Monday, December 31, 2007

HELLO 2008!! Digital crusaders and more…

Beijing Olympics 2008 will be the sporting event to look forward to... for all of us Pharmacists and healthcare professionals included!

In Jan 2007, I got a pleasant web surprise where in Mr. John Mack acknowledged a mail from myself to him in the following manner ... PLEASE CLICK HERE. 2007 was a great year for digital crusaders like John Mack, and surely 2008 will be the YEAR OF THE DIGITAL for Pharma and healthcare professionals and netizens.

This year 2007 has whizzed by – 2008 is just round the corner. Among various pharma and healthcare events, the withdrawal of inhalable insulin – EXUBERA for non-pharmacological reasons is the most interesting case study. Withdrawal of drugs or formulations is normally due to a problematic adverse reactions profile. Exubera was withdrawn for commercial reasons, as sales were not sufficient. So was the withdrawal of Exubera a marketing problem? Does the Exubera case study indicate a major silent shift in the structure of healthcare market? Is there a new undiscovered paradigm of decision making operating in the healthcare market? The curious case of Exubera is unanswered.

Visualizing emerging healthcare markets and trends in 2008

One of the most interesting tasks of stock taking every year end is crystal ball gazing – trying to make out the trends in the coming year.

The biotech trend will gather steam

2007 was an interesting journey: one biotech product - Exubera ‘bonged’, while Gardasil has taken off well, and this human papilloma virus vaccine looks to make history. Wyeth’s pneumococcal vaccine is penetrating markets worldwide admirably. Overall the biotech products will script success.

The global market for biotech products is growing fast and the 2005 estimate of revenues of major international biotech companies was 63.1 billion dollars market. The Indian Pharma companies too are looking at the attractive biogenerics segment as you can observe here…CLICK HERE.

From collaborative R & D to open source innovation, research, and development

The internet and the information revolution have contributed to an important phenomenon – that is empowerment. People are no more ignorant about various healthcare and other matters. Taking informed decisions has become the way of life for prospects and consumers. Furthermore, web 2.0 technologies have added to the spread of knowledge and wisdom through conversations and new media. This has added to healthcare literacy. Suddenly, one can go on to the net, gain significant understanding about health topics like say diabetes, and then can even blog to become an important opinion builder and resource on diabetes; for eg., Thus the new media has caused the collapse of the information float and created collaborative mindsets.

Thus, it has become inevitable for Pharma companies involved in R & D to collaborate and innovate, mainly to spread the risks involved and ‘bullet proof ‘ innovation activities. There by there is derisking of the R & D activities. Innovation projects are being outsourced to countries that can provide cost effective results. This collaboration mindset on innovation will know doubt get a fillip in 2008, but will further telescope in to open source healthcare R & D. Mr. Amit Sen Gupta, Gen Sec of All India Peoples Science Network has argued passionately in favor of the same on p no 14 of Economic Times, dated 26.12.2007. He makes a profound opening statement that TRIPS leading to increased innovation is only a mirage. Strong IP protection is encouraging protectionism and is harming the way science is done, he reiterates. Many more patents are taken out to stop others from working than to protect one’s own research, he argues. Open – source model of innovation is not new and is used extensively in the software sector, it organizes research from around the globe, he reiterates. It is possible that in 2008, there will be a new dawn in Pharma and healthcare innovation through collaborative and open-source innovation model.

Complementary healthcare products (including herbals) will rise

The recent Indian Pharmaceutical Congress 2007 at Varanasi was an eye opener. There was a lot of buzz on herbal drugs. There were interesting poster presentations and lectures on herbal trends. The Dr. P C Dandiya Endowment Trust Oration was dedicated to herbal drugs. An interesting scientific presentation on herbal medicine by Wei Duan, of Australia, has reiterated that about half the Australian population uses complementary and alternative medicine totaling an estimated 2.3 billion Australian dollars.

Here is an interesting report: CLICK HERE. More about herbal products industry: CLICK HERE.

Personalized medicine, SMART PHARMACY, and e-healthcare will strengthen

IT advances and biotech have helped map the human genome and is now leading to an era of personalized medicine. And the e-healthcare concept is gaining strength. For instance, the Economic Times, dated 29.12.2007 on p no 4, talks about how Talk to Frank is a drugs advisory and discussion web site that is creating a new paradigm in e-healthcare. The mantra of e-healthcare is demystifying healthcare knowledge, empowerment, and helping people take informed decisions.

2008 will see more excitement in the remote diagnosis and treatment healthcare space, as technologies for better telemedicine are already there and need to be applied.

2008 will see more of digitization of healthcare: open a website, and punch in signs and symptoms, get an idea of the healthcare issue, and may be even take internet based remote consultations with healthcare professionals.

2008 will see the rise of SMART PHARMACIES -where in community and clinical pharmacists will use IT, and help patients and consumers make the best health choices. One concept that pharmacists in collaboration with healthcare and Pharma companies will use is the After Rx Services concept using touchscreen devices.

Digital crusaders will shine even more

Digitization has created a new genre of crusaders - people who are passionate about certain issues, crusade in favor of their passions on the net. And these crusaders are creating new forces in the world through the most democratized medium – the internet. With web 2.0 getting strengthened, and web penetration gaining traction globally, such digital crusaders will shine even more.

In the Pharma and Healthcare digital world, here are some passionate crusaders (whom I recollect off hand): John Mack (passionate about his blog and the famous Pharma Marketing Blog Forum), John Virapen, Rich Meyer, Amy Tenderich, Dr. Steve, the team at, Peter Rost…

I RAISE A SPECIAL TOAST ON NEW YEAR’S EVE TO THESE BRAVE DIGITAL CRUSADERS. I AM SURE THEY WILL SHINE EVEN BETTER IN 2008. May their tribe increase, and may God shower them and their ilk, with the very best in 2008 and years to come.

You can access 49 blogposts put up by me in 2007 by CLICKING HERE. Please do read all the blogposts on this blog, enjoy, AND WISH YOU ALL A HAPPY NEW YEAR 2008. Thanks.

Monday, December 24, 2007

Chronicle Pharmabiz: shaping the destiny of Indian Pharmaceutical sector

Chronicle Pharmabiz is an important mirror of the Indian Pharmaceutical sector. This news weekly has just brought out a special issue on the occasion of the 59th Indian Pharmaceutical Congress, Varanasi. Chronicle Pharmabiz has also published some of my articles too, in the past, which you can access by clicking HERE. MY LATEST ARTICLE ENTITLED MARKETING (PERCEIVED) VALUE HAS BEEN PUBLISHED IN CHRONICLE PHARMABIZ SPECIAL SUPPLEMENT DATED 13.12.2007 AND CAN BE ACCESSED BY clicking here.

Excerpts from the article entitled Marketing (perceived) value:

"Pharma marketing is now experiencing tectonic shifts in value delivery processes with transformational developments in marketing and communication media. The vehicles of message transfer are transforming the way by which word-of-mouth (between doctors and between patients) occurs. Hence, the way marketing influences perceived value and consumption of products is also changing radically.

In marketing, the perceived value of a product or brand by the target audience is vital. A successful pharma product obviously has a high rating of perceived value by the prescriber, patient and retailer. Perception of value comes when the product is presented with sophistication and performs to the expectation. When value perception is negatively affected, the product becomes a whimper. It is essential to create a buzz to enhance value perception. Positive word-of-mouth enhances value perception".

The information age

We are now in the information age. Tools and systems that help create information from data; organizations that provide insights, ideas, and value through distilling, and analyzing information are in great demand. This is simply because in today’s wired world there is a collapse of the information float. Disruptive forces act faster on business systems. In this age, one can, at real time, share, and collaborate on the information superhighway to create value, and thereby enhance organizational effectiveness and efficiency. Successful organizations today focus on creating value from information through ideas, and insights. This helps organizations compete better.

