,forthemanufactureofIbuprofenfromthebasic stage in
technical collaboration with its parent company. Ibuprofen is a raw material of
Boots original research
1977: 1,48,150RightEquitysharesissuedtoIndianshareholders(prem.Rs3.50per shares:
prop. 2:9)
1979: 2,66,050Bonus sharesissuedinprop. 1:3

1983: The Companyissued 1,70,000-15% non-convertible debentures of Rs 100 each.

Thesedebentureswereredeemedon5thOctober,1990atapremiumofRs5 per
debenture
TheCompanyalso issued 4,27,290 No. ofEquityshares of Rs 10 each at a
premiumofRs 45per shareasrights toresidentIndianequityshareholders
TheobjectofrightsissueandofferforsalewastoreducetheholdingofBoots Company
PLC, England in the Company from 53% to 40%.
1984: 13,58,520Bonus equityshares issuedinprop.3:5

1986: 4,27,280newequityshareswereofferedasRightstotheresidentIndianequity
shareholders at a premium of Rs 45 per shares
1987: TheCompanyreceivedaletterofintentforboththeproductsandtheexpansion capacity
of Ibuprofen was being implemented
40,50,000 bonus equityshares issuedin prop.1:1
1988: TheCompanyundertookaprojecttosetupanewformulationfactoryatJejuriin Pune
district
1989: Anumberofnewproducts, namelyBrufen JuniorSyrup, ChotaStrepsilsIcy,
OptrexEyeLotion,HighlyPurifiedInsulinsandNausidomewerelaunchedduring the
year

29|Page
1994: ProductssuchasNovopen,Humanmixtard,Mixtardpenfillswere launched
BeemHealthcareLtd.,LenbrookPharmaceuticalsLtd.andValencia Pharmaceuticals
Ltd are the subsidiaries of the Company
1995: ItisproposedtochangethenameofthecompanytoKnollPharceuticalsLtd. effective 31st
October, name was changed to Knoll Pharmaceuticals Ltd.
1997: TheCompanyhasacquiredtheproductEpilexforatotalconsiderationofRs9.90 crores.
The product is used in the treatment of epilepsy
ThenewGoaplantofKnollPharmaceuticals,apartoftheBASFgroup,hasbeen set up.
BASF India has also set up two state-of-the-art plants to manufacture speciality
dyes and dispersons in Mangalore and these were commissioned.
1998: LupharmaGmbH, awholly-ownedsubsidiaryof KnollAGofGermany,hadmade a
public offer for acquisition of a further 11 percent holding in Knoll Pharmaceut-
icalsinordertotakeitsstakeupto51percentfromthecurrentlevelsof40percent
1999: BeemHealthcarewhichwasengagedinmarketingofconsumerbrandshasbeen merged
with Knoll with effect with July 1998
KnollPharmahasenteredintoathree-waypactwiththeGujarat-basedTorrent
Pharmaceuticals and Danish giant, Novo Nordisk, in theanti-diabetes segment
2000: TheCompanyhasenteredintoaagreementwithKalpataruHomesforthe assignment of
the leasehold
RanbaxyLaboratoriesLtdhasenteredintoanagreementwithKnollPharmaceutic- als
Ltd to market the latter's leading brands in select overseas markets
2001: LupharmaUKHoldingOneLtd.,awholly-ownedsubsidiaryofLupharmaGmbH has
proposed to acquire 82,62,000 shares i.e. 51 per cent of the share capital of Knoll
Pharmaceuticals from Lupharma Gmbh
2002: Knoll Pharmaceuticals, the maker of popular painkiller Brufen, has changed its
nametoAbbottIndiafollowingglobaltakeoverofKnoll'smajoritystakeholder- German
firm BASF Pharma - by US drug major Abbott Laboratories
2003: MrVDNarkar,DirectorofAbbottIndiaLtd,hasresignedwitheffectfromJune 19, 2003
Mr.AshokDayal is appointedas AdditionalDirectorofthe company
SchemeofamalgamationofLenbrookPharmaceuticals(awhollyownedsubsidi- ary of
the company) with the company

2008: AbbottIndiaLtdhasinformedthattheBoardofDirectorsoftheCompanyatits meeting

held on February 14, 2008, has appointed Mr. Thomas Dee as the Additional
Director of the Company
2010: AbbottLaboratoriesboughtPiramalHealthcareLtd.’sbrandedgeneric-medicine unit in
India

30|Page
CompetitionOverview
Competition is mainly from the domestic manufacturers and imports from
China because of the low manufacturing cost. With the new patent regulations the industry
expects to see a major structural shift with the entry of foreign pharmaceutical manufacturers.

There are five government-owned companies the Indian public sector. These companies are
the Indian Drugs and Pharmaceuticals, Hindustan Antibiotics Limited, Bengal Chemicals and
Pharmaceuticals Limited, Bengal Immunity Limited and Smith Stanistreet Pharmaceuticals
Limited. Some of the major Indian private companies are Alembic Chemicals, Aurobindo
Pharma, Ambalal Sharabhai Limited, Cadila Healthcare, Cipla, Dr. Reddy’s, IPCA
Laboratories, Jagsonpal Pharma, J.B. Chemicals, Kopran, Lupin Labs, Lyka Labs, Nicholas
Piramal, Ranbaxy Labs, Matrix Laboratories, Orchid Chemical and Pharmaceuticals, Sun
Pharmaceuticals, Ranbaxy Laboratories, Torrent Pharma, TTK Healthcare, Unichem Labs,and
Wockhardt. The foreign companies in India include Abott India, Astra Zeneca India, Aventis
Pharma India, Burrough-Wellcome, Glaxo SmithKline, Merck India, Novartis, Pfizer Limited,
and Wyeth Ledele India.

Top10PubliclyListedLifeSciencecompanies in India,asof 2011

Rank CompanyName Revenue2011(USD million)

1 AbbottIndiaLtd. 1348.51
2 Ranbaxy 1327.56
3 Dr.Reddy'sLaboratories 1178
4 LupinLtd 929.84
5 Aurobindo Pharma 865.19
6 Dabur 700.3
7 Sun Pharmaceutical 673.99
8 Cadila Healthcare 629.45
9 JubilantLifesciences 561.03
10 GlaxoSmithKlinePharmaceuticalsLtd 475.8

31|Page
CHAPTER 2
ResearchMethodology

32|Page
 OBJECTIVE& SCOPEOFSTUDY

ObjectiveoftheStudy

ThemainobjectivetoconductthisresearchistounderstandtheNeuromuscularBlocker (NMB) market

& develop the medical positioning for new product launch i.e. Cisatracurium

PrimaryObjective

 Tostudyandunderstandtheconceptandprocessof marketingresearch.
 Tounderstandandget theconceptofMarketingofPharmaceutical products
 Toget thepractical implicationofthe processinvolved inanyproduct launch

Scopeof theStudy

The project scope involves the study of the Anesthetists’ armamentarium of drugs.Understand
the Neuromuscular Blocker (NMB) category, their mechanism of action and clinical use of
NMBs & their place in therapy. The project scope also involves the finding of clinician
preferences in current NMBs available with the marketingresearch and developinga medical
positioning for Cisatracurium from the above collected data.

