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India's obesity drug market is entering a new phase as Novo Nordisk's key semaglutide patent expires, allowing Indian pharmaceutical companies to launch lower-cost versions of the active ingredient used in Ozempic and Wegovy.
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00:00Hello and welcome to a brand new episode of Health 360.
00:03On the show this week, we're going to be telling you why medical tourism industry in India is suffering because
00:10of the West Asia war.
00:13Semaglutide patents also expiring, which means very soon the market is going to be flooded with generic GLP-1 medicines.
00:21What does that really mean for obesity treatment in India?
00:25The LPG crisis means that in India, people are turning towards firewood.
00:31Also on the show, what's with the story that is doing the rounds on Bluetooth devices next to your ears
00:38causing cancer?
00:39And also new research pointing towards this direction that consumption of short trials interferes with your cognitive health.
00:49That and much more up ahead on the show, all the trending stories around health, wellness and fitness.
00:55I'm Sneha Murdani. Let's get started with Health 360 this week.
01:00Health 360 this week.
01:30The market is now entering a new phase as Novo Nordisk sees the expiration of its key semaglutide patent in
01:37India.
01:38The patent loss is going to allow several Indian pharmaceutical companies to now launch lower-cost versions of the active
01:44ingredient used in Ozampic and in Vigo V.
01:47These generic therapies are expected to be at least 50% cheaper.
01:52The Novo's treatment changing the way India handles obesity and diabetes.
01:57Here's a report on what is expected.
02:13India's GLP-1 market could grow from about 10 billion rupees last year to as much as 50 billion rupees
02:21by 2030,
02:22with prices possibly declining 40-50% following the patent expiry as additional manufacturers now enter this segment.
02:32This semaglutide GLP-1 will now be a household name.
02:38The reason is of course the drop in prices and the surge in obesity levels in India.
02:44When this patent expires, there are already more than 50 branded generics which will be there in the market because
02:54of which these medicines will be easily available.
02:58The access is going to significantly improve to the general population and also the cost of treatment which till date
03:07was about 8,000 to approximately 16,000 rupees in a month would drop down to 3,000 to 5
03:15,000 rupees in a month.
03:17The expiry of patents means a complete transformation of diabetes treatment landscape.
03:22Let the doctor decide about it, when to start their patients on this drug.
03:29So unnecessary publicity if you may use this word in the media or in the social media about the use
03:37of drug should be prohibited.
03:40And I think the government has to take action on this because not everyone, whether he needs it or not,
03:47should decide on their own to start this medication.
03:52Semaglutide belongs to a class of drugs known as GLP-1 receptor agonists and is widely used in the treatment
03:57of type 2 diabetes.
03:59In recent years, it has also gained global recognition for its role in weight management.
04:04Originally developed by Novo and Audis, semaglutide is marketed globally under well-known brands used for both diabetes and obesity
04:13management.
04:14Semaglutide increases the insulin levels in the body.
04:19Simultaneously, semaglutide also decreases glucose.
04:23Thereby, it helps in controlling blood sugars.
04:26It makes the blood sugars normal.
04:29These drugs need to be carefully used in people who are poorly controlled diabetics, obese,
04:33but they have something like which is called as retinopathy.
04:37The retinopathy may worsen.
04:38The vision loss can be seen in these patients if these drugs are not used appropriately.
04:43So it is very important to understand these drugs have side effects.
04:47And these side effects need to be discussed with your doctor before you start the medication.
04:52GLP-1, weight loss drugs like Ozempic, Vigo, we have gained immense popularity in recent times.
04:58Fueling a boom in clinics, telehealth, startups and even hospitals offering programs
05:03for instant weight loss.
05:05I caught up earlier with Jitendra Choksi, the CEO of Pune Bay's health tech startup, Fitter,
05:12who is cautioning against this phrase.
05:15Listen in to what he had to say.
05:17And I'm welcoming Jitendra Choksi, the founder of Fitter,
05:20which is one of India's largest online fitness and transformation communities.
05:24On the show today, Jitendra is a fitness coach.
05:28It's a very different and an interesting and an important take on GLP-1 medicines.
05:33Thank you for your time.
05:34You've been talking about the kind of concerns that you have regarding these medicines.
05:38Talk to us about how are you now, or rather what are you expecting now?
05:43Given that now there are just so many generics,
05:45which I'm thinking would be flooding the market after the patents,
05:50expiration of the patents.
05:52What are your thoughts on that?
05:54So three major concerns.
05:56First is about the approval and the way how these drugs were approved.