Media and communication are keys to organizational and individual success

Media (including social media like blogs) plays an all important role in shaping destinies of communities, industries, and individuals. One such medium in the Indian Pharma scene - is CHRONICLE PHARMABIZ. The launch of Chronicle Pharmabiz was an important event in the Indian Pharmaceutical scene as the magazine was focused to serve unrepresented portions of the Indian Pharma sector. Chronicle Pharmabiz addresses a market gap – it functions as a bridge between the Pharma industry, regulators, research, and educational institutions.

Today, the Chronicle Pharmabiz has grown to become South Asia’s No. 1 Pharma news weekly. In fact, Chronicle Pharmabiz has undergone a metamorphosis – in to a group called Saffron Media. This media group produces a no. of mags to serve different industries like the food and beverage industry. Saffron Media is a forward looking media group with presence in print and the online world.

Chronicle Pharmabiz like The Times of India, plays a key role in shaping important events related to the Pharma industry. For instance, Chronicle Pharmabiz has in the recent past played a lead role in helping organize the Indian Pharmaceutical Congress, and in the latest 59th Indian Pharmaceutical Congress that is currently underway at Varanasi, the official media partner is Chronicle Pharmabiz.

The Chronicle Pharmabiz team is friendly, professional, collaborative, and communicative. Their write-ups strike a balance between academia, and the commercial side of the Pharma sector. In fact, this is their cachet. Chronicle Pharmabiz presents readers with insights on the Pharma sector from the academic angle, and from the practical ground level of the industry. The Chronicle Pharmabiz editorials are bold and unprejudiced. Their articles show that the Chronicle Pharmabiz team is interested in publishing courageous, forward looking, and original insights.


All media are extensions of some human faculty – psychic or physical

This blogpost is dedicated to CHRONICLE PHARMABIZ and I personally wish the media group all the very best in its future endeavors. I TAKE THIS OCCASION TO WISH YOU ALL A HAPPY CHRISTMAS 2007. As always, I invite you all to take time and scroll down to read all other blogposts including by clicking on "older posts". Thanks.

Monday, December 17, 2007

Adolescence healthcare market: a forgotton frontier

To learn more about the above picture, please CLICK HERE.

The key to successful market expansion plans is uncovering new markets for existing products; identifying novel needs, wants, and desires, and addressing them with suitable products and services. Here is a market not very well addresssed, and that is the ADOLESCENCE HEALTHCARE MARKET.
Adolescence age
No one can forget one's golden age of adolescence. The adolescent vivacity, imagination, optimism, restlessness... the inexplicable forces generating a lot of energy...can one forget it at all?!!

Adolescence, biologically speaking, is the age when hormonal activity induces maturation changes in the individual. It is the age of new discoveries of the mind and body - with new behaviors - the adolescent is not yet an adult, and certainly not a child too. The age of puberty is when adolescence is said to begin.

In girls, adolescence leads to maturation changes - the girl is growing in to a young woman. Her voice gets shriller, deposition of fats in a 'rounded way' begins, development of breasts, and start of menstruation signal the arrival of adolescence. The girl starts to spend more time in front of the mirror, examining facial skin and so is a delicate age.

Boys...suddenly get aggressive, alternating between compliance and rebellion. Open sometimes and at times withdrawn, one wonders what happened to my boy?! Maturation changes makes their voices become hoarser (ie. deeper), muscular and skeletal development takes place at a rapid pace, and a moustache and beard make their first presence.

The challenges in adolescence age include:

a) mental health and right attitude development (antisocial behavior in schools and colleges give shivers to gaurdians and parents, because this is when peer groups become more important and powerful than gaurdians and parents!)
b) hormonal changes and maturation development
c) skin health (acne is the most common skin affliction)

Adolescent medicine

Adolescents face unique problems: emotional and maturation related changes. This is the age when nutrition becomes important since adolescence is associated with maturation changes and growth. Mood disorders are common among adolescent youth. Acne can drive young girls in to depression and social withdrawal. Endocrinology and gynecology become important in the management of girl adolescence health. Adolescence medicine becomes important from the ages of 9 to 11 for girls, and 11 to 13 for boys.

With the youth market becoming important in India, developed countries and emerging markets, adolescent clinics are becoming important.


While it is clear that adolescence healthcare market has its interesting sensitivities and represents a market opportunity to be addressed, the type of business model is very vital. When the adolescence healthcare market is addressed with an adolescence clinic, it is clear that the sickness dimension is being emphasised. Will such a nomenclature attract the right audience in large nos.? Or should an alternative business model be developed with a more positive image?

YOUTH WELLNESS CENTERS sound more positive, dosen't it?

There is a ready market for the taking - a market that needs to be addressed in a specific way, the market for adolescents is there. But it is useful to have a marketing communication activity taking parents and gaurdians in to confidence. After all which parent would not like to have a useful partner for strengthening the attitude and health of their adolescent children? A Youth Wellness Center manned by professionals, partnered by pharmaceutical and healthcare companies can give wellness and preventive medicine a new dimension. The social benefits of such marketing initiatives are welcome.

For eg., if a company gets a professional to endorse the use of healthcare products like Horlicks (I wonder why Horlicks should be a bedtime drink? And not be an anytime drink.) and say Brahmi (for mental sharpness), it is inevitable that the youth market will carry on the use of these healthcare products in the mature age phase too. So making inroads in to the youth market is sagacious for present and future business too!

Adolescent age group is the typical crossroads age group. What this set of prospects and customers requires is a positive health center. And there is a major youth market there for marketers to tap into.

Right now healthcare marketers are less focused on the teen (youth or adolescence) market segment, leaving the market open to personality development enterprises. With childhood and teen obesity, faulty eating habits, skin problems, emotional challenges ... pharma and healthcare marketers can make a difference to society and the financial health of their companies! (RIGHT ADOLESCENCE = GREAT FUTURE)

Please scroll down to read more interesting articles, you may have to click on OLDER POSTS for some more interesting blogposts.

Friday, December 7, 2007


The above is a nice image of a touchscreen from (CLICK HERE) and this device can herald a new era of pharma retailing and AFTER Rx SERVICE, do read on...

Digitalization is an unstoppable global juggernaut. The trend of digitalization is changing the way we communicate and conduct business. In fact, digitalization has transformed the way we live. In the field of pharma marketing and healthcare, digitalization is leaving a global footprint and has the potential to revolutionize healthcare CRM through an exciting concept (that I call) AFTER Rx SERVICE. Please read on…


The current orientation of pharma marketers is to focus on prescription generation and encashment in favor of marketed brands. Thus, physician engagement and availability at pharmacies, and ensuring encashment of prescriptions is the focus of sales and marketing efforts. However, the revolutionary trend of digitalization has the potential of creating yet another powerful touchpoint that can influence the consumption of products and services, and improve health outcomes.

After a prescription is generated for a brand – a connection is established between the company, the brand, doctor, pharmacist, and the patient. By capitalizing on the potential of digitalization, one can further strengthen the equation between company, brand, doctor, pharmacist, and patient for mutual benefits. Here is how, with a few illustrations:

Let us imagine a new person is diagnosed as a diabetic and is given a prescription for a brand of metformin. After purchasing a pack of the medication, the patient gets to read the pack insert, that informs him of the details of the medication, and encourages the patient to log on to the particular brand website. After logging on to the brand website, the patient is encouraged in the website to register himself. The brand website experience will inevitably be an empowering and encouraging experience, where the website will advice and inform the patient on diabetes management and lifestyle issues. Being a diverse manufacturer, the company will subtly inform the netizen about the availability of other CAM (complementary and alternative) products as supportive therapies for management of diabetes. The idea is to seed other relevant products in the receptive mind of the patient to help the patient manage the diabetic situation better. In fact, the accent can be on prevention of diabetic complications, for eg. an antioxidant product like Ocugold from Ajanta for better eye care. As the netizen reads about the complications of diabetes, he becomes aware of the dermopathies that a diabetic is susceptible to. Thus, his mind will be receptive to use of relevant creams as preventive care. Marketing preventive care is the challenge as there are a number of mental barriers for the adoption of preventive healthcare products. Notably, the reason is the inertia that is the thought that the product is not required by an individual as the sickness may not strike him. However, a person with sickness has a mind primed to reception of messages on preventive healthcare products (or services), particularly for the products related to complications like diabetic complications.