ManagerialUsefulnessof the Study

This study helps to understand marketing research basic terminologies & different strategies
for different market situation

TypesofResearchandResearchDesign

 Quantative Research- Quantitative research generates numerical data or

information that can be converted into numbers. Only measurable data are being
gathered and analyzed in this type of research.

 Qualitative Research- Qualitative Researchon the other hand generates non-

numerical data. It focuses on gathering of mainly verbal data rather than
measurements.Gatheredinformationisthenanalyzedinaninterpretativemanner,
subjective, impressionistic or even diagnostic

33|Page
ResearchMethodology

 Aquestionnairewasprepared togaugetheawareness of newmoleculein customer.

 Surveyhasbeendoneoutofthecompanycoveringawidecross-sectionoftheindustry.
 Thequestion waspresented inone tooneinterviewwith eachof the respondents.
 Responsesoftheconcernedpersons hadbeen thoroughlyanalyzed.
 Conclusions had been arrived at using the response of the concerned persons and not
on questionnaire alone.

Generally speaking, doctors are most reserve persons on the planet and they are not flattered
by attention and this sometimes overcomes any inhibitions so that matters quite secret are
paraded beforetheobserverwithseemingabandon.Atothertimes,particularlywhereanissue has
been the subject of recent press attention, the shutters go up and there is no way in. Allyou can
do in such circumstances is to give up and try something else likely to be more productive -
you haven't the time to spend on lengthy negotiation. Crucial to the business of initially
gaining access is the whole matter of assurances of confidentiality, anonymity, etc, which
Iconsider below. Your stance, once granted access, depends on how much of an active
participant you want to be in the arena you areobserving - the more obviouslycommitted you
are to one particular stance or ideology the more others will take this into account when
revealing their thoughts or their actions to you.

In this context the questionnaire was not a fully fledged one and was made with an intentionof
getting the main information as doctors don’t have that much time to spare and also a long
questionnaire mayirritate them. So the questionnaire used in myresearch was reallycrisp and
was aimed at getting the required information in the least time, also the questionnaire wasused
for primary purpose only.

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Research Design
Research design specifies the methods and procedures for conducting a particular study.A
research design is the arrangement of conditions for collection and analysis of the data in a
manner that aims to combine relevance to their search purpose with economy in procedure.
Research design is broadly classified into three types as:

 ExploratoryResearchDesign
 DescriptiveResearchDesign
 CausalResearch Design

DescriptiveResearch Design
Descriptive research studies are those studies which are concerned with described the
characteristics of particular individual. In descriptive as well as in diagnostic studies, the
researcher must be able to define clearly, what he wants to measure and must find adequate
methods for measuring it along with a clear cut definition of population he want to study.
Sincethe aim is to obtain complete and accurate information in the said studies,theprocedure
to be used must be carefullyplanned. The research design must make enough provision for
protection against bias and must maximize reliability, with due concern for the economical
completion of the research study.

SAMPLEDESIGN
ASampleDesign is adefiniteplanforobtaining asamplefrom a given population. It refersto the
technique to the procedure adopted in selecting items for the sampling designs are as below:

SAMPLESIZE
The sample size has been 40 doctors. Conclusions had been arrived at using the response of
the questionnaire.

SAMPLINGMETHOD
Inthismarketingresearchproject,IamusingRandomsampling method.

SAMPLETYPE
AreaSampling,and theareaof samplingis Mumbai& Pune.

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DataCollectionMethod

 Primary Data: - Primary data means data that are collected by different techniques
like questionnaire, Depth interview, Survey, Schedules etc. In this project, primary
data has been collected by the means of questionnaire.
 Secondary Data: - Secondary data means data that are already available i.e.: theyrefer
to the data which have already been collected and analyzed by someone else. Usually
published data are available in: Various publications of the central, state/local
governments or foreign governments, technical and trade journals etc. The secondary
data involved in this project has been gathered from the medical journals, literatures
and internet.

36|Page
 Limitation oftheStudy

 Thesampleareaandsample sizehasbeen limiteddueto timeconstraint.

 Doctors (respondents) are reluctant for their feedbacks & opinions, and authenticityof
their statements can’t be verified too.
 All the observation and recommendation will be made on the feedback obtained from
survey.

37|Page
CHAPTER 3
ConceptualDiscussion

38|Page
 AboutThe Product

NIMBEX®(Cisatracuriumbesylate)

NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal muscle relaxant for

intravenous administration. Compared to other neuromuscular blocking agents, it is
intermediateinitsonsetanddurationofaction. Cisatracuriumbesylateisoneof10isomersof
atracurium besylate and constitutes approximately 15% of that mixture.

Abstract
Cisatracuriumisaneuromuscular-blockingdrugorskeletalmusclerelaxantinthecategoryof non-
depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to facilitate
endotracheal intubation and to provide skeletal muscle relaxation during surgery or
mechanical ventilation. It is a bisbenzyltetrahydroisoquinolinium agent with an intermediate
duration of action.

It is the R-cis, R'-cis isomer of atracurium besilate and is approximately 3-fold more potent
than the mixture of isomers that constitute the parent drug. The ED95 for cisatracurium
besilate(doserequiredto produce95%suppressionoftwitchresponsetonervestimulation)in adults
is 0.05 mg/kg during N2O/O2 opioid anaesthesia. As for atracurium besilate, the primary
route of elimination of cisatracurium besilate is by spontaneous degradation.
Cisatracuriumbesilateisnotassociatedwithdose-relatedhistaminerelease(atbolusdosesof
< or = 8 x ED95) and, consistent with this, has demonstrated cardiovascular stability in both
healthy patients (< or = 8 x ED95) and those with coronary artery disease (< or = 6 x ED95).
In clinical trials, cisatracurium besilate has been used successfullyto facilitate intubation (at 2
to 4 x ED95) and as a muscle relaxant during surgery and in intensive care. Compared with
vecuronium, cisatracurium besilate was associated with a significantly faster recovery after
continuousinfusioninpatientsinintensivecare.Relativetoatracuriumbesilate,cisatracurium
besilate has a lower propensity to cause histamine release is more potent but has a slightly
longer onset time at equipotent doses. It also offers a more predictable recovery profile than
vecuronium after prolonged use in patients in intensive care. Thus, comparative data provide
some indication of the potential of cisatracurium besilate as an intermediate-duration
neuromuscular blocking agent but further comparisons with other like agents are required to
define precisely its relative merits.

