Wednesday, February 10, 2016

Putting Household Water Treatment Products to the Test

WHO’s new International Scheme to Evaluate Household Water Treatment (HWT) Technologies ensures that products used to treat water in homes are effective in protecting health.

Globally, an estimated 1.9 billion people rely on water supplies that are contaminated with faeces. This requires many to use household water treatment (HWT) technologies to help prevent disease and make water safe for drinking.

The global market for HWT products has now become flooded with products. From chlorination to filtration systems and solar disinfection, the options for purifying water are endless. Manufacturers claim their products make water safe for drinking, but in low-income countries, where many of these devices are essential, labs lack the capacity to verify these claims.

But, times are changing.

“The primary benefit from household water treatment is protecting health,” says WHO's Dr Batsi Majuru.

Now, the health benefits of HWT are increasingly recognized and the need for independent and rigorous evaluation is essential, adds Dr Majuru.

It is estimated that when used correctly and consistently, HWT and safe storage of water can reduce diarrhoeal diseases by as much as 45%, and save thousands of young children every year.

An international evaluation scheme

The International Scheme to Evaluate Household Water Treatment Technologies was established in 2014 to independently and consistently assess the performance of HWT products against WHO health-based criteria - an evaluation system similar to how pharmaceuticals and insecticide-treated bed nets are pre-qualified.

WHO International Scheme to Evaluate Household Water Treatment Technologies
Under the Scheme, a product can be evaluated if it is low-cost, appropriate for low-income settings, free standing and able to treat enough water to serve a limited number of individuals for a day. Products that meet these requirements are tested to see how well they remove microbiological contaminants, such as bacteria, viruses and protozoa, from drinking water. Product performance is classified based a 3 tiered system and those that achieve the highest removal of pathogens are given a 3-star rating.


Recently, WHO released the first round of results on 10 HWT technologies ranging from ultrafiltration to chemical disinfection and found 8 met performance targets. These products reach an estimated 60 countries and millions of users. Every year, WHO plans to test new technologies and release results to help countries like Ethiopia that are working to scale-up HWTselect the technologies that meet WHO performance criteria.

Improving regulation in Ethiopia

Ethiopia is often affected by droughts and floods, meaning that safe drinking water can be hard to come by and diarrhoeal diseases are common. To address the situation, the Government launched the ‘One WASH Programme’, which aims to achieve universal access to safe water, sanitation and hygiene, and improve safe storage and treatment practices in the household.

Prior to WHO’s scheme, many laboratories tried to evaluate HWT products, but there were no standard protocols or test processes. Now, the Ethiopian Food, Medicine and Health Care Administration Control Authority, which is mandated to test the safety of pharmaceuticals, food and beverages, is also mandated to regulate HWT products.

“Previously, we only conducted document reviews and chemical testing on chlorine-based HWT technologies being used in the country,” says Bikila Bayissa, Deputy Director General of Food & Medicines Quality Assessment, Ethiopian Food, Medicine and Health Care Administration & Control Authority. “Now, through WHO’s Scheme, we are also focusing on the microbiology, which is critical to ensuring drinking water is safe.”

WHO is working with the Government of Ethiopia to train staff from various government laboratories, ministries and regulatory bodies on how to do the microbiological testing to evaluate product performance, as well as implementing WHO Guidelines on Drinking-water Quality.

“Many HWT products are imported from other countries, but no one knows if they are good or bad,” says Dr Almaz Gonfa, coordinator, Food Microbiology and Food Safety Research Lab at Ethiopian Public Health Institute. “The WHO Scheme will help Ethiopians know the products they are using are actually cleaning their water and protecting their health.”

Scaling-up in more countries

Universal access to safe drinking water is called for in the Sustainable Development Goals. By strengthening protection and management of water supplies, including at the household level, WHO and governments are taking steps to achieve this goal.

This year, WHO is working with the Government of Ghana to develop HWT performance standards and a certification and product labeling system to aid users in making informed purchases. Once launched, the certification programme will support the Government’s National Strategy for Household Water Treatment and Safe Storage, aimed at reducing waterborne diseases by 2025.

“WHO’s scheme will help make sure the technologies in Ghana effectively clean water, are appropriate for local households and meet international standards,” says Kweku Quansah, programme officer, Ghanaian Ministry of Local Government & Rural Development.

“Once we pass technologies through the evaluation process, individuals will have the assurance that these technologies are internationally verified,” he adds.

Wednesday, February 3, 2016

Gliptin New Anti Diabetes Drug Cuts Treatment Cost by 80%

There's a new diabetes drug in the market which apparently cuts cost by 80%. We kid you not. This comes as good news for millions of diabetics tackling the debilitating disease.

By lowering the cost of therapy for patients by 80%, the new drug in the 'gliptin' family has disrupted the anti-diabetes market. With 15 companies offering offering the drugs, cost for a day's treatment is down from Rs 45 to an average daily price of Rs 9. This miracle drug could make life easier for the people tackling with the disease which gradually attacks and weakens all body organs.