06:00I don't think the CDA so followed the guidelines properly for the approval of these drugs.
06:06They have invoked the rule one of one for a waiver of local trials.
06:10And that rule is sort of an exception.
06:13It's not the norm, right?
06:14So it's reserved for very special cases.
06:17And unfortunately, I don't see how GLP-1 drugs fulfill that criteria.
06:22It's reserved for pandemic drugs, life-saving, biologics, defense drugs,
06:28drugs which offer a substantial therapeutic benefit over its predecessors.
06:33And so there are different kinds of criterias which needs to be met
06:37for a drug to be approved under this criteria, right?
06:39So here CDA so has exercised an exception.
06:43And during the same time, they did not follow the same exception
06:47for other life-saving drugs and therapies during the same time, right?
06:51So why this differential treatment for GLP-1 drugs?
06:56And if you have done that, then you have to be more transparent.
07:00Most of the companies have, you know, bombarded social media,
07:03even ICC World Cup with ads.
07:07They claim there used to be awareness ads, but this is surrogate marketing
07:11and again, also illegal.
07:12Yeah, even as these drugs now will become widely available,
07:15given that there's going to be a big drop in prices as well,
07:18it's going to be in the market, in all pharmacies, different brands,
07:22different options for people to choose from,
07:24that this isn't for everyone.
07:26It has to be in a doctor's prescription and be given accordingly.
07:30Isn't that a big area of concern that now people perhaps would be wanting to go and buy,
07:35you know, get these medicines and like experience is shown even without a prescription?
07:41Absolutely. I mean, in the email that CDSO sent us
07:45and supposedly the guidelines that have been issued by them,
07:48I could not find it officially on the website.
07:50But so far what I've known is that they have said that these drugs can only be prescribed
07:55by endocrinologists or doctors who have relevant experience, right?
08:01Somebody who is an internal medicine doctor.
08:03So very specific class of doctors can promote these drugs or prescribe.
08:08Actually, nobody can promote these drugs.
08:10But you go on social media, you see every other doctor is promoting these drugs
08:14and you cannot rule out monetary compensation.
08:17So we'll also be sending out a notice to NMC, which is the National Medical Council, yes.
08:25And they should be able to regulate these doctors because it violates the NMC guidelines.
08:30Doctors cannot prescribe or promote schedule H drugs online.
08:34It goes against the law and they cannot also,
08:37so this refers to us soliciting clients, which is forbidden in the NMC guidelines.
08:43So NMC as well as CDSO both have failed to regulate doctors as well as influencers
08:48and obviously the GLP-owned companies.
08:51I'm going to thank you for the moment for joining in and sharing your views with us.
08:54Viewers, remember that these are drugs that are available in the market
08:57and that you need a doctor's prescription.
09:00You know, we've stressed enough on the fact that there are side effects.
09:03So you must consult your doctor.
09:05It's not for vanity's sake just because you want to lose about two to five kilos.
09:09You think you can just go ahead and buy this drug and then take it without even consulting with your
09:14doctor.
09:14First of all, you should never really consume it for vanity reasons.
09:17And that is something that we want to point out.
09:19I'm going to thank you for joining in, Jitendra.
09:22Thank you so much.
09:24Well, it's official.
09:25Consuming videos, specifically the short video kind on social media,
09:29is frying your brain and rotting it.
09:32Heavy consumption of short-form videos lead to weakened cognition,
09:37shorter attention spans, impaired impulse control,
09:40and symptoms of anxiety, depression, stress and loneliness.
09:44So if you have been feeling all lost and drained out,
09:48after watching these videos on your phone,
09:50we are going to be telling you the science behind it.
09:57Have you ever felt tired, drained out, foggy, not even responsive?
10:04Sometimes you feel you don't even know what people around you are talking.
10:07All of this after using your phone,
10:10after consuming short videos on your social media platforms.
10:16Does this happen often to you?
10:18Well, there is science behind this.
10:21And that science is indicating increasingly towards this direction.
10:26The consumption of videos,
10:27the kind that pops up in our phones all the time.
10:31And mindless trolling is robbing you,
10:34not just of your mental peace,
10:35but it is also reducing your cognitive abilities,
10:38is harming your brain.
10:41And it's going to be causing not just short-term,
10:44but long-term problems.
10:45It's causing anxiety already.
10:47It's causing sleep disorders already.
10:49But there are long-term implications of the same as well.
10:52It's rotting your brains.
10:55Well, the study is called Feeds, Feelings and Focus.