39|Page
 Current Issue/News

March21,2012

Abbott Selects AbbVie as New Name for Future Research-Based

PharmaceuticalCompany

 Company Remains on Track for Separation into Two Publicly Traded Global Health
Care Companies by End of 2012

Abbott Park, Illinois (NYSE: ABT) — Abbott today announced that AbbVie [pronounced
Abb-vee] willbethenameofthenew,independentresearch-basedpharmaceuticalcompanyit
expects to launch by the end of 2012.

The naming of the new company is the latest milestone in the process that began in October
2011, when Abbott announced it would separate into two publicly traded companies, one in
diversified medical products and the other in research-based pharmaceuticals. AbbVie, the
research-based pharmaceutical company, will include Abbott’s current portfolio of leading
proprietary pharmaceuticals and biologics. The diversified medical products company, which
will retain the Abbott name, will consist of Abbott’s existing diversified medical products
portfolio, including its branded generic pharmaceutical, devices, diagnostics and nutritional
businesses. Both companies will be global leaders in their respective industries.

Miles D. White will remain chairman and CEO of Abbott. Richard A. Gonzalez, currently
executivevicepresident,GlobalPharmaceuticals,willbecomechairmanandCEOofAbbVie.

The name is derived from a combination of Abbott and "vie," which references the Latin root
"vi" meaning life.

"The beginning of the name connects the new company to Abbott and its heritage of
pioneering science," said Mr. Gonzalez. "The 'vie'calls attention to the vital work thecompany
will continue to advance to improve the lives of people around the world."

40|Page
"With a powerful family of products and a continued focus on breakthrough innovations
targeting some of the most critical medical needs, AbbVie will be positioned to deliver
market-leading performance and better health for patients," said Mr. White.

The research-based pharmaceutical company has nearly $18 billion in annual revenue today
and will have a sustainable portfolio of market-leading brands, including Humira, Lupron,
Synagis, Kaletra, Creon and Synthroid.An attractive pipeline of innovative R&D assets – in
important specialty therapeutic areas such as Hepatitis C, immunology, chronic kidney
disease, women's health, oncology and neuroscience – will help drive future growth.

TheAbbVie logo andgraphic identitywill beunveiled when thenewcompanyis launched.

May03,2012

Abbott Announces Collaboration with Syngene to Open First Nutrition

R&DCenter in India

Mumbaiand Bangalore, India — Abbott (NYSE: ABT), one of India's largest health care
companies, today announced plans to establish its first nutrition research and development
center in the country in collaboration with Syngene, India's leading contract research
organization. The Abbott Nutrition R&D Center in India will focus on the development of
science-based, affordable nutrition products for the country and enable the expansion of
Abbott's nutrition product portfolio there.

Abbott selected Syngene – a subsidiary of Biocon, the largest biotech company in India – to
provide a science-based research and innovation team to work closely with Abbottresearchers.
More than 50 researchers and scientists will be based at the Abbott Nutrition R&D Center in
India at Biocon Park in Bangalore, which is expected to open in June 2012.

The new R&D center will focus on the development of nutrition products for maternal and
child nutrition and diabetes care. Preventing undernutrition has emerged as one of the most
critical health challenges in India. An estimated 50 percent of Indians (570 million people)
have adequate calorie intake but are not consuming a sufficient level of essential nutrients. 1
Indiaalsohastheworld'slargestdiabetespopulation,withanestimated51millionpeople

41|Page
living with diabetes.2 Among the products being developed for the Indian market are meal
complements for diabetics and pre-diabetics. In addition, the center will address local tasteand
texture preferences with new flavors and formulations.

"India is a priority market for investment, growth and innovation," said Robert H. Miller,
Ph.D., divisional vice president, Global R&D and Scientific Affairs for Abbott Nutrition."Our
strategic collaboration with Syngene will accelerate the design, development and delivery of
science-based, affordable nutrition products in India, for India."

"Health care in India has reached a tipping point as patients seek quality care and products at
affordable prices," said Rehan Khan, managing director, Abbott Nutrition India. "We have
consistentlyinvested in India, and this world-class R&D center will allow us to leverage local
expertise and insights to develop the products we need to successfully expand our portfolio
here."

The nutrition market in India is relatively new and growing steadily. In addition to the
undernutrition and diabetes issues facing India, a rapidly expanding middle class and aging
population are driving increased demand in the country for high-quality, affordable nutrition
products.

"With malnutrition and common chronic diseases at their highest in this region, Abbott and
Syngene have a common vision and commitment to support the development of a healthier
India,"saidKiranMazumdar-Shaw,founder, chairmanandmanagingdirector,Biocon Group.
"The combined market insights and nutrition science expertise of our two organizations will
enable us to address these immediate needs by developing critically important, innovative yet
affordable nutrition products for the Indian population."

Commenting on the collaboration, Peter Bains, director, Syngene & Clinigene, said, "We are
extremely delighted to partner with Abbott for this synergistic collaboration for its nutrition
business. Our objective will be to develop new products for Abbott's nutrition portfolio. This
symbolizes Syngene's growing capability to offer science-based research and development
solutions across a wide range of life science platforms."

42|Page
AboutAbbott

Abbott (NYSE: ABT) is a global, broad-based health care company devoted to the discovery,
development, manufacture and marketing of pharmaceuticals and medical products, including
nutritionals,devicesand diagnostics.Thecompanyemploys approximately91,000people and
markets its products in more than 130 countries. Abbott currently employs more than 12,000
people throughout India.

AboutAbbottNutrition

For more than 85 years, Abbott Nutrition has been developing and marketing science-based
pediatric and adult nutritional products to support the growth, health and well-being of people
of all ages. Abbott offers a variety of nutritional products in India including PediaSure®
(complete, balanced nutrition for children), Similac® (infant milk formula for infants and
children), Mama's Best® (nutritional supplement for pregnant and breastfeeding mothers),
Ensure® (adult nutritionals), Glucerna® (nutrition for people with diabetes) and Prosure®
(nutrition for people with cancer).

