Monday, December 29, 2008
On the Indian pharma marketing front, there is a new fillip to 'people power'. People are mattering more than ever in pharma marketing. This is the conclusion drawn during my recent marketing experience during the 'in-stall activity' at ASICON 2008. Like many pharma companies we too had a great time communicating and having exciting in-stall activities for visiting surgeon delegates at ASICON 2008, Ludhiana. ASICON is the annual conference organized by the Association of Surgeons of India. In the latest edition of this annual event - a melting pot for surgeons - pharma marketers got their pool of surgeons to listen to their pitch, while the surgeons got an occasion to network and update themselves with the latest surgical techniques, laparoscopic procedures and the recent trends in tumor removal during cancer management.
Power plays are changing
Power is defined as the ability to control behaviors, events and resources. There are six types of powers:
Expertise power: the knowledge and skills of people.
Reward power: the power to grant rewards.
Coercive power: the power to create negative reinforcements, or to punish ie., to make people jump through the hoops!
Referral power: the charisma, charm and aura that some people have.
Legitimate power: the power that comes with the birth or designation of a person. For eg., a scion of an industrialist will have certain legitimate powers.
Connection power: having relationships with people who matter.
In India, money power and connection power are the traditional routes to market success. A company utilizes its connections with people who matter to obtain licenses and other approvals and consequently market a product successfully. The ability to obtain licenses and other approvals has always mattered a lot. In fact this was the differentiator. It helped companies get their product to the market fast - real fast - before others did.
However, with the product patent regime in place, the rise of media power, the spread of wealth, better education, more and more pharma production facilities, and every body becoming competitive and street smart, all marketers wising up to the concept of connection power, the power plays are now distinctly changing. The connection power for obtaining licenses, approvals and the money power to produce a product are not enough to connect with the market successfully. To make a product a continuous market success, connection power and money power alone are not enough. People power is gaining traction.
Everybody is game for pharma marketing
It appears that everyone now believes pharma marketing is not a rocket science! The MR has to connect with the target audience, deliver regular visits and communication, provide samples, literatures, communication inputs and gifts, negotiate sponsorships, and finally obtain prescription harvests. Every pharma company is aggressive and game for these SOPs (standard operating procedures). For eg., during the in-stall activities at ASICON, all pharma marketers were aggressively using tactics to get the maximum visits from delegates. If you start a lucky dip, the next day, the stall opposite to yours starts the same - to become competitive. Every one provides gifts, freebies and other services to create a better stall. Certainly this is happening on the field during in-clinic activity too. So the question is, how do you get an edge over the competitor pharma marketer? This is where people power gets traction.
People power is communication power
In pharma marketing, communication power is crucial. The process of sending messages successfully is crucial to marketing success. Communication between individuals depends on verbalization - to an extent of 7%, vocalization - to an extent of 38% and body language (particularly facial expressions) - to an extent of 55%. The ability to communicate effectively requires training and confidence. Both these come from knowledge and practice. In fact, this communication power made the difference during in-stall activities, and surely this is making the difference during in-clinic activities too. People communication power is becoming all the more important as most companies (MNC and Indian) are becoming equally aggressive in terms of visits to doctors, sampling, gifting and sponsorships. MNCs do this in style - they provide medical grants or scientific grants to influence prescribing behavior. Indian companies are a little more brazen, they call it deals and sponsorships. The end objective is the same. However, what makes the difference is the person from the company, his communication and representation. What makes the difference is the communication inputs of the company - at the corporate level and field level. The communication print and nonprint inputs and people power are the keys to win the contemporary pharma marketing battles. IT REMINDS ONE OF THE AGE OLD SAYING - PEOPLE DO BUSINESS WITH PEOPLE!
Thanks for reading this blogpost, please scroll down, read all other blogposts, click on OLDER POSTS wherever required. MERRY CHRISTMAS (belated) AND HAPPY NEW YEAR 2009 in advance.
Sunday, December 14, 2008
The answer is: PROBLEM SOLVING - the process of problem solving REQUIRES INFORMATION SEARCH.
The other name of life is problem solving. We are constantly solving problems and taking decisions accordingly. For eg., putting up a blogpost that is interesting is a problem and this requires a series of decisions and activities. However, the start of the problem solving process is INFORMATION SEARCH.
To solve problems, we search for information first within our memories. We try to make decisions to solve problems based on the wisdom of our past experiences or the stored up knowledge in our brain. At another level we tend to confer with trusted individuals and seek information to help solve problems. In fact, in the cyber dimension, Google has redefined and created a new paradigm in the problem solving process. We only have to type in the words associated with the problem and we can try and create a menu of actionable approaches to solve the problem.
SO WHAT ABOUT PHARMA/HEALTHCARE MARKETING AND THE PROBLEM SOLVING PROCESS?
Marketing communication and other activities address people - in fact, to be specific, marketing activities address the problem solving process of people. Marketing people present value to the prospects and customers - the net result is that the value preposition solves the problem(s) of the target audience.
