SMSRC and Group (Medclin Research and Synaegis), a healthcare research, intelligence and consulting organisation has published findings on major disease trends prevailing in India, and how they are currently being managed by healthcare providers. The study reveals that respiratory diseases are the largest disease in India.
The study was conducted based on MAT Feb 2024 prescription audit – de-identified and aggregated data, of more than 10,700 doctors over 15 years. DRS in the sample were distributed across all key specialities, across 80+ cities/towns of India.
According to the publication, Diseases of the Respiratory System is the largest disease area in India, constituting 15.3 per cent of all Rx of total patients with diseases in India. Endocrine and Metabolic diseases (eg Diabetes and others) are in second place with a 13.5 share of Rx of all patients, followed by GI-related diseases and circulatory diseases (hypertension, cholesterol etc) as the next ranked disease area.
Respiratory diseases that constitute various upper/lower respiratory tract diseases are treated via the following therapeutic class of medicines – antibiotics, cough and cold preparations, pain relievers and respiratory products. Respiratory products consisting of anti-asthma tablets, syrups, inhalers and nebulisers categories are one of the fastest-growing therapeutic classes of medicines in India.
Further, within Diseases of the Respiratory System, URTI (Upper Respiratory Tract Infection) constitutes 27 per cent of the share in 2024 and is the largest type of respiratory disease. However, over the past 10 years, COPD (Chronic Obstructive Pulmonary Disease – 6 per cent of all respiratory diseases) and “Running Nose” (an upper respiratory tract condition) have been relatively faster-growing. COPD which is driven more by the external environment (eg. pollution, biomass fuel) and lifestyle-driven factors like smoking, and burning tobacco has been a key driving factor. COPD is predominantly an urban phenomenon with metro and tier 1 cities seeing approximately 90 per cent of cases and its occurrence is majorly seen across male patients above 51 years.
Specialist doctor segments such as chest physicians, cardiologists, diabetologists and consulting physicians treat COPD patients with anti-asthma solids, anti-asthma inhalers, and nebulisation – in descending order of preference. Cough preparation and antibiotics are also used. As per the SMSRC report, since 2014 there has been a 1.3x growth in the usage of anti-asthma inhalants + nebulisation, as compared to anti-asthma tablets in the management of COPD. Inhalants/Nebulisation generally considered a superior and more effective treatment choice, still has immense potential to continue to provide increasing relief to a growing number of COPD patients, given they are still the second-ranked category to anti-asthma solids.
The incidence of asthma, a genetic condition contributing to 10 per cent of all respiratory diseases, has seen a more moderate increase over the past 10 years. Younger patients below 10 years constitute the largest chunk of asthmatic patients, although an increasing proportion of elderly patients are also seen being diagnosed with asthma as compared to 10 years ago (35 per cent above 41 years of age in 2014 vs 41 per cent above 41 years of age in 2024).
Chest physicians, cardiologists, and consulting physicians generally prefer anti-asthma solids followed by inhalers/nebulisers. Since 2014, the growth in the usage of inhalers/nebulisers has been 1.2x, as compared to that of Anti Asthma tablets. However, inhalers are still a second preference to anti-asthma tablets amongst specialist doctor segments. Unlike COPD though, given the younger age cohort in asthmatic patients, Paediatricians are also an important segment but the usage of inhalers is much lesser, with anti-asthma tablets and syrups and cough preparation being a more preferred mode of treatment.
Dr Sanjoy Mitra, Founder and MD of SMSRC mentions, “Given the inclination towards respiratory diseases in India, the general patient population is advised to maintain a better quality of lifestyle to help reduce the growing respiratory disease burden in the country. Authorities and policymakers could further strengthen controls on excessive pollution, whereas healthcare delivery stakeholders can focus on increasing both the depth (i.e., compliance) and spread (i.e., awareness of compliance) in the usage of the more effective treatment medication, such as inhalers in the management of COPD and Asthma in India.”
SMSRC plans to research further and support healthcare delivery stakeholders, in increasing both the depth and spread of effective treatment methods amongst Drs/Patients for COPD and Asthma to help reduce the disease burden.