Saturday, November 25, 2006

Prescriber fatigue and product life cycle management

Thursday, March 16, 2006 08:00 IST
Sunil S Chiplunkar

The 20th century business scenario created the profession of "brand building". Branding helps in differentiation, creating loyal customer base, insulating a product from obsolescence and competition, helps command a premium in the market place, reinforces trust with customers and delivers value to customer and company alike. An exciting brand development in the contemporary business scene is the extension of Kingfisher a beverage brand to an exciting airline brand, from a 'product brand' to a 'service brand'. If the 'service airline brand Kingfisher' establishes firmly, the multiplier effect on the brand Kingfisher will be magical! The total brand value of Kingfisher will be literally flying high!!

Today, the Indian pharma industry is a leading light in the global healthcare scenario. The Indian pharma industry is a well entrenched global manufacturer and marketer of APIs, formulations, herbal extracts and nutraceuticals. Moreover, medical tourism and health resort industry is lending wings to the image of India as a quality and value-for-money service oriented healthcare destination. Healthcare products and healthcare services together have over Rs 1 lakh crore business potential.

The robust challenge and opportunity ahead is building global Indian brands - brands that dominate domestically and internationally. In fact, brands like Wockhardt and Himalaya juxtaposed in the 'healthcare service sector' and 'pharma manufacturing and marketing sector' have a solid opportunity to exponentially increase brand value, a-la-Kingfisher.

A curious desi phenomenon

Domestic pharma brand building has an odd challenge: The Indian Patents Act, 1970, which allowed reverse engineering has created a fragmented market with brand clutter. This has led to rising power of retailers and stockists. In at least one Southern Indian state (Kerala) NOC is not given to more than 25 brands of a molecule, by the stockists association. Decades of "me-too new introductions" has commoditized products and lent a character of "promotional differentiation" in the field of pharma marketing and sales. This has also led to a need for "brand variety" by a prescriber, who also zealously guards "prescription secrecy". The cumulative effect of the above scenario is a curious desi phenomenon - prescriber fatigue, an obstacle to brand building, evergreening of brands and product life cycle management.

Several factors are responsible for this curious 'desi' phenomenon including brand clutter, commoditization of products, heavy focus on 'new introductions' and new technological developments.

Prescriber fatigue is indeed a challenge to marketers involved in brand building and product life cycle management.

Product life cycle (PLC) concept

The PLC (product life cycle) concept is a useful tool for analyzing a product's position and applying marketing decisions. PLC is based on the biological life cycle. A seed is planted (introduction stage), it grows (growth stage), matures (maturity state) then later on shrinks and dies. In theory, a product too passes through introduction, growth, maturity, decline and withdrawal stages.

Assuming this cycle to be true, marketing mix decisions are taken. For example, during introduction stage, a market penetration (low price) may be used or a leadership or market skimming pricing for recovering development costs is used. There is also a focus on brand building and promotion to innovators and early adopters. During maturity and decline stages product differentiation is introduced through line extensions and improved product features.

However, this PLC concept is only a guiding tool. Many products fail in the introduction stage. Cyclical maturity phases are also a feature of some products where promotion helps regain customers. The length of each phase varies product to product and brand to brand. Further, decisions taken by marketers greatly influences product fate. And finally there are situations where products bypass certain phases in the PLC. Nevertheless, the PLC is an interesting guiding tool.

Many pharma brands have grown significantly as per ORG JUN 2005 MAT. In 1991, Corex was Rs. 13.9 crores, which is Rs. 87.0 crores; Voveran was Rs. 12.9 crores, which is Rs. 86.2 crores; Becosules was Rs. 25.8 crores, which is Rs. 75.7 crores and Liv 52 was Rs. 17.2 crores, which is Rs. 66.2 crores as per ORG JUN 2005 MAT.

Overcoming prescriber fatigue

The challenge of overcoming prescriber fatigue is indeed exciting to a marketer in his bid to build brands and evergreen brands.

The following vistas are available to overcome prescriber fatigue:

1) Constant creative promotion to internal and external customers
2) Passing the baton generation to generation
3) Post marketing clinical studies and market research
4) Positioning and repositioning exercises
5) Line extensions and product improvements for brand vitality.

Constant creative promotion

A brand with a price advantage can simply be undercut. A brand with a performance advantage can be outflanked by technological development. But a brand with an emotional difference can potentially demand a premium forever - Don Cowley

As can be surmised, brands are vital productive assets. Constant creative promotion for a long time will make a brand financially tastier. A brand then becomes a legend and part of the market consciousness. To maintain and renew brand vitality promotional measures are required at two levels - one at the level of internal customers (the field force) and second at the level of external customers (doctors and chemists).

The 21st century (and the latter part of 20th century) has seen many media revolutions. Yet right from the time when Parke Davis started the world's first 'medical representatives', the field force particularly in India continues to be the dominant medium to communicate and influence the doctors' prescribing habits. Companies like Cipla have added database mailer marketing and advertising successfully to their marketing mix. Nevertheless, the field force is the backbone of product promotional activities in a company. Hence, what the field force does affects a brand's fortunes.