The cost of gliptin treatment amounted to Rs 16,200 per year (at Rs 1,350 per month). With the entry of the new molecule and subsequently aggressive pricing by domestic companies over the past six months, the cost of therapy has dropped to approximately Rs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients. The new entrant teneligliptin is also the fastest selling in the Rs 1,430 crore gliptin family which occupies 20% of the total anti-diabetic market.


Diabetics in the country have something to cheer about. A new drug in the 'gliptin' family has disrupted the anti-diabetes market by lowering the cost of therapy for patients by 80%, making it easier for millions of diabetics to tackle the debilitating disease which gradually attacks and weakens all body organs.

With the launch of teneligliptin molecule, the popular gliptin category has witnessed a price erosion of over 80% in the last six months, bringing down the cost from 45 for a day's treatment to an average of 9, with over 15 companies now offering it.

Most gliptins are priced around 45 for a day's therapy, taking the cost of treatment for patients to nearly 16,500 a year ( 1,350 a month).

The entry of the new molecule and subsequent aggressive pricing has led to the cost of therapy coming down to approximately 3,285 a year (or 270 a month), translating into savings of roughly 1,300 crore for patients.

The new entrant teneligliptin is also the fastest selling in the 1,430 crore gliptin family, which occupies 20% of the anti-diabetic market.

Teneligliptin, a third-generation new oral anti-diabetic drug manufactured by Mumbai-based Glenmark, received regulatory approval and was priced aggressively at nearly 20 for a day's therapy when it was first launched in June last year.

The launch of Zita Plus and Ziten (teneligliptin brands) by Glenmark paved the way for the entry of a host of other players to launch the molecule in the oral diabetic market, which is valued around 6,000 crore.

As per AIOCD data (December 2015), there are 16 teneligliptin brands in the market, with total sale of 36 crore.

The economic burden of diabetes is high in India as most patients pay out-of-pocket, and due to lack of medical reimbursement.

Worse, the cost of treatment also includes consultation, investigations, drugs, monitoring, complications, while the complications related to the disease may increase it substantially.
Dr Anoop Misra, chairman Fortis-C-DOC Hospital for Diabetes says, "Low cost medications are surely needed in India, however, all of us look at safety data before prescribing any medication. For teneligliptin, safety data is not long term, and confined to patients from far eastern countries, hence confidence to prescribe this medication viz-a-viz other gliptins is lower."
With the entry of the new molecule, the cost of therapy has dropped to approximatelyRs 3,285 a year (at Rs 270 a month), translating into national savings of roughly Rs 1,300 crore for patients.

Price war breaks out among anti-diabetes drug Gliptin in Market

Teneligliptin, a drug to control diabetes, is in the middle of an intense price war. While Mankind Pharma reduced its price by 50 per cent within 24 hours of a launch, Glenmark is evaluating the option of decreasing the price. A week ago, Zydus Cadila, another prominent player, already launched the lowest-priced Teneligliptin.

India's Gliptin market, estimated at Rs 2,000 crore yearly, is growing at around 60 per cent annually. Of the 68 million diabetics in India, about 1.85 million are on the Gliptin therapy to manage their type-2 diabetes.

According to October data from the All-India Organisation of Chemists and Druggists (AIOCD), the country's anti-diabetic drug market is seeing a growth of 25 per cent at Rs 7,638 crore.

"We are evaluating the option of lowering the price of our two Teneligliptin brands (Ziten and Zita Plus) to get more patients in the advanced Gliptin therapy fold," says Sujesh Vasudevan, president and head of India Business, Glenmark Pharmaceuticals.

Glenmark had launched these two drugs earlier this year at Rs 20 a tablet, half the price of the medicine sold by many multinational drug firms. Last year, anti-diabetes drugs accounted for only Rs 100 crore to Glenmark's overall revenue of Rs 6,600 crore. While it is a dominant player in dermatology, the company is now planning to expand its product portfolio in other therapeutic areas like diabetes.

Mankind Pharma, which launched its own Teneligliptin generic 'Dynaglipt' on November 23 at Rs 20 a tablet, decreased the drug's price a day later to Rs 8.60 a tablet.

"Diabetes is a growing epidemic; to cater to it, we are targeting the middle-class and rural diabetic patients, so that it becomes affordable and more economical. The change in prices will help reduce the cost of medicines by about half," said R C Juneja, chairman & founder, Mankind Pharma. The company is targeting at least Rs 200 crore in annual revenue from this drug.

Zydus Cadila, which launched its own generic drug 'Tenglyn' at Rs 7 a tablet a week ago, has no immediate plans to reduce the price further, according to a senior company executive.

"Considering the incidence of the disease, benefits of the drug, and price, Gliptin could become a large-volume drug and face further price erosion as volumes grow," says D G Shah, secretary-general, Indian Pharmaceutical Alliance (IPA).

The Organisation of Pharmaceutical Producers of India, representing multinational companies, refused to comment on the subject.

INTERPRETER OF REMEDIES

Glenmark to reduce teneligliptin prices (Rs 20 per tablet at present)

Mankind & Zydus Cadila have priced these below Rs 10 a tablet

Teneligliptin is a drug of gliptin category that has shown significant results in controlling blood sugar in type-2 diabetics