Medgate Today Magazine - Sep 2021

Volume XII | Issue IX | September 2021

COVER STORY

#USEHEART

WORLD

HEART

29, DAY SEPTEMBER 2021

USE

TO CONNECT

INTERVIEWS Dr. Ramakanta Panda

Vice Chairman, Asian Heart Institute

ASIAN HEART INSTITUTE: A CULTURE OF ETHICS AND EXCELLENCE

ADVANCEMENTS IN CARDIAC PACING - DR. VANITA ARORA ‘COVID 19 - A POISON FOR THE HEART’ - PROF.(DR.) M WALI

CARDIOLOGY IN INDIA: OUTLOOK FOR SERVICES AND DEVICES

Dr. TS Kler Dr. Abhijeet Dashetwar Dr. Bharat Kukreti Abrar Ali Dalal

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EDITOR SPEAK

Magazine

2021

Volume - XII Issue - IX September 2021 Editor-in-Chief

Md. Afzal Kamal

Feature Editor

Razi Ahsan, Smriti Mukerji

Editorial Advisor

Sales Head Sales and Marketing

Communicable disease used to be the largest single cause of mortality in India, barely three decades ago. Non-communicable disease or NCD now enjoys this dubious distinction with Cardiovascular disease or CVD alone responsible for half of all such deaths annually. This is why new advances in medicine, the scope of cardiothoracic surgery and interventional cardiology, cardiology in the Covid era, and challenges in cardiology are some issues worth exploring. The September issue of Medgate Today, ahead of World Heart Day on September 29, 2021, gets into these areas associated with cardiology, so as to give you, the reader, valuable insights into what’s happening in this branch of medicine.

Looking at medicine of the global stage, not only has Covid ushered in a new era of cooperation between India and the UAE on medical matters, we are also seeing many Indians take centre-stage in Dubai’s medical sector. In this issue, we explore the longstanding ties between the Emirates and India on medical matters, and also do a round-up of some eminent Indians who have made their mark in medicine in the UAE. We have profiled the likes of Dr Azad Moopen, Dr Shamsheer Vayalil, Dr Mohammad Tahir Jamal, Taher Shams, Dr Raza Siddiqui and Vikas Katoch – to name a few – in this issue of Medgate Today.

As always, Medgate Today remains committed to lessening the gap between the medical community, and the layperson, with our eye squarely on medical matters that can educate people about the latest advances in medicine, as well as challenges frontline workers must confront to bring healing to more people.

The Cardiology Special is no different. I trust that you will enjoy reading it as much as we did putting it together.

Have an insightful reading.

Your suggestions are most welcome!

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Magazine

COVER STORY

INSIDE VOLUME - XII ISSUE - |X SEPTEMBER 2021

CONTENTS 20-23

24

36

ADVANCEMENTS IN CARDIAC PACING: DR. VANITA ARORA 26-29

DR. RAMAKANTA PANDA VICE CHAIRMAN ASIAN HEART INSTITUTE

CARDIOLOGY IN INDIA: OUTLOOK FOR SERVICES AND DEVICES

42-46 16

15

DIGITIZATION AND REMOTE HANDLING WAY FORWARD IN COVID ERA- ABRAR ALI DALAL

17

EAT HEALTHY, STAY HEALTHY AND LIVE HEALTHY DR. ABHIJEET DASHETWAR 6

STRAIGHT FROM THE HEART DR. TS KLER

18

HEART OF THE MATTER DR. BHARAT KUKRETI

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INTERVIEW

30-33

44

34

‘COVID 19 A POISON FOR THE HEART’

PROF DR. M WALI

CORONA CAN TRIGGER AN UNDERLYING HEART CONDITION

DR. JAMAL YUSUF

INTERVIEW

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COVER STORY

22-

NAVIGATE YOUR SUCCESS THROUGH PASSION AND PERSISTENCE DR. RAZA SIDDIQUI

......................................................................

ASIAN HEART INSTITUTE: A CULTURE OF ETHICS AND EXCELLENCE

100 CATH LABS IN 3 YEARS AND COUNTING GAURAV AGRAWAL, IITPL

DOCTOR SPEAK

52-56

52 BI-PLANE CATH LABS TECHNOLOGY: A NEWER APPROACH FOR EMERGENCY INTERVENTIONAL CARDIOLOGY 54 WAYS TO KEEP THE HEART HEALTHY 56 HEART IN THE TIMES OF COVID

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COVER STORY

CONTENTS

22-25

38-43

Dr. Azad Moopen

Dr. Thambay Moideen

Dr. Shamsheer Vayalil

INDIANS BIG PLAYERS IN UAE MEDICAL & HEALTHCARE SECTOR Taher Shams

Madhukar Tanna

8-13

......................................................................