More as a rule than as an exception, achievement of predetermined sales targets takes the front seat 'month end' after 'month end'. Closing of the month sale 'a pharma obsession possesses the field force who take over stockists' premises (and even substockist and doctor attached retailers) during month end. Last minute offers and special sanctions enrich stockists while the company tries to reach the holy grail of the sales target. Achievement of the sales value and ensuring collection becomes the prime job of the field force.

The above actual scenario of many a pharma company becomes a real challenge to a marketer whose duty is brand building and brand renewal. More often, New Introductions (mostly me-too brands) obsesses salesmen and marketers to achieve primary sales, thus contribute to the topline. The secondary sales can then be taken care of through core doctor working. It should be noted that a 'me-too brand' is a new introduction for the company, but the nth brand for the doctor. So often, new introductions themselves pose a challenge to marketers whose goal includes evergreening of core brands.

With MRs focusing on doctor conversions for new introductions, sales targets, collection, stockist and substockist management, doctor deals, chemist deals, special sanctions…'in-clinic' focus for evergreen power brands gets only a 'reminder status'. The MR 'reminds and thanks' the doctor with regard to the well established brands, more often with just some samples or a quick flip of the visual aid "Dr., reminding for Brand X' or 'thank you doctor for Brand X' or mere verbal reminders without even the casual visual aid exposure. This situation is a picture of convenience to all concerned: the marketer can provide a regular promotional effort and input, the doctor can avoid the product presentation with an authoritative 'I KNOW', the MR ducks the detailing, the company shores up the topline through new introductions, stockists and retailers boost their earnings through offers and site facility. Thus, power brands become weaker day by day.

For a marketer to strengthen core brands in the above typical scenario it is even more challenging. A marketer should hence come out with creative approaches that appeal to doctors and field force. A rehash of established strategies and messages to the doctor just won't do. The communication platform has to be worked on keenly. To take FMCG examples even Lifebuoy today talks of both health and beauty; Lux is not just for the female stars, Shah Rukh Khan is lending his slender shoulders to support Lux; Anchor has roped in Rahul Dravid to emphasise the dependability of its electricity oriented products. The marketers' challenge doesn't end with a good communication platform for an old brand. The job includes creating exciting in-clinic activities with the fervor of youth to an old brand, ensuring inspiring moments for internal and external customers. The need for established 'reminder core brands' is innovative communication and in-clinic activity to overcome prescriber fatigue.

Passing the baton generation to generation

The above scenario of reminder promotion ensures power brands are 'reminded' to a trusted set of 'old' doctors, year after year. New introductions obsess the company and evangelically promote them to young doctors and innovators. The medical college hospitals the right centres for evergreening of brands, become theatres for 'new product promotion'. The older brand gracefully ages, the marketing team with all sagacity decides to focus on 'emerging markets' with new introductions, while brand assets are depreciated. As time passes, power brands whiter away with the old generation of doctors. The new generation of doctors is informed about the new brands. Thus, avoiding youthful and fresh campaigns to well established brands, reinforces prescriber fatigue towards the old power brands.

Post marketing clinical studies and market research

Evergreening of old brands requires the brand to have freshness, which can come through 'newness' in the product promotion. Post marketing clinical studies and market research (to understand customer perception) is a vital vista for brand renewal. Clinical studies will help reinforce brand usage, generate comparative benefits vis-à-vis competitor brands and produce knowledge required for brand renewal with contemporary metaphors thus appealing to new and old generations of doctors. This may even extend the therapeutic spectrum of usage. For example, prediabetes and prehypertension are fairly new clinical diagnosis, brands can fortify themselves through clinical studies addressing these new clinical concerns. Post marketing clinical studies and market research will help generate USPs, promotional and talking points for enhanced in - clinic effectiveness and overcoming prescriber fatigue towards old brands.

Positioning and repositioning exercises

The excitement in a marketer's line of activity comes with product positioning, repositioning exercises and creative promotionals. The positioning statement reflects how the brand fits in to the customer's mind, reflecting customer perception of the brand. Based on the newer dimensions of the product and changing market trends, repositioning helps overcome prescriber fatigue and gives a new lease of life to a product. A classic example is aspirin, a NSAID now a mainstay in cardiovascular therapy.

Line extensions and product improvements

Marketing is often described as a value delivery process. Line extensions and product improvements are long used strategies for evergreening of brands and strengthening value delivery process. Very often small innovations like shift from glass bottles to lupolein or polymer packs have rebooted brand values. Line extensions have shored up brand sales. For instance, omeprazole brands have strengthened themselves through launch of omeprazole and domperidone combinations. All in all, value additions through product improvements and line extensions definitely overcome prescriber fatigue.

We see above the changing dynamics of market and regulatory environment makes it imperative to build solid and strong pharma brands. Overcoming prescriber fatigue is one factor that will contribute to evergreening of brands. Some strategies have been discussed above.

- (The author is with Juggat Pharma (Pharma Div of Jagdale Ind Ltd), Bangalore)§ionid=46

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