Ajit Mahadevan, Partner, Ernst and Young, says, “When we say alternative medicines it may be any of the following line of treatments emanating from ayurveda, homoeopathy, unani, siddha, naturopathy and yoga. If we look at the evolution of this system, till 1950s it was spearheaded by vaidyas, the second stage was phased by the government bodies in India, and lately, the third phase is being led by biotech pharmaceutical companies in the global healthcare industry. Historical evidences point to the fact that during the cholera epidemic of early 20th century, ayurveda had successfully treated patients in different regions without forced mass quarantine.” He adds, “It’s believed to be practiced since ages and people perceive it with a positive notion for alternative treatment therapy rather than solely believing on allopathy.” However, he also points out that while modern therapies often are not affordable for people who fall below the average income levels in India, ayurveda poses a challenge due to inaccessibility and availability of certain herbs. AYUSH, a key organisation developed by government, supports the framework of integrated medicine in India, comprising a total number of c9,228 companies (mostly micro and small, 2010 data), with a turnover of Rs 88 billion (2010 data) and total export of Rs 10 billion (2010 data). The ayurvedic drug market size is c$65billion globally, with neutraceuticals amounting to c$100 billion, where the Indian share is c$1billion.”
Dr Manu Chaudhary Jt. Mng. Director & Director – Research, Venus Remedies |
According to Dr Manu Chaudhary, Joint Managing Director and Director-Research, Venus Remedies, use of integrative medicine appears to be increasing, especially among persons with chronic illnesses. Little data is available on the Indian market size but US had a market size of $ 45 billion in 2009 and is estimated to grow at 20 per cent per annum.
Awareness is an issue?
Lack of awareness could well be the basic reason behind lesser penetration of integrated medicines in the Indian market. People in India have been using ayurveda for ages and yet the market for integrated medicine in India is struggling to make its point. Industry experts believe that if more serious research is done in this segment then it will only add to its acceptability among masses.
Although modern medicine has made a huge contribution in bringing high quality healthcare to millions worldwide, there are still areas such as neurological conditions, where it does not have many answers.
Dr Gunvant Oswal Founder, Centre for Life Sciences, Health and Medicines (CLSHM) |
Pune-based Centre for Life Sciences, Health and Medicines (CLSHM), is one of the largest integrated medicine centres which work on neurological disorders. Dr Gunvant Oswal, Founder, CLSHM, says, “We have come out with a drug, Neuro G (previously known as G Therapy), which is an excellent example of integrated medicine to better the life of patients suffering from neurological conditions. Integrative medicine, which combines modern medicine with alternative approaches such as ayurveda and homeopathy hold a lot of promise. Today, integrative medicine is increasingly becoming popular. The world is accepting this form of medicine.” He adds, “We know that countries in the West, in their medical schools have research in ayurveda, Chinese medicine, etc. I feel the awareness has increased many folds. In India, the need of the hour is to continue research in integrative medicine, so that the benefits of traditional healing substances and methods can be subject to scientific scrutiny, and newer applications for traditional healing can be explored. We are approaching pharma companies who could come ahead to do clinical trials for Neuro G, a drug which has till date treated more than 20,000 patients worldwide.”
Market drivers
Ajit Mahadevan Partner, Ernst & Young |
According to Mahadevan, the traditional forms of medicine have been in practice over ages in India and the country also has a strong manufacturing base. Burgeoning global demands are bound to propel the growth of integrated medicine market. They also have good export potential. Medical tourism in India would further drive the growth of integrated medicine market in India. Moreover, strong thrust on promotion of this sector by Government of India would ensure that this medicine system consolidates its place in the Indian market.
No single system of medicine provides a holistic approach to the wellness of human beings. Modern systems of medicine have their own limitations in causing side effects. Need for safer, efficient medicine system would drive the growth of integrated medicine market in India, feels, Dr Manu.
Dr R B Smarta Managing Director, Interlink Marketing Consultancy |
Dr R B Smarta, Managing Director, Interlink Marketing Consultancy, points out that, education and awareness, consistent health consciousness, fear of falling sick and incurring more cost of sickness, as well as increasing purchasing power would decide the growth of integrated medicine market in India.
Dr Manu informs, “At present there is no separate governing body for integrated medicine in India, as different systems of medicine have their own governing council/body. There are few educational institutions and organisations such as IIM Jammu, which are imparting training and awareness programmes for integrated medicine. There is a need to explore this field and take more initiatives to establish this medicine system.”