The website can also lead the netizen to a conversational blog site wherein the patient can have conversations on the use of medicines, awareness and management of side effects, using complementary and other products for health benefits, and use the blog site as a moral support system. Thus, through the effective use of internet based digital medium the company cements its relationship with the patient through an augmented AFTER Rx SERVICES system.

One can enhance this in the case of vaccinations too. The mother can learn about the effectiveness of various vaccines on her own and take informed decisions about administering right vaccinations in consultation with the doctor. And get dosage alerts on her mobile from the website.

What the AFTER Rx SERVICE does is to strengthen the bond between patient and company through empowering information and inspiration. The company also gets an opportunity to introduce its complementary and preventive healthcare products.

Let us assume, a person is affected with tonsillitis. And he is prescribed antibiotics. The patient can go to the brand website and learn about tonsillitis and get to know of various immunostimulants like Septilin, Guduchi (through a co-promotion effort) etc that strengthen the healing process and prevent recurrent tonsillitis.

Liver dysfunction is often a side effect of drugs like anti TB drugs, antibiotics, and occurs due to alcohol consumption. In fact, chronic constipation, liver disease, and piles are related diseases. Thus, a TB patient or piles patient can through hyperlinks from brand websites connect to CAM products like Liv 52 that will help him heal better and faster, in consultation with the doctor. For eg., Lupin has anti TB medications and hepatoprotectives. A patient with a prescription for rifampicin, when he logs on to the brand website, he will get to know of the hepatic side effects, and can learn of hepatoprotectives that will play a constructive role in his road to recovery. All this is possible due to the digitalization trend in society today.

Digitalization can also help provide personalized messages to patients and doctors through e-mail and sms, based on specific queries and needs. Digitalization also helps create company or brand sponsored digital communities. For eg., patients of anxiety neurosis can belong to a brand digital community that acts as a support system. The entry to the brand digital community will of course come through a prescription for the brand. For eg., if a person is prescribed Anxit the patient can gain an entry to the Anxit digital community. Any messages on the Anxit message board can also be sent by sms to the patient’s mobile as Anxit sms alert.

Thus, we see that digitalization based AFTER Rx SERVICE is a form of customer relationship management (CRM) activity. The objectives of the AFTER Rx SERVICE will be

Strengthening bond between brand, company, pharmacist, doctor, and patient
Ensuring dosage compliance (can be done through sms dosage alerts too)
Offering complementary and related products to the receptive mind of the patient (aids prospecting)
Empowering persons on healthcare knowledge and issues
Preventing complications
Retarding the progress of the disease
Better health outcomes and improvement of quality of life
Customer brand engagement - strengthens confidence and allays fears
Helps retain customers
Increase throughput from each customer
Helps strengthen word-of-mouth and builds new opinion builder systems for healthcare products and services
Generating trust and customer delight (feel good factor)

Digitalization based CRM - AFTER Rx SERVICE - at the level of the pharmacies

Touchscreen based interactive information systems have great potential for AFTER Rx SERVICE. This can help pharmacies increase revenues through sale of semi OTC and OTC products (that are related to the patient’s disease). Let us imagine a patient is treated for PCOS (poly cystic ovarian syndrome), the patient is usually prescribed hormonal treatment, but PCOS women also suffer from acne (adult onset acne). Through the touchscreen device, the patient can learn more about PCOS including the acne problem. The touchscreen device can advise skin care products. In case, of pharmacy chains like Manipal Cure and Care that are now marketing Living Proof range of skin care products, the touchscreen device can help bolster sale of the skin care products.

Now imagine a lady patient suffering from osteoporosis & osteoarthritis (which according to a survey are the #1 ailments in India), with a prescription for raloxofene. Such a patient is usually of the menopausal age. Let us say she enters a Manipal Care and Cure center, after filling in the prescription, the community pharmacist invites the patient to learn about osteoporosis, osteoarthritis, and menopause with the help of the interactive touchscreen information system. The patient then learns through the attractive graphics that menopause also causes hot flashes (which she experiences), crows feet and fine wrinkling. By pressing appropriate touchscreen buttons the patient learns about the various OTC soy products for management of hot flashes, and the derma range Living Proof that will help in management of fine wrinkling and crows feet.

Thus, the above patient gets the benefit of better associated products, and the per patient revenue is significantly increased for Manipal Care and Cure.

Similarly, patients suffering from malaria can be exposed to information about anti – mosquito creams that can be applied, by other family members.

AFTER Rx SERVICE goes beyond physician engagement thanks to the digital medium represented by the internet, mobile, and touch screen based systems (for use at pharmacies). Particularly, for pharma retailers, touchscreen interactive information systems have a huge potential for offering augmented AFTER Rx SERVICE, and these along with pharmacist based counseling, can simultaneously enhance revenues significantly. Digitalization enhances CRM through AFTER Rx SERVICE and aids targeted messaging. Digitalization based AFTER Rx SERVICE is a 24/7 preposition and can go beyond geographies. There is respect for privacy and personalization of the digital experience. AFTER Rx SERVICE can revolutionize healthcare, augment brand building, and boost revenues.

I thank you for reading the above post, please scroll down to read a nice love story of a medical representative, and scroll down further for other articles, please click on older posts for articles if required. Thank you.


This is based on a true story of a MR from Tamil Nadu. The names have obviously been changed to protect identity and avoid unnecessary publicity. This is not a typical love story where the heroine is a much sought after beauty and the hero a rich guy; it is a story of mutual respect and very mature love. Read, enjoy and appreciate!!

The hero: The main character of this story is a Medical Representative (MR) by name … let us say, Bhima. This tall well built bespectacled handsome guy worked for a MNC. He was a hard worker with good rapport with chemists and doctors, and excellent territory knowledge. He lived and worked in Chennai away from his hometown. Like many a young man he did too suffer pangs of loneliness.

The heroine: Jyotika by name, she hailed from a feudalistic warrior caste, and belonged to a very poor background. Her father was a chronic drunk who even bashed up his wife and daughter for money to support his alcohol addiction. Her brother was a wastrel. 19 year old Jyotika was a very different beauty, her clear tanned complexion was arresting, and she had a maturity beyond her years.

The story: Bhima had to go to a far away suburb of Chennai every month. He often had his arguments with his boss to change his tour plan so he could avoid this suburb, and concentrate on business development in areas nearer to his residence. At last, his boss agreed, and today was to be his last business visit to this suburb. So he was extra happy while he rode on his bike to this far off territory.

His routine calling on doctors started, and at about 2.30 PM he was near to the last clinic. A friendly chemist had his medical shop nearby the clinic. It was routine for Bhima to rest in the medical shop, chat with the chemist, and make the doctor call when the doctor was free. A nurse used to control the entry of MRs to meet the doctor. It was routine for Bhima and other MRs to give some gift samples to the nurse so she can facilitate an early entry in to the clinic. (This point is important as it is one of the threads on which the love story began).

Today, when he entered the medical shop, he was a bit surprised, as the regular chemist was not there, and there was a girl who was manning the shop rather authoritatively. Bhima assumed it was the medical shop’s owner. Bhima smiled shyly and started to converse with her. She introduced herself as Jyotika. She happened to hail from near his home town. Their wavelength’s matched. And they had a warm casual conversation.

At this juncture, the nurse came over to Bhima and took some samples from him as was routine. After the nurse left, Jyotika reprimanded Bhima for misappropriating the samples. She said that the samples were meant for the doctor, and by giving the same to the nurse, Bhima had equated the nurse with the doctor. So it was very unprofessional. And further she even reprimanded Bhima for not being clean shaven and smartly dressed. The reprimand was different as there was authority tinged with concern. Bhima was taken aback. No one had behaved like this with him particularly in a maiden conversation. She even advised him to eat regularly and be more disciplined so as to balance personal care and professional commitments. She was a mix of firmness and love. Bhima was rather happy with the experience of meeting Jyotika. While she was leaving to her house in the evening he asked for her contact no., and Bhima gave his card with mobile no. written on it. Jyotika took the business card from Bhima and commented “I come from a very low economic background, the way I have seen poverty, and if you see the shack that we call our home, probably you will not want to see me again.” Bhima was softened and said I will be waiting for your call tomorrow at 8.30 am in the morning.

