Analysis of the drug market. Review of the pharmaceutical production market. Russian drug market

A marketing study of the market of sedative drugs (MP) has been carried out. The results of the content analysis showed that 96 OTC sedative drugs are registered on the Russian pharmaceutical market. The structure of sedative drugs by countries of origin, origin, forms of release was studied. The coefficients of completeness of the assortment of sedative drugs were calculated and their main suppliers in the regional pharmaceutical market were identified. The average prices for sedative drugs were determined. The main factors of competitiveness of OTC sedative drugs have been established.

medications

over-the-counter

pharmaceutical market

content analysis

sedative effect

range

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The modern pharmaceutical market in Russia is characterized by the steady growth of the product range. Over the past decade, there has been a significant expansion, replenishment and deepening of the range of all major groups of medical and pharmaceutical products. This trend is especially pronounced for drugs (MP). The increase in the product range is largely due to the registration on the Russian pharmaceutical market of a large number of generic drugs - generics of foreign and domestic manufacturers. This significantly increased the possibility of choosing the necessary drugs, taking into account modern approaches to the pharmacotherapy of various pathological conditions, individual characteristics of the course of diseases, consumer preferences of end users.

For pharmaceutical workers organizing drug supply to the population and medical organizations, the actual problem is the formation of a rational assortment policy that contributes both to meeting the needs of consumers and strengthening the market position of a pharmaceutical organization.

For this purpose, a study of the regional market of sedative drugs dispensed from pharmacies without a doctor's prescription was carried out. The objects of the study were: 79 pharmacy organizations of the Southern (cities of Volgograd and Rostov-on-Don) and North Caucasian (cities of the Caucasian Mineralnye Vody(KMV): Essentuki, Zheleznovodsk, Kislovodsk, Pyatigorsk) federal districts.

In the block of marketing researches of OTC sedative drugs (ORC), the main direction was the study of the assortment, consumer properties and competitiveness of drugs. Preliminarily, with the help of content analysis, which is a formalized method of quantitative analysis of documents (special literature, price lists, invoices, invoices, etc.), an assortment of sedative drugs BRO was analyzed.

The analysis showed that the pharmaceutical market of OTC sedative drugs in Russia is represented by 96 items, including 57 items (59.4%) - domestic production; 39 items (40.6 %) are imported (Table 1).

As follows from the data in Table. 1, the OTC sedative drug market is represented by 12 manufacturing countries. The leaders in the supply of drugs of this group in Russia are: the Russian Federation - 59.4%, Germany - 17.7%, Slovenia - 7.3%.

Table 1. The structure of the number of sedative drugs by manufacturing countries in the Russian pharmaceutical market

It should be noted that out of 96 names of sedative drugs BRO - 10 of synthetic origin, 71 - of plant origin, 15 - homeopathic drugs (Table 2).

Among the sedative drugs, the largest share is made up of herbal preparations containing valerian officinalis - 29 items (30.2%).

Sedative drugs BRO are produced in various dosage forms. A number of trade names of drugs with sedative action are produced simultaneously in 2-3 types of dosage forms. The largest share in the total nomenclature is occupied by solid dosage forms: tablets (90.6%), dragees, powders (33.3%), followed by drops (26.0%) and solutions for internal use (14.6%).

The main Russian manufacturers of OTC sedative drugs are Moscow Pharmaceutical Factory, Tver Pharmaceutical Factory, YuKOlab, Borisov Medical Industry Plant and ICN, which produce herbal medicines at a fairly low cost, which attracts regular customers.

Table 2. Quantification of OTC sedative drugs

A small part of the market for sedative drugs is occupied by homeopathic medicines. In recent years, the possibility of using homeopathic preparations (HP) has increased due to the creation of laboratory-developed complexes that allow obtaining a rapid therapeutic effect.

The main producer of HP is Russia, which produces 60% of homeopathic medicines presented on the domestic pharmaceutical market. In second place in the production of sedative GPs is Germany, which supplies Russia with 20% of the names of homeopathic medicines.

The range of OTC sedative drugs on the regional pharmaceutical market of the Stavropol Territory is much smaller than the list of this group of drugs officially registered in Russia. The product range, or rather its completeness, is of great socio-economic importance, since its quality determines the completeness of satisfaction of consumer demand. A narrow assortment can be one of the factors hindering the process of meeting the individual needs of each consumer. Determining the optimal assortment is a key moment in the economic activity of each pharmacy organization and allows to ensure its maximum economic efficiency. For the marketing characteristics of the assortment, the completeness coefficient was calculated, which is calculated as the ratio of the number of assortment positions of medicinal products with a sedative effect and available on the pharmaceutical market (actual completeness) to the number of medicinal products registered in Russia with a sedative (basic completeness):

P bases for sedative drugs BRO is 96 items.

Determined that highest value the coefficient of completeness was observed in the pharmacies of the CMS - 0.849 or 84.9%, followed by the coefficient of completeness in the pharmacies of Volgograd - 0.642 or 64.2%%, the lowest coefficient of completeness in the pharmacies of the city of Rostov-on-Don - 0.509 or 50.9% . The calculated coefficients show that only in the pharmacies of the cities of the Caucasian Mineralnye Vody there is a sufficient amount of sedative drugs without a prescription.

The main supplier of sedative drugs to the subjects of the Southern and North Caucasian Federal Districts are Protek CJSC, SIA International CJSC, Donskoy Hospital LLC, Apteka-Holding CJSC, Pharma-Sphere LLC, Armavir pharmacy base .

As shown by the analysis of retail prices of OTC sedative drugs in pharmacy organizations, there is a significant variation in prices for the same name (Table 3).

When dividing the entire range of OTC sedative drugs into groups, it was found that 47.4%, that is, almost half, have a cost of up to 50 rubles; 21.1 % - from 51 to 100 rubles; 17.5 % - from 101 to 200 rubles. and over 201 rubles. - 14.0 %. This enables low-income consumers to freely purchase sedative drugs from the pharmacy.

Imported analogues are distinguished by a higher quality of the drug substance due to a more technologically advanced production process, as well as a more convenient dosage form (for example, capsules, effervescent tablets) and high bioavailability.

The range of over-the-counter sedative drugs includes both monocomponent (21 items - 21.9%) and combined drugs (75 items - 78.1%).

Based on the marketing analysis, we have built an assortment macrocontour of OTC sedative drugs (figure).

Table 3 Average prices for selected over-the-counter sedative drugs in the cities of Caucasian Mineralnye Vody, Rostov-on-Don and Volgograd

The figure shows that the pharmaceutical market of Russia mainly contains sedative drugs of domestic production - 59.4%; combined composition - 78.1%, plant origin - 73.9%, including those containing valerian officinalis - 30.2%; solid dosage forms - 33.3% , including tablets - 90.6%. Consequently, the domestic pharmaceutical market offers the target segment of consumers a significant range of OTC sedative drugs.

It should be noted that a rationally formed assortment, taking into account the competitiveness of the goods, determines the quality of meeting consumer demand. Competitiveness factors include the quality of the product (drug) and its compliance with demand; cost price; design and promotional activities; forms of product promotion and customer service.

Assortment macrocontour of the Russian pharmaceutical market of OTC sedative drugs

For medicines, the most important factors for competitiveness are:

Therapeutic efficacy and safety of drugs (no side effects, adverse effects of treatment);

Cost indicator (price);

Rationality of the dosage form, dosage, packaging;

Medicinal products as a commodity have a number of features. One of these features is that the demand for them is formed by both the buyers themselves and the doctors. Therefore, the assessment of the main indicators of competitiveness should be carried out in the form of a survey of both doctors and consumers themselves.

When assessing the competitiveness of drugs, it is necessary to take into account the presence of drugs containing the same active ingredients from different manufacturers. To do this, it is advisable to conduct a marketing analysis of preferences for such indicators as a comparative analysis of the therapeutic efficacy of drugs, the severity of side effects, the form of release, dosage, method of application, etc.

Thus, the analysis of individual indicators of the competitiveness of medicines makes it possible to single out their assortment with the best consumer and lowest cost characteristics (with the same consumer, that is, qualitative characteristics), and to form the optimal assortment of BRO sedative drugs in a pharmacy organization to best meet the needs of customers .

Reviewers:

Molchanov G.I., Doctor of Pharmacy, Professor of the Department of Economics and Management of the Pyatigorsk branch of the Russian State University of Trade and Economics, Pyatigorsk;

Bat N.M., Doctor of Pharmacy, Professor of the Department of Pharmacy, State Educational Institution of Higher Professional Education "Kuban State Medical University of the Ministry of Health and Social Development of Russia", Krasnodar.

The work was received by the editors on 09/05/2011.

