ENTREPRENEURSHIP SCENARIO AFTER THE PHARMACY EDUCATION_Essay by Babita Sarangi

Introduction

Entrepreneurship can be viewed as a creative and innovative response to the environment and an ability to recognize, initiate and exploit an economic opportunity. An entrepreneur is an innovator who introduces something new in an economy. Entrepreneurship is doing things that are generally not done in the ordinary course of business. Innovation may be in, introducing a new manufacturing process that has not yet been tested and commercially exploited, introduction of a new product with which the customers are not familiar or introducing a new quality in an existing product, locating a new source of raw material or semi finished product that was not exploited earlier, opening a new market, until now unexploited, where the company products were not sold earlier, developing a new combination of means of production. Innovation involves problem solving and an entrepreneur is a problem solver. An entrepreneur does things in a new and a better way. Innovation leads to the dynamics that governs the interaction between science, industry, and society. Innovative organization wants must have to prepare for renewing the offerings and its delivery process to its stakeholders to survive in today’s globalised world.

Our educational programs have worked diligently to promote critical thinking and questioning, problem solving, and life-long learning throughout the curriculum. An entrepreneurial spirit can be thought to include elements such as creativity, uniqueness, adaptability, risk taking, developing potential, and business savvy, and ultimately can be self-destructive, if not realized and managed. As such, the word “entrepreneur” has had many definitions ranging from negative connotations such as pursuing business opportunities with or without regard for other resources and individuals for personal gain, to positive connotations such as being a trailblazer and leader, envisioning and creating new opportunities for their generation and beyond. Without intellectual curiosity and an entrepreneurial spirit, many of the technologies and approaches considered commonplace today would not exist. One need only look as far as cell phones and other electronic and computer devices, as well as technologies used in patient care, to demonstrate how intellectual curiosity and an entrepreneurial spirit have changed contemporary life, health care, and wellness.

Current Problems in Pharmacy field and need of Pharma entrepreneurs  

There has been a tremendous increase in the number of Pharmacy colleges in India, and hence the number of Pharmacy graduates is increasing year by year. The pharmaceutical industry is either reluctant to hire fresher or employ graduates at a very low salary scale and the scenario is not so different for M.Pharm graduates. The Ph.D. degree has also become a joke in few universities. The research and development activity in the Indian pharmaceutical industry still needs a lot of support in terms of funding. The pharmacy education in India is suffering from serious problems and the core streams like Community Pharmacy and Hospital Pharmacy have been neglected too much. Recently The Hindu also reported about this issue Pharm.D graduates take to the Streets. Hence, the pharmacy graduates are getting disheartened and frustrated.

Due to surplus availability of pharma manpower, it will be beneficial and appropriate if young pharmacy graduates seek out to exploit their full potential by starting their own ventures and thus becoming job generators rather than job seekers. Moreover the salaries being paid to pharmacy graduates are also not attractive and are not on par with other vocations. Hence this necessitates the pharmacy colleges in the country to take necessary steps to promote entrepreneurial learning programmes in the pharmacy curriculum so that the pharmacy graduate coming out from the colleges can become self reliant and inspire students towards self employment in their early career. Hence the pharmacy colleges should keep their attention on developing a syllabi which not only produces trained manpower for pharmaceutical industry but also produces self reliant entrepreneurial pharmacy graduates which accelerates the process of economic development and growth of the country.

Pharmacist as entrepreneurs  

A Pharma technocrat through entrepreneurship can bring a radical change that can meet the challenges of emerging changes due to liberalization and globalization. Fast changing Pharma industrial scenario, growing obsolescence in pharmacy curriculum stresses the need for Pharma entrepreneurship among the graduates. Pharmacy graduates have a strong bent of mind in science and are capable of maximizing their skills if given the right training. Entrepreneurship development among the pharmacy graduates will be an effective mechanism of renaissance in technology innovations and industrial development of a nation. 

Pharmacists need to view themselves as entrepreneurs and examine their individual careers as startup companies. Those who do so will be prepared to succeed in the future delivery model of health care and achieve professional satisfaction. Entrepreneurs are usually viewed as individuals who take substantial risks to go out and start new companies, but most pharmacists go to work for entities that are already established, such as a community pharmacy or hospital. Such positions are generally considered safe, as they promise a steady paycheck and continued employment. For that reason, entrepreneurship is not commonly listed among a pharmacist’s skill sets. A Nobel Peace Prize winner, Muhammad Yunus, quoted that “all human beings were self-employed at the start of human history, but that entrepreneurship was suppressed as civilized societies were formed”.