In the late 1960s and early 1970s the medical representative had a hallowed status in the field. During those times, the MR was the only source of valuable information that could add value to the clinical practice of a physician. Hence, there was a great value for a MR during those times. Besides there were very few MRs and this created additional value for the profession. Later on as the number of MRs increased and the print medium picked up (offering several print products with clinical information), the MR's role altered to becoming a relationship management expert (offering intangible and tangible inputs to the doctors). With the increasing internet penetration and the consequent collapse of the information float (this means people will have access to real-time information), the MR's role will alter considerably in coming days. Consequently, mobile based and internet based marketing communication activities will see increased focus so as to engage members of the target audience. The major role of the MR will be to create a human face to the company operations in the market and IMPORTANTLY HELP BUILD TRUST in the company products and processess.
I recollect my days of independent field working in Bangalore some time in the late 1990s. I read about a report in the Times of India that nifedipine on long-term use increases mortality. We had an antihypertensive product - atenolol and indapamide combination. I met a leading doctor, Dr. K G Das in Ulsoor. This gentleman is an illustrious and very knowledge oriented doctor. I detailed our antihypertensive product, and as part of the post-detailing discussions, I placed the newspaper report, in front of him, and said:"Sir, many of your patients may have read this report today morning, so naturally, they will be confused, and may confront you for answers." The doctor read this newspaper report and then had discussions with me for about 45 minutes about clinical trials, and many other matters. Needless to add, my prescriptions for our antihypertensive combination saw a rise.
The moral of the above story is that when marketers present information in a timely fashion, it helps the marketer achieve better success significantly.
Marketers need to understand the problem solving process of doctors and chemists. By understanding the problem solving process, and offering value added solutions, marketers can gain better prescription mileage.
Gifts, relationship management and other promotional tools are vital to influence prescribing behaviour and the chemist OTC behaviour, however, it is critical to participate successfully in the problem solving process of the target audience to attain key marketing success.
Thanks for reading this blogpost, please scroll down to read about a book in which, there is a chapter penned by me. Also, please scroll down and click on OLDER POSTS, to read all other blogposts. Thanks.
Tuesday, December 9, 2008
One such book is INDIAN PHARMACEUTICAL INDUSTRY: Strategies and Challenges in Formulations Marketing. And my article published earlier in CHRONICLE PHARMABIZ, has been compiled in to this book. The article entitled Prescriber Fatigue and Product Life Cycle Management is in Section 2 - it is Chapter 11, and on page no. 127.
My thanks are due to ICFAI, the editors - Mr. B V S Prasad and Mr. K Gowri Shankar who have published the article in the book. And I will be failing in my duty if I do not express my heartfelt gratitude to Mr. Anand Mohan Dass. He was not only important in the process of the above book production, he has also kindly couriered a complimentary copy of the book to me. I once again thank Mr. M Anand, Senior Research Associate, Icfai Research Center and Mr. Gowri Shankar. I also thank the Chronicle Pharmabiz team, in the first place, for having published the article some time back.
I request people interested in the Indian Pharmaceutical Industry to pick up this book as it is a great resource. It has 21 articles in all. The articles are in three sections: Section 1 is on Pharma Industry Overview, and the second section is on Marketing Strategies and Challenges: Formulations. The third section is on Company articles.
The ISBN is 978-81-314-1627-3
The book publishers are: The Icfai University Press, 52, Nagarjuna Hills, Punjakatta, Hyderabad, India, Pin code: 500082
GO AHEAD, DO KINDLY EXPLORE THE ABOVE BOOK.
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Saturday, December 6, 2008
INDIA IS THE LARGEST PRODUCER OF MILK IN THE WORLD. THE PACKAGED MILK BUSINESS IS HAVING AN ANNUAL TURNOVER OF AROUND Rs. 10000 CRORES! WE PRODUCE OVER 100 MILLION TONNES OF MILK, REPRESENTING AROUND 15% OF THE WORLD'S PRODUCTION. CAN THE PHARMA AND HEALTHCARE MARKETERS OF INDIA CASH IN ON THIS 'MILK OPPORTUNITY'?
Milk has a legendary status in
Milk as a vehicle provides exciting opportunities for strengthening nutrition, health, and healing.
Value added products derived from milk with special interest in pharma and health supplement business include:
Whey protein: is the best source of protein. In India, protein malnourishment is quite common. Whey protein has the highest biological value of any known protein. The biological value of a protein food, is the measure of how much protein gets incorporated in to the body. Higher the BV more the proteins from the food gets incorporated in to body's protein. Whey protein has a BV (biological value) of 106 to 150, egg whites have lesser BV of 100 BV - Whey protein BV is the highest for any protein food - no wonder in Indian traditions, the cow has a hallowed status... you see... Whey protein is derived from cow's milk, in fact, it is a by product of cheese manufactured from cow's milk. The globular proteins from whey protein are easily assimilated in the body particularly in the muscles. Hence, body builders too prefer whey protein based supplements.
Milk calcium (milk mineral complex): is a source of calcium derived from milk. In fact, it is more properly called milk mineral complex. This is a concentrate of minerals present in milk. Calcium is in the highest proportion. Milk calcium is also a whey by-product. Patient acceptance of milk calcium is obviously high - due to a positive image, hence, there are labelling advantages. Along with calcium, milk calcium offers magnesium, and the calcium to phosphorous ratio too is beneficial. Milk calcium has a mineral composition similar to bones CLICK HERE.