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Marketing analysis of the market of antihistamine drugs

Introduction

antihistamine drug marketing sale

Topic: "Marketing analysis of the market of antihistamine drugs"

The relevance of the study of the thesis

Allergy is one of global problems public health. According to experts, currently 40% of the world's population is diagnosed with one or more allergic diseases. Russia, unfortunately, is no exception, and the market for antiallergic drugs continues to grow.

The increase in the prevalence of allergic diseases is due to several reasons. First, the worsening of the epidemic situation led to human contact with strong allergens of pathogens, which competitively inhibited the reaction to predominantly weak environmental allergens. Secondly, the widespread use of various vaccines, sera and other substances of an antigenic nature leads to an increase in cases of sensitization of the body. Thirdly, the emergence of many new chemicals, including those not found in nature, can also cause an inadequate response of the body in the form of an allergic reaction. These substances also include drugs, the intake of which not only becomes uncontrolled, but also causes a change in the body's reactivity. Naturally, many natural factors (pollen, dust, food products, infectious agents, etc.) retain their importance as allergens.

The combination of all the above factors leads to a rapidly growing morbidity, an increase in disability and mortality, and significant economic costs for the treatment and prevention of allergic diseases. That is why allergic diseases in countries with a high level of industrial development and urbanization are a serious social and medical problem.

Antihistamines are one of the widely used groups of drugs, due to a significant increase in the number of allergic diseases among both adults and children.

Demand for antihistamines is somewhat seasonal, rising in spring and summer. The structure of consumption of this group of drugs is formed largely under the influence of medical prescription, which is primarily due to the specificity of the allergic diseases themselves (the impossibility of a pharmacotherapeutic effect on the cause) and the belonging of almost all antihistamines to prescription drugs.

Based on this, the aim is to investigate the market for antihistamines.

The object is the market of antihistamines

The subject of the study are antihistamines

Explore the range of antihistamine drugs

Research the market for the consumption of antihistamine drugs

Analyze sales of antihistamines

Identify the most popular antihistamines

Chapter 1. Theoretical basis research

1.1 History of antihistamines

The history of the creation of these drugs began in 1910, when DaleHallett (Henry Hallett Dale) discovered histamine, one of the main mediators of allergic diseases. It is secreted by mast cells and basophils. It has been shown that histamine is involved in the development of almost all symptoms of urticaria, angioedema, allergic rhinitis and anaphylaxis. The first antihistamines were synthesized by French scientists A. Staub and D. Bouvet, who worked at the Pasteur Institute in Paris, in 1937. Scientists have shown that these compounds reduce the severity of anaphylaxis in animals. However, the use of these compounds in patients turned out to be impossible due to high toxicity. In the early 40s of the XX century, the famous French scientist H. Halpern introduced into clinical practice phenbenzamine (antergan), and then pyrilamine (neo-antergan), which belongs to the first generation of AP. In the 1980s, second-generation APs were synthesized. Currently, more than 40 representatives of this class of compounds are known. Over the past few years, the question of the existence of a third-generation AP has been discussed. They tried to attribute metabolites and stereoisomers of modern antihistamines to these drugs. Antihistamines are substances that inhibit the action of free histamine. When an allergen enters the body, histamine is released from the mast cells of the connective tissue that are part of the body's immune system. It begins to interact with specific receptors and cause itching, swelling, rashes and other allergic manifestations. Antihistamines are responsible for blocking these receptors. There are three generations of these drugs.

1.2 Allergy

Allergy is one of the most common diseases in the world. According to statistics, today every fifth inhabitant of the planet suffers from it. Allergic diseases are very common and, according to World Organization health care, cover about 40% of the population the globe. The role of allergens can be played by a variety of substances, both biogenic and man-made nature.

The prevalence of allergic diseases and asthma is progressing, despite the fact that the consumption of antiallergic drugs has increased significantly over the past decade.

An allergy is an increased sensitivity to various substances (allergens) that (in similar amounts) do not cause noticeable reactions in healthy people.

In the middle of the 16th century, one of the English bishops fell seriously ill. The doctor Geralomo Cardano (1501-1576), who was invited from Italy, determined that the bishop had bronchial asthma. The treatment was a strict diet and physical exercise. But, in addition, the doctor strongly recommended replacing the downy feather bed on which the bishop slept with a cloth bedding. The patient has recovered! It was a brilliant guess by a Renaissance physician. We know that millions of people sleep on feather beds and this does not affect their health in any way. However, for some, down or pet hair causes an unusual reaction in the body, which is called an allergy.

The term "allergy" was coined by the Viennese pediatrician Clemens von Pirke in 1906. He noticed that in some of his patients the observed symptoms could be caused by certain substances (allergens) from the environment, such as dust, plant pollen, or certain types of food.

Clinical and epidemiological studies conducted over the past decades have shown a high prevalence of allergic diseases (AD) in various regions of our country: from 15 to 35%.

Genetic factors play an important role in the development of AD. They determine the constitutional features, race and gender, as well as the individual characteristics of the physiology of organs and tissues and the formation of an immunological response to an allergen. However, it is difficult to assume that in such a short period of time (several decades) serious genetic mutations have occurred that explain the high rate of increase in the incidence of AD. That is why all studies were aimed at studying environmental factors that, to one degree or another, could be involved in the allergy epidemic. There are a number of exogenous factors contributing to the realization of a genetic predisposition to AD. The increase in the prevalence of AD is influenced by ecological problems megacities associated with air pollution from exhaust gases and industrial waste; a huge number of manufactured pharmacological agents and their availability; changing habits and eating habits, which is more typical for large cities; increase in stress loads; an increase in the number of infectious-inflammatory, cardiovascular, endocrine and other diseases.

The upward trend in incidence is characteristic of all allergic pathology. However, there are a number of ADs that rank first in terms of prevalence or severity of clinical manifestations and require large financial costs for treatment.

Bronchial asthma (BA) is one of the most common chronic diseases. Around 300 million people worldwide suffer from asthma (GINA, 2006), and its prevalence varies from 1 to 18%. Over the past 20 years in industrialized countries, the prevalence of asthma in children and adolescents has increased by 3-4 times and is 0-30%. In Russia, BA is the most common AD (the incidence of BA varies from 2.6 to 20%). According to epidemiological studies, there are about 7 million patients with asthma in Russia, of which only 1.4 million are registered.

Allergic rhinitis (AR) is also widespread and often accompanies or precedes the development of asthma. Symptoms of AR are observed in 88% of patients with asthma. In the world, AR affects about 10-25% of the population. The incidence of AR in Russia reaches 12.7-24%. The highest prevalence of AR was noted in ecologically unfavorable areas (in the population exposed to chemical or radiation factors, AR occupies more than 50% in the structure of allergopathology); the percentage of cases of a combination of AR and conjunctivitis (rhinoconjunctivitis) is high.

Drug allergy (LA) is one of the most complex and severe manifestations of allergy. According to domestic and foreign studies, the prevalence of LA is 1-30%. According to the State Research Center "Institute of Immunology of the Federal Medical and Biological Agency of Russia", LA in the structure of all allergic pathology among outpatients is more than 5%. Most often it is a response to antibacterial drugs, non-steroidal anti-inflammatory drugs, non-narcotic analgesics. Lethal outcome in LA is mainly associated with the development of such severe conditions like anaphylactic shock (AS) and Lyell's syndrome. Allergic reactions to latex are quite rare, but their prevalence among healthcare workers ranges from 5 to 22%. General principles treatment of AD are presented in Table 1. 1.

Table 1.1. General principles for the treatment of allergies

Exposure levels Treatment methods Allergen contact Elimination of contact with the allergen (for example, stopping contact with pets and creating a hypoallergenic life for household and epidermal allergies, elimination diets for food allergies, eliminating occupational contact with the causative allergen, etc.) Pathogenic immune response Allergen-specific immunotherapy (specific hyposensitization), immunosuppressive treatment, immunomodulatory treatment Inhibition of the release of allergic mediators Mast cell membrane stabilizers Suppression of allergic inflammation Glucocorticoids Influence on receptors H blockers 1-histamine receptors Antihistamines (sedative and non-sedative) Leukotriene receptor antagonists Leukotriene antagonists, lipoxygenase inhibitors Specific treatment at the level of the affected organ Bronchodilators, secretolytics, skin treatment, restoration of impaired barrier function of the skin and mucous membranes, etc. Psycho-emotional sphere Psychotherapy, antidepressants, psychosomatic recommendations

The most common dosage forms of drugs for the treatment of allergies: tablets, syrups, solutions for internal use, solutions for parenteral administration, as well as dosage forms for external use: ointments, gels.