The global scenario
In the global arena, alternative medicines have increased their presence in a consistent manner. World market for alternative medicine is experiencing a robust growth triggered by growing demand for nature-based products and a belief that herbal products cause minimal side effects when compared to modern medicines. “Global traditional medicine market to reach $114 billion by 2015, according to a new report published by Global Industry Analysts,” informs Mahadevan. He adds, “Complementary and alternative medicine currently provide healthcare to about 75 per cent of the population in developing nations and over 50 per cent of the population in the developed world for lifestyle-related diseases such as diabetes and hypertension. In 2011, the market for alternative medicines in the UK was estimated at nearly $340 million, with one in five adults thought to be consumers and some treatments such as homeopathy available from National Health Service (Source: The Economist). In the UAE, demand for alternative medicine is bound to increase due to the affluent market structure, say local experts.”
According to Mahadevan, from May 1, 2012; sales of ayurvedic drugs and other herbal medicines have been banned across European Union (EU), owing to a growing concern over adverse effects of such medicines. Ayurvedic products marketed before the legislation came into force in 2004 were allowed to to market their product until April 30, 2011, under the transitional measures. After this time limit, all herbal medicinal products must have prior authorisation before they can be marketed in the EU.
Despite these measures, the use of alternate medicines are on the rise. Dr Manu agrees with the fact that world over the penetration of integrated medicine is increasing at a fast pace.
She asserts, “The metaphor of pharmaceuticalisation of herbal medicine system in the recent decades, by standardising herbal diagnostic and treatment protocols by in situ studies, documenting clinical practices and using modern techniques, is faster than ever.” One wing of Venus Medicine Research Centre (VMRC) is involved in the research on integrated medicine. Company is working on wound management and skin care segment and stress relieving, detoxifying products wherein they have developed a novel formulation of herbs using modern techniques and have generated enough scientific knowledge at par with international requirements.
While countries like India and China have long age-old traditions of alternative medicine systems, in recent years the West is also growing up to the benefits of integrative medicine. Oswal informs, “In the US, 38 per cent of adults and 12 per cent of children use alternative medicine according to the National Institutes of Health estimates. 40 per cent of French have been treated with homeopathy according to another estimate.”
Dr N P Dubey President, World Association of Integrated Medicines |
According to Dr N P Dubey, President, World Association of Integrated Medicines, the Traditional Chinese Medicine (TCM) is the most popular system in the name of integrated medicine. Most of the developed countries like US and Australia, where the modern medicine is the official system, they have also used integrated medicine to certain extent. In most of the developed countries it is known as complementary medicine while developing countries address it as alternative medicine.
Future dilemma
With the growing number of diseases, new medicines have also been getting introduced in the domestic and the global market. However, allopathy remains the first line of treatment in majority of the cases globally. Unfortunately, modern medicines couldn’t ever do away with their ‘side effect’ tag. This tendency of modern medicines has propelled the use of traditional medicines to a great extent. Yet, the market penetration of integrated medicines still remains less in India and in the overseas market. However, it is an undeniable fact that a combination of traditional and modern medicine can do wonders.
“It is true that doctors are beginning to recommend alternative (herbal) remedies to their patients when modern drugs do not work or because herbal medicines have fewer side effects, are less toxic and habit forming, in contrast to allopathic medicine, where toxic side effects may sometimes lead to serious sequels, sometimes death. In contrast, there is a growing evidence which shows that ingredients of medicinal plants act synergistically and that suitable combinations neutralise side effects. There is a need for mass awareness campaigns to educate society that herbs can also be developed as per latest standards of medicines and hence integrated medicines can be the drug of choice for masses,” opines Dr Manu. She adds, “The integrative medicine approach recently re-emerged with the hope of providing an affordable practical resolution to the global healthcare crisis. Many countries like Norway (Tromsø), Sweden (Karolinska), Australia, China and also countries in the Asian, African, European and Latin American regions have integrated medicines initiatives. Generally, it involves the interplay between various systems of medicine and therapies including allopathy and complimentary and alternate medicines (CAM). With shift of developed countries to integrated medicine system, the future prospects are bright.”
According to Mahadevan, many successful pharma drugs were originally made from plants and herbal medicines are regulated by FDA, but in the US herbs and extracts are sold as supplements (neutraceuticals) irrespective of lesser toxicity levels and side effects compared to synthesised chemical molecules used for conventional therapies. He signs off, “More often, herbal extracts or alternative medications are used for cosmetic purposes rather than for curative purposes. Though there is already a market for alternative therapies in the West, the regulatory challenges and weaker support from government to promote them as a second line therapy will remain key hurdles for the medium in the long term.”