Probiotic/prebiotic enhanced milk-derived products: Yogurt is a billion dollar business worldwide, and it is promoted as a healthy probiotic based drink. Yakult is the prime mover in this business. Yogurt is not a product of rocket science. It is a custard like food made from curdled milk. Yakult is trying to make its inroads in to the Indian market. And this in a country which is not a stranger to milk and milk based products. Yakult yogurt is a value added product derived from milk, and such a product is definitely possible for Indian manufacturers to manufacture. Yakult (or can we call it mishti dahi!?) is a Japanese doctor's invention. It uses Bifidobacterium and Lactobacillus. The reason that Yakult makes waves is the fact that it addresses the large gastrointestinal market. In fact, in India, 1/3rd of the Pharma market is gastrointestinal. Electrolyte energy drinks and other products too address the large gastrointestinal market (firstname.lastname@example.org). Similar to probiotic based milk products, prebiotic (FOS) based milk products are also doing good business globally. This clinical trial established that prebiotic and probiotic milks have good impact on pediatric health. (In this clinical trial there is also a lucid explanation on what probiotics and prebiotics are). There is good scope for such products in India too.
Colustrum: is the first secretion from female mammals immediately after birth of baby, for the first 2 to 4 days. It is a rich source of nutrients, antibodies, immunoglobulins, and growth factors. Bovine colustrum derived from cattle - it can be consumed by humans, and improves immunity, growth, and overall health. Merck in India is a lead player in the colustrum market.
Milk based vaccination: is an interesting concept being worked on by certain researchers. For eg., Immunization against malaria through milk, has been experimented upon CLICK HERE. Probably there will be biotech milks in the future with distinct therapeutic benefits like vaccination. Some marketers, call colustrum as nature's vaccination approach.
Milk based pharmaceuticals/nutraceuticals: imagine a Calcium Sandoz brand line extension in liquid milk form (offering vitamin D and calcium as milk mineral complex 50 to 100% RDA) - there you have a very big market that can ride on the Rs. 10000 crore milk market! Or ‘Shelcal milk’ from Elder Pharmaceuticals. If nanotech is used it is possible to mask taste and provide antibiotic-based milk preparations for specific uses in disease conditions. Thus, milk based pharmaceuticals and nutraceuticals are possible in the future. IS IT POSSIBLE TO ACHIEVE THE FOLLOWING IN THE FUTURE?
Fortified milk products: The world-over fortification is a mass approach to improve nutritional status of target populations. For eg., iodized salt is mass consumed in India, to improve thyroid health. Milk presents a great opportunity for vitamin and mineral fortification to provide healthy beverages to target populations.
IS IT POSSIBLE TO ACHIEVE THE FOLLOWING IN THE FUTURE?
World’s largest producer of whey protein:
World's largest producer of colustrum: India
Yes it is possible...
Yes it is possible...
HOW TO MAKE THIS HAPPEN?
This is possible through COLLECTIVE INNOVATION AND GENERIC MARKETING. THE SECOND FACTOR IS THE MOST CRITICAL FACTOR. BAD MARKETING CAN BURY MANY A GOOD PRODUCT. PRODUCT INNOVATION SHOULD BE BACKED BY MARKETING OR INNOVATIVE PRODUCTS WILL FACE MARKET FAILURE. (Generic marketing means nonbrand marketing, see below.)
The best marketing approaches can be worked out through studying established marketing models for other products. For instance look at this approach of the olive producers of European Union. The stakeholders as you will observe by clicking on the hyperlink, have formed an International Olive Council in Madrid, this non profit body has the sole objective of launching promo campaigns in high potential markets like India, and increase the consumption of olive oil. These are generic promotional activities. By this marketing activity, all stakeholders in the olive oil business, stand to gain. And more wealth will be created for the olive oil stakeholders. This is the way of business. And we can take a leaf from this olive oil story to create an organization to popularize Indian milk and particularly milk derived products of interest to pharma and healthcare marketers.
What will happen if we do not take the lead in creating value added products through milk, in India? The answer is somebody else will do it and take advantage of the home market in
Business is like a war – healthcare or other business operations are always run for gaining markets and profits. Earlier military wars used to be fought for gaining geographical territories (geographical expansion), and filling up the treasury of the country. Today, the fashion of war is different – it is called business. Products are offered and markets conquered with the intent of filling the corporate war chests with more and more cash. EITHER PLAY THE BUSINESS BY ITS RULES (UNWRITTEN OR WRITTEN) OR GET PLAYED OUT! SO WILL PHARMA AND HEALTHCARE MARKETERS BANK ON THE INDIAN MILK MARKET? LET US WAIT AND WATCH!!
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Saturday, November 29, 2008
Sunday, November 23, 2008
In the mainstream media today, depression has become a very common word. The global financial woes are collectively called 'economic recession' and/or 'economic depression'.Along with economic depression, the antidepressant drug market - particularly in the developed countries - is growing steadily. The hot hot market in the global pharma sector is depression. Period. Every one wants a quick fix solution, nothing like popping a pill to fight away the blues, feel high, and love oneself dearly. Diabetes carries along with it depression. And it is popularly known now,
As per IMS Health, in 2006, the maximum prescriptions dispensed in USA was for antidepressants. This was followed by lipid regulators, codeine and combinations, ACE inhibitors, beta blockers, proton pump inhibitors, thyroid hormones, seizure disorders, calcium channel blockers, and then benozodiazepines. It is important to note here that benzodiazepines are used in a broad range of psychosomatic disorders - from anxiety to convulsions. Hence, there is an overlap between antidepressant market and benzodiazepines market. WELL THAT IS THE STORY AS PER THE MAXIMUM PRESCRIPTIONS DISPENSED IN USA.