The next day when Bhima was at Chennai, at 8.30 am exactly, a call came to his mobile. It was Jyotika. Then what followed was an intense one hour long conversation. Jyotika shared her background details and expressed concern for Bhima. In fact, the opening remarks as soon as they started conversing, was with Jyotika enquiring whether Bhima had his breakfast, ironed his clothes, and other aspects of personal welfare. At the end of the conversation Bhima was inspired to pop up the question: Please will you marry me? To this Jyotika replied, “I think you should talk to your parents about this, seek their co-operation, and get a good well educated girl from a great family background from your caste, with a good dowry to match”. “I think”, she continued, “I am a mismatch to you, we are from different castes, I am from a poor background, and my education is only up to pre-university; so goodbye and take care”. She cut the line abruptly.

Bhima was in torment. Jyotika had in fact called from a public booth, so there was no way of reaching out to her immediately. Later, Bhima called up the medical shop, and said he wanted to speak to Jyotika; when she came on line he only said that he would come to the suburb medical shop the following Sunday, and wanted to talk to her. She did not respond. The call ended.

The following Sunday, Bhima rode on his bike to the suburb and stopped near the medical shop at a petrol bunk. Jyotika was there in the medical shop, she did notice Bhima, but was avoiding eye contact. Bhima stood for 2 hours under the hot sun at the nearby petrol bunk. At long last, Jyotika came up to him and advised him to leave. Bhima said “Please get on the bike and I want to talk to you at a better place”. Jyotika in an irritated manner started walking away. Bhima started his bike went near her and roughly ordered her to get on to his bike. She stared and got on to his bike. Bhima rode over to a nearby isolated beach. He started conversing with Jyotika and said “I think you are from the warrior caste (Thevar), yet I want to marry you”. Jyotika got angry, she yelled at him, ”You know, about my caste, the caste leaders are not tolerant of such inter-caste marriages, and besides you are better off economically and better educated, you are handsome.” “Please leave me alone”, she yelled and gave Bhima a hard slap. The slap was so tight, that Bhima experienced stinging pain and his spectacles even fell off. Still Bhima yelled back “Please I only want to marry you”.

Softened, Jyotika, paused, and advised Bhima to take a five day leave, go off to his native place, and speak about all this with his parents.

At Bhima’s hometown: When Bhima broached this subject with his conservative parents, sister and elder brother, there was sullen silence. Approval was obviously not forthcoming. Bhima’s elder brother, took Bhima for a short walk and said “Normally, love marriages occur for one of these reasons: a) for money of the girl’s family (b) the beauty of the girl (c) bonding and spending time with each other for a long time (d) mistake (ie. pre marital sex). As per Bhima’s brother this was a unique case as Bhima was marrying for none the above reasons. Bhima said he had immense respect for Jyotika and was inspired by Jyotika. Hence, he wanted to marry her. Bhima’s brother advised - 'then take the step of marrying on your own, without parental support, break links from the family, and remember this marriage is a delicate task since, it involves people from the feudalistic warrior caste'.

Bhima left immediately for Jyotika’s house: Bhima entered Jyotika’s house to find her brother and mother in the house along with Jyotika. He started off by apologizing for his abrupt entry, and begged his forgiveness for his love for Jyotika, and said that he wished to marry Jyotika. Her brother was taken aback and he reprimanded Bhima. Bhima pleaded his proposal to Jyotika’s mother. After much negotiation, Jyotika’s mother said she would agree only if Jyotika really wanted to marry Bhima. So once again Bhima broached Jyotika to marry him in front of Jyotika’s mother and brother. Jyotika firmly said she wanted to marry Bhima and be Bhima’s wife.

A new twist: After the above episode Bhima returned to Chennai. A day later he was rudely awakened by an urgent call. A doctor was on the line and he asked Bhima to rush to the suburb as Jyotika was hospitalized and she was constantly asking for Bhima and she was alone. The doctor also said that Bhima should come with some 10 toughies and take Jyotika away from the suburb. Apparently, in drunken anger, Jyotika’s father had hit Jyotika on her head with a stone, and pushed out a bleeding Jyotika out off the house. And anguished neighbours had admitted Jyotika to the hospital – Jyotika was hurt badly, bleeding and was alone.

Pannachi helps: Bhima immediately approached one Pannachi of Chennai, a local toughie belonging to the warrior caste (same as Jyotika). Bhima gave all details of his case. Pannachi was taken aback, yet appreciated Bhima’s courage and tact. Since, in this case, the girl will be benefited, Pannachi agreed to help behind-the-scenes, as he did not want to antagonize his caste members through direct help.

Bhima rushes to the suburb hospital: Bhima then hired a vehicle and along with 4 of Pannachi’s toughies, he went to the hospital at night. Bhima did one more courageous thing:

Bhima went alone to Jyotika’s house, met Jyotika’s mother, father and brother, and reprimanded them for their inhuman treatment to Jyotika. In return, the father started rebuking Bhima for this incursion. Jyotika’s mother started wailing loudly saying no one in their family had done such a bad thing like inter-caste marriage or affair. In the meantime a crowd of about 50 people had gathered and were silently witnessing the proceedings. Amongst the onlookers was an intelligent good Samaritan who rang up the police and explained the details to the sub-inspector (SI). The police arrived immediately. The SI gave one look at the decently dressed Bhima and understood the scene. He rebuked and furiously reprimanded Jyotika’s mother and father. He said that they, in fact, should consider themselves lucky since Jyotika had selected a good boy for herself, and all by herself. He took some details in writing from Bhima, and under police protection sent Bhima and Jyotika to Chennai.

With the help of a few well wishers and friends, they married after two days, after Jyotika had recovered.

Today Bhima and Jyotika live happily ever after… they have a lovely baby boy … Bhima’s family and Jyotika’s family have reconciled to the marriage and they silently have renewed ties. However, Jyotika’s brother and father unfortunately continue with their bad old ways.

In this story we see that the MR hero has given that which a man ought to give a woman – a great new life. He has done it with a lot of personal sacrifice. The hero has not exploited the situation & cheated the girl – but on the other hand shown perfect commitment and nobility.

The great pix at the top is taken from

Tuesday, November 27, 2007


The above picture is taken from this link that is excellent for social marketing and pharmaceuticals, please read on ...

The retailing revolution is creating newer market dynamics and facilitating better marketing communication activity. The platform of organized retailing presents a medium for social marketing. The objectives of social marketing is the application of marketing techniques, concepts and practices to achieve specific behavioural goals for a social good. The difference between commercial marketing and social marketing is that commercial marketing has more to do with financial goals.

Healthcare promotion based on social marketing

Healthcare promotional activities for social good include the anti-tobacco campaign that is currently locked in a battle of words between anti-tobacco campaigners and those lobbying the interests of beedi makers and tobacco cultivators, in India. Similarly, the pulse polio campaign and the hepatitis inoculation campaigns have been social marketing initiatives. Today, anti HIV campaigns and family planning campaigns are also in the ambit of social marketing.

Preventive healthcare

Preventive healthcare is a challenging task compared to management of marketing of products and services for sickness management. In the case of sickness or disease management, there is a strong motivation for seeking healthcare intervention. For instance, a person afflicted with upper respiratory tract infection will not waste time in seeking medical help by way of antibiotic and pain killer prescriptions and thereby gain well-being. However, in the case of preventive healthcare, it is difficult to motivate a prospect to seek therapy of say an immune booster ayurvedic drug so as to offset the onset and limit the severity of a possible future upper respiratory infection during the cold season. So the challenge to the marketer of preventive healthcare products and services is to find that hot button need, want or desire that will motivate the prospect to seek and gain preventive healthcare products and services.