About BioconLimited

Biocon Limited (BSE code: 532523, NSE Id: BIOCON, ISIN Id: INE376G01013) is India's
premierbiopharmaenterprisefocusedoninnovationtodeliveraffordablehealthcaresolutions to
patients, partners and health care systems across the globe. Established in 1978 by Ms. Kiran
Mazumdar-Shaw, Biocon is committed to reduce therapy costs of chronic diseases like
diabetes,cancerandautoimmunediseasestoprovideaccesstoaffordabletreatmenttopatients
globally. Biocon's key innovations include the world's first Pichia-based recombinant human
Insulin, INSUGEN®, insulin analog Glargine, BASALOG® and India's first indigenously
produced monoclonal antibody, BioMAb-EGFR®, for head & neck cancer. INSUPen® is a
next-generation affordable insulin delivery device introduced in India. With a risk-balanced
business model comprising small molecules, novel molecules, biosimilars, branded
formulations and research services, Biocon has evolved into an emerging global enterprise
serving its partners and customers in over 70 countries.

Moreinformation isavailableatwww.biocon.com

43|Page
AboutSyngeneInternationalLimited

Syngene is India's leading contract research organization offering integrated drug discovery
and development services with capabilities in medicinal chemistry, biology, in vivo
pharmacology, toxicology, custom synthesis, process Research and Development, and
formulation development for small and large molecules. Syngene has an expert team of over
1,500 scientists and 1 million sq. ft. of built-up laboratories equipped with state-of-the-art
infrastructure to support the Research and Development programs of global pharma, biotech
and nutrition companies. More information is available at www.syngeneintl.com.

44|Page
CHAPTER 4
Data Analysis

45|Page
 METHODS&TECHNIQUES
OF DATA ANALYSIS

DataAnalysisConcept

Data analysis is a practice in which raw data is ordered and organized so that useful
information can be extracted from it. The process of organizing and thinking about data is key
to understanding what the data does and does not contain. There are a variety of ways inwhich
people can approach data analysis, and it is notoriously easy to manipulate data during the
analysis phase to push certain conclusions or agendas. For this reason, it is important to pay
attention when data analysis is presented, and to think critically about the data and the
conclusions which were drawn.

Raw data can take a variety of forms, including measurements, survey responses, and
observations. In its raw form, this information can be incredibly useful, but also
overwhelming. Over the course of the data analysis process, the raw data is ordered in a way
which will be useful. For example, survey results may be tallied, so that people can see at a
glance how many people answered the survey, and how people responded to specific
questions.

In the course of organizing the data, trends often emerge; modeling the data with the use of
mathematics and other tools can sometimes exaggerate such points of interest in the data,
making them easier for the researcher to see. Charts, graphs, and textual writeups of data are
all forms of data analysis. These methods are designed to refine and distill the data so that
readers can glean interesting information without needing to sort through all of the data on
their own.

46|Page
DataAnalysisprocess

Once the necessary data collected, the next task is to aggregate the data in a meaningful
manner. A number of tables are prepared to bring out the main characteristics of the data. The
researcher should have a well thought out framework for processing and analyzing data, and
this should be done prior to the collection.

Itincludesthefollowing activities:

I. Editing
The first task in data processing is the editing. Editing is the process of examining
errors and omissions in the collected data and making necessary corrections in the
same.

II. Coding
Coding is necessaryto carryout the subsequent operations of tabulating and analyzing
data. If coding is not done, it will not be possible to reduce a large number of
heterogeneous data into meaningful categories with the result that the analysis ofdata
would be weak and ineffective, and without proper focus.

III.Tabulation
Tabulation comprises sorting of the data into different categories and counting the
number of cases that belong to each category. This is also called universal tabulation.
The analysis based on just one variable is obviously meager. Where two or more
variables are involved in tabulation, it is called vicariate or multivariate tabulation.

IV. Analysis
Aftertheallthreeabovesteps,themostimportantstepisanalysisofthedata.

47|Page
 DETAIL ANALYSIS

OBJECTIVE1:NMBMoleculePracticedbyDoctors

Intheprocessofmarketsurvey,thefirstthingtodeterminewastofindouttheNeuromuscular Blocker
(NMB) preferred by the doctors in their clinical practice. Out of those visited, the information
has been collected and it has been noticed that though most of the Doctors preferred one or
more available NMB molecule.

Hence, in order to find out the actual figure for the preference of the available NMB, the
criteria has been set to find out the actual preference of the NMB by doctors.

This is done by maintaining the criteria for NMB preference by doctors, if the percentage of
consumption of the particular molecule is 50 % or more than only it is counted in the
following chart:

PreferenceofNMBinClinicalPractice

16%

19% Atracurium

65% Vecuronium

Rocuronium

Chart1:MostCommonlyPreferedNMBagentinClinicalPractice

48|Page
INFERENCE

 65% of doctors Preferred Atracurim than any other available molecule and their
percentageofconsumptionrangedabove50% to 90%,someofthemwere using100% only
Atracurium

 The 2nd and 3rd preference by doctors were consecutively Vecuronium and
Rocuronium, with 19% and 16% respectively

 Othermolecules,likePancuronium&Succinylcholinetoostandinthepreferredlistof
molecules but their percentage of consumption is too less to be considered in theabove
chart.

PreferenceofNMBinClinicalPractice (Mumbai Region)

21%
Atracurium
11%
Vecuronium
68%
Rocuronium

Chart2:PreferenceofNMBinClinicalPractice(MumbaiRegion)

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 PreferenceOfNMBinClinicalPractice
(PuneRegion)

9%

Atracurium
33%
58% Vecuronium

Rocuronium

Chart3:PreferenceofNMBinClinicalPractice(PuneRegion)

INFERENCE

 Fromtheabovechart,itisquiteobviousthatAtracuriumisthemostpreferred molecule in
both Pune & Mumbai Region.

 But,anotherfactnoticedhereisthatRocuroniumisthe2ndbestpreferredand consumed in
Mumbai, while it is Vecuronium in the case of Pune.

50|Page
 90%

80% 77%
74%

70%

60% 55%

50%

40%

30%
22% 23%
20% 16% 16%
10%
10% 7%

0%
Atracurium Vecuronium Rocuronium

<30%ofConsumption
30-60%of Consumption
>60%ofConsumption

Chart4:%ofDistribution%ofConsumptionofdifferentNMB
INFERENCE

 The above Chart gives the clear view of the actual percentage of consumption of each
molecule.
 As seen above, Atracurium is themost preferred as well as most consumed molecule
compared to Vecuronium & Rocuronium,
 55% of doctors have higher degree of consumption of Atracurium, i.e. - more than
60%. While in the case of both Vecuronium and Rocuronium, only less than 20% of
doctor’s consumption value ranges in the same category.
 Again, from the chart it can be easily determined that Vecuronium has edge over the
Rocuronium in terms of consumption which lies between 30-60%.
 Pancuronium is no more practiced in the GA procedures. Only one or two cases were
found where Pancuronium is still being practiced, but in very few cases.
 Apart from this, Succinylcholine is used in the most of GA procedures, but its use is
mostly restricted to the intubation cases or difficult airway cases.