HOWEVER, GLOBALLY THE SALES PATTERNS ARE DIFFERENT, THE LIPID REGULATORS THERAPY CLASS IS THE NO. 1 IN SALES , AND VALUE WISE, ANTI-PSYCHOTICS, AND ANTI-DEPRESSANTS HAVE A POSITION OF NO. 6 AND NO.7 RESPECTIVELY. PLEASE CLICK HERE.
NOW THE MOOT POINT IS, AS THE INDIAN PHARMA MARKET EVOLVES, WILL THE ANTIDEPRESSANT MARKET EVOLVE BETTER TO BECOME A HIGH VALUE MARKET IN INDIA? IT IS DIFFICULT TO SAY, BECAUSE OF YOGA AND OTHER ALTERNATIVE HEALING SYSTEMS IN INDIA. (THIS REPORT IN INDIA TODAY SAYS THAT DIAGNOSIS AND LACK OF TREATMENT FACILITIES PLAGUE THE INDIAN DEPRESSION MANAGEMENT MARKET).
The China experience
'Removal of the stigma' and 'improving diagnosis' for market expansion
The most important aspect for marketers of anti-depressant brands is to get the market to expand through increase of the user base. How can it be done? The challenge is two pronged - one, remove the stigma attached and, two, improve the diagnosis of the ailment.
For the removal of the stigma: attached to depression, the best marketing communication approach would be to put the focus on 'IMPROVING THE PERFORMANCE AND SOCIAL LIFE' of a patient. Instead of using the word: depression, using phrases that have a positive presentation will help the cause of antidepressant and mood elevator marketers. For instance, talk about the ability of a drug (herbal or allopathic formulation) to improve social interactions, overcome stage fright, shyness, improve inter-personal relationships and communication, ability to create confidence for better negotiation, and thereby avoid adverse circumstances. Just do not talk depression, but communicate about the benefits of drug therapy for a better attitude. As such it would be an interesting marketing communication experiment to position antidepressant and mood elevator drugs as those that help create positive attitude. When the presentation is positive, the appeal will be positive.
Take the interesting case of alcohol beverage marketing: pharmacologically speaking alcohol is an addictive primary continuous depressant. But it is ironic that all ads and communication for alcohol show it as a fun drink - one that elevates mood, and is associated with celebration. Whereas the imagery for antidepressants that truly elevate mood and help manage attitude better - is that of stigma, morbidity, and sickness. THAT IS WHY MARKETING IS DESCRIBED BY AL RIES AND JACK TROUT AS A WAR OF PERCEPTIONS. Alcohol beverage marketers have ensured that the perception of the alcohol beverage brands is about positivity, fun, frolic, happiness, and being hep - whereas alcohol is actually about addiction and being a primary continuous depressant! Alcohol consumption causes inhibitions to be dropped, but that does not make it a stimulant! Alcohol only has a pretense of being a stimulant!! So the nub of the matter is that advertising, and marketing communication to physicians and patients (through patient information leaflets) should change the perception of antidepressant and mood elevator therapy class to be something positive, truly healing, and improving the attitude. That will go a long way in removal of the stigma attached to depression as a clinical disease.
Help the GP and other specialists to diagnose underlying depression. For instance, several diseases like diabetes and thyroid pathology, and stages of life like menopause are associated with mild to moderate depression. Thus, co-prescribing of antidepressants will go a long way in market expansion.
With China increasing its antidepressants market, and antidepressant prescriptions being the #1 dispensed segment in USA it remains to be seen whether the Indian antidepressant market will take off in the near future. The aspect that antidepressant prescriptions are #1 dispensed gives a clue - patients may be shy to take on to antidepressants, however, once they are on them, they do not seem to want to give up.
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Friday, November 14, 2008
Mass doctor calls and account management approach
There is a distinct movement, in MR field-level challenges - from doctor calls to account management. There is change in the air: from brand selling to relationship management and therapy management.
The intensification of market competition, and empowerment of society and patients with access to healthcare knowledge, has led to a situation wherein it's not remunerative to focus on a large amount of doctor calls. Yes, one has to expose the product to as many doctors as possible through all available media – including through MRs. However, from the general pool of doctors, it is wise to select a subset of doctors for intensive customer relationship management. The selection of these doctors would not be merely on the size of their practice but more importantly on whether they are amenable to close and profitable relations with the MR. After all, ultimately marketing is about customer relationship management in ways as to benefit the organization.
There are more than 120000 MRs in India. Some estimates are up to 200000 MRs in India. With such a massive force of pharma salesmen, it is inevitable that some relationships between certain doctors and a MR would be better than with other doctors. This is the reason why account management approach to doctors will work as opposed mass doctor calls only.
Hence, pharma marketing strategies operate at two levels: one - the general exposure plan where messaging and other freebies are targeted to a large community of doctors, and secondly, a focus marketing strategy plan to manage intimate relationships between the marketer and certain customers (product-wise core doctors). As part of the intensive customer relationship management in the second category, the MR would provide therapy management inputs, concierge services, and other inputs to extract high volume of prescriptions.
