Frost Sullivan Outlook On E-pharmacy Market In India

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IN THE SPOTLIGHT:e-Pharmacy in IndiaAn Exponential Growth Opportunity

21INDIAN HEALTHCARE IS WITNESSING A POSITIVETRANSFORMATION2UNDERLYING FUNDAMENTALS, OPPORTUNITIES, ANDOUTLOOK FOR PHARMACY3EVOLVING PLAYERS IN e-PHARMACY MARKET IN INDIA4e-PHARMACY : CHANGING THE PARADIGM OFHEALTHCARE

31INDIAN HEALTHCAREIS WITNESSING APOSITIVETRANSFORMATION

A Growing Challenge: To provide healthcareservices to 1.35 billion people4India is set to be the third largest economy in the world by 20501.1 Gross Domestic Product (GDP)India is the world’s sixth largest economy by nominal GDP and the third largest by Purchasing PowerParity (PPP). Its GDP at current prices (in US terms) has expanded at a compound annual growthrate (CAGR) of 5.4% from 2010 to 2017, making it the second fastest growing major economy in theworld after China [Source: Central Statistics Organization (CSO) and International Monetary Fund(IMF)]. The country recorded a GDP of US 2,439 Billion in 2017. Its strong democracy, industrialgrowth, and strategic relations (both regional and global) are expected to drive future growth,pushing its GDP to US 3,924 Billion by 2022 and thereby making it one of the top three economiesof the world over the next 10-15 years (Source: IMF).Exhibit 1.1: India's GDP at Current Prices and GDP Growth (2013-2022E)Historical CAGR (2013-17): 4.6%Expected CAGR (2017-22): 2%10%8%6%4%2%0%201320142015201620172018E 2019E 2020E 2021E 2022EGDP at current Prices ( billion)GDP Growth %Source: International Monetary Fund (IMF) & World Bank Data.India's GDP at current prices in US terms is expected to reach US 3.9 Trillion by FY22 and achieveupper-middle income status backed by digitization, globalization, favourable demographics, andreforms.India is expected to be the world’s third largest economy in terms of consumption, which isestimated to be triple by 2025, aided by the shift in consumer behaviour and expenditure patterns.We believe that owing to reforms like liberalization, simplified regulations, increasing role of theprivate sector, and opening up of the economy to competition, the country’s equity market is wellpositioned to become the world’s third largest. Our view is strengthened by India being among theonly two developing countries to feature in the top-10 emerging economies with advancing trends.

Increasing ageing population base with a higherpredisposition to chronic diseases51.2 Population by Age Groups12% of the total Indian population was estimated to be above the age of 54 years in 2010. Thisnumber is expected to increase to 14% by 2020. We expect the ageing population base and itspredisposition to various chronic diseases to stress healthcare resources in the near future and posea serious challenge to the idea of healthcare access for all. We also expect this to reemphasize theneed for development of healthcare infrastructure for all levels of care delivery—primary, secondary,and tertiary.Exhibit 1.2: Age Group Wise Classification of Population (2010-2022E)1.23 bn1.32 bn1.34 bn1.39 bn1.42 bnCAGR 2017E2020E2022E0-19 Years20-34 Years35-54 Years 54 YearsSource: United Nations Population Division, World Population Prospects (2017 Revision), Frost & Sullivan Analysis1.3 Healthcare ExpenditureIndia’s Total Health Expenditure (THE) stood at 91.7 Billion in 2015. The total expenditure onhealthcare constitutes current healthcare expenditure and capital healthcare expenditure incurredby government and private sources including external / donor funds. Current Healthcare Expenditure(CHE) for India stood at 82.9 Billion for 2015, whereas the capital healthcare expenditure was at 8.75 Billion, as per a report released on National Health Accounts by the WHO in October 2017.Exhibit 1.3: India's Current Healthcare Expenditure and Healthcare Expenditure asa % of GDP 012Current Healthcare Expenditure ( Billion)201320142015Current Healthcare Expenditure as % of GDPSource: World Health Organization Global Health Expenditure database, October 2017