51|Page
OBJECTIVE2:CharacteristicsdoctorspreferinanidealNMB

In the process of marketing survey, the most important task was to gather the information
regardingthe characteristicswhichdoctorsexpect inanidealNeuromuscular Blocker(NMB). For
this a set of characteristics was prepared and while interaction with doctors, they were asked
to number them in accordance to their preference which they consider most importantin the
NMB.

After the detailed analysis of the information collected, the following table has been tabulated
to form the facts desired:

Table1:PercentageofDoctorsandtheirPreference(MumbaiRegion)

PreferenceofCharacters-
ticsinan ideal NMB
1 2 3 4 5
Onsetof Action 35% 30% 13% 13% 9%
Durationof Action - 9% 17% 48% 26%
Safety 52% 39% 5% 4% -

RecoveryTime 9% 13% 52% 13% 13%

Potency 4% 9% 13% 22% 52%

With respect to above table it can be concluded that, in Mumbai doctors prefer the following
characteristics in an ideal NMB.

(Thelistgiven belowis inascendingorder)

1. Safety
2. OnsetOfAction
3. RecoveryTime
4. Durationof Action
5. Potency

52|Page
Table2:PercentageofDoctorsandtheirPreference(Pune Region)

PreferenceofCharacters-
ticsinanideal NMB
1 2 3 4 5
Onsetof Action 14% 36% 7% 29% 14%
Durationof Action 7% 29% 43% 14% 7%

Safety 79% 14% 7% - -

RecoveryTime - - 29% 50% 21%

Potency - 22% 14% 7% 57%

Withrespecttoabovetableitcanbeconcludedthat,inPunedoctorspreferthefollowing characteristics in
an ideal NMB.

(Thelistgiven belowis inascendingorder)

1. Safety
2. OnsetOfAction
3. Durationof Action
4. RecoveryTime
5. Potency

INFERENCE

 From the data collected, it can be easily figured out that Safety is the most important
characteristics that doctors seek in any molecule, while Potency is the least important
characteristics in the list.
 But, there is variation in the sequence of preference of the characteristics in an ideal
NMB in Mumbai and Pune area
 Consideringtheabovefactsnowthedataisfurthercompiledandanalyzedtogetareal picture
of the preference.

53|Page
Table3:Overall% ofDoctorsandtheir Preferenceof Characteristics

Preferenceof Characters-
ticsinanideal NMB
1 2 3 4 5
Onsetof Action 27% 32% 11% 19% 11%
Durationof Action 3% 16% 27% 35% 19%

Safety 62% 30% 5% 3% -

Recovery 5% 8% 44% 27% 16%

Potency 3% 13% 14% 16% 54%

With respect to above table it can be concluded that, doctors prefer the following character-
istics in an ideal NMB (the list given below is in ascending order):

1. Safety
2. OnsetOfAction
3. RecoveryTime
4. Durationof Action
5. Potency

On compilation of entire sample size, it is now clear that Safetyis the most important element
in the molecule which doctors values most, followed by Onset of action, Recovery Time,
Duration of Action and last Potency.

Out of the whole sample size, 62% of the sample space considers ‘Safety’ to be most ideal
characteristics in NMB.

54|Page
OBJECTIVE3:ParametersthatbestdescribestheNMBMolecule

The five characteristics that make a molecule an ideal NMB are: Safety, Onset of action,
Recovery time, Duration of action & Potency. Now, another task in the survey is out of these
characteristics which characteristics best describes the available NMB molecule.

For this, simple survey technique of multiple choices has been adapted and after the detailed
analysis of the collected data following output has been derived:

OnsetOf Action

Atracurium Pancuronium
6% 3%

Succinylcholine
Rocuronium
47%
44%

Chart5:BestpositioningofNMBwith'OnsetofAction'

55|Page
 DurationOfAction
Succinylcholine
3%

Pancuronium Rocuronium
22% 17%

Vecuronium
25% Atracurium
33%

Chart6:BestpositioningofNMBwith'DurationofAction'

RecoveryTime

Rocuronium
22% Succinylcholine
6%
Cisatracurium 5%

Atracurium
67%

Chart7:BestpositioningofNMBwith'RecoveryTime'

56|Page
 Safety

Rocuronium
19% Cisatracurium
11%

Vecuronium
28%
Atracurium
42%

Chart8:BestpositioningofNMBwith'Safety'

Potency

Pancuronium
8%
Vecuronium Atracurium
33% 14%

Rocuronium
42%

Succinylecholine
3%

57|Page
Chart9:BestpositioningofNMBwith'Potency'

58|Page
 70%

60%

50%

40%

30%
%of

20%

10%

0%
Atracurium Rocuroniu Vecuroniu Succinylch Pancuroni Cisatracuri
m m oline um um
OnsetofAction 6% 44% 0% 47% 3% 0%
DurationOfAction 33% 17% 25% 3% 22% 0%
RecoveryTime 67% 22% 0% 6% 0% 5%
Safety 42% 19% 28% 0% 0% 11%
Potency 14% 42% 33% 3% 8% 0%

Chart10:Overall%ofdoctorssupportingNMBwithitsbestattribute
INFERENCE

Fromthe abovechart thepositioningofthemolecules can beeasilyderived.

 While considering the Safetyaspect of NMB, 42% doctors consider Atracurium as the
safest NMB followed by Vecuronium & Rocuronium.
 47% of doctors are with Succinylcholine & 44% of doctors are with Rocuronium,
interms of onset of action.
 Intermsofrecoverytime,67%ofdoctorsconsiderAtracuriumthebestneuromuscular agent.
 Withthe42%ofdoctorssupportingRocuronium,itisconsideredthemostpotent NMB agent.
 Most interesting fact came in the study is that, before the launch of Cisatracurium- it
has positioned itself as the safe molecule and also holds a position with good recovery
time.

59|Page
OBJECTIVE4:PreferenceofNMBwithfollowing Parameters

Though preference of molecule in GA procedures has been determined earlier, it is evident to

findout whethertheuseofthatmoleculeisindependentofsurgerydurationornot.Hence, the
parameter has been set to find out the desired facts.