As such, the above strategy of intensive customer relationship services to core doctors, has been followed by MRs of many a Indian company, but the scenario today is such that all companies (whether MNCs or Indian) – are forced to follow the CRM approach for key accounts.
In the key account management approach: intense CRM is to certain doctors, as opposed to mass doctor call approach - where the focus is on quantity of calls. In the account management approach, products prescribed and sold are due to the management of key accounts (or core doctors) and prescriptions generated there by.
Whether a company follows mass doctor call approach or account management approach or a mix of the two, one thing is for sure, SMILES AND GIFTS take the company a long long way.
The 'profit season' in Indian pharma is April to Sept., when sales are good and demand is high for pharma products. After that in the lean season we have the 'gift season'. This is because from Oct to Dec, festivals dot the calendar: Ganapathi pooja, Id, Durga pooja, Dasara, Diwali, Christmas, and New Year Eve celebrations. These are all gifting times for pharma companies.
A smile has a lot of significance in human relations and salesmanship. In fact, it is said: A SALESMAN IS NOT DRESSED FOR THE DAY, TILL HE WEARS A SMILE! A smile means a lot: it can indicate love, kindness, amusement, and joy. As John Mack has said in one of his blogposts, A FRIENDLY REP GETS MORE TIME WITH THE PHYSICIAN, MAKES MORE CALLS, AND DOES MORE BUSINESS. It is evident that the pharma company with more smiling MRs can do more business.
The focus of a MR while detailing and performing his in-clinic activity ought to be to get the doctor to smile, genuinely, particularly in agreement with the MR - to his points of detailing. When the MR sees a smile he is sure to win the business. A dashing MR (now a first line manager) Mr. Kiran kept a data bank of the birthdays' of his key doctors. One memorable day, Kiran wished a doctor with a bouquet and wished him Happy Birthday, after his detailing. The doctor was actually surprised as he had forgotten it was his birthday! While happy with the compliment from Kiran, he rewarded him with a good POB (personal order booking) worth Rs. 5000/-. This is a simple example. However, it reflects the importance of key account management, generating customer delight and SMILES from target doctors.
Gifts are very important in human transactions and as business tools. WHO DOES NOT LIKE TO RECEIVE GIFTS?! Even the richest crorepathy likes receiving gifts. A gift is an act of love, kindness, sacrifice, and care. It is a gesture that bonds the marketer to his customer and vice versa.
Gifting as per Indian philosophy is of three types:
Saatvic gifting is providing gifts with unconditional love. It is a very high level of thinking. For eg., true saints often give gifts with unconditional love.
Raajasic gifting is the typical business gifting procedure. There is an element of give and take. There are unwritten conditions of gifting. A MR provides a New Year eve gift to a target doctor with the intention of receiving worthy prescription support.
Taamasic gifting refers to giving a gift with unhappiness, contempt, anger, remorse, and other negative emotions.
In any case, gifts play a very important role in CRM (customer relationship management) with reference to pharma company and doctor relationship.
Say the word GIFT and perhaps the first pharma name that pops up is Himalaya Drug Company. They virtually built a huge base of goodwill and sales through regular gifting practices to doctors.
Another interesting example of rajasic gifting that I recollect from my field days is of Cipla: if they gave a costly gift (during those days gifting a fridge to a clinic was a costly gift), to a doctor, they would strike a deal - "Dr., please accept this gift and become a Monday doctor for us for about 6 months". This means, every Monday, the target doctor would give prescriptions only for Cipla products - the rest of the days in the week, he is free to prescribe other pharma products. Every Monday the concerned MR or executive would give a call to the doctor, reminding that he is a Monday doctor! It is kinda cute idea and it worked very well for the company.
With key account management practices coming in vogue in the field of pharma marketing, gifts and smiles have gained more importance.
Realizing the impact of gifting in pharmaceutical selling, OPPI and other bodies have tried to put in to practice a code of conduct with relation to gifting. CLICK HERE.
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Sunday, November 9, 2008
I GOT THE ABOVE IMAGE RELATED TO NEUROPATHY FROM HERE.
Shakespeare, the bard of Avon has said, "There is a tide in the affairs of men, which when taken at the flood, leads to a fortune". These timeless words reflect the importance of timing in creating wealth. All said and done, most of pharmaceutical and healthcare organizations, are in the business of health for wealth, while concomitantly achieving social goals. Thus, it is of utmost importance to latch on to emerging trends early and go along with the tide to gain a fortune.
Today, reflecting on diabetes and diabetic complications (NOV 14th is WORLD DIABETES DAY), one does realize that a small pot of gold awaits the patient pharma marketing warriors riding on the neuropathy disease trend.
The march of diabetes continues unabated
As per the Nov 2008 issue of Reader's Digest, p.no.57, there are about 230 million diabetics in the world, 41 million (4.10 crores) are in India. In fact, our country, India, is called the diabetes capital of the world. By 2025 the projections are that there will be 70 million diabetics in India, every fifth diabetic in the world by 2025, will be an Indian.
Type 1.5 diabetes
Newer research insights have lead to interesting facets of diabetes, so much so that diabetes researchers have now observed a new class of diabetics (Type 1 1/2!) OR (TYPE 1.5). As such, there are two major classes of diabetics: Type 1 (those that are dependent on insulin) and Type 2 (who are on diet control, lifestyle management, and oral antidiabetics). 70% to 80% of Indian diabetics are Type 2. Type 1.5 diabetics are non insulin dependent, are not overweight, and do not show significant insulin resistance.