62UNDERLYINGFUNDAMENTALS,OPPORTUNITIES, ANDOUTLOOK FORPHARMACY

Growing at a Double-digit Pace, Indian Pharma ismaking Incredible Progress72.1 Indian Pharmaceutical Industry Market Size and GrowthThe Indian pharmaceuticals market is the third largest in terms of volume and 13th largest in terms ofvalue, globally. This market grew from US 28.5 Billion in 2014 to US 29.6 Billion in 2017. It isexpected to grow at a CAGR of 11.3% and reach US 55 Billion by 2020. This growth will be primarilydriven by the high burden of disease, good economic growth leading to higher disposable incomes,improvements in healthcare infrastructure, and improved healthcare financing, to name a few. Indiais expected to be among the top three pharmaceutical markets by incremental growth and the sixthlargest market globally in absolute size by the end of 2020.Exhibit 2.1: Revenue for the Indian Pharmaceutical Sector (US urce: Frost & Sullivan2.2 Retail Pharma MarketThe retail pharma market in India is currently at a promising stage with its three broad segments ofgeneric drugs, over-the-counter (OTC) drugs, and patented products. Generic drugs form the largestsegment, with around 70% market share in terms of revenue. OTC medicines and patented drugsconstitute 21% and 9% shares, respectively, of the total market.The domestic pharma retail market, valued at around US 17,643 Million (INR 119,641 Crores) in2017, is primarily driven by the anti-infective market with a 15.2% share, the cardiac drugs market at12.5%, the gastrointestinal drugs market at 11.8%, the vitamins / minerals / nutrients market at8.8%, and the anti-diabetic market at 8.1%.1 US INR 67.8

82.3 Challenges for Retail PharmacyLow Industry MarginsRetail pharmacy is a highly fragmented and competitive industry with 8,00,000registered retail outlets across the country. Drugs are bought in smaller quantities bythese retail stores from drug distributors at high prices which in turn reduces theirprofit margins.Sustainability of the IndustryDue to increased competition and rising pressure on price controls, the sustainabilityof the retail pharmacy industry is at risk due to the already lower profit margins.Technology adoption can help this industry to increase productivity and providevalue-added services to consumers.Drug AbuseAllegations of medicine sales without prescriptions are levied at retail pharmacies.This has led to significant number of cases of drug abuse.Counterfeit MedicinesRetail pharmacies in India are alleged to sell sub-standard and fake medicines,thereby increasing the risk of adverse effects.Documentation/TrackingSale of drugs also happens without providing bill / invoice for the purchase, affectingthe amount of tax collected. Poor documentation of prescription drug sales istherefore impacting the drug recall process.Poor Inventory ManagementIn India, it is generally not feasible for a single pharmacy to store a wide range ofproducts, which forces consumers to visit multiple pharmacies for procuring all theirmedicines.Currently, the retail pharmacy ecosystem has high friction, leading to inefficienciesand high cost to the consumers. Thus, there is a need for a technological upgrade ofthe model for streamlining the processes. Computerization of pharmacies, recordingof transactions, and restricting cash transactions could transform the industry.