Allthesurgeryprocedurehasbeenclassifiedintothreeparts:

- <30 minutes
- 30 -60 minutes
- >60 minutes

In the process of survey, further remarks were collected from doctors for the use of the
molecule. Though no. of vials used for the single surgical procedure couldn’t be determined.

<30minutesSurgeryProcedure
Vecuronium
Succylincholine
3% 5%
Rocuronium
5%

Atracurium
87%

Chart11:PreferenceofNMBin<30minutesGAprocedures

 Atracuriumisthemostcommonlyusedmoleculeinlessthan<30minutessurgery procedure.
 Vecuroniumistheleastpreferredmoleculewiththeaboveparameters.
60|Page
61|Page
 30-60minutesSurgeyProcedure
Pancuronium

13%
Rocuronium
3%

Vecuronium Atracurium
26% 58%

Chart12:PreferenceofNMBin30-60minutesGAprocedures

>60minutesSurgery Procedure
Pancuronium 3%

Atracurium 32%
Rocuronium 39%

Vecuronium 26%

Chart13:PreferenceofNMBin>60minutesGAprocedures
62|Page
INFERENCE

 From the above chart, it is evident that 87% doctors prefer Atracurium in <30 minute
surgery while only 58% doctors prefer Atracurium in 30-60 min. surgery procedure.
 But, the percentage is quiet low in case of>60 minute surgery. Only 32% doctors
prefer Atracurium in long surgery procedure.
 The positioning of Rocuronium is best in terms of long surgery procedures with an
hour or more than that. 39% of doctors prefer Rocuronium over other molecule in >60
minute surgery procedures.
 Vecuronium is the second most preferred molecule in the 30-60 minutes surgery
procedure.
 Though Pancuronium is very less in clinical practice these days. But still 13% of
doctors prefer it in 30-60 minutes procedures.
 From the above facts, it is quite clear that choice of NMB in GA is also dependent of
the surgery duration.

RemarksSitedbyDoctors fortheirPreferenceofNMB

Succinylcholine

 Recoveryis complete&good

Pancuronium

 Longeracting

Rocuronium

 Duration
 Safe
 Betterrelaxant
 No repetition
 Longerdurationofaction

63|Page
 Atracurium

 ShortActing,Less recoverytime
 Shortduration&safe
 EarlyandeasyRecovery
 Nohistaminerelease
 Bestforkidney&liver dysfunction, renal disease
 Ultrashort acting&selfreversal
 Goodrelaxation& cardiostable
 Onlyshort actingmusclerelaxantavailable
 Noresidualblockade
 Recoveryisgood
 Altertheduration byusinginDIP
 Adaptablefor anyduration
 Canbeusedforintubation

Vecuronium

 Nocardiac effect
 Longerdurationofaction
 Intermediateacting
 Cardiostable&Potent NMBagent
 Topupsneeded aftersomereasonableperiod
 Potency& Safety

64|Page
OBJECTIVE5:UseofReversal Agent

Doctors use the reversal agent in all the cases, has been the common belief for years. Hence,in
order to determine the actual fact regarding this it is essential to directly interact with doctors
and collect the needful information. What has been basic motive behind using the reversal
agent?

Withallsuchquestions,aftertheanalysiscorrectfactand figurehasbeenderived:

NeedofReversalAgentinGAProcedures

21%
Yes No
79%

Chart14:DistributionofDoctorsthatpreferReversalAgent

65|Page
 100%
16% 16%
90% 24%

80%

70% 63%

60%
92%
50%
84% 84%
40% 76%

30%

20% 37%

10%
8%
0%
Atracurium Rocuronium Vecuronium#CisatracuriumSuccinylcholine

Yes NO
Chart15:DistributionofNMBAgentswiththeir%ofNeedofReversalAgent

Note: - In terms of Cisatracurium, most of the doctors resisted in providing opinions about it
since they weren’t using it. Hence, total sample size is only 16 in the case of Cisatracurium.
Out of which, 63% of doctors believed it don’t any reversal agent.

ReasonsfortheNeedofReversalAgentas mentionedby Doctors

 Thepatientshouldbereversedeventhoughitisaselfreversalagent,toruleout residual
blockade if any.
 Therehasbeencommonbeliefthat,reverseallpatients.
 Usedto be sureof reversal
 Hoffman’selimination
 Justasasafety, majorthoughnot mandatory
 Cannotavoid reversal

66|Page
Majorfindingsfromthe aboveanalysisand chart canbe concludedas:-

 79% of doctors have a belief that a patient must be reversed, even though if it is a self
reversal agent.
 Though, it is not true in the case of Succinylcholine, 92% don’t use anyreversal agent
with it.
 ComparedtoRocuronium& Vecuronium,Atracuriumhasbetter positioning asself
reversal agent as only76% of doctors use reversal if Atracurium has been used in GA.
 Rocuronium&Vecuroniumstandsatsimilarsituationhaving84%doctorsusing reversal
while used in GA.
 Mostimportantconceptintheanalysiscameoutas,Cisatracuriumisconsideredas self
reversal agent as likes of Succinylcholine.
 63%doctors believeitdoesn’t needanyreversal.

67|Page
OBJECTIVE6:DeterminationofIntubation&Maintenance NMB

In the process of marketing survey, it is essential to determine whether doctors prefer thesame
Neuromuscular Blocking Agent for intubation as well as in maintenance. The main purpose of
finding this is to know whether doctors use different combination of drugs in surgical
procedure. If yes, what possible combination they follow.

In thecourseof analysis, it came to noticethat not all thedoctors usedifferent combination of

molecule. Mostly, the surgeryis initiated byusing Succinylcholine in intubation and followed
by any other available NMB agent. The finding of analysis is as:

24%
DifferentNMB

76%
SameNMBAgent

0% 10%20%30%40%50%60%70%80%

%ofDoctorsUsingSameNMB

Chart16:PercentageofDoctorsusingsamerelaxantinGAprocedures

Since, percentage of doctors using the different NMB molecule in intubation andmaintenance
is very low but most of doctors still mix the molecule as per the patient norms. Mostly, it
depends on the type of surgery and the criticality of the case. Availability of moleculealso
influences the decision of using the sameNMBagent in intubation as well as in maintenance.

