Cipla concall was today at 10:40 pm (late night)

Here are the key takeaways 😃

@unseenvalue @darshanvmehta1 @AlgoBoffin @iramneek

Introduction

- Company being the first one to launch Remdesivir and the whole portfolio for covid 19

- Company is no.2 in lung leadership. Will try to unlock the complex generics in US.

- Growing faster than the average market growth.
- Trying to bring respiratory technology in China and in Brazil.
- There is a fair amount of unlocking through digitalization.
- ESG to improve in future. Becoming carbon neutral and water neutral.
US business
- Were able to add

- would be doubling the revenue in US.

- The pipeline is nicely diversified , now the products are diversified into respiratory + injectable around 30%
Indian market: One india strategy
- To cosumerize the business.

- Generic business is no.1 in india.

- Brand is moving from generic business to consumer business.

- Goal is to keep beating market growth by expanding the depth in portfolio.
- There has been a deeper distribution system because the generic business is moving faster than expected.

- Synergizing the distribution channel for prescription, trade generics, and consumer health.
Consumer wellness
- Goal is to make 12- 15% of revenue in next 3 to 5 years. Right now ots around 5 percent.
South African business
- Going relatively fast in CNS and respiratory business.
- Nice portfolio in HIV.

Emerging markets
- Solid partnership are present in these market.
Digital initiative

- Can unlock a great potential in profit through digitalization
- Automation in manufacturing and digitization of data.
- Company is re imagining the business to be more digital.
ROIC story

- Capital is being diverted to respiratory division. Comaony likes this category.
- 50 to 60% will come from new launch of products and rest would be through cost control.
- In india company want to expand a bit but the major focus is to push the revenues higher.

Respiratory portfolio
- The company has a para 4 filing and has a partnership with a generic company.
Future acquisition
- Company is open to acquisition which would be easy to digest

- India and us business are very attractive but company is not seeing huge potential in capital allocation towards acquisition.

More from The Tycoon Mindset

More from Health

You gotta think about this one carefully!

Imagine you go to the doctor and get tested for a rare disease (only 1 in 10,000 people get it.)

The test is 99% effective in detecting both sick and healthy people.

Your test comes back positive.

Are you really sick? Explain below 👇

The most complete answer from every reply so far is from Dr. Lena. Thanks for taking the time and going through


You can get the answer using Bayes' theorem, but let's try to come up with it in a different —maybe more intuitive— way.

👇


Here is what we know:

- Out of 10,000 people, 1 is sick
- Out of 100 sick people, 99 test positive
- Out of 100 healthy people, 99 test negative

Assuming 1 million people take the test (including you):

- 100 of them are sick
- 999,900 of them are healthy

👇

Let's now test both groups, starting with the 100 people sick:

▫️ 99 of them will be diagnosed (correctly) as sick (99%)

▫️ 1 of them is going to be diagnosed (incorrectly) as healthy (1%)

👇
1/16
Why do B12 and folate deficiencies lead to HUGE red blood cells?

And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?

For answers, we'll have to go back a few billion years.


2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.

Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine

But why does DNA contains thymine (T) instead of uracil (U)?

https://t.co/XlxT6cLLXg


3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).

In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?

https://t.co/bIZGviHBUc


4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.

DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.

https://t.co/bIZGviHBUc


5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.

When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.

[*Note: thymine is the base in dTMP]

https://t.co/AnDUtKkbZh
Public Health Scholarships

This may help for those considering MS/PhD in Public Health

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10. Kofi Annan Global Health Leadership

11. MA in European Public Health

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12. MSc in Public Health Scholarships - Maastricht University,
1/15
Why can cefepime cause neurological toxicity?

And why is renal failure the main risk factor for this complication?

The answer requires us to learn about cefepime's structure and why it unexpectedly binds to a certain CNS receptor.

#MedTwitter #Tweetorial


2/
Let's establish a few facts about cefepime:

🔺4th generation cephalosporin antibiotic
🔺Excretion = exclusively in the urine (mostly as unchanged drug)
🔺Readily crosses the blood-brain barrier (so it easily accesses the brain)

https://t.co/rjYG1BfGPR


3/
The first report of cefepime neurotoxicity was in 1999.

A patient w/ renal failure received high doses of cefepime and then developed encephalopathy, tremors, myoclonic jerks, and tonic-clonic seizures.

✅All symptoms resolved after hemodialysis.

https://t.co/u7JLVitQpp


4/
Cefepime neurotoxicity is surprisingly common, occurring in up to 15% of treated critically ill patients (w/ symptoms varying from encephalopathy to seizures).

💡The main risk factors = renal failure and lack of dose adjustment for renal function.

https://t.co/nxbnzSq8AR


5/
What about cefepime induces neurotoxicity?

One clue is that it's not the only antibiotic that causes neurotoxicity, particularly seizures.

This actually is a class effect w/ other beta-lactam antibiotics (including penicillins and carbapenems).

https://t.co/Lf4BhON9IY

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