How to increase the adoption of preventive healthcare concepts, products and services?

The main approach to increase adoption of preventive healthcare concepts, products and services is by raising the consciousness of dangers of ill health, that is to say the importance of being careful and not being negligent or careless. First of all the consciousness that health is controllable and not something out-of-control needs to be established; there are even believers that disease comes due to curses of celestial forces rather than something due to the individual. This is to say marketing communication activity should establish that there is an internal locus of control for establishing health. Thus, it is important that an individual becomes aware, convinced, and believes that it is possible to be healthy and that it is important to take certain proven and sure shot preventive healthcare steps that will establish positive health in himself or herself.

So the emphasis on the cause and effect (causal relationship) between actions and disease is required in the marketing communication activity. This means preventive healthcare is about creating the right habits.

Preventive healthcare through pharmacies: opinion builder pharmacists

The pharmacies are important centers of healthcare. It is at these spots that the patient or prospect gets to browse through products and pick up those over-the-counter that appeal to him. At this point one can strengthen the decision making process of patients or prospects by providing information and empowering counsel either through touchscreen based information systems and also by way of well trained community or clinical pharmacists. If a patient has to pick up a preventive ayurvedic medicine or nutritional supplement, it will require confidence building information that only a hitech-hitouch experience can give. The hitech touch can come by way of touch screen based information systems and pharmacists can offer the hitouch feel.

This approach in fact has tremendous scope for social marketing of concepts like awareness of chronic diseases and their management (diabetes, cardiometabolic diseases, hypertension, asthma, arthritis etc), vaccination and dermatological concepts (like anti wrinkling, anti aging, anti acne, anti photoaging etc), anxiety disorders, forgetfulness (dementia in the young and aged)…

Like wise, products can piggyback on the social marketing concepts and increase consumption for social good. In fact, this is value added social marketing concept with a commercial bias. However, required social good is achieved through behavioral changes of the target audience.

Social marketing is very relevant today

Obesity and wrong healthcare choices play an important role in morbidity and mortality. One important approach is to increase the consumption of fruits, vegetables and CAM ie complementary and alternative products like nutritional supplements, herbals, ayurvedic medicines, (which have a major role to play in delaying the onset of disease, reducing the severity and symptoms of diseases, and hastening the recovery from illness). In fact, with the empowerment of society through the internet, there is a rapid growth of the market for CAM products worldwide. This CAM movement will only gain in size as sickness management gets costlier and the importance of preventive healthcare gain traction through the media.

This report gives you a peek a boo at the growing CAM product market

This link gives you an idea of the developing trends of the Indian pharma market:

Pharmacies may also start using cutting edge technology like the telepresence technology

This is my 60th blogpost, many thanks for reading this blogpost, kindly do scroll down and read all other posts, including by clicking on olderposts wherever required.

Tuesday, November 20, 2007

Horror story telling skills

Pharma industry marketing is an interesting experience with loads of stories. Here are some tough - may be horror - stories! Please read them...any resemblence to people, characters, and events is purely coincidental and unintentional. Another suggestion please listen to Kaho na Kaho song from the movie Murder while reading this blog to add to the effect!

The rebel MR of Karnataka

It was a hot sunny April afternoon in a town of Karnataka. The MR was waiting for his first line manager at the bus stand. The boss was not exactly a pleasant man. He was harsh with his words and harsher with his actions. In fact, there were a number of grouses between the MR and the first line manager.

The manager arrived with his usual swagger and got on the pillion seat of the MR's bike and started to nag and curse him while the MR started to drive.

Suddenly, the MR went to a highway, and drove at high speed; he cut across to the countryside and drove away fast and furious to a desolate far off stretch. The manager was hanging for dear life.

The MR screeched to a halt, in chaste and rough Kannada, asked the manager to alight. After abusing the manager, cursing him for working free - of - cost, since the manager would not share the field expenses incurred, he handed over the MR bag to him, and informed the manager that he had already posted his resignation letter. The MR drove off...the manager had to trek all the way to the main highway from the desolate spot carrying the heavy bag.

The first - line manager's tragedy

Mr. S was a top MR in a big company. He was very successful beating records establishing new sales benchmarks. He then married confidently and his life turned even more pleasurable as he was awarded the first-line manager's post. The promotion was a tonic to him.

However, his life took a new turn for the awful. As a manager there were more pressures on his time. Attending to his now pregnant wife became tedious. Yet he managed adroitly. As the delivery date was approaching his anxiety grew, and he still managed his official work and domestic responsibility. As fate would have it, on the exact date of delivery Mr. S was at a far away location attending a sales meeting under pressure from his bosses. He was forced to put his mobile off and not even allowed to put the mobile on silent mode.

In the late evening, when he put his mobile on, a bad suprise awaited him. A sms announced that he had to rush back as his newborn son was in danger. Using his personal resources he flew to his hometown. His life was devastated forever, his son had an irrereversible nervous system problem due to a badly managed forceps delivery. To this day, he wonders if it was worth yielding to his un-co-operative bosses, as he feels if he was with his wife he would have taken his wife to a better place for delivery avoiding the forceps delivery and ensuring.

While he was sitting at his home, depressed, guilty and hurt a phone call from his superior ordered him to attend another sales meeting, there was still no touch of concern from his boss.

That was the last straw ... Mr. S faxed his resignation. The company and the boss accepted his resignation without remorse and regret. Mr. S was only a statistic.

Today, Mr. S manages his child with all love as he grows with lot of nerve damage related problem. Who will answer Mr. S's questions?

The MR's highway suicide

He was a dashing MR. Young and sensitive. Popular with the crowd. He did have the impetousness of a young person.

It was the dreaded sales closing time. There was heavy pressure to bill and reach the sales targets. In India, there is a unique phenomenon when sales figures are ramped up on the sales closing date - last minute offers and other schemes are the order of the day.

The MR was ordered to go to another town to get an order from a stockist there. It was late evening, on the way, his bike had a tyre puncture. He rang up to his boss of this event and that there was a delay. The boss blasted him... called him a liar...however, the MR pressed on... repaired his bike and rode on. His boss kept calling him repeatedly putting pressure and getting constant updates.

Suddenly something snapped in the MR ... when the MR got a call again from his boss, he retorted that the boss would not get the stockist order not would he get the MR again. The MR cut the line...

He got on the bike and to the horror of the bystanders, he rammed at high speed on to a speeding truck coming from the opposite side. Death was instantaneous. A young and bubbly life was snuffed out.

When some bystanders checked through his pockets and some how informed the second line manager about the incident, the second line manager in turn called up his first line manager to go to the spot and attend to the case.

The first line manager from a nearby HQ rushed to the accident spot and reported on phone to the second line manager. The first line manager was in for a shock. The second line manager remorselessly asked him to take care of the case so that no problem should come to the company, and importantly to check the MR bag, collect the cheque and order from the stockist and pass it on to him the next day. The second line manager wanted to immediately bill the goods, the MR's demise was another statistic. The first line manager could not stand this inhuman response. He blasted his superior, announced his resignation. Later a delegation of MRs beat up the second line manager too.

The young man's soul however, probably, is still seeking answers...So who will answer him and what can be the answers?

So, the above was a different blogpost; it is some story telling from my end. Not exactly palatable stories I agree, but this is my attempt to polish my horror story telling skills. But please do not get disheartened, there are some very interesting blogposts - please scroll down below - and there are no more horror stories...just nice and sugary stuff on pharmaceuticals and healthcare. This is Sunil S Chiplunkar, and I thank you for reading my blogpost and I request you to read all other posts too by scrolling down and clicking on older posts wherever required. Thanks.

Friday, November 16, 2007

CLINICAL PHARMACY AND PHARMA MARKETING collaboration – an emerging dimension This url gives you access to the article and above image. It is a good URL. Please click and read below too...