Among these drugs, a significant part of the pharmacy assortment is occupied by antihistamines. There are several generations 1- blockers. With each generation, the number and strength of side effects decreases, the duration of action increases. Third generation drugs are active metabolites of second generation drugs.

3 Classification of antihistamines

There are several classifications of antihistamines, although none of them is generally accepted. According to one of the most popular classifications, antihistamines are divided into first and second generation drugs according to the time of creation. First-generation drugs are also called sedatives (according to the dominant side effect), in contrast to non-sedative second-generation drugs. At present, it is customary to single out the third generation: it includes fundamentally new drugs - active metabolites that, in addition to the highest antihistamine activity, exhibit the absence of a sedative effect and the cardiotoxic effect characteristic of second-generation drugs (see Table 1.2).

In addition, according to the chemical structure (depending on the X-bond), antihistamines are divided into several groups (ethanolamines, ethylenediamines, alkylamines, derivatives of alphacarboline, quinuclidine, phenothiazine, piperazine and piperidine).

First generation antihistamines (sedatives).

All of them are well soluble in fats and, in addition to H1-histamine, also block cholinergic, muscarinic and serotonin receptors. Being competitive blockers, they reversibly bind to H1 receptors, which leads to the use of rather high doses. Although all of these drugs quickly (usually within 15-30 minutes) alleviate allergy symptoms, most of them have a pronounced sedative effect and can cause unwanted reactions at recommended doses, as well as interact with other drugs. The following pharmacological properties are most characteristic of them.

· The sedative effect is determined by the fact that most of the first-generation antihistamines, being easily dissolved in lipids, penetrate well through the blood-brain barrier and bind to the H1 receptors of the brain. Perhaps their sedative effect consists of blocking the central serotonin and acetylcholine receptors. The degree of manifestation of the sedative effect of the first generation varies in different drugs and in different patients from moderate to severe and increases when combined with alcohol and psychotropic drugs. Some of them are used as sleeping pills (doxylamine). Rarely, instead of sedation, psychomotor agitation occurs (more often in medium therapeutic doses in children and in high toxic doses in adults). Due to the sedative effect, most drugs should not be used during tasks that require attention.

· The anxiolytic effect characteristic of hydroxyzine may be due to the suppression of activity in certain areas of the subcortical region of the central nervous system.

· Atropine-like reactions associated with the anticholinergic properties of drugs are most characteristic of ethanolamines and ethylenediamines. Manifested by dry mouth and nasopharynx, urinary retention, constipation, tachycardia and visual impairment. These properties ensure the effectiveness of the discussed remedies in non-allergic rhinitis. At the same time, they can increase obstruction when bronchial asthma(due to an increase in sputum viscosity), cause an exacerbation of glaucoma and lead to infravesical obstruction in prostate adenoma, etc.

· The antiemetic and antiswaying effects are also probably associated with the central anticholinergic effect of the drugs. Some antihistamines (diphenhydramine, promethazine, cyclizine, meclizine) reduce the stimulation of vestibular receptors and inhibit the function of the labyrinth, and therefore can be used for motion sickness.

· A number of H1-histamine blockers reduce the symptoms of parkinsonism, which is due to the central inhibition of the effects of acetylcholine.

· Antitussive action is most characteristic of diphenhydramine, it is realized through a direct action on the cough center in the medulla oblongata.

· The antiserotonin effect, which is primarily characteristic of cyproheptadine, determines its use in migraine.

· α1- the blocking effect with peripheral vasodilation, especially inherent in phenothiazine antihistamines, can lead to a transient decrease in blood pressure in sensitive individuals.

· Local anesthetic (cocaine-like) action is characteristic of most antihistamines (occurs due to a decrease in membrane permeability to sodium ions). Diphenhydramine and promethazine are stronger local anesthetics than novocaine. However, they have systemic quinidine-like effects, manifested by prolongation of the refractory phase and the development of ventricular tachycardia.

· Tachyphylaxis: decrease in antihistamine activity with long-term use, confirming the need for alternating drugs every 2-3 weeks.

· It should be noted that the first generation antihistamines differ from the second generation in the short duration of exposure with a relatively rapid onset of the clinical effect. Many of them are available in parenteral forms. All of the above, as well as low cost, determine the widespread use of antihistamines today.

Moreover, many of the qualities that were discussed allowed the “old” antihistamines to occupy their niche in the treatment of certain pathologies (migraine, sleep disorders, extrapyramidal disorders, anxiety, motion sickness, etc.) that are not associated with allergies. Many first-generation antihistamines are included in combination preparations used for colds, as sedatives, hypnotics, and other components.

The most commonly used are chloropyramine, diphenhydramine, clemastine, cyproheptadine, promethazine, phencarol, and hydroxyzine.

Chloropyramine (Suprastin) is one of the most widely used sedative antihistamines. It has significant antihistamine activity, peripheral anticholinergic and moderate antispasmodic action. Effective in most cases for the treatment of seasonal and year-round allergic rhinoconjunctivitis, angioedema, urticaria, atopic dermatitis, eczema, itching of various etiologies; in parenteral form - for the treatment of acute allergic conditions requiring emergency care. Provides a wide range of usable therapeutic doses. It does not accumulate in the blood serum, so it does not cause an overdose with prolonged use. Suprastin is characterized by a rapid onset of effect and short duration (including side effects). At the same time, chloropyramine can be combined with non-sedating H1-blockers in order to increase the duration of the antiallergic effect. Suprastin is currently one of the best-selling antihistamines in Russia. This is objectively related to the proven high efficiency, controllability of its clinical effect, the availability of various dosage forms, including injections, and low cost.

Diphenhydramine, best known in our country under the name diphenhydramine, is one of the first synthesized H1 blockers. It has a fairly high antihistamine activity and reduces the severity of allergic and pseudo-allergic reactions. Due to the significant anticholinergic effect, it has an antitussive, antiemetic effect and at the same time causes dry mucous membranes, urinary retention. Due to lipophilicity, diphenhydramine gives pronounced sedation and can be used as a hypnotic. It has a significant local anesthetic effect, as a result of which it is sometimes used as an alternative for intolerance to novocaine and lidocaine. Diphenhydramine is presented in various dosage forms, including for parenteral use, which determined its widespread use in emergency therapy. However, a significant range of side effects, unpredictability of consequences and effects on the central nervous system require increased attention in its application and, if possible, the use of alternative means.

Clemastine (tavegil) is a highly effective antihistamine drug similar in action to diphenhydramine. It has a high anticholinergic activity, but to a lesser extent penetrates the blood-brain barrier. It also exists in an injectable form, which can be used as an additional remedy for anaphylactic shock and angioedema, for the prevention and treatment of allergic and pseudo-allergic reactions. However, hypersensitivity to clemastine and other antihistamines with a similar chemical structure is known.

Cyproheptadine (peritol), along with antihistamine, has a significant antiserotonin effect. In this regard, it is mainly used in some forms of migraine, dumping syndrome, as an appetite enhancer, in anorexia of various origins. It is the drug of choice for cold urticaria.

Promethazine (pipolfen) - a pronounced effect on the central nervous system determined its use in Meniere's syndrome, chorea, encephalitis, sea and air sickness, as an antiemetic. In anesthesiology, promethazine is used as a component of lytic mixtures to potentiate anesthesia.

Quifenadine (fencarol) - has less antihistamine activity than diphenhydramine, but is also characterized by less penetration through the blood-brain barrier, which determines the lower severity of its sedative properties. In addition, fenkarol not only blocks histamine H1 receptors, but also reduces the content of histamine in tissues. May be used in the development of tolerance to other sedative antihistamines.

Hydroxyzine (atarax) - despite the existing antihistamine activity, it is not used as an antiallergic agent. It is used as an anxiolytic, sedative, muscle relaxant and antipruritic agent.

Thus, first-generation antihistamines that affect both H1- and other receptors (serotonin, central and peripheral cholinergic receptors, a-adrenergic receptors) have different effects, which determined their use in a variety of conditions. But the severity of side effects does not allow us to consider them as drugs of first choice in the treatment of allergic diseases. The experience gained with their use has made it possible to develop unidirectional drugs - the second generation of antihistamines.

Second generation antihistamines (non-sedating). Unlike the previous generation, they have almost no sedative and anticholinergic effects, but differ in their selective action on H1 receptors. However, for them, a cardiotoxic effect was noted to varying degrees.

The following properties are the most common for them.

· High specificity and high affinity for H1 receptors with no effect on choline and serotonin receptors.

· Rapid onset of clinical effect and duration of action. Prolongation can be achieved due to high protein binding, accumulation of the drug and its metabolites in the body, and delayed elimination.