e-PHARMACY HAS TAKEN CENTERSTAGE INADDRESSING THE NEED GAP9

e-Pharmacy Market In India102.4 e-Pharmacy: A Potential Pharmacy Modele-Pharmacies are online platforms where consumers can purchase medicines without having to visitbrick-and-mortar pharmacies. These platforms have improved the convenience of consumers andresulted in a rising demand for the model across the world. In addition, increasing utilization of ePrescriptions in hospitals globally has also led to the growth of this industry.According to Frost & Sullivan, the e-Pharmacy market in India is estimated to be around US 512million ( INR 3,500 Crores) in 2018 and is estimated to grow at a CAGR of 63% to reach US 3,657million ( INR 25,000 Crores) by 2022. The global e-Pharmacy market is currently led by NorthAmerica and Europe. However, the major opportunity lies in addressing the vast unmet needs of thedeveloping Asia Pacific market.Exhibit 2.2: e-pharmacy market in India (US million)3,6575122018E2022PSource: Frost & Sullivan, Economic Times (dated 7 December 2018)e-Pharmacy is at its nascent stage in India, but like other categories, has the potential to be a verylarge industry segment in the near future. The online purchase of medicines is gaining momentum inIndia. The advent of online pharmacy retailers in the Indian market will further increase thepenetration of the organized pharmacy segment. It is expected that the e-Pharmacy model couldaccount for 15%-20% of the total pharma sales in India over next 10 years, largely by enhancingadherence and access to medicines for a majority of the under-served population.Currently, many e-Pharmacy players such as Medlife, Netmeds,1MG, Pharmeasy, Myra, CareOnGoand Pharmasafe operate in this segment. Medlife is currently a leading player with about 30%market share of the total e-pharmacy market in India3.Exhibit 2.3: Market share of leading e-pharmacy players in India (%) 2018Medlife 30%70%1.CII, 'e-Commerce in India A Game Changer for the Economy' (April 2016) 72. 'Indian ecommerce market to grow fastest globally over 3 years: Morgan Stanley‘3. -future-plans-major-investments-made-ipo/Other e-pharmacyplayers2018 - 1 US INR 68.362022 - 1 US INR 68.36

Factors contributing to growth of the e-PharmacyIndustry in India111. Rapid internet penetration in IndiaInternet penetration in India has risen significantly in recent years and the total Internet subscribersset to increase at a CAGR of 15-16% from 2015 to 2020. Mobile Internet has led this growth, drivenby the proliferation of Internet-enabled mobile devices and 4G deployments by telecom providers.The top nine Indian cities account for 35% of all urban Internet users. With improving broadbandconnectivity under the ‘Digital India Program’, the number of Internet users is expected to increasesubstantially. Smartphone users, who will transact digitally, are expected to grow to 600 million inthe next five to seven years.Exhibit 2.4: Internet Users in India (Million)CAGR (2015-2020): 267.420152016Source: TRAI2. Digital India InitiativeDigital India is a flagship program of the Indian Government with a vision to transform the countryinto a digitally empowered society and knowledge economy. It is a campaign launched to ensure theGovernment's services are made available to citizens electronically by way of improved onlineinfrastructure and by increasing Internet connectivity or by making the country digitally empoweredin the field of technology.The fundamental objective of this program is to digitally connect every corner of the country,including smaller towns and remote villages, with high-speed Internet. It aims to empower citizensto avail services with more ease and to conveniently interact with the Government. This initiative isexpected to not only boost the country’s economic growth but also improve the lives of its citizens.

Factors contributing to growth of the e-PharmacyIndustry in India123. e-Healthcare Initiatives by the GovernmentThe Ministry of Health & Family Welfare has undertaken various initiatives using Information &Communication Technologies (ICT) for improving the efficiency and effectiveness of the publichealthcare system. Some of the initiatives are depicted in the exhibit below.Exhibit 2.5: Government initiatives for e-HealthcareNational Health PortalOnline RegistrationSysteme-Hospital@NICCentral DrugsStandards ControlOrganization(SUGAM)National HealthPortalOnline RegistrationSysteme-Hospital@NICSUGAMAn online portalwhich Providesinformation tocitizens andstakeholders indifferentlanguages tocreate awarenessabout healthprograms andservicesIt is a generic software forhospitals in thegovernment sector whichcovers major functionalareas like patient care,laboratory services,workflow-baseddocument informationexchange, humanresource, medical recordsmanagement.Provides services tocitizens for takingonline registrationsand appointments,payment of fees,online viewing ofdiagnostic reports,enquiring about theavailability of bloodonline etc. in variouspublic hospitalsIt is a single window formultiple stakeholders. Itenables onlinesubmission ofapplications, theirtracking, processing andgrant of approvalsonline mainly for drugs,clinical trials, ethicscommittees, medicaldevices, and vaccines.Source: Frost & SullivanAlong with these initiatives, the National Health Stack is expected to significantly bring down thecosts of health protection, converge disparate systems to ensure a cashless and seamlesslyintegrated system for the benefit of patients. All these government initiatives will bring more andmore patient services online and make people familiar with using online health services. This will inturn help private online healthcare providers to sell their services with ease.

