Healthy Life - April 2017: Marketing Inwards A Generics-Rich Environ
There is never a tiresome 24-hour interval inwards the pharma marketer’s life! Respected Mr. north Modi, PM of India, has sent shivers downwards the spine of pharma marketers - on 17.4.17 at Surat during a infirmary inauguration: Mr. Modi announced inwards his spoken language at that spot that the cardinal govt. volition convey inwards a police to ensure doctors prescribe generic drugs (Ref.: The Times of India, page no. 1 headline, Ahmedabad edition). The reference was that doctors should write unbranded generic drug names on prescriptions ie., for example, doc volition non prescribe Dolo 650, he has to prescribe paracetamol 650 mg!
Now allow us remember, almost entire of Indian pharma marketplace is the branded generics market, which is promoted to doctors. Pharma companies take away maintain built their fortunes together with gained huge shareholder value on the basis of pen habit of doctors to prescribe branded medicines (me-too products) together with earned profits. This has helped pharma companies to recruit patch personnel to expand operations, ensured marketplace penetration of character products to the nook together with corner of Indian pharma market; this has helped pharma companies create manufacturing set-ups, together with export products to almost every dry ground of the world. And pharma companies take away maintain also started R together with D endeavours.
Overnight, amongst the PM's announcement, this pharma concern model is nether threat past times the envisaged law. No to a greater extent than volition a doc prescribe Taxim, he volition write cefixime 500 mg, it is upto the patient together with pharmacist to ensure the consumption of this drug, either unbranded generic or whatever 1 of the branded options available amongst the pharmacist.
Now, if the police that is to come, allows the doc to prescribe both paracetamol 650 mg together with his recommended create inwards brackets eg., (Dolo 650), together with thence at that spot is to a greater extent than or less steam left inwards the branded generics pharma marketplace infinite promoted to doctors.
Background
During 1950s, the medical representative (MR) see was a most welcome entry for the doctor. Probably he would larn 1 medical representative see every 24-hour interval inwards urban areas, together with inwards semi-rural together with rural visits, if at all a MR would visit, the doc would larn a MR see may hold upwards in 1 trial a week. Hence, the MR amongst his production updates together with samples was a welcome presence to the doctor.
From 1970s, amongst production patent regime existence abandoned (thanks to the Indian Patents Act, 1970), (the production patent was re-introduced inwards 2005), me-too production manufacturers together with marketers burgeoned. More medical representatives started entering the doctor’s clinics, bonus offers before unheard off…became a rage, pharmacies also started pushing brands that offered meliorate margins or complimentary goods (sales promotional offers). As the number of medical representatives started increasing, the leverage was amongst the doctor, together with he started gratefully accepting diverse quid-pro-quo gifts from pharma marketers. Those who were aggressive inwards gifting grew rapidly…this story continued into 1980s. However, at that spot were also to a greater extent than or less pharma marketers who were non gifting or providing sponsorships adventurously.
The belatedly 1980s, together with 1990s saw the before conservative companies, shed their shyness, throw their ethics out of the window, since they saw their counterpart companies who provided gifts together with bonus offers growing humongous, together with got into the gifting together with sponsoring of doctors gameplan. Various wannabe biggie companies also started playing amongst penetration pricing to garner marketplace share. CRM (customer human relationship management) was the nitty-gritty of pharma marketing. PCD (propaganda cum distribution) companies started taking origin together with gained traction inwards the showtime decade of 21st century. The political party has locomote bigger together with bigger.
Doctors are splurged; several unconfirmed legendary CRM activities create rounds during marketing “gupshup”:
a) After the formal cocktail dinner launch of a breakthrough create of antiulcerant, of import doctors were given keys to a luxury car… together with prescribers who were gifted their iv wheels left broadly smiling
b) Another leading doc working for psycho-somatic wellness of patients, was given plenty cars past times diverse companies – 1 motorcar for each 24-hour interval of the week! And the 24-hour interval the doc takes out a sure car, on that 24-hour interval the pharma brands belonging to the motorcar gift-giver would curlicue out of the pen of the doctor
c) Sponsored unusual tours for families together with other indulgences inwards the unusual tours engrossed doc fraternity together with brands paraded inwards their minds
d) Sponsorship of get-togethers, cocktail dinners together with diverse other meetings masqueraded nether the garb of CMEs (Continuing Medical Education)
And it goes on together with on together with on…each pharma marketer vying amongst each other to give together with take…for usual gains amongst the medical fraternity.
WHY DO PHARMA MARKETERS ‘GIVE’ TO THE DOCTOR?