The hottest topic in Pharmacy now is clinical pharmacy (and the associated term -pharmacy practice). In fact, clinical pharmacy is becoming an important link in the chain to deliver quality healthcare. Coming in the backdrop of Vioxx and the Avandia controversies, the clinical pharmacist is becoming an increasingly powerful entity in influencing the consumption of drugs. The clinical pharmacist not only helps in research of drugs (ie. preclinical and clinical trial stage) but also plays a lead role in optimizing the use of marketed medications to ensure the right blend of safety and efficacy. In India, as corporatization of hospitals gathers momentum, clinical pharmacy too is gaining steam.

Clinical pharmacy in drug development

As costs of drug development soar and the risks associated with new drug development increase, optimizing the use of new-to-the-market drugs is very important so as to avoid improper clinical usage and hence adverse effects. In fact, higher incidence of adverse effects can ring alarm bells resulting in product withdrawal at the worst. Clinical pharmacists would play a lead role in rationalizing the direction of flow of clinical trial studies based on the initial leads of clinical research.

Eg. of how the clinical pharmacist and pharma marketer can collaborate in product marketing of Gardasil

The launch of Gardasil cervical vaccine by Merck is an important development in medicine. The HPV (human papilloma virus) opportunity has been successfully tapped by Merck through their quadrivalent vaccine. In fact, vaccines are the futuristic market and biogenerics are expected to dominate the future pharma markets. However, success of any good Pharma product depends on patient compliance. It is not easy to convince patients on the potential benefits of preventive healthcare products like vaccines. Patient compliance is easily higher for curative medicines. However, one approach is collaborating with clinical pharmacists in helping educate potential patients for Gardasil. Pharma marketers need to take cognizance of the fact that physician centric marketing communication needs to be augmented to address patients and other healthcare professionals like the clinical pharmacists.

Eg., of clinical pharmacy and consumption of CAM (complementary and alternative products)

Clinical pharmacists would play a lead role in influencing the consumption of CAM products including Ayurvedic products. When clinical pharmacists are armed with sophisticated presentation techniques like use of computers etc on CAM products, potential patients will trust the clinical pharmacist in helping achieve health goals.

Role of clinical pharmacist in educating and enhancing usage of revolutionary dosage forms such as Exubera

Exubera is an interesting case study. The product was taken off market not for any negative adverse risk profile, but for the fact that adoption rates for this product were poor and making the product commercially unviable. The clinical pharmacist has an important task of aiding patient compliance by making the prescription of the doctor, patient-friendly; this is a critical step that can enhance the confidence of the patient in adopting the product prescribed. For instance, if the clinical pharmacist was intimately involved in explaining the pros and cons of inhaled insulin, and educating the patient on using the Exubera device, may be the sales picture would have been rosier for Exubera.

The clinical pharmacist in case of specialty care

The pharmacist (community and hospital) in his role as a clinical pharmacist is becoming all the more important in educating patients on use of medications. This becomes all the more vital in case of vaccines and pediatric care. In specialty sections like oncocare, nephrocare, management of diabetes and diabetic complications, dermacare, plastic surgery, critical and trauma care, cardiac care … patient compliance and right usage of medications makes a world of difference in health outcomes, quality of life, and life expectancy.

As the clinical pharmacy profession gathers steam, the clinical pharmacist is fast becoming an important opinion builder (for healthcare products) who has the influence to educate patients. The acceptance of the clinical pharmacist is fast increasing in healthcare setups, since right usage of medications can make the difference, any wrong usage can lead to negative health outcomes resulting in bad publicity for the product, and negative image for the Pharma company.

Indian mass market: is semi urban and rural

Indian mass markets are semi urban and rural, where drug and health illiteracy compounds the problems of improper consumption of medications. It is here that clinical pharmacy inputs that can strengthen rational use of medications and thereby influence consumptions of medications.

In short, it is vital not to ignore the marketing potential through Pharmacists – please CLICK HERE.

The internet and telecalling will strengthen clinical pharmacy

The growth of internet and telephone based consultation will strengthen clinical pharma practice and thereby influence the consumption of drugs and supplements. It is here that pharma marketers need to collaborate and strengthen rational and increased consumption of specific brands.

Pharma marketers: Go ahead and collaborate with Clinical Pharmacists!!

The buzz of clinical pharmacy is on – it is a major trend; aided by information technology developments, this entity in the healthcare system is gathering importance. It is prudent to collaborate with clinical pharmacists at all stages of drug development and marketing. In Phase 3 clinical studies, data gathered will help optimize the product positioning and indications, phase 4 clinical studies will yield good data on safety and efficacy resulting in better inputs for product positioning and product communication activities that can make a great difference in business results. Collaborating with clinical pharmacists in post prescription activities will ensure right usage, adverse report data gathering, and patient compliance. This will ultimately impact pharma product consumption – increasing the consumption is after all the core of marketing.


Thanks for reading this blogpost. Please scroll down to read other posts, please click on older posts to read all posts, they are worth it!! - Sunil S Chiplunkar

Wednesday, November 14, 2007

Workplace masked depression

This is not about disgruntlement. The write up below is a reflection of the hard realities facing business organizations in India, and there is a special focus on the issues currently gripping Pharma companies. It is a straight and plain talk below.

Do not brood over past mistakes and failures as this will only fill your mind with grief, regret and depression. Do not repeat them in the future.

- Swami Sivananda

Hidden or Masked Depression - a reality in Indian society

The new illness wave in Indian society so far underplayed and not conspicuous is depression – hence, this can be rightly called as Hidden or Masked Depression (just as we have hidden or masked anemia).

Depression is defined as an illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.

Some commonplace signs and symptoms of depression include: loss of interest in self and the environment, persistent sadness, overpowering feelings of guilt, hopelessness, and worthlessness, difficulty in thinking, concentration and memory recall, loss of energy – persistent fatigue, sleep disturbances including oversleep, overeating or under-eating, irritability, thoughts of suicide and suicide attempts, and vague physical complaints like digestive complaints, headache and bodyaches.

Reasons for workplace depression include:

a) Inappropriate use of reward and coercive power by bosses
b) stress – feeling of inability to cope with a situation being experienced by individuals; lack of recognition of stress in workplaces and absence of communication channels and systems to reduce toxic stress levels in companies further strengthen stress
c) inappropriate financial rewards (basically it refers to low pay & facilities, and high work and top stress levels)
d) spill over of domestic tensions resulting in synergistic work plus domestic stress
e) non-caring environment and absence of an environment that taps an individual’s potential (self-actualization) (remember Google officially allows employees to invest 20% of their official time for their favorite and personal projects)
f) loss of self-esteem (a work environment that does not strengthen self-esteem)
g) over emphasis on use of authority and coercive power to manipulate and control in the work environment; rather than use of reward power, positive strokes, positive reinforcements, and expertise power.

Depression among Pharma field personnel

Pharma sales and marketing field is a high stress and negative stroke environment. All along their professional life, Pharma field personnel receive more brickbats than bouquets. Negative strokes are encountered from the stockists, chemists, doctors, general society, and even bosses. So all in all, Pharma field personnel develop a typical hypocritical (and cynical) attitude towards their profession and company. As such, the non availability of ‘respectable and paying jobs’ (ie. up to mid 90s) ensured a steady supply of quality people to this profession – today, with an up turn in the economy and growth of BPO-IT-ITES-Medical transcription sector, better availability of educational institutions, globalization, new business opportunities, and migration of skilled people, there is a paucity of quality people entering the Pharma field and particularly, Pharma marketing and sales profession. If Pharma companies refuse to take cognizance of these facts, companies will continue to face the problems of lack of good field personnel and high employee turnover (this high turnover is not just due to change of companies, but also migration of employees to other professions like BPO, ITES, insurance and other fields) for a long time to come. In a way, it is ‘depressing’ to note that toxic stress, negative stroke environment, and depression are more prevalent in the Pharma field while in fact, it has to be a model work environment to other non-Pharma organizations.