68|Page
DifferentCombinationofNMB whichdoctors prefer:

Succinylcholine  Atracurium/Vecuronium/Rocuronium/Pancuronium

Rocuronium  Atracurium

Atracurim  Vecuronium

Vecuronium  Atracurium

From the above facts & feedbacks collected in research process, it can be said mostly
Succinylcholine is used in intubation and continued byanyof the muscle relaxant available or
the muscle relaxant of their choice. But, as the above chart shows 76% doctors don’t mix the
molecules in surgery procedures. If Atracurium/Rocuronium is used in intubation than it is
followed by same molecule in maintenance. Only in few cases, Rocuronium is followed by
Atracurium & Atracurium is followed by Vecuronium

69|Page
OBJECTIVE7:MostVitalCharacteristicsofCisatracurium

One ofthemostimportantinformationneededtoconceptualize istodetermine,whatisthe most vital

characteristics of the Cisatracurium? The options for this question were:

a. Morepotent than available NMB agents

b. Less riskassociated withthe molecule
c. Veryless histamine releasethanAtracurium
d. AmongotherintermediateactingNMB, ithasslower onsetofaction

Among the choices, the doctors supported for the following choices which according to them
are vital characteristics of the molecule.

A. Onlya
B. Onlyb
C. Onlyc
D. Bothb&c
E. Allthethree(a, b&c)
F. Allthechoices(a,b, c &d)

MostVitalCharacteristicsofCisatracurium

47%

A
16% B
CDE
F

18%
13%
3%
3%

Chart17:DistributionofmostvitalcharacteristicsofCisatracurium

70|Page
OBJECTIVE8:IdealConditionforuseofCisatracurium

With the most vital characteristics of Cisatracurium known to us, thus it is evident to find out
the target market in which it would function smoothly. Hence, it is necessary to find out the
ideal condition for use of Cisatracurium. For this purpose, the GA procedure has been
segmented into three categories:

a. AlltheGAprocedureswithduration below30 min.

b. AlltheGAprocedures withduration between30-60 min
c. AlltheGAprocedures withabove60 min.

Though, given with only three choices most of the doctors considered Cisatracurium to be
used in all GA procedures. The final analyses of this research concluded with the following
findings:

A. Onlya
B. Onlyb
C. Botha &b
D. Bothb&c
E. Allof theGAprocedures (a, b &c)

ClinicaluseofCisatracuriuminGAProcedures

8%
11%
41% A
B
16% CD

E
24%

Chart18:DistributionofclinicalopinionaboutCisatracuriuminGAprocedures

71|Page
INFERENCE

Fromthechartabove,itcanbederivedthat:-

- 41%ofdoctorsoutoftotalsamplesize,thinks CisatracuriumcanbeusedinallGA procedures.

- 24%ofdoctorsfeelitwillbeusefulonlyinGAproceduresbelow30minutesof surgery
duration.
- Restallhasthemixopinionabout Cisatracurium.
- One of themajor findings, from the above analysisisthat majority of doctors feel itcan
be used in all the GA procedures.

Though, Cisatracurium is yet to be launched in India. Hence the initial opinion about the
molecule has positive response from doctors.Some of doctors consider that Cisatracurium is
more useful in Kidney disease patients. One of the other positioning characteristics of
Cisatracurium came in research process is that, few doctors has belief that Cisatracurium may
not require reversal agent as complete recovery is possible out of it.

72|Page
CHAPTER 5
Findings,Conclusion
And Suggestions

73|Page
 INTERPRETAION

Abbott Lab’s strength is in its differentiation. Its strength in differentiation comes from the
immense diversity of products the company offers that are considered innovative and unique
compared to products made by competitors. Abbott Labs produces pharmaceutical, medical,
and nutritional products. They are the leading innovators in anesthetics, and diabetes care.

Abbott’s financial performance is consistent with its mission, objectives, and organizational
environment. The company’s vision is “Always at the forefront, always first choice,” and the
company embraces the idea of “focusing on a culture of continuous improvement and a
dedication towards organizational excellence”. This includes the improvement of employees,
products, and the companyas a whole. Abbott’s greatest differentiator is in the diverse mix of
their business portfolio. Abbott’s broad line of products and the success of their employees is
what contribute to such high numbers, as well as the company’s ability to produce whatpeople
need throughout the world, medically, pharmaceutically, and nutritionally.

The industry is changing fast. To survive and to prosper involves managing drug pipelines –as
drugs come off patents they no longer bring in enough revenues and must be replaced quickly
by other drugs with durable patents. This means that the companies have to think ahead,
something that sounds easy but involves great risks. Huge sums must be invested in uncertain
in-house research and development and/or must go toward mergers and acquisitions with
other promising companies. Strategic alliances can be used to augment opportunities as well.
As companies develop their new pipelines, they must be mindful of changes caused by
regulations and deregulations in countries all over the globe. The global competitive
environment creates challenges and opportunities for the companies – with equal importance
for the communities in which they reside.

This research offers no new insights into what it takes to build a viable new product launchbut
it surely underlines two facts – that it is worth doing in Indian market and that it will involve
retaining and attracting more market share with financial boost that need to take sizeable
financial risks.

74|Page
 FINDINGSFROMTHERESEARCH

An important facet of research is “the analysis and positioning of available Neuromuscular

Blocker (NMB), and discuss opinion about the Cisatracurium before the launch in the Indian
market”. Cisatracurium has been available in International market for years, but the
availability of the new molecule in India solely depends on the Abbott Laboratories. Since,
Cisatracurium is licensed to use by Abbott Laboratories.

In terms of the new molecule Cisatracurium, Abbott holds monopoly in the market. But, it is
essential to study the detailed performance of available muscle relaxant in the market, in the
NMB category. This would determine the clinical positioning of Cisatracurium.

 From the research, it has been figured out that ‘Safety’ is the most important
characteristics that individual seek in a NMB agent.
 Atracurium has been in the top of the list in their clinical practice in any GA
procedures, followed by Rocuronium and Vecuronium. This creates a good market for
Cisatracurium, since most of the doctors consider it as one of the safest molecule inthe
NMB category.
 Apart from this, use of reversal agent in GA procedure has been very often orcommon.
Though, the main reason cited for the need to use reversal has been that,79% of
doctors believe the patient must be reversed.
 But, it is not true for all the molecules. In terms of Succinylcholine, 92% doctors
believe it doesn’t need any reversal, as it is considered as self- reversal agent. 63% of
doctors have similar belief about Cisatracurium, which gives it competitive advantage
over available NMB agents.
 While considering the distribution of GA procedures, it has been found that
Atracurium dominates the market share when it comes to below 30 minutes surgeryor
30 – 60 minutes surgery.
 But more than 60 minutes surgery is controlled by nearly equal market share of
Vecuronium, Rocuronium & Atracurium. Where, Rocuronium has edge over the other
two.
 From the above analysis it is evident that Atracurium is the most preferred moleculeby
doctors and also holds larger market share than other competitors.