A research study says, weight loss of 5% to 7%, exercising for 30 minutes, 5 times a day, lowers the risk of developing diabetes by 60% - this goes to show that sedentary lifestyles are the main cause of increasing diabetes in India.
Dr. Abdul Kalam, our Ex President of India, in his book India 2020 says, on page 231, about 5 to 10% of Indian population suffers from diabetes.
The most common complication in diabetics is neuropathy, ie., disease of the nerves. The Indian Practitioner, Oct 2008, p.no.622, says about 19% to 28% of diabetics suffer neuropathy. Neuropathic pain is said to affect 16% of diabetics.
Back of the envelope calculations
Let us say there are 50 million diabetics in India ie., 5 crores (1 million = 10 lakhs, 100 lakhs = 1 crore). This means there are 1.4 crore diabetics suffering neuropathy (@ 28%), and 80 lakh diabetics suffer neuropathic pain (@ 16%).
Diabetes is not the only cause of neuropathy, - HIV, herpes, toxins, alcohol, and cancer chemotherapy also cause neuropathy.
In the US, neuropathic pain management business is 2.6 billion USD. Lyrica (pregabalin) from Pfizer, and Cymbalta (duloxetine) from Eli Lilly, are the mainstay drugs, their patents will expire in 2013 & 2018, respectively. In India, gabapentin is used frequently for neuropathic pain management.
Market development and Management of neuropathy
Neuropathy, particularly diabetic neuropathy, is not well understood. A lot of research is on. To manage this condition with drug treatment - antidepressants too are used. Regular type of NSAIDs (ie., non steroidal anti inflammatory drugs like diclofenac and combination drugs) are also clinically attempted, and morphine analogues are used clinically.
Dietary supplements/drugs like alpha lipoic acid, and methylcobalamin have good scope in diabetic neuropathy management as per clinical studies.
However, a lot of new drugs are in the pipeline of various companies targeting neuropathy.
One of the major aspects of neuropathy is that this irreversible condition is frequently under-diagnosed. A LOT OF SOCIAL GOOD AND COMMERCIAL GAIN DEPENDS ON A MARKET BUILDING APPROACH BY PHARMA AND HEALTHCARE MARKETERS.
Diagnosis camps: The camp approach (camps sponsored by pharma companies) is vital to create vibrations in the market, increased consciousness, and increase the no. of diagnosed cases. For eg., osteoporosis was a not so-popular indication in clinical practice a few years back. When pharma marketers organized a no. of free osteoporosis diagnosis and treatment camps (with the aid of DEXA or DXA machines), the market bloomed, and a lot of social good was achieved. Similar success followed the strategic camps for hepatitis B vaccination (by the way Gardasil the cervical cancer vaccine has been launched on a very low note in India - without much publicity, wonder why?).
Thus, consistently organizing neuropathy detection camps particularly for diabetics will usher in a new age of clinical management of neuropathy in India. To detect neuropathy particularly in diabetics, an instrument called vibrometer is used, where the vibration perception threshold (VPT) is measured.
Creating the buzz is vital: It will certainly not suffice if the camps alone are conducted. A buzz is required in the public media and through posters and other print materials at healthcare points (clinics, chemists, diagnostic labs, gyms and Yoga centers, and other healthcare service providers). ONE SHOULD ENGAGE THE DOCTORS AND PATIENTS ON THIS ISSUE FOR THE BUZZ.
One interesting approach is to use the mobile to create the buzz for neuropathy:
For eg., let us say 500 doctors (spread across India) are identified to participate in a series of neuropathy diagnosis camps. As per this approach, each of these doctors will receive daily sms updates on how the camps are progressing India wide. For eg., one message can be Dr. Manjunath of Bangalore has had excellent response to his neuropathy diagnosis camp, 25 new cases detected with mild neuropathy on first day, 14 cases of moderate neuropathy detected. Another sms message can be Dr. Venkat of Chennai is very happy with Brand A benefits in mild neuropathy - good response for Brand A seen within 24 hours of therapy in 50% of patients. ONE MORE MESSAGE CAN BE: Dr. Singh's Delhi diabetic neuropathic camp inaugurated today morning by the Chief Minister of Punjab, 500 patients attend camp on first day .... SO ON.
Today, like Shakespeare has advised, one has to ride on the tides - to gain a fortune. Neuropathy is an emerging area of clinical management with significant commercial appeal.
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Monday, November 3, 2008
Modern lifestyle has led to a boom in the market for pharmacological and non-drug management of the so-called lifestyle diseases. Yoga evangelists like Baba Ramdev are riding on this lifestyle disease wave. Examples of lifestyle diseases include: cardiovascular disease, cancer, diabetes, obesity, and respiratory diseases like COPD, and asthma.
Cardiometabolic disease refers to a combination of cardiovascular disease and metabolic dysfunction. The patients of cardiometabolic disease have cardiovascular disease and an accompanying endocrinological or metabolic disorder like diabetes. Cardiometabolic diseases are also a part of the lifestyle diseases.
Cardiovascular disease refers to diseases of the heart & blood vessels. 80% of deaths due to cardiovascular diseases occur in developing countries. In fact, 28th Sep is celebrated as World Heart Day to highlight the growing cardiovascular risks. By 2015, there will be 100% rise in deaths due to cardiac ailments in India as per WHO. In Japan in the meantime deaths due to cardiovascular diseases have decreased by 60%!