Entrepreneurship is generally associated with the establishment of community pharmacy and business management. However, entrepreneurship and its associated skills are key to the development of a range of health services in community and hospital sectors. Medication therapy management programs allow pharmacists to counsel patients on drugs, while interactive voice recognition tools remind patients to order or pick up prescriptions. Innovation is a key component of the pharmaceutical industry and biomedical research. Every drug or medicinal product developed and released to the market stems from an intellectual curiosity that requires a proof of concept spanning years. Pharmacists and health care professionals have a responsibility for the health and well-being of the population, the so-called “social capital.” Therefore, pharmacists may be defined as “social entrepreneurs” rather than the standard “business entrepreneur,” for whom financial profit is key to successful enterprise. Entrepreneurs have an outward vision in order to recognize fully the opportunity that confronts them and look forward in order to plan its growth and future prospects. Followings are the key traits that successful Pharma entrepreneurs share:

Ø  Pharma entrepreneurs draw inspiration from their unique experiences.

Ø  Pharma entrepreneurs surround themselves with like-minded individuals.

Ø  Pharma entrepreneurs use technology to reach more patients in new ways.

Ø  Pharma entrepreneurs strive to advance the practice of pharmacy through their unique    skillsets.

Ø  Pharma entrepreneurs are adaptive to change.

Ø  Pharma entrepreneurs view taking action to achieve their dreams as an exciting challenge.

Ø  Pharma entrepreneurs don’t listen to naysayers.

Ø  Pharma entrepreneurs are proactive in helping others and building support systems.

Ø  Pharma entrepreneurs aren’t afraid to adjust to market demands.

Ø  Pharma entrepreneurs know that innovation takes courage.

Few themes for entrepreneurship after pharmacy education include:

1. Healthcare Industry

2. New drug molecule / Active Pharmaceutical Ingredients (API) / New Chemical Entity (NCE)

3. Manufacturing and Production of new formulations

4. Production of Pharmaceuticlas, R&D

5. Contract Research Organizations (CROs)

6. E-Pharmacy in India

1. Healthcare Industry

 Entrepreneurial strategies to lower costs and improve outcomes, such as telehealth applications and retail clinics have recently emerged and may have the ability to lower costs and improve outcomes in healthcare industry. Technology has facilitated patient self-management at home and remote provider consultations. Development of retail clinics and use of community health workers has expanded access to care.

In the early twentieth century, several factors led to a consolidation of healthcare delivery in the modern hospital. Advancements in medical technology had made medical care much more complex and expensive, such that only large institutions could afford to own and operate the new diagnostic and life-sustaining equipment. In addition, professional round-the-clock nursing care had demonstrable value and was available to most people only in a hospital setting. At the same time, the practice of medicine was largely dependent upon the intuition of a limited number of well-trained physicians and most clinical outcomes were the result of their trial-and-error experimentation. Optimizing good outcomes necessitated employing and training many specialists within the same institution, and hospitals became the sole source of solutions to complex medical problems. In fact, this pattern of consolidated expertise reflects the early stages of many industries, as it represents the optimum way to maximize use of costly and scarce resources when production outcomes remain largely uncertain. However, as hospitals’ capabilities and functions have expanded over time, they have been slow to spin off more routine work to new institutions of care, a process that would typically lower per unit costs. Nevertheless, an increasing amount of clinical care has been offloaded to less costly providers working in decentralized venues. The trend toward outpatient care in ambulatory settings has existed for decades, but a more recent example is the rapid expansion of retail clinics staffed by pharmacists, at least in states that allow pharmacists to provide care without direct physician supervision. Advances in telehealth and home monitoring have further shifted care into patients’ homes, and select patient groups, such as type 1 diabetics, have already assumed much of the routine, day-to-day management of their diseases.

2. New drug molecule / New Chemical Entity (NCE)

India became a hub for drug discovery collaborations in the late-1990s when global pharmaceutical and biotechnology companies started outsourcing non-IP-sensitive chemistry such as chemical libraries, intermediates and reference compounds. Even though Western companies are looking increasingly for added value beyond cheap labor, cost arbitrage together with the availability of synthetic chemistry expertise, generics development and manufacturing business had largely been the drivers to a large extent. The service offerings expanded beyond chemistry into biology and pharmacology and a number of deals gradually evolved into IP-generating collaborations with Indian inventors. In addition to a growing network of smaller companies, this led to the rise of several large contract research companies.

The launch of biotechnology and startup companies with the aim to generate IP and licensing revenues by discovering new drugs and by partnering these for development is a more recent addition to the country’s pharmaceutical environment. This is due to the significantly higher risk involved, which some companies compensate in part by generating a revenue stream from offering, in addition to discovery collaborations, a range of discovery and development services to Indian and global companies.