10:58A systematic review and meta-analysis examining the cognitive and mental health correlates of short-form video use.
11:07Published recently in Psychological Bulletin,
11:10reviewed 71 studies involving 90,299 people.
11:16It highlighted that while the link between hyper-fast, endlessly strolling videos and mental health is correlational,
11:25the patterns are hard to ignore.
11:27According to the study,
11:29across 14 studies,
11:30heavier use of short videos was linked to reduce attention,
11:34weaker inhibitory control,
11:35and smaller but noticeable dips in memory and working memory.
11:40So, what exactly happens?
11:42Basically,
11:44what we have realized and what we have observed also that
11:46most of the things what we see or look at these short videos,
11:5118% of the things we tend to forget after a while.
11:55Why this happens?
11:57Number one,
11:57there are various reasons for it.
11:59because you need some time for the brain networks and the synapses to form connection and consolidate.
12:07So, once you are scrolling down,
12:11the attention span of the brain,
12:14the time which brain needs to process that information is very short to form meaningful connection in the memory area
12:20of the brain.
12:21So, that is why that memory or the visual is not getting consolidated and it's not being retained.
12:29How do short videos trigger dopamine spikes in the brain?
12:33Dopamine, which is your pleasure hormone.
12:36Some get it from the beautiful sun.
12:38Others get it from scrolling.
12:40Well, the brain loves the stimulation
12:42but struggles with the calm down once you stop using the phone.
12:47Because of the bursts of dopamine release,
12:50the effortful thinking or the behaviors which require sustained attention and memory are lost.
12:57This is because we are seeking this instant gratification in our day-to-day lives.
13:02We are wanting to do the task which gives us immediate result
13:05and not ready to focus or spend time in the things which can be done with a little more attention.
13:13Similarly, these reels, because they are short, they are multiple,
13:16they come in rapid sequence.
13:19The memory is also not there.
13:21Because there is no time for these reels to get consolidated and register and the recall value goes down.
13:27A link has also been found between heavier short video use,
13:31especially late at night, and poorer sleep quality.
13:34Blue light and overstimulation, worse sleep in turn,
13:38worsens anxiety, mood and cognitive clarity.
13:43It ultimately leads to reduced attention, memory deficits and lack of focus.
13:49Youngsters these days are craving low effort, constant nobility.
13:53That's why they are scrolling these reels.
13:55However, many youngsters are coming these days to the OPD with attention and memory deficits,
14:00which is basically overstimulated dopamine full brain.
14:04And this has been coined as a digital dementia.
14:06So should you quit viewing shorter videos?
14:10Well, avoid if you have trouble concentrating,
14:14irritability after long strolling,
14:16compulsive checking or sleep disruption.
14:19Possibly, your brain is begging for a reset.
14:24Wireless headphones go everywhere with us.
14:27On commutes, at the gym and even in bed.
14:30We know they're undeniably convenient.
14:33But wireless headphones are radiation-emitting devices.
14:37So having them close to your brain does raise some very valid concerns
14:42about the adverse impact of the scene.
14:45What's the truth really?
14:47Here's what you need to know.
14:48Have you heard of this all the time?
14:51That Bluetooth headphones like these cause problems.
14:54And the radiation that is emitted by this or this
14:58is going to harm your brain, cause cancer, cause neurological problems.
15:03You should not be wearing them.
15:05You should be doing away with them.
15:07And that Bluetooth headphones and Bluetooth buds
15:10would be causing you problems in the longer run.
15:13What does the science really say?
15:15First things first.
15:16What is Bluetooth technology?
15:20Well, technology developers use Bluetooth
15:22to create wireless connections between two different technologies.
15:27Bluetooth uses short-range radio frequency
15:29to connect devices within a certain distance.
15:33Bluetooth devices use radio frequency radiation
15:35that actually falls under the category
15:38of electromagnetic radiation or EMR.
15:41RF radiation occurs in natural and artificial states.
15:45Cell phones, AM and FM radio
15:49radio and television emit RF radiation.
15:52Then comes the big question.
15:54Is this radiation bad?
15:56Too close to our brain?
15:58This is the fact.
15:59Bluetooth by itself causes non-ionizing radiation.
16:03It is safe to use as far as safety standards and protocols are concerned.
16:09The problem with the Bluetooth in using next to your ear or in your ear
16:13is not so much as the radiation hazard, as the sound and decibel level,
16:18as well as damage to the ear by itself.