Heart attack, TIA (transient ischemic attacks), strokes and leg attack (peripheral vascular disease) are manifestations of cardiovascular disease. As per ORG IMS Sep 2008, the Indian market of cardiovascular disease management drugs is Rs. 3584.17 crores per annum and growing at 18%.
Primary prevention or leading a healthy lifestyle – is essential to reducing the cardiovascular disease burden. A daily routine of at least 10000 steps is a must for a healthy lifestyle. In fact, lack of exercise increases the body's risk of developing heart disease by 150 per cent. Quitting smoking, right management of stress, and a healthy diet are a part of healthy lifestyle.
High blood pressure – hypertension – can be reduced by supporting diuresis and vasodilation. As such, excessive calcium ions in the muscle cells of heart and blood vessels, causes increased contraction of actin and myosin (the contractile proteins). This results in excessive contractions of heart and blood vessel muscles. Hence, increased pumping of blood by the heart and increased contraction of blood vessels leads to increased cardiac output (more blood being pumped out by the heart) and vasoconstriction (blood vessels contract, decreasing the lumen of the blood vessel) respectively. This leads to increased blood pressure (ie., the lateral pressure of blood exerted on the blood vessel walls through which it is flowing).
A new approach in the clinical management of hypertension is by establishing ion-water balance across the cell membrane, and preventing entry of excessive calcium ions in to the cells, thereby reducing excessive vasoconstriction. To establish normal ion-water balance across the cells, and maintain normal cell volume the body has natural organic osmolytes. Myo-inositol and taurine are two important organic osmolytes that help in maintaining ion-water balance across the cell membrane.
Uncontrolled hypertension leads to kidney damage (one in 10 Indians suffer kidney disease), blood vessel damage, heart attack, and congestive cardiac failure.
Obesity, diabetes, and hypertension are the chief causes of CVS diseases. A key component of unhealthy lifestyle is SMOKING. When a cigarette is smoked, the person inhales 250 to 400 toxic chemicals (50 of them being carcinogens). The chemical poisons inhaled during cigarette smoking is known to cause endothelial dysfunction. The first stage of atherosclerosis (thickening and hardening of blood vessel walls, leading to loss of elasticity) is endothelial dysfunction (the innermost lining of blood vessels does not function normally). Smoking increases the chances of heart disease by two fold.
The world over, gastrointestinal and anti-infective pharma markets are big bucks. However, cardiometabolic disease, onco segment, and other lifestyle disease markets are growing in size rapidly.
A boost to metformin
Metformin is an oldie goldie drug in the management of diabetes. Currently, there is a school of thought gaining traction in medical circles, to make metformin the ABSOLUTE first line of therapy. The reasons are not just pharmacological; it is also about, patient compliance due to metformin's pocket friendly price.
Further, there is new and exciting information that metformin helps in reigning in mortality due to heart disease in diabetics. Now, that is powerful information. The strength of metformin is the great amount of valuable clinical experience backing it.
Metformin seems to be fated to becoming an evergreen drug in the management of diabetes (particularly Type 2), the world over.
Managing diabetic complications: 'serious stand alone markets'
In the management of cardiometabolic disease, it is not just blood sugar control, the management of diabetic complications too is emerging as serious stand alone markets for pharma marketers. There are various drugs and dietary supplements available, to effectively manage diabetic complications.
The market for managing diabetic complications is nascent and growing rapidly due to increasing consciousness of diabetes and its complications. Of the All India Pharma market which is worth Rs. 33604 crores with growth of 13%, the market for drugs used in diabetes is valued at Rs. 1756 crores and growing at 20%. . An example of a hot sub-market in the diabetes segment is the diabetic neuropathic market (disease of the nerves in diabetics). This is the hottest segment of the drug markets for diabetic complications.
Diabetic neuropathy – it is the most common complication of diabetics. The prevalence in India is supposed to range from 19% to 28% of diabetics. The prevalence increases with age and duration of diabetes. Concomitant factors like increased blood lipid levels, smoking etc increase occurrence and intensity of diabetic neuropathy.
Signs and symptoms of diabetic neuropathy:
- numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
wasting of the muscles of the feet or hands
indigestion, nausea, or vomiting
diarrhea or constipation
dizziness or faintness due to a drop in blood pressure after standing or sitting up
problems with urination
erectile dysfunction in men or vaginal dryness in women
Osmotic stress on the cell membrane is common in diabetics and hypertensives. In hyperglycaemic patients, sorbitol and reactive oxygen species levels rise leading to osmotic stress on cells. These osmotic changes lead to neuropathic pain. Organic osmolytes may have a role in helping manage neuropathy.
Methylcobalamin 1500 mcg and alpha lipoic acid 300 mg per day are useful in arresting the progression of diabetic neuropathy and its severity. (The Indian Practitioner, Oct 2008, p.nos. 621 to 628).
The kidney connection
The renal basis of hypertensive cardiovascular disease is becoming more and more evident. The importance of the kidney in hypertension, is due to the group of cells called JUXTAGLOMERULAR cells. These cells secrete an enzyme called renin. This enzyme converts angiotensinogen - a protein circulating in blood - to angiotensin 1. Angiotensinogen is produced by the liver and put in to the blood circulation.