· Minimal sedative effect when using drugs in therapeutic doses. It is explained by the weak passage of the blood-brain barrier due to the peculiarities of the structure of these funds. Some particularly sensitive individuals may experience moderate drowsiness, which is rarely the reason for discontinuing the drug.

· Absence of tachyphylaxis with prolonged use.

· The ability to block the potassium channels of the heart muscle, which is associated with prolongation of the QT interval and cardiac arrhythmia. The risk of this side effect increases when antihistamines are combined with antifungals (ketoconazole and itraconazole), macrolides (erythromycin and clarithromycin), antidepressants (fluoxetine, sertraline and paroxetine), grapefruit juice, and in patients with severe liver dysfunction.

Below are second-generation antihistamines with their most characteristic properties.

Terfenadine is the first antihistamine drug devoid of a CNS depressant effect. Its creation in 1977 was the result of a study of both the types of histamine receptors and the features of the structure and action of existing H1-blockers, and laid the foundation for the development of a new generation of antihistamines. Currently, terfenadine is used less and less, which is associated with its increased ability to cause fatal arrhythmias associated with prolongation of the QT interval. Astemizol is one of the longest-acting drugs of the group (the half-life of its active metabolite is up to 20 days). It is characterized by irreversible binding to H1 receptors. Virtually no sedative effect, does not interact with alcohol. Since astemizole has a delayed effect on the course of the disease, it is not advisable to use it in an acute process, but it may be justified in chronic allergic diseases. Since the drug has the ability to accumulate in the body, the risk of developing serious heart rhythm disturbances, sometimes fatal, increases. Due to these dangerous side effects the sale of astemizole in the United States and some other countries has been suspended.

Acrivastine (semprex) is a drug with high antihistamine activity with a minimally pronounced sedative and anticholinergic effect. A feature of its pharmacokinetics is a low level of metabolism and the absence of cumulation. Acrivastine is preferred in cases where there is no need for permanent antiallergic treatment due to the rapid onset of effect and short-term effect, which allows for a flexible dosing regimen.

Dimethenden (Fenistil) - is closest to the first generation antihistamines, but differs from them in a significantly lesser severity of the sedative and muscarinic effect, higher antiallergic activity and duration of action.

Loratadine (Claritin) is one of the most purchased second-generation drugs, which is quite understandable and logical. Its antihistamine activity is higher than that of astemizole and terfenadine, due to the greater strength of binding to peripheral H1 receptors. The drug is devoid of a sedative effect and does not potentiate the effect of alcohol. In addition, loratadine practically does not interact with other drugs and does not have a cardiotoxic effect.

The following antihistamines are topical preparations and are intended to relieve local manifestations of allergies.

Levocabastin (Histimet) is used as an eye drop for the treatment of histamine-dependent allergic conjunctivitis or as a spray for allergic rhinitis. When applied topically, it enters the systemic circulation in a small amount and does not have undesirable effects on the central nervous and cardiovascular systems.

Azelastine (Allergodil) is a highly effective treatment for allergic rhinitis and conjunctivitis. Used as a nasal spray and eye drops, azelastine has little to no systemic effects.

Another topical antihistamine, bamipine (soventol), in the form of a gel, is intended for use in allergic skin lesions accompanied by itching, insect bites, jellyfish burns, frostbite, sunburn, as well as mild thermal burns.

Antihistamines of the third generation (metabolites).

Their fundamental difference is that they are active metabolites of antihistamines of the previous generation. Their main feature is the inability to influence the QT interval. Currently, there are two drugs - cetirizine and fexofenadine.

Cetirizine (Zyrtec) is a highly selective peripheral H1 receptor antagonist. It is an active metabolite of hydroxyzine, which has a much less pronounced sedative effect. Cetirizine is almost not metabolized in the body, and the rate of its excretion depends on the function of the kidneys. Its characteristic feature is its high ability to penetrate the skin and, accordingly, its effectiveness in skin manifestations of allergies. Cetirizine neither in the experiment nor in the clinic did not show any arrhythmogenic effect on the heart, which predetermined the field of practical use of metabolite drugs and determined the creation of a new drug - fexofenadine.

Fexofenadine (Telfast) is the active metabolite of terfenadine. Fexofenadine does not undergo transformations in the body and its kinetics does not change with impaired liver and kidney function. It does not enter into any drug interactions, does not have a sedative effect and does not affect psychomotor activity. In this regard, the drug is approved for use by persons whose activities require increased attention. A study of the effect of fexofenadine on the QT value showed, both in the experiment and in the clinic, the complete absence of a cardiotropic effect when using high doses and with long-term use. Along with maximum safety, this remedy demonstrates the ability to stop symptoms in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria. Thus, the pharmacokinetics, safety profile and high clinical efficacy make fexofenadine the most promising of the antihistamines at present.

So, in the doctor's arsenal there is a sufficient amount of antihistamines with various properties. It must be remembered that they provide only symptomatic relief from allergies. In addition, depending on the specific situation, you can use both different drugs and their diverse forms. It is also important for the physician to be aware of the safety of antihistamines.

Table 1.2

Three generations of antihistamines (trade names are shown in brackets) I generation II generation III generation · Diphenhydramine (diphenhydramine, benadryl, allergin) · Clemastine (tavegil) · Doxylamine (Decaprine, Donormil) · Diphenylpyralin · Bromodifenhydramine · Dimenhydrinate (Dedalone, Dramamine) · Chloropyramine (suprastin) · pyrilamine · Antazolin · Mepyramine · Brompheniramine · Chloropheniramine · Dexchlorpheniramine · Pheniramine (avil) · Mebhydrolin (diazolin) · Quifenadine (Phencarol) · Sequifenadine (bicarfen) · Promethazine (phenergan, diprazine, pipolfen) · trimeprazine (teralen) · Oxomemazine · Alimemazine · Cyclizine · Hydroxyzine (atarax) · Meclizine (bonin) · Cyproheptadine (peritol) · Acrivastine (semprex) · Astemizol (gismanal) · Dimetinden (Fenistil) · Oksatomide (tinset) · Terfenadine (bronal, histadine) · Azelastine (allergodil) · Levocabastin (Histimet) · Mizolastin · Loratadine (Claritin) · Epinastin (alesion) · Ebastin (Kestin) · Bamipin (Soventol) · Cetirizine (Zyrtec) · Fexofenadine (Telfast) · Deloratadine (erius) · Norastemizole (sepracor) · Levocetirizine (Xyzal) · carabastin

On the basis of the data obtained, it was concluded that first-generation antihistamines are used as emergency aid at the first sign of any allergic reaction - itching, rashes, beginning swelling of the eyelids.

For a more selective action in relation to allergic reactions, H1-antihistamines of the so-called second generation have been obtained. These drugs have practically no effect on the central nervous system, do not cause sedative and hypnotic effects, and can be administered during the daytime.

Antihistamines of the third generation (metabolites). Their fundamental difference is that they are active metabolites of antihistamines of the previous generation.

Combined preparations containing H1-antihistamines are widely used, they help both with allergic conditions and with colds or flu.

Chapter 2. Practical part of the study

1 Analysis of the situation in Russia during the study period

To select the study group, we will analyze the range of antihistamines depending on chemical structure(according to ATH classification). Consider their ratio in absolute and percentage terms (Table 2). As can be seen from the table, antihistamines of various structures occupy the largest market share, which is associated with the search for more effective substances.

Table 2. Analysis of the assortment structure (by component composition)

Groups of antihistamines Number of LSAbs. Share, % Aminoalkyl esters313.63Substituted alkylamines14.55Substituted ethylenediamines14.55Phenothiazine derivatives418.18Piperazine derivatives313.64Other antihistamines1045.45Total22100.00

Table 2.1. TOP10 corporations by share of sales of antihistamines in the retail commercial sector of the Russian pharmaceutical market, MAT April 2015 (rub.), %

RankingCorporationMarket ShareSales GrowthMatter Apr 2015Math Apr 2015/Math Apr 20141NOVARTIS23,8042MSD21,73153SERVIER11,1054UCB7,6225DR REDDYS LAB6,63166SANOFI5,55137GSK4,63148TEVA1,9 1339VALENTA1,79-910NYKOMED/TAKEDA1,638

There were no significant changes in the TOP10 corporations over the year. The most notable growth in sales (+33%) belongs to Teva, which moved up two positions, displacing domestic Valenta to ninth place in the rating (Table 2.1). Such a jump became possible as a result of the launch in 2014 of a number of generics: Loratadine-Teva, Cetirizine-Teva and Desloratadine-Teva, as well as a 40% reduction in sales of the drug Diazolin produced by Valenta .