It was identified that total 28 major Indian pharmaceutical companies and 14 biotech and startup companies that have reported proprietary NCE R&D with preclinical or clinical development compounds between 1994 and mid-2016. India is however making progress in putting in place an ecosystem which is more conducive to biotechnology entrepreneurship through a series of grant schemes to foster innovation and bio-incubators which provide space, access to scientific equipment, connections to industry and mentorship for IP management to startup companies.

3. Manufacturing and Production of new formulations

 Indian Pharma sector has registered 1.5 times higher growth rate than the overall GDP growth of the country. Even as contract manufacturing of pharmaceuticals products has provided ample opportunity for small and medium enterprises to attain high growth however the sector remains a distant dream for fresh entrepreneurs. Costly machinery, stringent regulatory norms and price controls are seen as major deterrent for new entrepreneurs from venturing into pharmaceuticals business including contract manufacturing, which contributes about 50 per cent to the country’s domestic drug business worth Rs. 77,000 crore. According to industry insiders, contract manufacturing in the country is growing at the rate of 20 per cent per annum.

According to industry experts, government support is required to make contract manufacturing lucrative for entrepreneurs and boost exports from India. Last year, India exported Pharma products including formulations and Active Pharmaceutical Ingredients (API) worth Rs. 90,000 crore. India exports Pharma products to about 210 countries with 28 per cent going to the US, 19 per cent to Europe and 19 per cent to Africa.

S V Veerra Mani president, Indian Drug Manufacturers’ Association (IDMA) at the inauguration of fifth edition of “Pharma India 2014” at Mahatma Mandir in Gandhinagar  said that “This is an industry, which is highly regulated with highly controlled prices. Also, it calls for zero defects with stringent regulatory requirements. So, even if we have seen new investments taking place in the sector, no new company has been launched.

4. Production of Pharmaceuticlas, R&D

Producing pharmaceuticals is a complex process that requires a reliable, high quality supply of raw materials, technical expertise and a stable supply of electricity, gas and other utilities, plus sufficient human resource capacity with Ph.D.level scientists and expertise in pharmaceutical process and regulation. Pharmaceutical plants are capital intensive and take many years to develop and tend to be located in countries with good infrastructure, reliable utilities and access to technical expertise. Indeed, there already appears to be enough capacity to produce all needed active ingredients as well as to finish bulk formulations sourced from global suppliers. Thus, it has been argued that increase in production can be accomplished within the present capacity of the global industry. Certainly, the vast majority of the manufacturing cost is in the primary manufacture of active ingredients and the opportunity for smaller local manufacturers to save cost is limited. The distinctions brought out earlier between local production as industrial policy and as a stimulator of pharmaceutical “access” are relevant. The fact that a developing country with manufacturing facilities is able to finish off bulk active ingredients sourced from developed or other countries at high costs may have no impact whatever on patient access to needed medicines.

India's pharmaceutical industry is one of the most highly regulated industries in the country. Price controls have a strong effect on profitability in the industry. Before 2005, India had no product patent protection but this posed only a short-term threat to foreign investment in India's drug market. The sheer size and growth of India's domestic pharmaceutical industry is making it increasingly difficult for the government to regulate prices for every single firm. The market structure of the Indian pharmaceutical industry is skewed with a small number of large firms and many smaller pharmaceutical companies. The large private sector includes domestic manufacturers, foreign controlled companies and smaller private firms. The Indian foreign controlled companies import most of their bulk drug requirements and produce formulations, their focus being the domestic market. Pharmaceutical policy in India is perceived as industrial policy, not health policy. Since 1970, domestic firms have increased in number and since 1999, about 8-10 of these have developed sufficient in house R&D capacity to be able to develop new drug molecules as well as produce bulk drugs. Indeed, some of these large Indian companies have become multinationals themselves. However, the vast majorities of private manufacturers are small-scale and have problematic quality assurance systems and procedures. The success of the Indian pharmaceutical sector has come mainly from the larger Indian corporations. Smaller firms have limited capability for brand building or for developing distribution networks and will tend to contract with larger firms or collaborate with universities or research labs to remain viable. In terms of health policy, there is considerable variability in the quality and pricing of drugs throughout India and these differences are due primarily to differences in quality of training and infrastructure.