08 APPROVAL OF FIRST INTERCHANGEABLE BIOSIMILAR INSULIN WILL INCREASE COMPETITION WITH PAYER CONTRACTS, SAYS GLOBALDATA

10 GLOBAL HEMATOLOGICAL CANCER MARKET SET TO GROW RAPIDLY ACROSS ALL TREATMENT SEGMENTS IN THE NEXT FIVE YEARS,SAYS GLOBALDATA 12 COVID-19 BIGGER BLOOD CLOT THREAT THAN VACCINES, UK STUDY FINDS 12 HALF OF HOSPITALISED COVID PATIENTS HAVE PERSISTING SYMPTOMS AFTER A YEAR: LANCET STUDY 12 AUROBINDO PHARMA GETS USFDA NOD FOR CANCER TREATMENT INJECTION 12 INCREASE IN VIRAL INFECTION CASES IN DELHI HOSPITALS 13 AIMED WELCOMES GOI’S FINANCIAL SCHEME TO BUILD HEALTHCARE INFRASTRUCTURE : RAJIV NATH

...........................................................................................

NEWS UPDATE

Vikas Katoch

EXPERT VIEW

Dr Jamil Ahmed

46-50

46 LEVERAGING ELECTRONIC MEDICAL RECORDS FOR BETTER PATIENT ENGAGEMENT AND CLINICAL OUTCOMES

48 MENDING HEART HEALTH WITH REHABILITATIVE CARDIAC CARE

50 BATTLING CARDIO VASCULAR DISEASES IN A POST-COVID ERA WORLD WITH TECHNOLOGY

......................................................................

Mohammad Tahir Jamal

......................................................................

Sukhdeep Sachdev

Dr. Raza Siddiqui

PRODUCT LINE

58-60

58 ERDA INTRODUCES MEDICAL DEVICES CALIBRATION FACILITY 60 ERDA INTRODUCES MEDICAL DEVICES CALIBRATION FACILITY SONORAD K40 HIGH PERFORMANCE POINT OF CARE ULTRASOUND SYSTEM w w w.medgatetoday.com September 2021

7

NEWS UPDATE

APPROVAL OF FIRST INTERCHANGEABLE BIOSIMILAR INSULIN WILL INCREASE COMPETITION WITH PAYER CONTRACTS, SAYS GLOBALDATA

W

hen it comes to insulin choice, price is currently the biggest barrier, as insulin brand preference is primarily determined not by a doctor, but through payer contracts with pharma companies, according to GlobalData. The leading data and analytics company notes that while patients will be increasingly prescribed Viatris/Biocon’s Semglee (biosimilar insulin glargine-yfgn) over Sanofi’s Lantus (insulin glargine) due to its competitive pricing, Semglee’s commercial success will be limited due to the declining use of firstgeneration long-acting insulins.

Samisha Khangaonkar, Pharma Analyst at GlobalData, comments: “Semglee was first approved in 2020 by the US Food and Drug Administration (FDA) as a followon biologic, and it is the cheapest biosimilar of Lantus available on the market. Eli Lilly’s Basaglar (insulin glargine), the first-tomarket biosimilar insulin (followon biologic in the US), is around 22% cheaper than Lantus, whereas Semglee is roughly 64% cheaper than Lantus in the US based on its wholesale acquisition cost.

“However, due to the contracts that payers develop with companies and the specific type of insurance held by patients, Lantus, Basaglar, or even Novo Nordisk’s Levemir (insulin detemir) may be cheaper for patients, despite Semglee’s heavy wholesale price reduction.

Without interchangeability, prescribers need to specifically name the biosimilar over the

8

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reference product in a prescription, which limits the potential for biosimilars to gain market share and compete based on price.”

The US only recently opened the 351(K) designated biosimilar pathway for approval. In May 2019, as outlined in The Biologics Price Competition and Innovation Act of 2009, the FDA began receiving applications via its new biosimilar pathway. Prior to the launch of this pathway, therapeutics that were highly similar to a reference product would need to apply to the FDA as a follow-on biologic.