We ought to observe that new economy companies have highly advanced HR practices, an open, communicative, and business-like professional atmosphere. New economy pay packets, perks, HR processes, and facilities are a sea change compared to regular Indian Pharma companies. This has a high impact and Indian Pharma is losing a steady stream of potential employees and regular employees to these new economy companies.

Today, there is not much of unionism; it is ‘jettisonism’ (people jettisoning companies and even the profession) in the Pharma field. However, the current union trends are towards becoming more strident about norms of joint field working, meeting timings, and no. of hours put in field work.

A culture that encourages, trains, strengthens and rewards talent, and focuses on problem-solving, as opposed to a culture of mediocrity and mutual back – scratch, is what will help Pharma marketing and sales.

Depression and self-esteem

Self-love or self-esteem is an important bulwark against depression. However, with negative strokes at every corner of the Pharma profession, it is little wonder that masked depression (that is unacknowledged but manifests in various signs and symptoms and as self destructive habits – like alcohol consumption and smoking) is definitely prevalent in our Pharma field.

The writing is on the wall

It is well known that there are very few senior MRs or managerial field personnel who will allow their children to follow their footsteps into Pharma sales and marketing or the Pharma field itself. This truism reflects the reality of our Pharma field.

Depression 2.0: grass is not greener on the other side

The economic boom in India has given birth to a new type of depression 2.0. Please click here to know more. So depression 2.0 reflects the challenges in new economy companies too. However, it would be interesting to survey and find out if the workplace stress levels there, are anywhere comparable to Pharma work (field, office, and factory) environments.

The vacuum will be filled

Whatever the issues that crop up and challenge organizations, businesses will continue to be dedicated towards strengthening topline and bottomline. In this endeavor, companies will focus on various avenues and options to strengthen the topline and bottomline. In this regard, to bolster marketing and communication activity, it is inevitable that companies will lay more emphasis on outsourcing of business activities, courier marketing, internet marketing and communication, group meetings of customers (like doctors’ meets), and MRs of Pharma companies will particularly end up focusing on co-ordination and building up of clinical experiences with products and brands.

People are the real assets

People assets are vital. Unless the Pharma sector takes up proactive and positive steps to attract and retain quality people, the flight of intellectual capital to other industries and sectors will continue…Pharma India will be the loser.

This write up is by Sunil S Chiplunkar I thank you for reading this blogpost. Please do read all other blogposts, by clicking on older posts when appropriate.

Wednesday, November 7, 2007

November musings: Diwali, Diabetes and Exubera (will it make a come-back?)

Albert Einstein, American scientist: "We owe a lot to the Indians, who taught us how to count, without which no worthwhile scientific discovery could have been made."

Diabetes in India

Madhumeha (diabetes mellitus) has been documented from 1500 BC in India. The first description of diabetes is in the Atharva veda. Charaka samhita the Ayurvedic text dating back to 1st century AD has also descriptively dealt with madhumeha. The ancient text had recognized that diabetes was indeed a metabolic disorder.

Diabetes a metabolic disorder affects carbohydrate metabolism. The metabolic derangement results in elevated blood sugar levels. Although the signs and symptoms of prolonged elevated blood sugar levels are giddiness, irritability, burning or tingling sensation in the extremities, excessive thirst and hunger, fatigue, cramps in the calf muscle area, itching, impaired wound healing, fungal and other persistent skin infections, skin allergies, blurring of vision, sudden loss of body weight, susceptibility to infections and fever,…the real danger of diabetes are the diabetic complications.

Diabetic complications include vasculopathy (disease of the blood vessels), cardiomyopathy (disease of the cardiac muscle), neuropathy (disease of the nerves), dermopathy (disease of the skin), nephropathy (disease of the kidneys), retinopathy (disease of the retina)… Diabetic individuals are more susceptible to osteoporosis, dental and gum related problems, infections, silent heart disease, diabetic liver, erectile dysfunction, sexual problems, urinary problems, and impaired wound healing. It is these frightening complications of diabetes that add to the morbidity (loss in quality of life) and mortality. Diabetic complications can cause absolute despair in sufferers.

The worst thing about diabetes is the fact that it can be asymptomatic too. Many diabetics do not find their signs and symptoms to be very serious and start to neglect or take it easy. This apathy and careless attitude can then cause exacerbation or worsening of the condition and leads to the diabetic complications.

In that sense, diabetes is like AIDS. The HIV infection causes weakened immunity and the person finally succumbs to the complications of HIV infection, such as gastrointestinal infections, TB etc. Diabetes too is dangerous, not because of the elevated blood sugar levels, but due to the complications of diabetes that causes morbidity and mortality.

Diabetes in India

Much has been written about India being the diabetic capital of the world – ahead of even China.

It has been projected that 300 million individuals would be affected with diabetes by the year 2025. (About 35 million individuals are estimated to be diabetic in India). The reasons for this escalation are due to changes in lifestyle, people living longer than before (ageing) and low birth weight could lead to diabetes during adulthood. Diabetes related complications are coronary artery disease, peripheral vascular disease, neuropathy, retinopathy, nephropathy, etc. People with diabetes are 25 times more likely to develop blindness, 17 times more likely to develop kidney disease, 30-40 times more likely to undergo amputation, two to four times more likely to develop myocardial infarction and twice as likely to suffer a stroke than non-diabetics.

The booming antidiabetic and cardiometabolic market for India is characterized by a lack of public awareness campaigns on diabetic complications

Even though racial susceptibility, lifestyle changes (increasing sedentary lifestyle), stress, and faulty diets/obesity are increasing the incidence of diabetes in India, there is a peculiar lack of public awareness campaigns on diabetic complications in general. Unless, the public are made aware on diabetic complications, rather than dangers of diabetes alone, the true gravity of the situation will not be understood.

November is the sweet month for Indians – the festival Deepavali or Diwali in the month November is celebrated with crackers, new clothes, and sweets. Yes! The famous variety of Indian sweets is an important component of Diwali celebrations. Ironically, November 14th is the World Diabetes Day and America observes November as the diabetes awareness month. Maybe it is apt that diabetes awareness campaigns and Diwali should run parallel.

Public awareness campaigns on Diabetes and Diabetic complications are the need of the hour

It is high time that the GOI sets up a NATIONAL DIABETES INFORMATION RESEARCH AND EDUCATION MISSION; this mission is not about researching about a diabetic cure; it is about researching the information and propagating messages on diabetes and diabetic complications. One of the most important tools of diabetes management is education, and the emphasis should be on diabetic complications. This would help the public perceive the disease as a grave challenge and needs to be managed through lifestyle modification, exercise, Yoga, good habits, diet control, and medication.

The awareness campaigns for diabetes and diabetic complications ought to be on the same scale as that of the Pulse Polio campaigns.

Diabetes day random blood glucose check camps

The Central and State Govts., in India can have diabetes day random blood glucose check camps at Govt. PHCs, special camps, private clinics on the lines of Pulse Polio campaign and in collaboration with private sector companies and HRD depts. of large organizations.

Such camps will create vibrations and consciousness about diabetes and diabetic complications.
Please click here for a great site to check the diabetes risk aspect. Another link here gives comprehensive information on diabetes with hyperlinks. Indian researchers have discovered that fat cells have the property of producing insulin. It is interesting to read about this development please click here!

Will Exubera make a comeback?

The attractiveness of the diabetes management market has seen companies invest billions to develop and market products. Very few fail in this market. One interesting recent failure has been that of Exubera. It is very unusual of Pfizer to suffer such a setback. Perhaps it could have done better on the front of brand engagement and persuasive clinical documentation. It is too na├»ve to think that Pfizer will let go off a powerful concept such as inhaled insulin (with its abundant market potential and first mover advantage). Pfizer has a history of being an aggressive marketing tiger in the Pharma market. One cannot forget how piroxicam was a dud molecule when launched by Indian companies in the Indian market. Pfizer’s Dolonex (piroxicam) however, created history by being a blockbuster Pharma brand in the Indian market. Exubera will make a comeback – this is my gut feeling. The withdrawal was only strategic. A new avatar of Exubera may be back in action.


