Case 3: Broad generic antimicrobial portfolio, Cipla

As a generic medicine manufacturer, Cipla uses a low-cost, high-volume model that allows it to specialise in developing generic versions or formulations of products such as amoxicillin and azithromycin after patent expiry. Across the industry, this business model has proven highly successful at expanding access to medicines in recent decades, particularly through price reduction. Yet it is seemingly at odds with the need to reduce the overuse of antibiotics. Looking ahead, generic medicine manufacturers have a clear responsibility to market their antibiotics appropriately.

Cipla has a presence in more than 80 countries, with 43 manufacturing facilities worldwide and markets more than 1,500 products across various therapeutic areas. This includes at least 25 antimicrobial medicines, 23 of which are listed on Section 6 of the WHO Model List of Essential Medicines (EML). It is one of only two generic medicine manufacturers in the scope of the Benchmark that reported an equitable pricing strategy that covers antimicrobials as well as multiple stewardship activities, particularly surveillance. Its inter-country equitable pricing strategy is based on countries’ levels of income (gross national income (GNI) per capita). 

Stewardship activities
Cipla is the only generic medicine manufacture in the scope of the Benchmark that engages in multiple activities to educate healthcare professionals (HCPs) on antibiotic stewardship. The company also implements brochure and packaging adaptations to facilitate appropriate use of antibiotics by patients. For example, it includes information about treatment duration on the strip of the box of the antibiotic azithromycin to help improve patient adherence to the treatment. It has conducted several AMR-related prevalence studies, delivering the results via conferences and peer-reviewed journals. 

^{For a full list of references, please see the 2018 AMR Benchmark report.}