Factors contributing to growth of the e-PharmacyIndustry in India134. Increase in Health insurance penetrationThe number of lives covered under health insurance in India has more than doubled in the last fiveyears. It stood at 437 Million in 2016-17, registering a CAGR of 20.5% between 2012-13 and 2016-17.Major drivers for this increase are a growth in lives covered by government and group (other thangovernment) schemes in the last three years, which in turn is largely dependent on increasedawareness and uptake of insurance products, and rising launches of insurance schemes by variousstates and the central government. Exhibit 2.6 shows the number of persons covered by varioushealth insurance businesses.Exhibit 2.6: Number of Lives Covered (in %) by Various Health Insurance 7%2012-132013-142014-152015-162016-17Retail policiesGroup Schemes(other thanGovernmentSchemes)Governmentsponsored schemesSource: IRDAI annual report 2016-175. Ayushman Bharat Health Insurance SchemeAyushman Bharat Yojana, or National Health Protection Scheme, is a program which aims to providea service to create a healthy, capable, and content new India. The scheme is targeted at poor,deprived rural families. 8.03 crore rural families and a further 2.33 crore in urban areas are entitledto be covered under this scheme. It will cover around 50 crore people and will have a defined benefitcover of INR 5 lakh per family.This increase in health insurance penetration along with new innovative products launched byinsurers has led to increased uptake of OPD services. Many e-pharmacy players have started tie-upswith health insurers to provide medicines to the customers at cheaper prices in turn saving the costsfor insurers and keeping their claim ratio under check. Also, more and more health insurers areincreasingly promoting the customers to buy medicines through e-Pharmacy portals.

Factors contributing to growth of the e-PharmacyIndustry in India146. Changing disease patterns in IndiaThere has been a major epidemiological transition in India in the last 25 years, and the focus hasshifted from communicable to non-communicable diseases (NCDs). The morbid population basewith diabetes and hypertension in India is expected to rise to 263 Million by 2020. However, manydo not seek medical help due to a lack of awareness and the high cost of treatments. An estimated77.2 Million people in India were pre-diabetics as of 2014. Exhibit 2.7 shows the Top ten diseasescausing the highest mortality and morbidity in India.Exhibit 2.7: Top ten diseases causing the highest mortality and morbidity in India, 2016Ischemic heart disease-60.00% -40.00% -20.00%0.00%20.00%40.00%45%Chronic Obstructive Pulmonary Disease (COPD)23%Diarrheal diseasesLower respiratory infectionCerebrovascular diseases-50%-50%23%Iron-deficiency anaemia15%Neonatal preterm birthTuberculosisSense organ diseasesRoad injuries60.00%-40%-35%30%28%Source: Global burden of diseases, HealthdataThe precursors to some of these diseases are linked to conditions which are preventable; some ofthose are diabetes and hypertension, which have been on a rise due to changing lifestyles. This shiftin disease pattern towards chronic diseases has led to increased demand of daily medicines to betaken over long term. e-Pharmacies provide cost benefits to chronic disease patients by supplyingmedicines at lower cost than retail pharmacies along with providing regular reminders forreplenishing medicines in turn leading to increased drug compliance