Consumption of medicines is decided past times the doctor, inwards the electrical flow situation, it is past times prescribing the branded generic. If a doc prescribes create X, the patient buys it. The patient has implicit trust on the doc (the medical professional person before definitely had a demi-God condition inwards Indian society) together with obediently goes amongst the doctor’s create recommendation. The final result is pharma marketers who take away tending of doctor’s needs savor meliorate sales outcomes together with profits.
In this business, the patient does non create whatever selection betwixt brands amongst the same generic drug. It is the doctor’s concern to select the pharma create for the patient. But the payer is the patient!
Ignorance of create options amongst same generic drug, lack of volition past times patient to exercise create options, together with non-encouragement past times the environs to select alternative brands or unbranded generics are the primary reasons why patients locomote along obediently amongst the doctor’s create recommendation.
This pussy basis past times the patient provides an chance for the doc to purpose his influence amongst patients together with encourage consumption of his favoured brands. And this gives an chance for the doc to strike quid-pro-quo relationships amongst pharma create marketers! And both the pharma companionship together with doc savor the benefits of pharma create sales, thank you lot to a real co-operative mental attitude of the patient.
WHY DO PHARMA MARKETERS PROMOTE PRODUCTS TO DOCTORS?
Pharma brands are built past times the doctors prescriptions, if a doc gets chiliad to 2500 patient visits per calendar month (average of twoscore to 100 patient visits per day; 25 working days per month), together with prescribes an average of iv assorted pharma brands per patient, then, 4000 to 10000 pharma create purchases take away maintain happened (it volition non hold upwards 4000 to 10000 dissimilar brands, at that spot volition sure enough hold upwards a number of repeated overlapping brands) - a doc later on all, may hold upwards able to recollect maximum 100 to 200 dissimilar pharma brands?
So the thought for the pharma marketer, is to hold upwards amid the 100 to 200 brands or so, which a doc remembers (certainly to a greater extent than or less brands are etched permanently inwards the doctor's heed ‘non-volatile ROM brands’ together with others are ‘volatile RAM brands’, the latter are the brands that float inwards together with out of the doctor’s mind, depending on the regularity of production promotional activity).
It is together with thence vital to gain patronage of the doctor, together with ensure the promoted pharma brands sell. Thus, prescribing the pharma create call is key to commercial success of a pharma company.
GENERIC PRESCRIPTIONS: death-knell for the pharma create business
The ruling BJP political party together with Mr. north Modiji are focused on winning elections, the side past times side large 1 is the Lok Sabha elections of 2019. To get together votes, they postulate to tell a story of doing expert to their voters, mainly the middle shape together with piteous sections of society. Capping the prices of stents has endeared the govt. to the masses. Now ensuring purchase of unbranded generic medicines, which are available at stone bottom rates volition farther create the authorities voter friendly. There is a expert talking call for hither for the ruling party.
a) Branded generics promoted to doctors (these ship maximum premium (high MRP) together with are hugely prescribed past times doctors)
b) Branded generics non promoted to doctors, sold past times pharmacies to patients, together with also purchased past times dispensing doctors who sell them to patients
c) Unbranded generics non promoted to doctors sold past times pharmacies to patients, together with also purchased past times doctors who sell them to patients.
In developed countries, the patient is non ignoramus. The doc has to justify his recommendation to patients. Normally, prescriptions are for unbranded generics inwards developed countries. Many of these unbranded generic medicines sold inwards developed countries are manufactured inwards Republic of Republic of India together with marketed abroad.
However, inwards India, it is a time-honoured exercise to manufacture together with market, branded generics together with the prescriber chooses to patronize sure brands of his selection based on the doctor’s experience amongst the technology scientific discipline together with character of the brand, together with marketing inputs provided past times the pharma marketer. The Indian patient is ignorant of his mightiness to create a selection betwixt branded together with unbranded generics.
ARE PHARMA BRANDS EQUIVALENT?
The answer is yes together with no! Brands of the same category are chemically equivalent (contain the same quantity of the active ingredient). However, at that spot tin hold upwards of import differences. This is amongst the excipients together with the manufacturing procedure parameters of the brand. For example, if you lot compare the dissolution profile of albendazole tablets, you lot may hold upwards surprised; Zentel from GSK is said to take away maintain the best profile. Similarly, Advanced Crocin has sure excipients to improve dissolution together with consequent absorption of paracetamol into the bloodstream, when ingested.
