High prevalence of gastroenteritis for unhygienic eating habits alongside consumption of spicy foodstuffs, in expert views, is contributing to the expansion of anti-gastric and antiulcer drugs market in Bangladesh.
To bank on a robust market of these drugs in terms of sales, the medicine-makers are now using world's latest molecules to produce anti-ulcerants. And their market share is also growing fast, according to surveys.
In such a situation of ailments related to gastrointestinal disorder -- some turn out to be fatal in the end -- Bangladesh's six of top ten sold branded drugs are antiulcer and anti-gastric with their aggregate market share of nearly Tk 12.50 billion.
The market share is equivalent to nearly 7.0 per cent of the total medicine market of the country, as of last December, according to US-based pharma intelligence IMS Health.
The top-ten pharmaceutical products have nearly 10 per cent share of approximately Tk 177.43 billion worth of total pharma market.
Even in 2009, only three gastric and ulcer products were among the top-ten products and antibiotic and pain-killer products used to dominate the top-chart products.
Alongside the top brands, there are many drug manufacturers who also produce medicines by using the latest anti-ulcer molecules. And if their shares are taken into account, the amount of money in annual drug sales for ulcer and gastric will surge further.
However, old anti-gastric drugs produced by ranitidine molecules now become less-sold though once they used to dominate local market.
Top executives at the local drug-manufacturing companies told the FE that eating habits like the consumption of spicy foods, including peppered ones, and unhygienic style of eating were main reasons for such robust market growth.
They also said around 35 per cent patients require anti-gastric and anti-ulcer drugs as supplement to other drugs.
Syed Kaiser Kabir, managing director of Renata Limited, said: "Eating habit is the prime reason for such high prevalence of ulcer and gastric patients in the country."
He said his company first introduced 'esomeprazole' molecule to produce anti-ulcer drug 'maxpro' which remained market leader ever since in the wake of high prevalence of ulcer patients.
"As a pioneer of using the molecule, it has been maintaining a continuously high growth rate among the anti-ulcer and anti-gastric products," Mr Kabir told the FE.
He said the latest molecules are being used in the country to make anti-ulcer drugs.
According to the IMS, top two molecules or medications are now esomoprazole and omeprazole with their market share of nearly 11 per cent of total drugs with their market of around Tk 18.0 billion.
Esomeprazole sold under the brand name Nexium (or Nexum), among others, is a proton-pump inhibitor which reduces stomach acid.
Omeprazole, discovered in 1979 and sold under the brand names Prilosec and Losec, among others, is a medication used in the treatment of gastroesophageal reflux disease, peptic ulcer and similar syndromes.
Rabeprazole is an antiulcer drug in the class of proton-pump inhibitors. It was developed by Eisai Co. and is available worldwide under many brand names.
AM Faruque, CEO and managing director at newly-established Sunman-BIRDEM Pharma, told the FE that Bangladesh's drug usage is definitely different from the rest of the world save some South Asian countries.
This is due to nothing but traditional food habit.
Globally, such products stand at 18 and onwards. Harvoni is a new medication used to treat hepatitis C. It is now number-one medication globally. Humira, an anti-arthritis medication, is number-two product globally followed by lantus, a long-acting insulin used to treat adults and children with type-1 diabetes.
Mr Faruque finds psychological reason besides intake of the anti-ulcer drugs by many when they feel uneasy in their stomachs.
"Many purchase without a doctor's prescription at a time when they feel uneasy at their stomachs," he said.
He diagnoses consumption of adulterated foods as the main reason behind the rise in the sales of anti-gastric drugs.
Dr Sayeed Ahmed, head of marketing of Ziska Pharmaceuticals, told the FE that there is a habit of not washing hands before taking meals--and this is a reason for a rapid increase in the number of ulcer patients in the country.
He said helicobacter pylori (H. pylori) is a type of bacteria that can enter bodies and live in digestive tract, causing ulcers, as many people do not wash hands properly.
He said people consume black peepers and dry peepers which are rich in vitamin C.
Six antiulcer branded drugs are: seclo of Square Pharma, sergei of Healthcare, maxpro of Renata Limited, pentonix of Incepta, losectil of Eskayef and finix of Opsonin.
IMS Health shows seclo, an omeprazole product, still number-one-selling product in the country with market share of 2.02 per cent worth Tk 3.58 billion as of 2016.
Sergei stands second with a market share of 1.41 per cent or Tk 2.5 billion.
Maxpro is the third-biggest product with market share of 1.18 per cent worth Tk 2.09 billion.
Fourth-largest product is Pentonix with a market share of 1.16 per cent worth Tk 2.05 billion.
Losectil is the eighth-largest-selling product with a market share of 0.65 per cent worth Tk 1.15 billion.
Finix is the tenth-largest product with its market share of 0.52 per cent worth Tk 920 million.
The others among top-ten products are cef-3, an antibiotic, mixtard-30 and insulin, napa extra and napa.
However, the data are based on the retail sales of the local pharmaceuticals and there are some institutional sales which did not figure in this reckoning.