Table 2.2. Main TMs in the segment of antiallergic drugs by share of sales in the retail Commercial sector of the Russian pharmaceutical market, MAT May 2015 (rub), %

Method of applicationATS - groupRatingTMCorporationMarket share, Mat April 2015, % Sales growth, MAT May 2015 / MAT April 2014, % Externally D04A - preparations for the treatment of itching, including antihistamines and anesthetics EOPATH0,04-3NasalR01A - Nasal preparations1NasonexMSD9,48342VibrocilNOVARTIS6, 74-113AvamysGSK3,63224FlixonaseGSK1,06-75Tafen nasalSANDOZ1,0215For internal useR06A0 - Systemic antihistamines1SuprastinSERVIER10,0942CetrinDR REDDYS LAB6,72163EriusMSD6,5334ZirtekUCB6,290,3 5ClaritinMSD5,918Eye dropsS01G - Eye antiallergic, decongestants, antiseptics 36215LekrolinSANTEN0,3413

MAT (moving annual total) - 12 calendar months (in this context, from June 2014 to April 2015 inclusive).

As can be seen from (table 2.2), the market leader in sales for internal use in terms of value among antiallergic drugs continues to be TM "Suprastin". The drug has a wide range of applications and is available in two different forms (ampoules and tablets). Suprastin is the leading drug manufactured by Egis / Servier, accounting for 24% of the manufacturer's sales. The commercial success of this drug inspired marketers to bring second-generation antihistamines to the market with similar name- "Suprastinex" (INN levocetirizine). The increase in sales of the latter for the specified period amounted to +48% in value terms.

The leader in sales in the group of dermatological anti-allergic drugs was Fenistil Gel - its share in the segment was 6.64% (Table 2.2).

Among the drugs used for nasal allergies, preparations containing corticosteroids predominate in value terms. The first position is occupied by the topical glucocorticoid "Nasonex" - its sales growth amounted to +34%.

The smallest group in terms of commercial retail sales in the antiallergic segment are eye drops with an antihistamine effect - they account for 2.6% of sales. In recent years, many new anti-allergic ophthalmic agents have been introduced to the market - among the launches, we especially note TM Okumetil, Opatanol, Vizin Allergy, etc.

Consider the average prices for this period, they are presented in (Table 2.3.) Published in Pharmexpert.

ATC - groupAverage price, RUB MAT April 2015R01A1 - Nasal corticosteroids without antimicrobials632.6S01G3 - Ophthalmic antiallergics, multiple action391.0D04A - antipruritic drugs, including antihistamines and anesthetics289.2R01A6 - Nasal antiallergics211.9R06A0 - Systemic antihistamines156, 0S01G1 - Ophthalmic antiallergics, antihistamines129.7S01G2 - Ophthalmic antiallergics, mast cell stabilizers92.7

MAT (moving annual total) - 12 calendar months (in this context, from June 2014 to April 2015 inclusive).

The market volume of antihistamines for the period June 2014 - April 2015 amounted to 14.1 billion rubles, which is 10% higher than in the previous year. Growth was mainly due to an increase in average prices for antiallergic drugs, in natural terms, the increase in sales is insignificant (+2%). Allergies often manifest in combination and affect several organs at the same time, so treatment is usually symptomatic.

Currently, among antiallergic drugs, the most budgetary in terms of cost are systemic antihistamines of the 1st generation - their selling retail price averages 133 rubles. for conditional packaging. For comparison: III-generation LPs are on average three times more expensive - 416 rubles. for conditional packaging.

The average price for topical hormonal drugs (ATS-group R01A1 - Nasal corticosteroids without antimicrobials) in pharmacy retail is 632.6 rubles. per package (Table 2.3).

As for the preferences of buyers when choosing antihistamines, the share ratio of sales of drugs of the 1st and 2nd generations is almost comparable (Fig. 1). First generation drugs with a pronounced side effect - drowsiness, continue to be in demand due to their proven high safety and efficacy, incl. when used in pediatric practice. Relatively recently, 3rd generation drugs that have entered the market occupy 16.7% of the market.

Figure 1 Share ratio of sales of different generations of AP

CONCLUSION: More than 50% of the antiallergic drug market is occupied by systemic antihistamines. Such drugs are most in demand among buyers due to the convenience of taking and the ability to purchase them in pharmacies without a prescription. The same group is very attractive for manufacturers - more and more players are expanding their product portfolio due to it. So, in 2013-2015. GRLS (State Register of Medicines) registered a number of domestic drugs with INN cetirizine (II generation of antihistamines), levoceterizine and desloratadine (both belong to the III generation). Perhaps the appearance on the market of modern Russian generics will give impetus to a general reduction in prices for the latest generation of drugs in the segment.

According to the GRLS data, at present registration activity in the segment is shown mainly by domestic manufacturers. Thus, the current situation, when 95% of the market in value terms is occupied by imported drugs, may change somewhat in the near future. However, for this Russian companies will have to seriously engage in the promotion of their products.

3. Analysis of the assortment structure in the pharmacy on the basis of which the research was conducted

Pharmacy assortment

The assortment of pharmacies includes many categories of goods, including medicines (drugs), medical devices (MD), cosmetics and dietary supplements. The maximum share in the total volume of pharmacy sales falls on drugs. The drugs most in demand in this pharmacy for the treatment of the cardiovascular system, analgesics, antispasmodics, NSAIDs, antivirals, drugs for diseases of the gastrointestinal tract, laxatives, antiseptics, antibiotics all occupy 60.5%. Biologically active additives, medical products and medical cosmetics - 33.8%, and their total percentage of demand is 94.3%. The remaining 5.7% are antihistamines.

Figure 2. Pharmacy assortment

Table 3. Analysis of the structure of the assortment (production attribute - manufacturer)

Producer Share, %Countries of foreign production, total67.09India ( Dr. Reddy's Laboratories Ltd.) 2.5 Hungary (Egis) 23.8 Switzerland (Novartis Consumer Health, Nycomed) 19.3 France (Servier, Sanofi) 6.6 Germany (STADA) 2.8 Israel (Teva) 1.39 Domestic manufacturers, total 32.91 Akrikhin 5.2 Rosmedpreparaty 2, 4Vertec1.2Veropharm5.2Gedeon Richter-RUS3.0Pharmstandard3.5Microgen RF3.5Actavis4.0Olinepharm2.0Organica2.91

From the data obtained (Table 3) it can be seen that the main place is occupied by foreign manufacturers (67.09%) Figure 3.

Figure 3

With regards to domestic manufacturers, the market share of antihistamines manufactured by manufacturers is only 32.91%. There is no clear leader, but the leading companies are Akrikhin, Veropharm, with a market share of 5.2%.

The leading company is Egis (Hungary), which is a contender for leadership (23.8% market share). The second place is occupied by Switzerland (Novartis) with the drug suprastin, its share is 19.30%. The United States and France are not far behind them, they have a 10-6% market share. Germany, India and Israel occupy places with less demand in the market.

Figure 5. Countries of foreign production of antihistamines

1 The structure of the range of antihistamines by types of dosage forms

Dosage forms of antihistamines can be divided into three groups: solid, liquid and soft. To hard dosage forms include tablets, capsules and dragees, liquid - injection solutions, syrups, suspensions, drops (including eye drops). Soft dosage forms are represented by rectal suppositories. Most drugs are produced in solid dosage form. Liquid dosage forms are mainly represented by injection solutions and syrups. Syrups are used in pediatrics, which is associated with the possibility of their use in young children. A small proportion of liquid LF is associated with the difficulties of their stabilization. Rectal suppositories are represented by one trade name of the drug - suppositories with diphenhydramine for children over one year old, which are produced by 4 Russian manufacturers. Sales of antihistamines in tablets accounted for the majority (73% market share in physical terms). Dragees and drops occupy 15% and 6% of the market in real terms, respectively. The remaining dosage forms (syrups, suspensions, capsules, injectable dosage forms, suppositories) account for 6.1%.

Figure 6. Market structure of antihistamines by dosage forms

2 Market segmentation

Consumer

50 pharmacy visitors were surveyed (Appendix 1), and an assessment was made of the demographic structure of consumers, as well as the structure of consumers by income level and social status. The data obtained are shown in Figures 7-10.

Figure 7. Demographic structure

Figure 8. Structure of consumer consumers by age by gender

Figure 9. Structure of consumers by

Figure 10. Structure of consumers by income level and social status

Figure 11 Reasons for buying AP

When choosing medicines, the consumer first of all seeks to receive high-quality treatment, therefore, efficiency, safety and price come first (Fig. 12).

Figure 12. Consumer ratings of importance when buying AP

The packaging of the drug, which ensures its safety, transportation, as well as the external design or design of the package, has a slight effect on the purchase.

