GSK to bring Herpes Zoster vaccine Shingrix at one-third of US price: MD

Shingrix is for the prevention of shingles or what is also known as herpes zoster and also post-herpetic neuralgia in people aged 50 and above, says GSK Pharmaceuticals MD Bhushan Akshikar

GlaxoSmithKline Pharmaceuticals, launched the Herpes Zoster vaccine named Shingrix on Monday, is now focusing on adult vaccination in the country. GSK Pharmaceuticals MD Bhushan Akshikar talks to Sohini Das about the company’s India plans. Edited excerpts:

Why is it important to take the Shingles (Herpes Zoster) vaccine for adults?

Shingrix (Zoster vaccine recombinant) is for the prevention of shingles or what is also known as herpes zoster and also post-herpetic neuralgia in people aged 50 and above. It’s the world’s first non-live recombinant subunit vaccine administered through the intramuscular route in two doses.

Shingles is caused by re-activation of the varicella zoster virus (VZV), the same virus that causes chicken pox.

More than 90 per cent people in India aged 40 years or more had this virus and were thus vulnerable to shingles, an acutely painful rash. In a large number of cases, the pain persists for months or years — this is known as post-herpetic neuralgia. The risk of developing post-herpetic neuralgia is 30 per cent higher and the pain is more debilitating in people above 50. Shingles can also lead to complications such as vision loss and hearing loss in older adults. Studies have shown Shingrix to have an efficacy of 97 per cent for age groups 50 years and above, and 91 per cent for 70 years and above. The two-dose vaccine (second dose can be taken 2-6 months after the first dose) gives protection for 10 years.

Will there be a special India price for Shingrix?

Yes, the vaccine will be introduced in India at a significantly lower price than the US where it costs around $450 for two doses. Here, we plan to introduce it at a one-third price of the US so that more people can take it. It is estimated that India has 260 million people aged above 50.

Your vaccine revenues have fallen by 34 per cent. What are the reasons, and how do you plan to revive it?

The pandemic hit the vaccine uptake significantly. For almost 8 months there was no footfall at paediatrician clinics where most private vaccination takes place. However, we see that from February this year, there has been a revival and the vaccination rates have gone back to pre-Covid levels. For the paediatric segment, our focus vaccines are the hexavalent vaccine, which protects against six diseases (diphtheria, tetanus, acellular pertussis, hib — haemophilus influenza — hepatitis B and inactivated polio vaccine). We also had some issues with stocks, for example, our varicella vaccine was not available. We only have a single source for our vaccines – Belgium. The vaccines are manufactured, filled and finished and then sent to India. This is different from our pharmaceuticals business where 98 per cent is made in India. Now we expect the products to be available, and that will give a volume boost.

We also plan to build awareness around adult vaccination, which has anyway picked up during the pandemic. We have tied up with brand ambassadors such as Amitabh Bachchan to spread awareness about shingles vaccine. We are reaching out to hospitals, clinics, doctors such as dermatologists, rheumatologists (or immunologists), infectious disease doctors for our adult vaccines such as Shingrix. Just like our paediatric vaccines have an ecosystem, we are trying to create the same for adult vaccines.

Which are the global clinical trials happening now in India for GSK?

India is part of 24 global clinical trials, and this gives us an edge when it comes to launching these products here as we would already have local data that we can submit with the regulator. While I cannot divulge much, trials are on for some oncology products, and our new urinary tract infection antibiotic. In the next 12 months, an oncology product and RSV vaccine will be the immediate ones to be launched here.

More than 40 per cent of your portfolio is under the National List of Essential Medicines (NLEM). How do you plan to protect your margins?

Most of our brands are trust marks. For example, Augmentin (the highest selling drug brand in 2022), T-Bact, Calpol, etc. We have decided to focus on 9-10 core brands and launch their brand extensions. Even for low-priced drugs such as paracetamol (Calpol) we are not holding back on innovation. We recently launched a variant of Calpol, which has faster action, and faster disintegration, etc. We are also working on increasing our volumes. We are trying to expand our connection with doctors.