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Pharmaceuticals
to Nutraceuticals
A Shift in
Disease Prevention
Pharmaceuticals
to Nutraceuticals
A Shift in
Disease Prevention
Dilip Ghosh
R. B. Smarta
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
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Section i introduction
v
vi Contents
Chapter 14 Medical Foods: A New Domain in the Food–Drug Interphase ....... 173
Dilip Ghosh
ix
x Authors
Dr. Smarta has penned eight books in the areas of pharma marketing and pharma-
ceutical business and nutraceuticals. Some of his titles have also been translated into
German. He regularly contributes articles to several dailies and industry periodicals.
He has produced video-based training packages called Interact for corporate train-
ers to enhance their skills on an ongoing basis. Dr. Smarta is a recipient of many
national awards.
Contributor
Rohit Ghosh
School of Medicine
Western Sydney University
Campbeltown, Sydney, Australia
xi
Introduction
The famous aphorism “Let food be thy medicine and medicine be thy food” (report-
edly by Hippocrates) can be applied to the emerging area of research at the inter-
face of pharmacology and nutrition. This field is currently experiencing a renewed
impetus as several food components are now being employed as medicines, either
directly or as prodrugs. Indeed, there are areas in which the border between “food”
and “pharma” is not well defined, as the former often contains several bioactive com-
pounds, including secondary plant molecules (polyphenols), fibers, friendly bacteria,
essential fatty acids, probiotics, and other contributors. Currently, there are several
drugs that are derived from natural products, including those which humans have
been exposed to via diet. It is sometimes difficult to distinguish between bioactive
molecules termed “drugs” and other substances that are classified as “nutrients.”
Optimal health and prevention of chronic diseases can be attained (to a certain
extent) by modulating the intake of macro- and micronutrients, often in phar-
macological doses as in the case of supplements, nutraceuticals, and functional
foods. Classic pharmacotherapy can also be accompanied by adjunct treatments
with nutrition-derived remedies that are often able to decrease the doses of medi-
cines or lessen their side effects. In summary, the border between pharma and
food is becoming less distinct, and companies are marketing affordable, fast-
moving nutraceutical products, with a focus on fortified foods and beverages
(Street, 2015).
xiii
xiv Introduction
CHALLENGES
The nutraceutical market is one of the most promising ones in the world. However,
this market is not without its share of challenges. One of the most important fields
of focus today is the need to have evidence-based nutraceuticals. These are also
referred to as the third-generation nutraceuticals. When deriving evidence-based
nutra products, it is vital that they be studied scientifically, supported on a clinical
level, and contain standardized new ingredients derived from plants, foods, and
so on.
The advancement of science has created three fundamental economic prob-
lems, namely, managing risk, integration, and learning. One of the most impor-
tant elements of innovation is management technology, which is essential for a
science-based business. Recombination and successful integration of the different
bodies of knowledge that already exist have the potential to create breakthroughs
in evidence-based nutraceutical innovation, such as traditional Chinese and Indian
Ayurvedic medicines.
DIVERSIFICATION
Companies have started to look for alternatives to the blockbuster philosophy,
which is simply, diversification. For example, Pfizer and Merck, being world leaders
in consumer healthcare and animal health, are following diversification into their
new business arenas. The 2009 acquisitions of Wyeth and Schering-Plough, respec-
tively, have consolidated their market positions. Pfizer Consumer Healthcare is one
of the top five over-the-counter (OTC) companies in the world. It sells two of the top
ten selling OTC brands worldwide, which accounted for revenues of €2093 million
after the acquisition of Wyeth (Pfizer, http://press.pfizer.com/press-release/pfizer-
acquire-wyeth-creating-worlds-premier-biopharmaceutical-company, accessed on
July 8, 2016). The acquisition has also allowed Pfizer to gain a foothold in the nutra-
ceutical market, whose infant nutritionals have brought revenues of €1410 million for
2010. Pfizer Nutrition is expected to grow worldwide due to the less strictly regulated
Introduction xv
market and faces competition from other diversifiers as well as the established food
industry. A clear trend here is the move into delivering not just treatments, but out-
comes. An example of outcome management is the Changing Diabetes program of
Novo Nordisk (http://www.novonordisk.com/about-novo-nordisk/changing-diabetes.
html), which provides support such as specialized training for healthcare profession-
als, support for diabetes patient organizations, free blood sugar screening services,
and supplying equipment for diabetes clinics.
