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You probably take for granted that you can buy or sell a share or stock at a moment's notice. Place an order with the broker and within seconds it is executed. Have you ever stopped to wonder how this is possible. Whenever an instrument is bought or sold there must be someone on the other end of the t

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

ransaction. If you wanted to buy 100 shares of McDonalds you must find a willing seller and visa versa. It is very unlikely that you are always going to find someone who is interested in buying or selling the same quantity at exactly the same time - this just does not happen. So - how does it work? Th

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

is is where the MARKET MAKER comes in!!

The market maker is like a wholesaler. Customers arrive and leave all day long, some returning goods to the warehouse, others leaving with new purchases from 8.00 am until 4.30 pm every weekday (in the UK). The difference with this operation is that the wholesa

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

ler only has one item to trade, which are all identical. These items are continually bought and sold. The only responsibility that the wholesaler has it that he must keep his doors open during market hours, and he is responsible for setting the prices, second by second and hour by hour. He makes his m

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

ney by buying at a lower price and selling at a higher price. This is known as the spread and has two components - a bid price and an ask price. He makes his money on the difference between the two which is his profit. This may only be pence or cents, but when you are dealing in 100's of millions of s

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

hares it is a vast amount of money.

Now - let me ask you a question - what happens when a customer comes in for a large buy order, but there are insufficient goods available. A normal wholesaler in the real world would buy in more goods from the manufacturer to fulfil the order. Our wholesaler does n

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

ot have this option, he has to encourage people to sell to him, otherwise he has nothing to offer his customers. So what does he do? ( here's a clue - he sets his own prices for the market !!!) He has two options available. Firstly he could move his prices down fast and frighten people into panic sell

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

ing. Alternatively he could move his prices up quickly, and encourage people to take some profits and selling. Lets assume that he decides to take the first course of action and he moves his prices down fast ( probably on the basis of some fictitious piece of news or gossip, or even a world event)

Su

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

prised? - you shouldn't be. This happens every hour of every day of every week in all markets around the world. Is this market manipulation - yes of course it is. It also explains why markets fall faster than they rise - in the fall the wholesaler is in a hurry to get new supplies of goods, on the way

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

back up he is taking his time making profits. This technique is known as ' shaking the tree' for obvious reasons!!! Naturally he cannot frighten everyone too much, otherwise he could end up with too many sellers and not enough buyers (he could of course have moved the prices up to encourage some clie

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

nts to sell and take their profit - there is always more than one way to skin a cat!!!!)

The wholesaler is of course the MARKET MAKER. They are professional traders. They are licensed and regulated and have been approved to 'make a market' in the shares you wish to buy and sell. They are usually larg

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

e internationally banking organisations, usually with thousands or tens of thousands of employees worldwide. Some of them will be household names others you will never have heard of, but they all have one thing in common - they make vast amounts of money. As you can now see (I hope) the market makers

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

re in a unique and privileged position, of being able to see both sides of the market (supply and demand). They also have the unique advantage of being able to set their prices accordingly. Now - I don't want you to run away with the idea that the entire market is rigged, it is not, as no one market m

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

aker could achieve this on their own, but you do need to understand how they use windows of opportunity and a variety of trading conditions to manipulate prices.

The above explanation is of course a vast over simplification but the principle remains true. In America, the NYSE and AMEX have a single m

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

ember known as a specialist that acts as the market maker for a given security. Other exchanges such as the NASDAQ, have several competing market makers for the same security. Do they ever work together? (I'll leave you to be the judge of that !!!!). On the London Stock Exchange there are official mar

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

ket makers for many securities (but not for shares in the largest and most heavily traded companies, which instead use an electronic automated system called SETS).

Now why I have spent so much time explaining what these companies do when actually you never see them at all. The answer is very simple.

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

s professional traders they sit in the middle of the market, looking at both sides of the market. They will know precisely the balance of supply and demand at any one time. Naturally this information will never be available to you, but there is a way to interpret it from a chart using one single indic

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

ator. That one indicator is VOLUME. Whilst they will use every piece of news, world event, rumour and gossip to manipulate prices and the markets, this is one piece of information that they cannot hide (although even this they delay on larger orders).

Volume shows the activity of trading during the p

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

articular time period chosen which can be anything from 1 minute to 1 year. However, volume on its own does not tell us much, other than the number of securities traded in the period. Comparing one day with another tells us a little more, and it is then not difficult to see whether today's volume is h

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

igh, low or average. If you have 20 people standing in a row, it is easy to see who is the tallest, shortest, and those of average height. However, add the volume to the price spread for the time period, and suddenly using common sense and the knowledge above, you can begin to start reading the market

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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Dutch Disease gets its name from an economic phenomenon seen in Holland. The discovery of natural gas reserves in Holland in the 1960s led to a slump in other sectors like manufacturing. Dutch Disease is the recession that hits other sectors when one industry dominates, or increases its exports.

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