5. Contract Research Organizations (CROs)

Contract research organizations (CROs) provide clinical trial and other research support services for the pharmaceutical, biotechnology, medical device industries and also serve government institutions, foundations, and universities. In the changing economy, pharmaceutical companies are increasingly looking to outsource critical functions, including manufacturing and research. More and more of the major corporations are using CROs to lead clinical trials and develop new medications. CRO is a service organization that provides support to the pharmaceutical industry and offers a wide range of "outsourced" pharmaceutical research services to aid in R&D process and is thus an essential tool for undertaking clinical trials in the present scenario when high stakes are involved in the drug discovery process. This industry also offers a safe option of investment as the industry is largely recession-proof, with a significant upscale growth. Presently India occupies a very small pie of the global market share in the Clinical Trials Industry but it reached at 5% of global clinical trials by 2012. The global CRO industry valued $18 bn in 2008 and the market annual growth rate was 14% between 2009 and 2013. Top multinational pharmaceuticals companies are venturing into the Indian business, in collaboration with the Indian Drug Companies. According to a recent study by Mckinsey & Company, the Indian Clinical Research Industry attracted $1.5 bn of revenue from US and EU by 2010. Such an increase in outsourcing from the western countries has led the global Pharma companies and Indian entrepreneurs to set up Contract Research Organizations (CROs) in India. To bring this into realization and fulfill the market demand, while simultaneously aiding in improving the country's economical standards and market position, joint and well-coordinated efforts on part of the government, industry, and working professionals are needed in terms of regulatory affairs, audits, transparency in work affairs, garnering patient confidence  and pharmacovigilance.

6. E-Pharmacy in India

According to Transparency Market Research, the global e-Pharmacy market was around US $29.3 Billion in 2014 and is estimated to grow at a CAGR of 17.7% to reach a valuation of US $128 Billion by 2023. The global e-Pharmacy market is currently led by North America and Europe. However, the major opportunity for the global e-Pharmacy market lies in the vast unmet needs of the developing Asia Pacific market. According to a Boston Consulting Group report released in April 2016, the e-Pharmacy market in China was around US $1.1 Billion in 2014 and is on an upturn.

E-Pharmacy is at its nascent stage in India, but like other categories, it has the potential to be a very large industry segment in the near future. Factors driving the demand for e-Pharmacy in India include rising number of people with unmet medical needs due to large population and increasing penetration of internet in both urban and rural India. With the rapidly changing consumer behavior in India, there is a huge demand for accessing a wide range of products at the click of a button, and at competitive prices. It is expected that the e-Pharmacy model could account for 5-15% of the total Pharma sales in India, largely by enhancing adherence and access to the medicines for a lot of under-served population. The Government of India has set up approximately 250,000 common services centers (CSC) across the country which plays a pivotal role in delivering various e-health services, like telemedicine, e-Diagnostics, e-Pharmacy, especially to the rural population.

An e-Pharmacy aligns very well with the national development objectives and has clear and tangible benefits to the consumers as well as the industry. Meanwhile, it has also been observed that growth of e-Commerce and retail are complimentary and reinforce each other. By leveraging the technology in a smart way and under stringent regulatory control, the e-Pharmacy has a scope of adding immense value to the existing retail industry in India.

Conclusion

Pharmacy education will enrich the entrepreneurial scope and skill. It will enhance the capacity of graduates to provide more innovative pharmaceutical services to society either as owners of pharmaceutical businesses or as managers in such operations. The pharmacy education requires a solid educational foundation to promote critical and lateral thinking, problem solving including study skills and team-working skills, leadership skills, effective communication, and the analysis and use of numerical data. For the benefit of student learning, a deeper appreciation of what is required to be an effective entrepreneur is needed.  Development of entrepreneurial spirit and positive attitude towards entrepreneurship should be an important component of such an educational process. Entrepreneurship has more scope for innovative ideas, problem solving attitude and creativity. The need of the hour is to encourage more entrepreneurship in pharmaceutical sector so that the drugs and pharmaceuticals can be produced at affordable prices. Every pharmacy college should launch an entrepreneurship development cell with a view to encourage students to consider self employment as a career option, provide training in entrepreneurship through modular courses and to teach the relevance of management. This cell will introduce the concept of entrepreneurship in curricula of pharmacy. It also facilitates self employment and entrepreneurship development through formal and non-formal programmes. A faculty development programme can be conducted by the cell to develop professionals in entrepreneurship development so that they can act as resource persons in guiding and motivating the students to take up entrepreneurship as their career. This faculty development programmes will provide a platform from which formal and informal programmes can be conducted to support skill development activities particularly catering to specific areas of requirement to identify and provide solutions for the problems of small business management and entrepreneurs to provide training and retraining of entrepreneurs through variety of programmes and to train trainers, counselors and motivators involved in the development of pharmaceutical entrepreneurship.