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 CONCLUSION

The pharmaceutical industry currently represents a highly competitive environment.

Pharmaceutical companies have to operate in a highly regulated environment; the degree of
regulation to a significant extent depends on the country and type of the product. One of the
most important aspects of government regulation for pharmaceutical companies is price
regulation, and different countries have different policies on this issue. As the result of price
control, prices of the same products can significantly differ in different countries.

Abbott Laboratories has been enjoying the long run of its monotonous market in terms of its
product Sevorane. With the new product launch, Cisatracurium it wouldn’t be wrong to say
that company will enjoy the similar situation, if price being the competitive factor.

With the Atracurium occupying the maximum market shares in NMB category, it would be
easy to be replaced by Cisatracurium. Since, it is one of the 10 isomers of original molecule
atracurium besylate. Prior to its launch and clinical use Cisatracurium has been wellpositioned
as self reversal agent. Hence, it has good positioning in terms of need of reversal agent.
Cisatracurium being one of the safest molecule in the NMB category, it can pick up in the
market quiet well. As in the research it has been found that ‘safety’ is the most important
characteristics that doctor seek in an ideal NMB. Apart from this, majority of doctors has a
belief that it would be essential for all GA procedures.

Hence, it can be considered that the market condition and initial opinion about the product is
ideal for the launch of Cisatracurium.

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 SUGGETIONS
The main challenges for drug companies come from four areas. First, they must deal with
competition from within and without. Second, they must manage within a world of price
controls that dictate a wide range of prices from place to place. Third, companies must be
constantly on guard for patent violations and seek legal protection in new and growing global
markets. Finally, they must manage their product pipelines so that patent expirations do not
leave them without protection for their investment.

Lastly, in terms of Cisatracurium the market development is essential which would help the
company in creating increased market share. For this purpose Abbott India Ltd. should focus
on following:

 Cisatracurium being one of the 10 isomers of original molecule atracurium besylate; it

should be market as that way. Its advantages over Atracurium should be counted in its
marketing strategy.
 There is a need of self reversal agent in the NMB category, since the Succinylcholine
is only muscle relaxant available hence Cisatracurium should be positioned as self
reversal agent. Most of the individual alreadybelieve that it doesn’t need anyreversal.
 ‘Safety’ and ‘Onset of action’ are two most vital characteristics for an ideal NMB
which doctors prefer and Cisatracurium is considered to possess both characteristics.
Thus, it should be counted in the marketing strategy of the product.
 Cisatracurium is considered to perform better in Kidney & Renal patients. Thus, this
market should be targeted prior to expansion of any other area.
 Abbott Labs’ should launch it India with price being competitive. It will be the best
molecule available in market so if priced competitively it will be picked up like
anything.

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CHAPTER 6
Appendix &Bibliography

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 MarketingResearch(SampleQuestionnaire)

Objective:TounderstandtheNeuroMuscularBlocker(NMB)market&developthemedical
positioning for Cis-Atracurium

Name:Hospital
Name: E-mail:
PhNo.:
1. KindlymentiontheNMBsthat youusein yourclinicalpracticeandthe%ofGAproced- ures in
which they are used?
NMBMoleculeName Percentageof Consumption
Atracurium
Pancuronium
Vecuronium
Rocuronium
Succinylcholine

2. WhatarethecharacteristicsyouexpecttobeinanidealNeuromuscularBlocker(NMB)? Put the

numbering as per your preference.
Parameters Preference
Onsetofaction
Durationof action
Safety
Recoverytime
Potency

3. Amongthegivenparameters,whichparameteryouconsider,bestdefinesthebelowment- ioned
NMB? (Kindly mark only one molecule with [√ ], against each parameter)
Neuromuscular Onsetof Durationof Recovery
Safety Potency
BlockerAgents Action Action Time
Atracurium
Vecuronium
Rocuronium
Succinylcholine
Cisatracurium
Pancuronium

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4. Kindlymention thedosageprotocolyou followfor eachof thefollowingNMB agents.
Intubation Maintenance 1stmaintenance 2ndmaintenance
NMB
(mg/kg) (mg/kg) (Time in min) (Time in min)
Atracurium
Vecuronium
Rocuronium
Succinylcholine
Cisatracurium
Pancuronium

5. Underthefollowingparameters,whatis yourpreferenceoftheNMBmolecule?Mention the

quantity of the molecule used along with the reason for the choice.
Surgery NMBAgent QuantityUsedinsingleProcedure Reasonforthe
Duration Preference No.ofVials Strength Choice
<30
minutes

30-60
minutes
>60
minutes

6. Doyouneedtousethe‘Reversalagent’withthefollowingNMBmolecules? If yes,What is the

percentage of surgery procedure in which you have to use ‘reversal agent’?
Alsogivethe remarksforitsneedofuse.
ReversalAgent? What%ofProcedures?
NMBAgents Yes No
Remarksif any?
Atracurium
Vecuronium
Rocuronium
Succinylcholine
Cisatracurium
Pancuronium

7. Doyouusethesameagentforintubationandmaintenanceofneuromuscularblockade? If No,
what are the different combinations of NMBs that you use clinically?
Intubation NMB MaintenanceNMB %of procedures?

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8. Accordingto you,whichofthefollowingisthemostvitalcharacteristicofthe Cisatracu- rium?
a. Morepotent than available NMB agents
b. Less riskassociated withthe molecule
c. VeryLesshistaminereleasethan Atracurium
d. AmongotherintermediateactingNMB, ithasslower onsetof time

9. Consideringtheaboveadvantages,whichofthefollowingwillbetheidealconditionfor the use

of Cisatracurium?
a. AlltheGAprocedureswithdurationbelow30min
b. AlltheGAprocedures withdurationbetween 30–60 min
c. AlltheGAprocedureswithduration above60 min

Date:- Signature

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 Abbreviations
NMB:NeuroMuscularBlocker

GA:General Anaesthesia

R&D:Research and Development

ABT[NYSE]:ABBOTT[NewYorkStockExchange]

E.E.S.:ErythromycinEthylsuccinate

FTC: Federal Trade Commission

FDA:FoodandDrugAdministration

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 Bibliography

Reference Books

Marketing Management, Philip Kotler 14th Edition

ResearchMethodology,C.R.KothariSecondEdition

StrategicMarketingManagement,RichardM.S.Wilson,3rdEdition Medical

Journals

Clinical Literatures

Website References

 www.generalanaesthesia.info
 www.drugs.com
 www.wiki-meds.com
 www.druglib.com
 en.wikipedia.org
 www.abbott.co.in
 www.abbott.com

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