Thursday, November 1, 2007


The single biggest problem in communication is the illusion that it has taken place.
-George Bernard Shaw

CISCO has announced a revolutionary technology that reminds us of the catch phrase from the famous Star Wars: Beam me up Scotty. This truly awesome and stunning technology allows a person to feel as if the person he is talking to is present, on the location (through high definition video projection systems). Thus, this technology creates the ultimate where probably Mr. John Mack in USA and myself here in India can see each other and talk. It is another dimension of communication. So it will not be a surprise if we will be able to download telepresence podcasts from Mr. John Mack’s Pharma Marketing Forum on various Pharma issues, say two years hence. An example of such a telepresence podcast would probably be a conversation between Mr. Mack and say Mr. Kindler the CEO of Pfizer on how telepresence technology is redefining marketing communication in the Pharma industry! And if it is a real time telepresence podcast may be Mr. John will be kind enough to beam up other participants like me from India!


CISCO the inventors of this technology introduce the ‘meeting technology – telepresence’ as follows:

Focus on Your Meeting, Not on Your Technology
Cisco TelePresence is an innovative, new technology that creates unique, in-person experiences between people, places, and events in their work and personal lives—over the network. The first application is the Cisco TelePresence Meeting solution. Cisco TelePresence delivers - Greater productivity, Faster decision making and improved time to market, Improved responsiveness, Improved communication and collaboration with co-workers, partners, and customers
As we observe, this is a networking technological innovation. There is more on the same here:

What Is Cisco TelePresence?
Cisco TelePresence is a new technology that combines rich audio, high-definition video, and interactive elements to deliver a unique in-person experience—over the network.

The Cisco TelePresence Meeting creates a live, face-to-face meeting experience over the network, empowering users to interact and collaborate like never before.

We live in a world of paradox. Technology has allowed us to establish economically advantageous business operations worldwide. However, to excel in today's fast-moving business environment, you now have to interact and collaborate with co-workers, partners, and customers all over the world at a moment's notice. You need to continuously innovate and transform your business model to maintain competitive edge. And you need to plan ahead to respond rapidly to unexpected issues that impact business continuity.

At the same time, much of business is still done based on the quality of the relationships you have with those people with whom you interact most often.

To build and maintain these critical relationships, you often need to travel, which translates to lost time and reduced productivity, not to mention valuable time spent away from home and family.

Benefits of Telepresence
All of this points to the need for a technological solution that allows the same type of face-to-face business interactions, without the constant need for global travel. That's where the concept of Cisco TelePresence comes in
. It allows for real-time, face-to-face communication and collaboration over the network with colleagues, prospects, and partners, even if they're in opposite hemispheres. The potential scenarios:

C-Level: executive meetings
Human Resources: job interviews
Customer Service: troubleshooting of technically complex products and access to remote experts
Sales: presentations and demonstrations of products and services with product specialists
Design: collaboration between teams and involvement of experts as needed
Consulting: interaction between outside vendors and clients
Staff Meetings: regularly scheduled updates of projects between personnel at remote sites
Employees derive both personal and professional benefits using Cisco TelePresence. This drives greater productivity in several ways. Employees:

Spend less time out of the office
Increase the number of interactions they can have with co-workers, partners, and customers
Derive the maximum value out of each interaction through richer and more valuable communication
Extend and maintain key business relationships in between in-person visits
Simplifying the Concept

Despite their relatively low cost, there are a variety of reasons why traditional video systems sit dormant and dusty in conference rooms around the world, but chief among them is that the systems are not reliable, offer low quality, and are too difficult to schedule and use. Scheduling meetings using traditional technologies frequently requires a combination of e-mail, hard-copy, and verbal communications. Once scheduled, they are frequently hobbled by technical issues, either in initial setup, or during the meeting with difficulty in seeing or hearing.

Cisco TelePresence is a new category of collaborative application that offers several significant advantages:
Integration with enterprise groupware (for example, Microsoft Outlook) allows users to schedule TelePresence meetings in the same way they would send a calendar invitation

Instead of confusing remote-control keypads used with most television-based systems, users can initiate TelePresence meetings using a telephone keypad. After scheduling, the meeting information is pushed to the meeting room's phone display. Users simply select the meeting from the display to launch the call. Similarly, cameras are prepositioned for optimal coverage of the room, so participants do not need to adjust them during their meetings.

The network provides the same reliability as dial tone, making TelePresence a solution that users can depend on, even for external meetings.

Services in the network ensure high quality, security, and reliability for every meeting.

The result: meetings that start promptly, proceed smoothly, and aren't hampered by audio-visual difficulties, which is especially important for meeting participants who might be attending outside of traditional work hours. Because of improved visual communication, it's more likely that important issues—especially those of disagreement—are more efficiently discussed, with less opportunity for misinterpretation and confusion. Now, you can focus on the meeting instead of the technology.

Future Applications
The vision for Cisco TelePresence is to expand to provide "virtual experiences" in many environments, from business into the home, with applications that would not have otherwise been possible with traditional video technologies.
Companies are increasingly focused on the parts of their business that create a competitive advantage. Activities that do not fall into this core category will be handed off to partners and suppliers. As this trend continues, collaboration increases in importance. Thus, ensuring that communication is clear and straightforward becomes more crucial. This is where Cisco TelePresence can help provide organizations an immediate productivity gain, change their business processes, and create sustainable competitive advantage

Potential of telepresence in Pharma marketing

The most obvious application is ‘calling on doctors’ through telepresence of MRs. This technology can help a MR promote products to a group of doctors in another location or if the portability of the telepresence system develops in time to come, nursing homes and clinics can have these devices and at mutual convenience, the MR can make a telepresence call to highlight the product (possible to many doctors at different locations at the same time).

In fact, another dimension is creating a digital avatar (so the telepresence form of MR will be uniform and unique contributing to branding); this avatar will be beamed to make Pharma product presentations to the doctor(s) at a seminar or in the clinic.
Telepresence based CMEs and new product launches with opinion builder doctors interacting is another dimension. This will allow real case history viewing too as part of the live CME.

Potential of telepresence in healthcare

Telepresence technology has the promise to revolutionize diagnosis and healthcare delivery through telemedicine. It would be possible to beam up the patient’s image for telepresence consulting to specialists located elsewhere. This will be Godsend for patients in the interiors of India who can avail second opinions and consultations from city based specialists.

Pharma companies can catalyze adoption of products by having telepresence kiosks in Pharmacies. The telepresence avatars or special patient educators can beam up to these kiosks and educate patients and customers (for eg., use of inhalers in asthma management).

Time for CISCO to collaborate on the telepresence technology platform

CISCO would reward itself and enhance adoption of the telepresence technology in various spheres of human activity by collaborating with specialists in each field, who can act as consultants and ambassadors for visualizing the application of this technology and catalyzing its diffusion. For eg., tourism experts would help in setting up such telepresence centres in business centres of hotels and thus help in creating telepresence meetings.

In the sphere of healthcare, CISCO experts and others from institutions like Narayana Hrudayalaya, Apollo, Fortis , Wockhardt, etc can start collaborating with primary health centres of the Indian Govt., to offer telepresence based healthcare diagnosis and treatment solutions.

The more that CISCO does to involve the public and other domain experts in providing inputs for this technology and collaboratively develop the product further for various applications, the faster will this product grow. In the end, CISCO will end up creating an ecosystem for communication and collaboration akin to Google on the internet. And later, this ecosystem can be tapped for advertisement revenues too. There is more to this product than being a meeting solution, it can revolutionize marketing, particularly Pharma and healthcare marketing, communication, diagnosis and treatment, and redefine healthcare delivery.


Here is a limerick:


CISCO has an innovation
For use in many a permutation
A mega revolution is in the making
Ignore not, Digital Health is there for the taking
Welcome one and all, to telepresence collaboration

This is my 54th blogpost, please do read all other blogposts, by clicking on older posts, wherever necessary, they are worth it!! Thnks - Sunil S Chiplunkar