Factors contributing to growth of the e-PharmacyIndustry in India157. Foreign Direct Investment (FDI) policyThe Union Cabinet has given its nod for amending the existing FDIpolicy in the pharmaceutical sector and allow FDI up to 100% underthe automatic route for the manufacturing of medical devicessubject to certain conditions. This has helped in ensuring (i)continuous availability and supply of drugs, (ii) non-discontinuanceof essential medicines, and (iii) an increased supply of drugs over aperiod of time.8. Single Window ApprovalIn March 2018, the Drug Controller General of India (DCGI)announced its plans to start a single-window facility to provideconsents, approvals, and other information. This process will aid the’ease of doing business’. The move is aimed at giving a push to theMake in India initiative.9. Increased Spending on MedicinesMedicine spending in India is expected to increase at a 9-12% CAGRbetween 2018 and 2022 to US 26-30 billion, driven by increasingconsumer spending, rapid urbanization, rise of NCDs, and raisinghealthcare insurance among others.10. Growth in Healthcare Financing ProductsDevelopments in the Indian financial industry, with the introductionof products such as health insurance policy, life insurance policy, andcashless claims, have eased the financing of healthcare services. Thishas resulted in an increase in healthcare spending which, in turn,has benefitted the online pharmaceutical industry.

Factors contributing to growth of the e-PharmacyIndustry in India1611. Booming Indian EconomyIndia is the world’s sixth largest economy by nominal GDP and thethird largest by purchasing power parity (PPP). It’s GDP at currentprices (in US terms) grew at a CAGR of 5.4% from 2010 to 2017,making it the 2nd fastest growing major economy in the world afterChina [Source: Central Statistics Organization (CSO) andInternational Monetary Fund (IMF)].Its strong democracy, industrialgrowth and strategic relations (regional and global) are expected todrive future growth such that it is set to become one of the topthree economic powers of the world over the next 10-15 years(Source: IMF).12. Increase in Domestic DemandWith the increase in awareness levels, growth in per capita income,changes in lifestyles due to urbanization, and the rise in literacylevels, the demand for advanced medical treatment is expected toincrease. Moreover, growth in the middle class population wouldfurther influence the demand for pharmaceutical products.13. Growing Number of Lifestyle DiseasesThere has been a major epidemiological transition in India in the last25 years, and the disease incidence has increased fromcommunicable to NCDs. This increase in lifestyle diseases likediabetes and hypertension generates a regular and lifelong demandfor drugs.

17Existing e-Pharmacy Models1. Inventory-based Model of e-PharmacyInventory-based model of eCommerce means an activity where the inventory of goods and servicesis owned by the eCommerce company and the products are sold to the customers directly. Similarly,in e-Pharmacies, the e-Pharmacy owns the inventory of medicines / drugs that are stored inwarehouses / fulfilment centers across geographic locations. Once orders are received by the ePharmacy on its website / app, they are checked by the registered pharmacist. Orders which requirea prescription are checked for a valid e-prescription / scanned prescription uploaded by theconsumer on the website. Medicines / drugs are not dispensed without a valid prescription.Registered pharmacists wrap the medicines in a tamperproof pack and deliver them to customersthrough a courier service.Inventory-based Model of e-PharmacyWebsite,mobile appConsumerLicensedPharmacyConsumerSource: Frost & Sullivan2. Marketplace-based Model of e-PharmacyMarketplace-based model of eCommerce means that the technology companies act as a facilitatorbetween a buyer and a seller. In this model, the e-Pharmacy plays the role of an aggregator. Itprovides a technology platform that connects the buyers and sellers of medicines. The e-Pharmacywebsite empanels licensed pharmacies and lists their products. Consumers select the medicines /drugs available on the website / app. The e-prescription / scanned prescription is uploaded on thewebsite / app. The order is passed on to the licensed pharmacy. The pharmacy verifies the orderagainst the prescription and then prepares the order. The orders are cancelled in the absence of avalid prescription. The medicines are then delivered to the customers through a courier service.

