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KJMC Capital Market Services Ltd. The main reason is that Lupin's growth in this segment is basically from the sales of cardiovascular API. The company is not doing business on `Pril" and "Statin" range of products directly in the US market. Lupin's main business revenue from this segment coming from domestic formulation market and API export market. The domestic cardiovascular formulation market is growing a flat rate for the last couple of years, which is again quite prominent from the 7% growth of Lupin in cardiovascular formulation market in FY 02-03. The only hope lies in the export of cardiovascular API business where growth gets restricted after a certain level due to inherent limited growth of any API business. Also, the growth will be further challenged by the increasing exposure of low-priced Chinese import in the international market after China's entry in WTO. As a result, the growth rate will taper off from the current high level of sales. The reason is that cardiovascular API business covers only 7% of the total revenue of Lupin in FY 02-04. Thus, growth here would make a marginal impact on top line growth. `Statin' range of cardiovascular drugs is fastest growing class of medicine with worldwide sales of $19 billion. This is also reflected in the latest list of top-10 highest selling drugs on the basis of sales of the last 12 months ended March 2003. The top two positions went to `stating' level drugs, Lipton branded name of atorvastatin drugs manufactured by Pfizer ; secured the top position with global sales of $7.97 billion and Zocor branded name of simvastatin drugs manufactured by Merck ; got second position with global sales of $5.6 billion among the top selling drugs across various therapeutic segments. Patent expiry of L8pitor and Zocor in the US is in 2010 and 2005. However, the patent of Zocor is expired in major European market such the UK, and Germany at the end of 2002. The current patent of atorvastatin drugs will not allow Lupin to expand the export business in regulated market whereas there is opportunity in simvastatin drugs in European market from 2003. Presently, Lisinopril and Lovastatin are the only two major cardiovascular drugs of Lupin, which covers only the domestic market and a part of export market. Though, there is good opportunity in `statin' off-patent formulation business in European market, Lupin's main focus is in cardiovascular API business. Therefore, company's expectation of getting very high rate of growth in Cardiovascular API segment is going to be restricted by market growth level of 20% for FY 03-04 and 25% in 0405. The growth expectation has also taken in to consideration the initiative of the company to market their Cardiovascular formulation products Lisinopril went off-patent last year ; and Lovastatin Cholesterol reducing drug ; and other `statin' and `prill' range of product which are going off-patent. We believe that lack of focus of Lupin in cardiovascular formulation business will hamper substantially the growth of the business in cardiovascular segment at a higher base. Moreover, the company is late in taking initiative to enter in to the cardiovascular segment with the fact that it will be hard for them to maintain growth in cardiovascular business in domestic market, as there is strong presence of DRL and Ranbaxy in domestic market. Therefore, we have assumed that the cardiovascular API business will earn sales of Rs.90 crore and Rs.113 crore in FY2003-04 & FY2004-05 respectively. Whereas, Lupin's cardiovascular formulation business is expected to earn sales of Rs.26 Crore and Rs.28 crore in FY 2003-04 & FY2004-05 respectively. NSAIDS--Started painful journey Apart from Cephalosporin and cardiovascular segment, Lupin Ltd. has pinned their hope on a star product of NSAIDS segment, Rablet. This is in line with their increasing focus on gastoenterology. They are planning to introducing some of the new drugs along with existing line of product Rofecoxib and Celecoxib in the Cox 2 inhibitor range ; . Rofecoxib molecules are emerged as largest molecules in this segment in India and altogether accounts for Rs.80 crore. All the drugs in this segment introduced by Lupin are addressing various treatments in anti-ulcerant treatment only, which is also major growth driver in this segment. Though the market growth in NSAIDS is 15% in 2002-03, the company has managed to register negative -13% ; growth in FY02-03 despite the good sales performance of Rablet in and lotensin.
PHARM.PRODUCT SUBSTANCE simvastatin ZOCORD ZOLOFT sertraline sumatriptan IMIGRAN metoprolol SELOKEN ZOC felodipine PLENDIL VALTREX valaciclovir phenoxymethyl-pc KVEPENIN amoxicillin + enz. Inhib. SPEKTRAMOX LOSEC MUPS omeprazol ZOMIG zolmitriptan lansoprazol LANZO citalopram CIPRAMIL PULMICORT TURBUH. budesonide inhal. LIPITOR atorvastatin sildenafil VIAGRA.
Most doctors feel that antipsychotic drugs are essential, and that you will need to take them in order to be able to benefit from any other sorts of treatment, such as cognitive behaviour therapy, that may be available. If you have had episodes in the past and know what is helpful to you and what is not, you may disagree and prefer to use alternatives to drugs. Crisis centres Crisis centres are alternatives to hospital, planned as places of asylum and refuge. Staff can support people through their experience, together with others who have been through a similar crisis themselves. Such services are still too rare in this country. Talking treatments You may find it helpful to talk to a counsellor or a psychotherapist about your experiences, to try and make sense of them, or to relate them to events in your life. More and more GPs are employing counsellors in their practices. If not, your GP or your psychiatrist may be able to refer you to a psychotherapist or counsellor and lotrel.
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The authors note in their discussion that the results of their review found that HRT was associated with an overall 29% increase in the risk of stroke. Additionally, the authors note, "Importantly, the severity of stroke was increased with hormone replacement therapy, since the frequency of a poor functional outcome, judged as combined death and disability or dependency, was 56% higher in those randomised to therapy". The authors add that based on their results, HRT cannot be recommended for the primary or secondary prevention of stroke. BMJ UK health news reports on a related article in the Times newspaper today. In this, Professor John Stevenson of the British Menopause Society said: "The extra risk is absolutely minimal, amounting to less than one stroke in 1, 000 women using HRT during their lifetime". The article notes that the latest review included evidence from the US "Women's Health Initiative" WHI ; study, which in 2002 linked HRT with higher risks of breast cancer, heart attack and stroke. A Department of Health spokesman told BMJ health news that women on HRT should discuss the risks with their doctor and have regular health check-ups and macrobid!
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