Pharma brands are also presented inwards unique differentiating ways that improves patient credence together with create salience. The shape at the rima oris of bottle inwards oral pharma formulations may assist pourability, purpose of sure permitted colours together with flavouring agents also enhances patient acceptance, purpose of Alu-alu pack past times sure pharma brands (may non hold upwards used past times plainly vanilla unbranded generic medicines) enhances patient compliance together with patient acceptance. Pharma create marketers locomote on differentiating their products through value added excipients to improve organoleptic qualities (improved patient credence through mouth-feel, flavour, texture, odour, colouring together with taste); these are non a consideration inwards plainly vanilla unbranded pharma products.
Though brands may hold upwards chemically equivalent, or fifty-fifty proven to hold upwards bio-equivalent, nevertheless create performance may non hold upwards same; together with create credence at patient grade volition non hold upwards same. Furthermore, doctor’s confidence volition non hold upwards same on each brand. It depends on the doctor’s experience amongst the brand, technology scientific discipline used inwards the brand, together with patient feedback to the doc on the brand.
IS information technology RIGHT TO DO ‘DEBRANDIZATION’ (brand-bandi inwards doctor's prescriptions) OF INDIAN PHARMA MARKET?
Patient health, recovery together with well-being are paramount for medicine marketers together with doctors. Quid-pro-quo relationships are at 1 level, but patient recovery & well-being (public health) is the non-negotiable foundation where pharma marketers, doctors together with other stakeholders such equally regulatory agencies concord to hold upwards on 1 page.
So the fundamental query to inquire is, whether advertisement of unbranded generic medicines - volition improve populace health?
The merits of ‘debrandization’ inwards pharma market:
a) People volition come upwards to know of availability of unbranded generic together with branded generic medicines (which are non promoted to doctors), thence this alternative volition gain traction; together with patients tin exercise this alternative if they wish
b) Doctor-pharma marketer human relationship volition locomote “cleaner”
c) PCD (propaganda cum distribution) companies who are known to offering robust services to doctors inwards central for their prescription or purchase support, volition end
d) Accessibility volition improve
e) Cost of therapy volition come upwards down.
The demerits of ‘debrandization’ inwards Indian pharma market:
a) The electrical flow pharma marketing concern model volition collapse
b) Shares of large pharma listed companies whose concern depends on pharma brands volition autumn steeply
c) Industry turnover volition fall
d) If the doc stops prescribing branded medicines, medical representatives volition non encounter them, many medical representative jobs volition hold upwards lost
e) Companies volition cut down jobs inwards marketing (particularly patch jobs)
f) Field personnel volition focus on pharmacist retailers than doctors, offering incentives together with freebies to retailers to stock together with force their products (as per the Times of India, 19.4.17, page no. 19, Bombay edition, retail margin on drugs may hold upwards equally high equally 1000%, this volition stress pharma marketers, equally they take away maintain to offering competitive margins together with offers, this volition erode fiscal forcefulness of pharma companies)
g) Innovation together with technology scientific discipline improvements volition non occur, all pharma companies volition locomote for manufacturing the plainly vanilla formulations (without whatever improvements), it volition locomote a commodity game
h) Quality volition locomote a query issue. For instance drugs (APIs) together with excipients are available at diverse crystalline purities, together with the manufacturer volition locomote inwards for lowest acceptable crystal purity (only economic scheme volition weigh on the heed of manufacturer)
i) Packaging volition hold upwards passé together with volition non offering whatever improved benefits to patients
j) With turn a profit margin squeeze, companies volition non take away maintain adequate surplus monies to invest on geographic expansion, export ventures, production development, R together with D, novel molecule research, social marketing etc
k) Companies volition cut down emphasis on launch together with marketing of modern medicines, they volition prefer to invest on nutraceuticals together with Ayurvedic formulations. These volition non hold upwards affected past times the proposed police (in fact, Himalaya Drug Company together with other such companies volition locomote laughing all the way to the bank, spell residuum of pharma volition hold upwards stressed). Besides Ayurvedic formulations together with nutraceuticals tin hold upwards advertised. We volition lose our standing, competence, global border together with cognition of manufacturing together with marketing of modern medicines
l) In instance of branded formulations containing multiple ingredients such equally Becosules Z, it volition hold upwards virtually impossible for the doc to write names of generic drugs or vitamins/minerals included inwards the formulation on his prescription
m) Monitoring the implementation of this ‘generic call solely law’ for prescribers is nearly impossible…let us tell at that spot are virtually 10 lakh active prescribers (across India), together with allow us assume, every working 24-hour interval these 10 lakh active prescribers write virtually 50 prescriptions each. This way v crore prescriptions per day! And for 25 working days, it is 125 crore prescriptions per month!! Are you lot going to monitor this?!!