18e-Pharmacy In IndiaOperate under Drugs and Cosmetics Act & RulesMarketplace-based Model of e-PharmacyOperates underthe IT ActPharmacy 1Pharmacy 1Pharmacy 1Website,mobile appConsumerPharmacy 1Source: Frost & Sullivan3. Generic eCommerce MarketplaceGeneric eCommerce marketplace is a technology-driven electronic platform where a wide variety ofproducts like electronics, fashion, furniture, home furnishings, and cosmetics are sold. This modelprohibits the advertisement and sale of prescribed drugs or any drugs, which are in violation of theDrugs & Cosmetics Act. Examples of this marketplace are Flipkart and Amazon.Risks to Existing e-Pharmacy Models Existing brick-and-mortar chains can establish their presence online: Brick-and-mortar pharmacychains like Apollo Pharmacy can establish online portals for selling their drugs. The chains alreadyhave a geographical presence in different parts of the country and have an establishedprocurement and delivery process. Established eCommerce players may enter the e-Pharmacy business: eCommerce players likeFlipkart and Amazon can acquire brick-and-mortar pharmacy chains or existing e-Pharmacies toadd to their basket of existing products. The eCommerce players already have the supply chain inplace. The e-Pharmacy business will substantially add to their profit margins. Evolution of the existing models: There may be consolidation of the existing e-Pharmacy playersin terms of mergers and acquisitions. Dual models like e-Pharmacy in combination with brick-andmortar stores may evolve.

19Regulations for e-Pharmacye-Pharmacy Draft GuidelinesThe Union Health Ministry released draft rules on the sale of drugs by e-Pharmacies on 28th August2018 and is awaiting feedback over the next few weeks before finalizing the policy. On 7th DecemberDrugs Controller General of India Eswara Reddy confirmed that The union government is expected tocome out with final regulations for the companies selling medicines online by the end of this monthKey Highlights of the e-pharmacy Draft GuidelinesRegulatory AuthorityRegistration of e-Pharmacy e-Pharmacies are currentlygoverned by state drugregulators. The draft proposesthat the DCGI should be the sole agencygranting approvals to e-Pharmacies. The DCGI will be regulated under theDrugs and Cosmetics Rules 1945 as wellas the Information Technology Act 2000under which eCommerce companies areregulated. Companies operating e-Pharmacies arerequired to take one license in any state.Any state license will enable thepharmacies to sell drugs all over thecountry.Any person who intends toconduct the business ofe-Pharmacies will have tomandatorily apply for registration to theCentral Licensing Authority (“CLA”) by fillingup Form 18AA along with paying a fee of INR50,000 (US 730) and furnishing therequisite documents through the onlineportal of the CentralGovernment. Registration is mandatory forthe purposes of selling, distributing,stocking, exhibiting, or offering for sale ofdrugs through the e-Pharmacy portal by anyperson. Registration would remain valid for threeyears from the date of issue. An e-Pharmacy registration holder will berequired to make an application for renewalbefore its expiry or three months beforeexpiry in Form 18AA along with a fee of INR50,000 (US 730) and the requisitedocuments as specified in Form 18AA. The portal would also have to abide bythe provisions of the Drug and CosmeticAct, 1940. Failing to follow the guidelinescould lead to suspension and cancellationof the e-portal.Verification The registered pharmacistmust verify the details of thepatient, registered medicalpractitioner, and arrange for thedispensing of drugs as per the instructionsof the registered medical practitioner. Thedetails of the drugs dispensed along withthe patient details are to be maintained onthe e-Pharmacy portal.‒The registration will be deemed to haveexpired if the application for its renewalis not made within six months after itsexpiry.‒The e-Pharmacy registration holder mustkeep his place open for periodicinspection, every two years, by anauthorized team of the CLA.‒The e-Pharmacy registration holderneeds to inform the CLA in writing uponany change in the constitution of thefirm operating under the registration.