3 ABC analysis

The product range of OAO Regional Pharmacy Warehouse consists of many items. To prioritize between products and decide on exclusion from the assortment, it is necessary to conduct a comprehensive analysis of sales. One of the methods of such analysis is ABC-analysis - a method that allows you to classify the company's resources according to their degree of importance. It is carried out by analyzing inventories divided into three categories, presented in table 3.1

Table 3.1 Classification of the border of commodity groups in OAO Regional Pharmacy Warehouse

Group nameShare of revenue (%)Percentage of items (%)A-group8020B-group1530C-group550

Group A includes drugs, the share of revenue from which in the pharmacy is 80% of all drugs. At the same time, this is a limited number of product names from the entire range presented, about 20%. Group B consists of drugs that have an average consumer demand. The share of revenue from them for the company is 15%, and the percentage of product names presented in the pharmacy is 30%. The rest of the revenue comes from drugs of group C, which are the most stale on the shelves of the pharmacy, that is, they are poorly sold. The percentage of these product names is 50%. By dividing the entire assortment into several groups, you can determine the top sellers, as well as identify the reasons why item items from low priority groups cannot move to a group one level higher.

For the analysis, a summary documentation was obtained on the turnover of the studied drugs for 3 months at the beginning of their seasonality (February, March, April) 2015.

Based on the data received from the management, during the internship at pharmacy No. 48 of OAO Regional Pharmacy Warehouse, an ABC analysis of drugs used to treat allergies was carried out. Calculations using the ABC analysis method are presented in Table 3.2

Classification of drugs by the amount of sales for 3 months.

Preparations Release formPriceRevenue% of the total amountClassSuprastinexTab. 5 mg №7317,004755,0011,38ASuprastin Tab. 25 mg No. 20155.004340.0010.39ACetrin Tab. 10mg No. 20190.003990.009.55AZyrtec Drops 366.003660.008.76ALoratadin Tab. 10 mg No. 1090.002970.007.11AZodak Drops 10ml234.002574.006.16ADiazolin Dragee 100mg No. 1062.001922.004.60AFenistil Drops 343.001715.004.10AFenistil Gel tube 50, 0384.001536.003.67ACetrin Tab. 10mg No. 30302.001208.002.89AFenistilGel tube 30.0343.001029.002.46ALorahexalTab. 10mg №1058,00986,002,36AClaridol tab. 10mg №7104,00936,002,24ARupafin Tab. 10mg №7312,00936,002,24AEriusTab. 5mg №7446,00892,002,13AXISALTab. 5 mg No. 7388.25776.501.85V Fenkarol tab. 25 mg No. 20353.50707.001.69V Zodak express tab. 5mg No. 7235,00705,001,68V Claritin Tab. 10mg No. 7195.00585.001.40Verius Syrup 60 ml550.00550.001.31V Deslorathodine Tab. 5 mg No. 7253.00506.001.21BZodak Tab. 10 mg No. 10119.50478.001.14B Kestin Tab. 10 mg №5 210.00420.001.00В Tavegil Tab. 1 mg No. 20193.50387.000.92VZodak expressTab. 5 mg No. 28373.00373.000.89 V Elisey Tab. 5 mg No. 10181.00361.500.86B Kestin Tab. 10 mg No. 10342.00342.000.81 V Dezal Tab. 5 mg No. 30281,00281,000.67BZyrtecTab. 5 mg No. 7252.00252.000.60CZodakTab. 10 mg No. 30249.50249.500.59 CD Desloratadine TevaTab. 5 mg No. 10246.50246.500.59CTavegilTab. 1 mg No. 10111.50223.000.53SLoratadine Tab. 10 mg No. 30181.50181.500.43SSuprastin Solution 20ml No. 5177.00177.000.42SDiazolin Tab. 100 mg No. 1077.00154.000.36CDesal Tab. 5 mg No. 10146.50146.500.35SCytirizine Tab. 10 mg No. 20114.00114.000.34 SDiazolin for children. Tab. 50 mg No. 1048.0096.000.22C

The sequence of actions according to the ABC method on the example of the drug Suprastinex Tab. 5mg #7. Determination of the total amount of sales of antiallergic drugs for 3 months in rubles (table 3.1, column 4):

The total amount of drug sales for 3 months is 41,761.00 rubles.

Determination of the share of profit for 3 months from the sale of each drug (in percent) according to the formula (table 3.1. column 5):

For the drug Suprastinex 5 mg No. 7, the share of the total profit is:

00* 100% / 41 761,00 = 11,38%

Ranking of the share of sales: from the maximum to the minimum share (in Table 3).

Calculation of the cumulative sum of sales shares (in %), adding the following to the first share in succession:

Class A (revenue share 80%)

38+10,39+9,55+8,76 +7,11 +6,16 +4,60+ 4,10+3,67+2,89+2,46+2,36+2,24+2,24+ 2,13=80,04%

Class B (revenue share 15%)

85+1,69+1,68+1,40+1,31+1,21+1,14+1,00+0,92+0,89+0,86+0,81+0,67=15,50%

Class C (revenue share 5%)

60+0,59+0,59+0,53+0,43+0,42+0,36+0,35+0,34+0,22=4,43%

According to the calculations, we conclude:

A) Preparations: Suprastinex, Suprastin, Cetrin, Zirtek, Zodak, Loratadin, Diazolin, Fenistil, Lorahexal, Claridol, Rupafin, Erius account for 80.04% of the total turnover. Consequently, these drugs belong to the group of goods A - these are goods - leaders in sales. The total proceeds of these funds amounted to 33,449.00 .

Based on the foregoing, we can conclude that these drugs provide the main income of the pharmacy chain and pharmacy workers need to ensure one hundred percent availability of this item.

B) Preparations: Ksizal Tab. 5mg No. 7, Fenkarol Tab. 25 mg No. 20, Zodak Express Tab. 5mg №7, Claritin Tab. 10mg № 7, Erius Syrup 60 ml, Desloratodin Tab. 5 mg No. 7, Zodak Tab. 10 mg No. 10, Kestin Tab. 10 mg No. 5, Tavegil Tab. 1 mg No. 20, Zodak Express Tab. 5 mg No. 28, Eliza Tab. 5 mg №10, Kestin Tab. 10 mg №10, Desal Tab. 5 mg #30 represents 15.50% of total sales. The total proceeds of these funds amounted to 6,471.50 .

These drugs belong to the group of goods B. This means that the employees of the pharmacy under study require constant attention to the availability of goods and periodic control of the stock.

C) Having examined group C, which resulted from our study, we see the following drugs: Zyrtec Tab. 5 mg No. 7, Zodak Tab. 10 mg No. 30, Desloratadine Teva Tab. 5 mg No. 10, Tavegil Tab. 1 mg No. 10, Loratadine Tab. 10 mg No. 30, Suprastin Solution 20 ml No. 5, Diazolin Tab. 100 mg No. 10, Desal Tab. 5 mg No. 10, Cytirizine Tab. 10 mg No. 20, Diazolin for children. Tab. 50mg #10 accounts for 4.43% of total sales. The total proceeds of these funds amounted to 1,839.50 . Drugs, in principle, do not bring significant profit and are not very popular, but there are places to be bought during the seasonal period.

The results of the ABC analysis by the number of titles for 3 months are provided in Table 3.3

Table 3.3

Group of goods Number of items of goods Share in the total number of items,% А1540В1335С1025

The results of the ABC analysis by the number of trade units sold for 3 months are shown in Table 3.4

Table 3.4

Group of goodsNumber of items of goodsShare in the total number of items,% A19685B2310C135Total232

A pharmacy to optimize the consumption of antihistamine drugs should meet the needs of the population in any such remedy. But at the same time, it is forced to think about obtaining financial profit, which ensures its survival and development. Based on the ABC analysis, it was found that the share of product groups in the total number of items was distributed as follows: Group A \u003d 40.0%, group B \u003d 35.0%, group C \u003d 25.0%, which means that the group A has a very high and marketing potential (Suprastinex Tab. 5mg No. 7, Suprastin Tab. 25mg No. 20), the rest of the groups are medium and low, but bringing significant income.

The range of drugs that affect allergies on the pharmaceutical market is quite saturated and is represented by manufacturers from different countries world in different price categories, which makes antihistamines affordable enough for patients with different income levels. It can be said that the JSC OAS pharmacy under study currently offers consumers a diverse list of modern, reliable and safe drugs to eliminate allergies in a wide price range. Thus, it is able to meet the needs of the population in any form of medicines.

The dominant place in consumption for 3 months (February, March, April) 2015 is occupied by Suprastinex Tab. 5mg #7; Suprastin Tab. 25mg #20; Cetrin Tab. 10mg #20. These drugs were the leaders in sales and have affordable prices among the drugs of their generation.

The price of drugs is a determining factor when choosing a drug.