16:21So, when we use devices which are Bluetooth enabled
16:24and we put them inside our ears like insert headphones and earphones,
16:27there is a possibility we stop the ear from breathing.
16:31We cause certain mechanical and traumatic damage to the ear canal.
16:35Our recommendation is that you should not listen to more than 60% of the sound level
16:39and you should be able to listen to what people behind you are saying
16:43so that you understand what they are saying.
16:45This is safe for you and this is better for you.
16:48Bluetooth devices actually give off slightly less radiation than our cell phones.
16:54That exposure could add up if you use wireless Bluetooth headphones for hours a day
16:59to listen to music or to podcasts.
17:01You will get less exposure than if you hold your phone up to your ear.
17:08So, your phone is going to be having or giving you more exposure to radiation
17:12than your Bluetooth if you are wearing it all day.
17:16First of all, a Bluetooth device is safer to use as far as non-ionizing radiation is concerned
17:21because a cell phone carries higher amount of signals when you keep them close to the ear.
17:25So, in that manner, Bluetooth is safer than the cell phone when kept next to your ear.
17:30Secondly, as far as keeping your ear safe from Bluetooth devices,
17:34the two lessons that we have learned is first of all, use headphones.
17:38Use padded headphones rather than insert earphones.
17:41And second is, make sure that the volume is not very high.
17:44Keep the volume low so that the hearing inside is not damaged.
17:48And finally, I would request, use them for limited periods.
17:51Do not use them throughout the day.
17:53Do not use them for prolonged periods because then the cumulative effect is worse for your hearing.
17:58Bluetooth technology is a type of non-ionizing radiation,
18:03which means it is not cancer-causing.
18:06Headphones can damage your hearing if you do not use them responsibly.
18:11You cannot reverse hearing loss, but in many cases, you can prevent it.
18:15We have to understand the difference between ionizing and non-ionizing radiation.
18:20Ionizing radiation like sun's rays, CT scans, X-rays,
18:24these are important sources of radiation hazards in the humans and they cause cancer.
18:30Non-ionizing radiation have a much lower dose of body or DNA-altering substances.
18:36So they are safer, they can be emitted from microwaves, they can be emitted from light bulbs.
18:42They are emitted at such a low dose that their chances of causing cancers in the human being is negligible.
18:48Well, the fact is, to cut a long story short, Bluetooth devices do not affect your brain adversely.
18:57At least, short-term exposure doesn't.
18:59Of course, you must limit your headphone use to just about 60 to 90 minutes daily with regular breaks
19:05and a volume of no more than 60 to 80%.
19:09As of that, and the link to cancer, that evidence is a little too weak as of now.
19:16Medical tourism industry in India has taken a big backseat, courtesy the West Asia War.
19:22The escalating tensions have had an adverse impact on medical tourism in Delhi and other cities,
19:28with hospitals specially chains across this region reporting an average decline of around 30% in international patient footfall.
19:38India has a growing medical tourism industry where patients from Africa, the Arab world, UAE and many other countries
19:46travel for cheaper and good medical facilities.
19:50Here's a report.
19:51For years, medical tourism has thrived in India.
19:55Overseas patients from countries like Israel, Iran and the UAE.
19:59Well, the fallout of the prolonged war in West Asia is now being seen in Indian hospitals.
20:05Hospital chains are seeing a 50 to 75% drop in international inflows due to the Iran-Israel war.
20:13The drop in patient inflows has been seen from countries like Oman, Saudi Arabia, Iran, Iraq and Yemen.
20:19Fortis Healthcare expects a 15% to 20% revenue hit for March, a sentiment shared across the industry.
20:27Artemis Hospital has already reported a 35% dip in revenue in its international segment.
20:34Well, the situation is worsened by widespread flight cancellations and closed airspace,
20:40which have driven up airfares by 15 to 25% and increased travel times.
20:46This is a setback for the entire medical tourism industry, whether it is India or European market,
20:53Turkey or even Southeast Asia.
20:56All the markets are getting equally affected.
20:59The medical tourism sector, valued at approximately 6 billion US dollars in 2022,
21:06is projected to surpass 13 billion US dollars by 2026, by the end of this year.
21:13India has emerged as one of the world's most sought-after medical travel hubs,
21:18thanks to its blend of advanced healthcare and affordable pricing.
21:22Medical tourism in India thrives for many reasons.
21:26First of all is the availability of humongous clinical talent across India,
21:32the great connectivity of Indian subcontinent with the rest of the world,
21:37and especially those developing countries where the healthcare facilities are already in shambles.