Geographical diversification is being pursued through the numerous contribu-
tions from the world’s fastest-growing, emerging markets, such as those in China,
India, Brazil, Argentina, Turkey, and Romania. Despite high variations in their char-
acteristics and stability, business in these areas offers important opportunities for
growth over time. The most important strategic move is to relocate the expensive
R&D activities into a lower-cost country and secure a front position in the largest
emerging market through local partnerships.
In conclusion, the most innovative pharmaceutical companies are undergoing a
transition from their traditional business models. The industry is attempting to con-
trol the direction of this transition by resorting to better pipeline management, merg-
ers, and open innovation. Diversification is pursued by looking at novel scientific,
business, and geographical areas.
REFERENCES
Anscombe, J., Wise, M., Cruickshank, C. et al. September 2009. Pharmaceuticals out of bal-
ance: Reaching the tipping point. A.T. Kearney, Chicago, IL. http://www.atkearney.com/
index.php/Publications/pharmaceuticals-out-of-balance.html. Accessed July 8, 2016.
Danner, S., Hosseini, M., and Rimpler, M. October 2010. Fight or flight. Diversification
vs. Rx focus in big pharma’s quest for sustained growth. Roland Berger Strategy
Consultants, Munich, Germany. http://www.rolandberger.com/expertise/industries/
pharmaceuticals/2010-10-25-rbsc-pub-Fight_or_flight.html. Accessed July 8, 2016.
Rusu, A., Kuokkanen, K., and Heier, A. 2011. Current trends in the pharmaceutical industry—
A case study approach. Eur. J. Pharm. Sci., 44: 437–440.
Street, A. 2015. Food as pharma: Marketing nutraceuticals to India’s rural poor. Crit. Publ.
Health, 25: 361–372.
Section I
Introduction
Redefining Nutraceutical and Functioning Foods 13
— Miksi? — Kai hän niin uskoi. Moni muukin luulee, ettei missään
muualla voi olla hyvä olla kuin luonnollisten vanhempain luona.
Missä on hyvä, siellä on, ja useimmilla kylläkin on hyvä. Mutta tiedän
varmaan, että on paljon lapsia — niitä on enemmän kuin
otaksutaankaan — joiden olisi parempi olla muualla ja jotka muilta
saisivat enemmän rakkautta kuin saavat omilta vanhemmiltaan. Ja
riippuuhan kaikki kuitenkin siitä, kuinka paljon rakkautta saa.
Mutta sen jälkeen sattui sangen usein, että illoin tartuit käsiini
kuiskaten:
15.
Entä jälkimaailma!
*****
Mutta kun aamu valkeni, olivat kaikki syvämietteisyydet häipyneet
itsestänsä. Kahvi höyrysi verannan pöydällä ja uimahousut riippuivat
kaiteella. Ja ulapalla lähtivät ensimmäiset aallot liikkeelle
aamutuulen herättäminä Ensimmäiset purjeet välkkyivät auringossa
ja siellä täällä joku varhainen liikehtijä meloi kanootissaan rantaa
pitkin.
16.
*****
Sen varjo oli syvä, sen harmaat rungot mahtavat, valotäpliä siellä
täällä, auringon läikät hohtaen läpi lehtiverkon. Ja korkealla latvoissa
oli vaalea, mehevä vihreys.
*****
*****
Entä suomalaiset! Silloin oli vielä se aika, jolloin meidän piti istua
kotona harmistuneina siitä, ettemme missään saaneet olla
näkyvissä.
Eikö totta, Yrjö, sitä oli vaikea sulattaa? Se harmi paisutti mieltäsi
siinä pystyttäessäsi telttaasi. Jospa edes nuo tanskalaiset pojat
olisivat ymmärtäneet panna arvoa sille mikä heillä oli, mutta eivät he
käsittäneet sitä onneksi eikä miksikään. Pitivät sitä vain itsestään
selvänä asiana. Sitä oman maasi kohtaloa ajattelit viikon varrella yhä
enemmän, varsinkin päivän parhaimpana hetkenä, sinä hetkenä,
joka sinut eniten tenhosi.
Se oli heti aamulla. Ensin juoksivat kaikki pojat uimaan, ja siinä oli
polskuntaa ja huitomista ja huutamista. Mutta hetkeä myöhemmin oli
suuri kenttä aivan äänetön. Seitsemänsataa poikaa kiinnitti
katseensa yhteen ainoaan pisteeseen, lipputankoon kummulla — ja
siihen nousi hitaasti Tanskan lippu. Kaikki päät paljastuivat ja tangon
juurella soitettiin kansallislaulu. Ensin Tanskan, sitten Norjan ja
Ruotsin. Viimein Englannin.
*****