My Pharma Reviews

Salil Kallianpur

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All things pharma and transformation mypharmareviews.substack.com

14h ago

The Last Prescription

The entire commercial logic this series has examined from the MR-driven detailing model in Episode 8, the chronic refill economics implicit in the GLP-1 story in Episode 5 , assumes a patient who keeps coming back. Cell and gene therapy breaks that assumption completely. CGT is often a single infusion, priced once, intended to either cure the patient or durably control the disease, eliminating the recurring revenue stream entirely. NexCAR19’s journey from a ₹42 lakh launch price to a ₹30 lakh price, alongside its first full year of real profitability, shows India is not just a low-cost copier of this model but an active participant proving a harder economic problem can be solved, making a curative, one-time therapy commercially sustainable at a fraction of Western pricing. • The actual chronic-care cost stack for relapsed/refractory blood cancers in India — BMT, multi-line chemotherapy, targeted therapy — set directly against NexCAR19’s single ₹30 lakh dose • ImmunoACT’s real financial trajectory: ₹42 lakh to ₹30 lakh pricing, ₹62 crore revenue and ₹12 crore profit in FY25, 350+ patients treated across 70 hospitals • Why a one-time cure is a harder business model to sustain profitably than a chronic therapy, and what ImmunoACT’s manufacturing scale-up reveals about solving that problem • What this means for Indian pharma companies whose commercial and financial architecture, examined in Episodes 7 and 8, is built entirely around recurring revenue Listen in to Episode 8 of the Bio-Health Supercycle. “My Pharma Reviews - The Podcast” is now available for you to listen on your favourite podcasting apps like Spotify and Apple. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

14 min
2d ago

Episode 8: The Gatekeeper Who Is Leaving the Building

The traditional Indian pharma commercial model was built around one assumption: that the physician is the primary, often the only, gatekeeper between a molecule and a patient, and that an army of medical representatives visiting doctors’ clinics is the most effective way to influence that gatekeeper. That assumption is now wrong for a rapidly growing share of the market, across all three income tiers of the country simultaneously, for three different and unrelated reasons. The three-India framework from earlier analytical work is the right lens for seeing this clearly because the disintermediation is happening differently, and at different speeds, in each of the three Indias. • The three-India commercial reality, updated with new 2025-2026 data showing which segment is being disintermediated by what, and how fast • Government digital health infrastructure at unprecedented scale - 780 million ABHA digital health IDs, 372 million eSanjeevani teleconsultations, numbers most pharma commercial strategy decks have not internalised • The quick-commerce entry into pharmacy (Zepto Pharmacy’s 10-minute delivery) as a genuinely new disruptive vector • Tata 1mg and PharmEasy’s combined 55% share of online pharmacy sales, non-pharma-company platforms now sitting at the centre of the distribution chain • What this means concretely for how Indian pharma should restructure commercial spend, threading back to the Episode 7 capital allocation lens Listen in to Episode 8 of the Bio-Health Supercycle. “My Pharma Reviews - The Podcast” is now available for you to listen on your favourite podcasting apps like Spotify and Apple. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

16 min
3d ago

Episode 7: The Capital Allocation Crisis

Indian pharma’s R&D intensity has been structurally stagnant for years, sitting at roughly half of global large pharma’s spend as a share of revenue and less than a third of China’s. This is not simply a function of India being a generics-focused industry, it is a capital allocation choice, made repeatedly, by boards that have other options. Sun Pharma’s $355-416 million acquisition of Checkpoint Therapeutics shows what disciplined innovation capital allocation looks like. A single, sizeable, strategically coherent bet on a commercial-stage specialty asset, rather than either no investment at all or a scattering of small, low-conviction bets that read well in an annual report but change nothing structurally. • Hard benchmark numbers: Alphabet’s $61 billion annual R&D spend vs. the combined R&D spend of India’s top 10 listed pharma companies • R&D intensity comparison: global large pharma at ~23.5% of sales, China at ~17.5%, India at ~4.4-7.5%, essentially flat for years • The Sun Pharma-Checkpoint Therapeutics deal as a worked case study in disciplined, sizeable, strategically coherent innovation capital allocation • What boards should be asking and typically are not, connecting back to the Ternus Test introduced in Episode 2 Listen in to Episode 7 of the Bio-Health Supercycle. “My Pharma Reviews - The Podcast” is now available for you to listen on your favourite podcasting apps like Spotify and Apple. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