21:45Third, you know, the kind of quality care or excellence which is being delivered in India
21:50across various hospitals, it is available at a very affordable price,
21:55almost one-sixth to one-tenth of, if you compare with European or the American markets.
22:01The Ministry of Tourism says that medical tourism has contributed over 9 billion dollars
22:06to India's economy in 2020.
22:09Patients world over contribute to this industry.
22:12Well, my wife had an eye problem, eyesight problem,
22:17so we checked, we had inquired about the hospital in Delhi.
22:23We were taken good care of by the attendants.
22:28Kamenga from Zambia, I came here with my son, Emanoj Tengimuhanga,
22:34who's been battling with sickle cell from the age of six months.
22:38I thought of seeking a permanent solution, which is bone marrow transplant.
22:43So that's when I thought of coming to India.
22:46The experience at 40s has been awesome.
22:49So how does the industry now intend to deal with this challenge?
22:52I'm hoping that in times to come, both the sides will call a truce
22:58and they are going to allow essential services including not just the oil transportation
23:05but also the healthcare services only by improving the aviation.
23:10LPG shortages is being reported from across the country and particularly commercial sector.
23:16Now, what really is happening is that a lot of people are turning towards firewood
23:20in traditional way of getting their fuel.
23:24Well, experts warn that smoke from these fuels really is harmful particles
23:29that is going to eventually damage the lungs, raising the risk of COPD, asthma and infections.
23:35Of course, it has a deep bearing on the air pollution aspect as well.
23:40Here's more.
23:56People are switching to wooden things, right?
23:58Which is causing a lot of pollution.
24:04Production is also done, but what do we do? It is necessary.
24:13In a way, there are other buildings, right?
24:14There's no water in the air pollution.
24:15There's a lot of pollution.
24:22You know, there's no water in the air pollution.
24:22Environmental hazards, sir.
24:24It affects people's life in a very bad way.
24:32Well, it is a crisis that has arisen amidst the war in West Asia, a fallout that one perhaps
24:38wouldn't have expected. Indians are now moving to use firewood instead of liquefied petroleum
24:45gas, courtesy the shortages caused by the war.
25:13Well, the shift towards firewood has been reported in several areas and mostly roadside
25:18food vendors.
25:21Difficulties in accessing LPG cylinders and rising costs have forced them to revert to traditional
25:27wood-based cooking methods. Experts say such a transition could undo nearly two decades
25:32of progress made in promoting cleaner cooking fuels.
25:37Firewood combustion releases several harmful pollutants, including carbon monoxide, a particulate
25:43matter PM2.5, black carbon, all of which contribute to poor air quality and increased respiratory
25:49diseases. The carbon footprint of firewood is also considerable. Burning just one kilogram
25:55of firewood releases roughly 1.8 to 2 kilograms of carbon dioxide or CO2. If a household or
26:02commercial kitchen burns around 100 kilograms of firewood, it could release nearly 200 kilograms
26:08of CO2 significantly adding to greenhouse gas emissions. What about the impact on healthcare?
26:16First, you have to understand that what does traditional fuel or wood or cow dung cakes and all those biomass
26:26fuel causes? It causes indoor air pollution. While we have been so long worried about outdoor air pollution,
26:34indoor air pollution becomes all the more important because then person is exposed for longer period
26:41of time in closed environment. Our country was doing very well in terms of providing clean fuel to our
26:50households. So we can go back to that era in which women in households are again developing respiratory
26:57illnesses just because of using traditional fuels. Traditional fuels let out lot of smoke, particulate
27:04matter, carbon monoxide, which can give rise to respiratory disease, which can worsen pre-existing
27:09respiratory disease. Not only that, it can also affect cardiac health. A population who has pre-existing
27:16lung disease like asthma or COPD, they are more vulnerable to indoor air pollution because that will lead to
27:24exacerbation of this illness, leading to more increase of medication, more increase of nebulizer or
27:30inhaler, increase in number of hospitalization. Investing in solar power today could help cities avoid a
27:36future marked by rising pollution, worsening health conditions and further loss of green cover.
27:43Well, that report brings us to the end of this edition of Health360. You can find that much more up
27:49on our
27:49website. It's indiatoday.in. You can download the app as well. All of these reports do go up on our
27:55social media platforms. It's YouTube, Instagram, Twitter or X and Facebook. Our hashtag is Health360
28:03Plus. Do not forget to like, subscribe and share. Until next time, thank you for watching. Take very
28:09good care of yourself. Bye for now.
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