A comprehensive analysis of sales made it possible to prioritize antihistamine drugs.

3.4 Determination of sales volume

Demand analysis of antihistamines

According to the results of the ABC analysis, the first five drugs of group A were taken, which are often purchased in this pharmacy. As we can see from the calculated data, Suprastin occupies a large share of sales - 25%, the sales of Cetrin and Zodak do not differ much from it, they have a 22-21% share, Suprastinex and Zyrtec are sold a little less often - 19 and 14%.

Figure 13. Demand analysis for antihistamines

Determination of sales volume was carried out on the example of the pharmacy "Regional Pharmacy Warehouse" in the period from February to April 2015

Table 4 Pharmacy sales data from February to April

Preparations FebruaryMarchAprilTotalNumber of packsSuprastin591529Tsetrin79925Zodak461020Suprastinex25815Zyrtek43411Erius0145

As can be seen (from table 4), the sales volume is relatively small, which is associated with the seasonality of allergic diseases. Demand rises in spring and summer.

Figure 14. Sales of drugs

From Table 4, we see a peak in demand in April, during this month the largest number of packages of antihistamines of different generations were sold, as you can see, demand rises by mid-spring during the season of allergic diseases. The preference in buying was given to the drug leader Suprastin, 29 packs were sold. Tsetrina sold 25 pieces, its demand is high due to fewer side effects, its plus is that it can be prescribed from 2 years in the form of syrup. Zodak was purchased in the amount of 20 pieces for its variety of forms and effectiveness, suprastinex was sold in 15 packs.

The interval in which consumers typically choose antihistamines.

Figure 15. Prices of antihistamine drugs

As we can see, price is an affordability factor and plays a significant role in the choice of pharmaceutical products. A quarter of buyers is ready to pay no more than 200 rubles for a medicine, such a drug, as we see, is the first generation drug Suprastin, its price is 155.00. In fact, a third of the respondents choose drugs costing from 150 to 350 rubles, such as Cetrin, Zodak, Suprastinex. Medicines costing more than 350 rubles are a priority in the choice of the rest of the consumers, who noted that the high price for them is an indicator of the quality of Zirtek, Erius medicines.

5 Promotion

Distribution Methods

Wholesale. The drugs are distributed through distribution companies: Protek, SIA International, Katren, Rosta, Shreya Corporation, Biotek, Genesis, Pharmkomplekt, Yukon-Pharm.

Retail. Drugs are allowed to be sold to pharmacies, drugstores, drugstores, kiosks.

AGP sales promotion methods used by manufacturing firms

Ø Publications in specialized editions, in new medical reference books. Special magazines and newspapers print information about the drug itself.

Ø The work of medical representatives to promote drugs.

Ø Conducting lectures for pharmaceutical workers.

Ø Advertising souvenirs - pens, calendars.

3.6. Environmental impact analysis is a marketing tool designed to identify social (Social), political (Political), economic (Economic), and technological (Technological) aspects of the external environment that affect the business of companies.

Social factors:

According to demographers, all over the world, in highly developed countries, today there is a rapid aging of the population, so we can conclude that the number of potential consumers is decreasing.

Technological factors:

The Russian pharmaceutical market is developing rapidly. Annually its volume increases by about 14-15%. At the same time, there are many problems in this industry that should be dealt with, including by the government of the Russian Federation.

Structure of the pharmaceutical market

The Russian pharmaceutical market consists of commercial and government segments. The second, in comparison with the first, includes sales not only through pharmacies, but also through medical institutions and within the framework of the supplementary drug provision program. The commercial segment is characterized by annual positive dynamics and is considered one of the most intensively developing sectors of the country's economy. For example, the growth for the first five months of 2015 compared to the same period in 2014 was 22.6%.

The pharmaceutical market of the Russian Federation has a complex structure. It interacts with:

• consumers (patients and medical workers);
• intermediaries (wholesale and retail distributors of medicines);
• health authorities of different countries;
• drug manufacturers.

Features of the pharmaceutical market

1. A high proportion of traditional generic drugs (with the composition and form of original drugs, but without patent protection) and the prevalence of over-the-counter drugs.
2. The transition of most enterprises to the manufacture of finished medicines. But due to insufficient experience in the development of their own drugs, a narrow range and low quality of products, they cannot press foreign players on the market.
3. In developed Western countries, the main expenses for the purchase of medicines are covered by medical insurance; in Russia, they are borne by end users.
4. The tendency of the population to herbal medicine, self-treatment, buying cheap medicines.

Problems of the Russian pharmaceutical market

1. Insufficient solvency of the population due to instability in the country's economy.
2. Imperfect regulation of the industry at the legislative level.
3. A large number of counterfeit drugs.
4. Lack of state funding for drug supply programs, as well as support for Russian manufacturers.
5. Enhanced Level market competition.

The current state of the pharmaceutical market of the Russian Federation

The volume of imported products is 43 times higher than the volume of goods exported. The main countries-suppliers of medicines to Russia are Germany, Poland, Austria.

The share of over-the-counter drugs in total sales is 47% in monetary terms and 71% in physical terms (packages).

Shares of consumed medicines depending on the cost:

• up to 50 rubles / pack - 10%;
• 50-150 rub./pack. -24%;
• 150-500 rubles/pack — 44%;
• from 500 rub./pack. - 22%.

The volume of the pharmaceutical market in Russia by segments for 1-3 quarter. 2015

TOP-10 Anatomical-Therapeutic-Chemical (ATC)-groups of the 1st level in terms of the share of sales in the retail commercial sector, based on the results of 1-2 quarters. 2015

TOP-10 trade names by share of sales in the retail commercial sector, based on the results of 1-2 quarters 2015

Portrait of a consumer of pharmaceutical products

44% of Russians prefer domestically produced pharmaceutical products, for 42% the country of manufacture does not matter. A large share of medicines from Russian companies falls on consumers from villages and small towns. This is due to their lower cost compared to imported drugs.

Approximately half of the population of the Russian Federation purchases pills and other medicines in pharmacies, and on a weekly basis. Most of the customers are older women. Difficulties in purchasing medicines are experienced by 25% of the inhabitants of the Russian Federation.

When choosing a drug, about 60% of consumers are guided by the recommendations of doctors, but at the same time they rely on own experience(41%), listen to the advice of pharmacists (18%) and relatives (17%). Only 34% of the population believe that doctors prescribe drugs based solely on the health of their patients.

The group of medicines that Russians most often buy on their own, without consulting a doctor, includes vitamins, medicines for headaches and coughs, and nasal drops. On the recommendation of a specialist, antibiotics are most often purchased, antifungal drugs, anti-allergens, oral contraceptives.

The main players in the pharmaceutical market

There are three groups of participants in the Russian drug market:

• manufacturers (domestic and foreign);
• distributors (wholesale suppliers);
• retail pharmacies (individual outlets and pharmacy chains).

About 75% of the pharmaceutical market is occupied by medicines from foreign manufacturers. The largest share of products from Russian manufacturers falls on the Vital and Essential Drugs group (essential and essential drugs).

In 2015, the Novartis International AG corporation became the leader among manufacturers, producing Sandimmun (to improve the quality of organ transplant operations), Sandostatin (used for stomach bleeding), as well as Voltaren Emulgel, known to most Russians, Teraflu", "Lamisil", "Dlyanos", "Fenistil".

The second position was taken by the Sanofi company, which manufactures the medicines Essentiale, Festal, No-shpa, Amaril, and others.

TOP-10 manufacturers by the share of sales in the retail commercial sector, based on the results of 1-2 quarters. 2015

Distributors play an important role in the development of the pharmaceutical market. Thanks to a wide network of branches, they can provide medicines to residents of many regions of the Russian Federation. The leaders among distributors are Katren and Protek, whose total market share in 2015 exceeded 31%.

TOP-10 distributors by market share of shipments to final recipients (including preferential deliveries), based on the results of 1-2 quarters 2015

In the retail segment of the pharmaceutical market, about 40% are municipal and state pharmacies. But in the near future, this figure will decrease, as the share of private pharmacy chains is growing (for example, Miracle Doctor, Apteki 36.6, etc.)

Pharmaceutical holdings are being formed on the market, for example, Otechestvennye lekarstva OJSC (has a controlling stake in four manufacturing enterprises), Profit House (owns manufacturing enterprises and a retail sales network).

Russian pharmaceutical market development forecast for 2016

Increasing the market share of Russian-made products

Thanks to the expansion of the production of low-cost domestic drugs and generics, the share of imported products on the market in physical terms will decrease and will be approximately 41%.