18 min
4d ago

Episode 6: The Talent That Got Away

The Coefficient Bio acquisition reveals the true price of computational biology talent at the frontier. Roughly $44 million per person, paid not for revenue or product but for scarce expertise that would otherwise take years to build internally. This is not anything Indian pharma payrolls can compete with, and trying to compete on that basis is a strategic error. The realistic Indian pharma AI strategy is not to out-bid Anthropic, Google, and OpenAI for individual computational biologists but to behave more like Eli Lilly did with Insilico Medicine - pay for access to an AI-native platform’s output, rather than trying to own the scarce talent that built the platform. • The Coefficient Bio deal anatomy: 8 months old, fewer than 10 people, $400 million, all-stock, and why that price was rational for the buyer • Where this talent actually comes from: Genentech’s 2025 layoffs as Roche pivoted toward embedded AI, releasing exactly the computational biology talent pool that Coefficient Bio’s founders came from • The acqui-hire versus platform-partnership distinction, using Eli Lilly’s contrasting $2.75 billion Insilico Medicine deal as the comparison case • What this means concretely for Indian pharma: the talent-acquisition path is largely foreclosed; the platform-partnership path remains genuinely open • The regulatory vacuum around AI-generated claims in pharma promotion and prescribing support, and the specific compliance exposure this creates for any Indian company moving fast on AI-assisted commercial tools Listen in to Episode 6 covering Wave 5 of the Bio-Health Supercycle. “My Pharma Reviews - The Podcast” is now available for you to listen on your favourite podcasting apps like Spotify and Apple. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

19 min
6d ago

Episode 5: The Day the Patent Fell

The semaglutide patent cliff played out almost exactly as the commodity-trap thesis predicted. Prices collapsed by up to 90 percent, more than 40 companies launched over 50 brands within weeks, and margins in the injectable semaglutide category compressed toward levels that will reward only the lowest-cost, highest-volume manufacturers. But the data 4-8 weeks later revealed something the commodity-trap framing alone would not have predicted. Eli Lilly’s tirzepatide, sold as Mounjaro, sitting completely outside the genericisation event (because its patents do not expire until roughly 2036) captured a larger share of category growth than semaglutide did. Doctors who had patients stable on Mounjaro mostly did not switch to cheaper semaglutide generics. Some actually increased prescriptions. This is the most important data point for understanding where actual pricing power sits in the GLP-1 category, and it is a direct, real-world confirmation of the ‘commodity trap versus the real prize’ argument first raised in Episode 2. Listen in to the next episode of the Bio-Health Supercycle Series. “My Pharma Reviews - The Podcast” is now available for you to listen on your favourite podcasting apps like Spotify and Apple. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

20 min
Jun 23

Episode 4: The Qualification Gap

A CDMO opportunity is not won by capacity announcements, MOUs, or press coverage of a competitor’s regulatory trouble. It is won through multi-year client qualification cycles, sustained GMP/FDA inspection performance, and demonstrated commercial-scale output across the specific modality a client needs. The WuXi AppTec designation created a genuine tailwind, but the timeline for that tailwind to convert into Indian order books is longer, and the qualification bar is higher, than most coverage of this opportunity acknowledges. Listen in. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

23 min
Jun 18

Episode3: The Biologics Report Card

Episode 2 diagnosed the Generics Trap at the industry level and introduced the three-cluster stratification framework in general terms. Episode 3 applies that framework with full company-level specificity to the ten biologics subsidiaries of listed Indian pharma majors. This is the most data-dense episode in the series, closer to an equity research note delivered in audio form than a macro narrative. The deliverable for the listener is a working mental map. Ten names, three clusters, and a five-signal diagnostic they can apply themselves to any biologics subsidiary not covered here. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

28 min
Jun 17

Episode 2: The Generics Trap

Episode 1 established the macro framework - six biological platform waves, the tech supercycle parallel, and where wealth concentrates in platform transitions. Episode 2 descends one level from the global arc to the Indian pharma story specifically. It answers the question that Episode 1 left hanging, if biology is the next platform, what is Indian pharma’s position on that platform and is it strong enough? This is the diagnostic episode. It earns the right to make prescriptions in Episodes 7 through 10 by doing the structural analysis first. For listeners’ reference here is the bio-health supercycle as i visualise it. “My Pharma Reviews - The Podcast” is now available for you to listen on all your favourite podcasting apps - Spotify, Apple, and Youtube This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit mypharmareviews.substack.com

33 min

All things pharma and transformation mypharmareviews.substack.com

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Salil Kallianpur
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My Pharma Reviews