n) If a doc writes to a greater extent than or less create names, together with inwards Republic of Republic of India where at that spot is a province of affairs of less number of doctors, together with to a greater extent than patients, what penalization are you lot going to administer? Prevent them from practising?
o) If medical representatives together with patch personnel lose jobs, inwards a dry ground where under/unemployment is high, is this initiatory worth it? Please recollect marketing creates to a greater extent than jobs than manufacturing or R together with D (in pharma field)
p) Doctors may give oral recommendations for brands, or unsigned slips containing create names, or pharmacies volition force sure brands on oral recommendation of doctors … at that spot are ways to shell this law…
q) There could hold upwards legal challenges to this ‘debrandization’ equally it takes away the liberty to promote branded products together with recommend them
r) Patients may hold upwards unhappy amongst the generic call prescriptions since the doc is non prescribing “quality brands” (it is a affair of liberty of selection together with many patients desire character brands…brands are the covenants of trust)
s) Patients together with patient attenders may hold upwards upset amongst the natural language twister together with complex generic names of medicines, inwards comparing to cute, slow to recall, slow to pronounce together with slow to recollect create names of medicinal products.
HOW MAY PHARMA COMPANIES MANAGE THE NEW CHALLENGES?
PESTEL standing for political, economic, social, technological, environmental together with legal environs is ever inwards a province of flux, depending on the diverse happenings on the PESTEL front, pharma organisations volition respond inwards diverse ways:
a) Some volition adopt the facial expression together with watch, others volition atomic number 82 a counter response through diverse forums similar IDMA together with KDPMA; few others volition purpose their expert offices amongst diverse authorities together with nowadays their viewpoints. Some others volition nowadays their take away on social media together with speak to the media
b) Companies volition start investing on novel marketing technology scientific discipline to strengthen their patient-centric communication, together with strengthen CORPORATE EQUITY together with PRODUCT EQUITY at patient-level.
c) There volition hold upwards a rising inwards OTX (over-the-counter together with prescription) route of marketing (including communication/advertising/digital messaging to patients) to strengthen sales outcomes; also OTX products volition hold upwards launched inwards a rush: ayurvedic, dental, nutritional powders, nutritional supplements, wellness soaps, together with other nutraceutical products (including inwards unique packaging similar Tetra Pak based products or products amongst unique concepts similar virgin kokosnoot oil)
d) A chemist-focused together with dispensing-doctor focused working volition hold upwards emphasised to ensure production availability
e) Companies volition locomote inwards for umbrella branding, umbrella create colouring concept, together with uniform packaging for creating marketplace identity for their products; thence that chemist/pharmacy retail-push/pull volition start; pharma marketers volition also locomote inwards for launch together with pushing unbranded generics together with branded generics (low cost, that are non promoted to doctors)
f) Companies volition growth no. of medical representative calls to pharmacies (eg., fifteen per day) together with cut down doc calls (to tell v per day)
g) Companies volition in all likelihood rationalize patch personnel count together with coverage, together with consolidation of divisions/SBUs etc., to cut down costs
h) Companies volition invest to a greater extent than on pharmacist coverage, example: paying chemists/pharmacies to volume shelf infinite for their products, offering freebies to chemists, & having patch personnel to comprehend to a greater extent than chemists/pharmacies together with dispensing doctors
i) Some companies amongst deep pockets may start their chain of pharmacies (for eg., Cipla pharmacy), together with volition also emphasize online chemist's shop marketing toos
j) Companies volition invest to a greater extent than to create patented medicines, products amongst novel drug delivery systems or products that produce non take away maintain many me-too products...
j) Companies volition invest to a greater extent than to create patented medicines, products amongst novel drug delivery systems or products that produce non take away maintain many me-too products...
What may the Govt. do?
a) Govt., may tighten doctor-pharma marketer relationships amongst novel laws
b) Govt., may inquire doctors to write generic names solely on prescriptions
c) Govt., may inquire doctors to write the generic names together with the create call alternative (in brackets), thence that the patient volition take away maintain an alternative to purchase the generic call production if he wants or locomote ahead amongst the doctor’s selection of a branded production or the patient may select to a greater extent than or less other branded product, a companionship of his choice.
It would hold upwards prudent to locomote the alternative C, since it meets governmental requirements, patient psychology, doctor’s confidence together with liberty, together with Indian pharma manufacture traditions.
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