Localization of foreign enterprises on the territory of the Russian Federation

The appearance of foreign investors is predicted, who will be able not only to organize their production in Russia, but also to transfer their own technologies to domestic companies. However, localization will have a slow pace, and will be carried out only subject to the observance of warranty obligations by Russian enterprises.

Changes in legislation

It is expected that the state will take legislative measures aimed at tightening the access of foreign medicines to the Russian market, as well as supporting domestic manufacturers.

Raising the price of medicines

According to the amendments to the Law “On the Circulation of Medicines” adopted in 2015, indexation of producer prices will be carried out depending on the inflation rate. The average price of medicines may increase by about 16%, and the increase in cost may affect about 90% of medicines from the list of vital and essential drugs.

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• 1. Overview of the pharmaceutical market in Russia
• 2. Features of the Russian pharmaceutical market
• 3. Strategy for the development of the medical industry of the Russian Federation for the period up to 2020
• 4. Medical equipment market.
• 5. Market of medical services
• 6. Legislation
• conclusions
• 1. Overview of the pharmaceutical market in Russia
• Foreign and domestic manufacturers, distributors, pharmacies and hospitals, the government and other government agencies operate on the Russian pharmaceutical market. Domestic manufacturers, according to the classification of OKONH, belong to the chemical and pharmaceutical industry (part of the medical industry). The market is characterized by a high share of imported products, about 65% of products are imported.
• The sales market for Russian pharmaceutical manufacturers is limited to Russia and the CIS countries, since the range and quality of products do not allow them to take worthy positions in foreign markets; moreover, within the country, Russian-made drugs are gradually being squeezed out in the areas of consumer groups with the lowest incomes.
• A serious problem of the Russian pharmaceutical market is the spread of counterfeit products. The scale of this phenomenon is terrifying, in the Russian market more than 10% of products (up to 30% according to unofficial data) distributed through the pharmacy network are fake. According to a survey commissioned by the Association of International Pharmaceutical Manufacturers (APIM) and the Coalition for the Protection of Intellectual Property Rights (CIPP) among the leaders of 53 Russian and foreign pharmaceutical companies, the share of counterfeit medicines on the Russian market is 12%. The companies represented in the survey control over 55% of the pharmaceutical market in Russia. At the same time, the annual losses of companies from this phenomenon, such as lost profits, the cost of combating counterfeiting, etc. exceed 250 million dollars. The volume of the market for counterfeit products is 250-300 million dollars, and according to unofficial data, about 1 billion dollars, while 67% of counterfeit products are domestic products.
• However, falsification of pharmaceutical products is not only a Russian problem.

2. Features of the Russian pharmaceutical market

1. The Russian pharmaceutical market is characterized by a high share of traditional generic drugs and a predominance of over-the-counter drugs.

2. The structure of demand was strongly influenced by the long-term isolation of the Russian market from the world market, the tendency of the population to self-treatment and herbal medicine. In addition, traditional generics are much cheaper than modern drugs.

3. In developed countries, the main expenses for the purchase of drugs are assigned to the medical insurance system, in Russia it is rather weak and the lion's share of the costs of treatment is borne by the end users - the population.

In the Russian market today, the retail price of domestic drugs is more than four times lower than that of imported ones. CMI "Pharmexpert" compiled the dynamics of the volume of this market, including forecast data, based on which:

There are no national pharmacy chains in Russia yet, the annual turnover of which exceeds 2 billion rubles. and which are present in at least six federal districts. To the largest interregional networks with a turnover of at least one billion rubles. and presence in at least two federal districts include: "Pharmacy 36.6", "Rigla", "03", "Natur Product", "Implosion", "Doctor Stoletov", "BIOTEK". On average, pharmacy chains increase the number of outlets by 50 pharmacies per year, mainly through the purchase of regional chains. "Pharmacy 36.6" is the leader not only in terms of the number of pharmacies, but also in terms of sales. The company's closest competitors are "Doctor Stoletov" (former leader in terms of the number of pharmacies) and "03" in terms of the number of pharmacies and sales volume, respectively. In the next three years, network players are expected to grow larger through mergers and acquisitions, as well as a significant increase in their share in the industry's total income.

3. Strategy for the development of the medical industry of the Russian Federation for the period up to 2020

This strategy was developed by the Ministry of Industry and Trade of the Russian Federation in order to develop a competitive medical industry in Russia. The implementation of the strategy is planned in 2 stages: Stage I - 2010-2017. - stimulating the development of domestic production; Stage II - 2015-2020 - creation of infrastructure for the development of own technologies. During the implementation of the Strategy, it is planned to achieve the following results: availability of highly qualified personnel; availability of its own technological base that meets international requirements; development of niche solutions to the level of world leadership; the share in the domestic market of medical equipment and medical products manufactured in the Russian Federation is at least 40%.

The employees of the Ministry predicted the minimum volume of the medical industry market in Russia by 2020. According to their calculations, it amounted to 450 billion rubles.

Diagram. Forecast of changes in market volumes.

Review of salaries in medicine in the first quarter of 2011.

Today, many doctors work two jobs or two positions and prefer to work in commercial institutions. So, a young specialist, working in the commercial sector, earns much more than in the public sector. According to experts, the shortage of medical personnel in Moscow is over 23,000 people, of nursing staff - over 46,000.

4. Medical equipment market.

Main problems:

1) High share of imports.

2) Use of outdated technologies.

3) Insufficient qualifications, lack of personnel.

4) Lack of investment in development and production.

5) Insufficient number of specialized medical centers and departments.

At present, in terms of the level of equipment, the Russian Federation lags behind the leading countries by several times, and for certain types of equipment, this lag reaches 10-15 times.

Table 2. The amount of equipment with high-tech medical equipment.

First of all, Russia lacks specialized radiological departments and medical centers. Diagnostic and therapeutic technologies of nuclear medicine, as a rule, are used in combination with modern clinical and instrumental diagnostic methods and radiosurgical methods of treatment and should be created on the basis of specialized medical institutions.

Competition. Foreign companies operating on the Russian market are large TNCs with a turnover of more than $1 billion each. There are no Russian companies of this scale yet. Nevertheless, Russia also has a certain technological backlog - unique gamma therapeutic equipment manufactured by FSUE Ravenstvo, production of therapeutic isotopes, prototypes of diagnostic equipment - gamma cameras, medical centers operating on domestic technologies in Dubna and Protvino . Russia is also traditionally strong in the production of linear accelerators, which in many cases are indispensable for the treatment of brain cancer.

5. Market of medical services

pharmaceutical assortment generic herbal medicine

An analysis of the medical services market in Russia, prepared by BusinesStat in 2011, shows that about 50% of the country's residents use paid medical care. At the same time, the share of users of commercial services is increasing every year. The development of infrastructure causes the growth of medical services and the commercialization of public medicine.

According to forecasts in 2011-2015. no significant growth in the client base is expected: firstly, because the share of users of paid medical services in Russia is already quite high, and secondly, because the incomes of Russians do not allow them to use optional services.

According to marketing research, in 2010 the average number of medical services provided was 15.1 services per patient. Thus, the results of the study showed that only half of the patients make several visits per year, but the other half receive many services at once, due to the passage of complex diagnostics, a medical commission or courses of procedures. Market research shows that in 2010 the healthcare industry in Russia was represented by 56.4 thousand medical institutions. These institutions vary greatly in terms of activities, number of clients and number of employees. Most of the medical clinics in Russia provide services in several medical areas. Of the narrow-profile medical clinics, dental clinics are widely represented. The market overview shows that in 2010, 4.4% of the total working-age population or 3.71 million people were employed in the healthcare industry in our country. On average, there are four more employees per one practicing doctor in the medical industry of the Russian Federation: two employees of average medical qualification and two employees of other professions. Moscow and St. Petersburg are leaders in terms of the number of employees.

6. Legislation

The State Duma simultaneously adopted the Law "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" in the second and third readings. Its consideration was postponed from July 8, 2011 to the autumn session under pressure from public organizations. On November 8, 2011, the law was approved by the Federation Council. It is planned that the new document will come into force on January 1, 2012. Some of its provisions requiring a transitional period will enter into force in 2013 and 2015.

The Government of the Russian Federation by Decree No. 917 of 10.11. 2011 approved a list of types of educational and medical activities, in which enterprises may not pay income tax, including, in particular, therapeutic and surgical cosmetology, manual therapy, dentistry and maxillofacial surgery.

conclusions

Problems hindering the development of the medical services market in Russia:

1. Absence of a modern practically implemented healthcare model in the Russian Federation.

2. Lack of a plan and criteria for assessing the achievement of results in the modernization of the healthcare system.

3. Lack of a modern legislative base on health issues.

4. Corruption and inefficiency in the performance of state functions in the healthcare system.

5. Paid services in public institutions.

6. Lack of modern information infrastructure.

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