Regulations for e-Pharmacy20DRUGS WHICH CANNOT BESOLD ON THE E-PHARMACYPORTALCONFIDENTIALITY OFINFORMATION GENERATEDTHROUGH THE PORTALHELPLINE ANDGRIEVANCE REDRESSALThe e-Pharmacy registration holdermust not deal in drugs that arecovered under the narcotic andpsychotropic categories as referredto in the Narcotic Drugs andPsychotropic Substances Act, 1985.The e-Pharmacy will be required tokeep all its customer informationconfidential but will be duty boundto disclose any information to theState or the Central Government,whenever required, for publichealth purposes.The e-Pharmacy will be requiredto keep all its customerinformation confidential but willbe duty bound to disclose anyinformation to the State or theCentral Government, wheneverrequired, for public healthpurposes.DATA COLLECTIONIt is mandatory to establish an ePharmacy portal in India and all thedata generated is to be kept in thecountry. The data generated ormirrored through the e-Pharmacyportal cannot be sent or stored, byany means, outside the country.Prashant SinghCo-founder, MedlifeADVERTISEMENT ANDPUBLICITYData to be available on the ePharmacy portal Registration issuedin Form 21AA, constitution of thefirm (details of directors andpartners with ownership patterns),official logo of the e-Pharmacyportal, details of the logistic serviceprovider, return policy of thedispensed drugs, etce-Pharmacies are forbidden toadvertise on any mediaplatform like print, television,or the digital medium.The government as well the CDSCO is very supportive of ePharmacies. There are no regulatory pressures other thanexpectations of following the laws. The HC judgment too wasonly with regards to pharmacies selling online who do notcarry the valid licenses to dispense and hence operateillegally.““MAINTENANCE OFTHE E-PORTALSource: Frost & Sullivan

Retail Pharmacy vs. e-Pharmacy Chains21The e-Pharmacy model presents various advantages over the traditional retail pharmacy model. Theadvantages range from higher profit margins, keeping a better check on counterfeit / fake drugs, andsuperior adherence to regulatory checks. The following table enlists a detailed comparison betweenretail pharmacy stores and e-Pharmacy chains.ModelRetail Pharmacy Storese-Pharmacy ChainsProfit Margins Single retail pharmacies haverelatively low profit margins. Drugs are purchased in small volumesfrom distributors at high prices, whichreduces the profit margin. e-Pharmacies purchase in bulk directlyfrom companies/ distributors, whichenables them to get the drugs at asubstantial discount there by increasingtheir profit margin.Counterfeit /Poor QualityDrugs Sub-standard and fake medicinescould get sold through this channel,increasing the risk of adverse effects. e-Pharmacy chains could prevent sale ofpoor quality drugs through their efficienttracking mechanismInventoryManagement It is less feasible for a single pharmacyto store a wide range of products,which forces consumers to visitmultiple pharmacies for procuring allthe medicines. Apart from storing a wide range ofproducts, the software helps e-Pharmaciesto analyse the consumption pattern ofcustomers, enabling them to predictfuture requirements, thereby leading toefficient inventory management.Documentation/ Retail pharmacies generally lack haveTracking andthe resources to invest in advancedLevel ofinformation technology software forTechnologydocumentation and trackingChallenges Retail pharmacies are facing thechallenges of high rental rates andrising overhead costs combined withthe growing threat from onlinepharmacies. e-Pharmacies have the resource to investin the latest information technologysoftware. Digitalization of pharmaciesenables them to record and tracktransactions and increase productivity. Consumer loyalty towards retail pharmacyand the growing threat from the risingnumber of online pharmacies are the keychallenges.

22Benefits of the e-Pharmacy ModelPatients /ConsumerRegulatorPharmaciesBenefits of the e-Pharmacy Model to CONSUMERS1Increased ConvenienceConsumers would be able to order medicines in a convenient manner from their mobile phones orcompute

The domestic pharma retail market, valued at around US 17,643 Million (INR 119,641 Crores) in 2017, is primarily driven by the anti-infective market with a 15.2% share, the cardiac drugs market at 12.5%, the gastrointestinal drugs market at 11.8%, the vitamins / minerals / nutrients market at 8.8

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