This interchangeability designation now allows pharmacies to substitute the cheaper therapeutic for patients, regardless of what is on the prescription, much like how generic drugs are routinely substituted for brand-name drugs. This is commonly called pharmacy-level substitution and is subject to state pharmacy laws.

Khangaonkar continues: “This new pathway, and its interchangeability designations, will allow for more biosimilars to not only receive expedited approval, but to potentially receive an interchangeability designation and increase the price competition with its branded originator. Despite this interchangeability designation, access to the lower pricing of Semglee is entirely dependent on Viatris’ ability to negotiate with private payers in the US. Key opinion leaders interviewed

by GlobalData have noted a general hesitancy to prescribe insulins

from unfamiliar manufacturers, which has limited the uptake of biosimilar insulin.

Khangaonkar says: “Lantus has been the gold-standard long-acting insulin analog and is still the longacting insulin with the greatest patient shares across type 1 and type 2 diabetes. It will be important for Viatris to capitalize on the interchangeability designation to establish itself early on, as the overall patient shares of insulin glargines are expected to decrease over the next ten years.”

Diabetes patients are increasingly switched to insulin pumps, where they will not need a long-acting insulin, or are transitioned from first-generation long-acting insulin analogs like Lantus, to the secondgeneration long-acting analogs like Sanofi’s Toujeo (insulin glargine U300) or Novo Nordisk’s Tresiba (insulin degludec), which have demonstrated fewer incidences of hypoglycemia. Viatris’ price point, and its potential impact on compliance, will play an important role in its inclusion in private payer formularies.

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NEWS UPDATE

Global hematological cancer market set to grow rapidly across all treatment segments in the next five years, says GlobalData

T

he hematological cancer therapy market is diverse and highly genericized, with chemotherapies currently accounting for the highest number of marketed drugs. However, the availability of more targeted and innovative therapies means that sales of antibodies, cell therapies and targeted therapies are all set to increase to 2027 at Compound Annual Growth Rates (CAGRs) of 11.5%, 20.1% and 3.2% respectively, according to GlobalData, a leading data and analytics company.

According to GlobalData’s latest report, ‘Global Hematological Cancer Therapy Market Overview’, growth will be driven by the continued expanding use of expensive cell therapies, as well as the growing adoption of expensive combinatorial regimens, particularly where these are used over many years as maintenance therapy. The increasing number of options available for patients, will mean that in some indications patients may cycle though up to eight lines of therapy, contributing to further growth.

Jessica McCormack, PhD, Oncology and Hematology Analyst at GlobalData, comments: “As our understanding regarding the molecular mechanisms of diseases has improved, this has led to the development and introduction of numerous targeted therapies, which has changed treatment paradigms. Targeted therapies are increasingly being combined with generic chemotherapies in the first line, as well as providing additional options for patients progressing to second line therapy and beyond.”

Significant unmet needs are expected to remain in the hematological cancer market, which present considerable commercial opportunities. Particularly, the lack of options for relapsed/refractory and some high-risk patients is an issue.

The increasingly high costs of therapy is set to put pressure on healthcare systems so novel therapies that can be offered at lower costs are particularly needed.

McCormack continues “While new market entrants, as well as the use of some therapies in earlier lines for more high-risk patients are expected to go some way to addressing some of these

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issues, there are still several patient groups who have very few treatment options available to them, and more innovation may be needed to tackle this problem. The increasing cost of therapy is also a major issue. As more cell therapies enter the market costs may be expected to come down somewhat. It is also hoped that offthe-shelf cell therapies could also lead to reduced costs compared to currently available cell therapies.

However, ultimately this is likely to remain a major issue in coming years.”

The hematological cancer pipeline is dominated by cell therapies, small molecules and antibodies, but also features a range of novel therapeutic approaches including vaccines, gene therapies and peptides. A wide variety of novel and tried-and-tested targets are also being investigated.

McCormack concludes: “The use of cell therapies for the treatment of cancer has been pioneered in hematological malignancies, with these therapies having a transformative effect on the treatment of relapsed/refractory patients who would otherwise have had limited options. The diversity and degree of innovation present in the hematological pipeline currently indicates that allogeneic, off-the-shelf therapies are also likely to see their potential realised within this market.

The addition of such a treatment modality would be highly beneficial for patients across many indications.”