Angiotensin 1 is then further converted in to angiotensin 2 by another enzyme angiotensin converting enzyme (ACE). Angiotensin 2 is a potent vasoconstrictor (constricts or contracts blood vessels). This increases blood pressure. Further, angiotensin 2 through its influence on a hormone called aldosterone increases absorption of water from kidneys (the water comes from the filtered blood), and shifts it back to blood. This increases blood volume. The net result: increased blood pressure.
The most popular antihypertensive drugs on the kidney system are the ACE inhibitors that inhibit activity of angiotensin converting enzyme. There are angiotensin 2 antagonists like losartan sodium, and new off-the-block drugs are renin antagonists.
The haemodynamic equation
So ultimately what do all these antihypertensive drugs do? They either decrease the vascular resistance (ie., cause blood vessels to dilate) or decrease the cardiac output (ie., blood pumped out by heart in one minute) or decrease both ie., vascular resistance and cardiac output. This is encapsulated in the haemodynamic equation:
BP (blood pressure) = PVR X CO
In this equation, PVR is the peripheral vascular resistance, which depends on the diameter of the blood vessels. The CO factor is cardiac output. This depends on the force of contraction of heart, heart rate, and the blood volume.
Antihypertensive drugs tend to decrease the heart rate, or force of contraction, or blood volume (by increasing the urine output), or cause vasodilation (increase blood vessel diameter).
The final conclusion
Cardiometabolic diseases are causing immense morbidity and mortality world wide. Developing countries are not spared nor are the developed countries safe from these diseases. Pharma marketers have donned their war gear for waging a war against cardiometabolic disease. However, they are just one front, the Govt. and NGOs need to launch massive communication exercises to create a lot of societal consciousness on cardiometabolic diseases. For eg., NACO is an organization to help fight AIDS. Similarly, we need a specialized apex body to lead the communication battle to ensure increased focus on cardiometabolic disease – a killer disease on the prowl.
THANKS FOR READING THIS BLOGPOST, PLEASE SCROLL DOWN AND CLICK ON OLDER POSTS AS AND WHEN REQUIRED, TO READ OTHER POSTS. This blogpost is put up at 7.45 pm on 3.11.2008 .
Sunday, October 26, 2008
The current buzzword in IT is CLOUD COMPUTING. This tech wave too rides on the collaborative trend in business activities.
Cloud computing is a nice poetic descriptive word. This refers to the concept of IT as a service. Data and information is present on the internet (cloud), and clients using various devices can access it from remote locations. It is a very exaggerated or amplified form of LAN (local area network). Companies like Cisco are betting big on this tech wave - and those who become clients of Cisco for this technology, are expected to enhance efficiency of businesses through the cloud computing phenomenon. Essentially, the "cloud" meets all the computing needs of the subscribing company.
Egs.: Google apps is an application where documents are present in the "cloud". Basically data and information is not stored in an in-house server. It is like a website of many a company. The website data does not sit in an in-house server. The website is hosted from another location. This is similar to say many e-mail ids, which are not created on in-house servers.
IMS is another some-what similar example on how it provides data to client companies these days. IMS is a premier market data provider for pharma companies. Client companies are given a password and allowed to access the data from IMS website.
How can cloud computing benefit pharma or healthcare companies?
Let us say a pharma company starts storing its sales data "in a cloud".
Let us take a hypothetical example of Brand Bo whose sales data is in the "cloud". Now presume, a Medical Representative (MR) from Madurai (in Tamil Nadu) logs in and checks the brand performance in various MR territories of India. And he sees that one of the highest sellers of Brand Bo is from Manipal.
So this kindles the curiousity of the MR from Madurai, and now he wants to check out why Manipal sells most. Now remember, it is because the data is in the "cloud" that the Madurai MR comes to know that Manipal sells most of Brand Bo. The Madurai MR can now send an e-mail to the Manipal MR asking for further information on how he is selling such high quantities of Brand Bo.
Further, if an analytics software is present along with the data - all the MR has to do is click on the sales figure of Brand Bo in Manipal, and the MR from Madurai can get a nice bar graph of the doctor segments that are prescribing Brand Bo the most.
Let us assume Brand Bo is being well supported by ENT segment in Manipal and is the main contributing doctor segment, while in Madurai it is the OBG segment that is bringing in the prescriptions for Brand Bo.
Thus, the gentleman from Madurai can use this tip to launch a special campaign, say call a doctor meet for all ENT specialists of Madurai, in a nice hotel, serve dinner, make a powerpoint presentation on Brand Bo, and excite the prospects of Brand Bo in the ENT segment. And may be even create a videoconferencing discussion between ENT specialists of Madurai and ENT specialists of Manipal.
This is a hypothetical example on how "cloud computing" can be applied to enhance business results, and make the working of the field force more efficient.
Cloud computing can, to put it in a sentence, HELP GET MORE BANG FOR THE MARKETING BUCK.
It is perhaps for this reason that companies like Infosys are repositioning themselves as TRANSFORMATIONAL AGENTS for client companies providing not only software for companies, but also software-as-a-service along with analytics and consulting. Thus, IT companies are trying to play a lead role in helping transform business results for companies.
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Friday, October 24, 2008
Wednesday, October 22, 2008
The Tequila is an interesting alcoholic drink concept. The charisma of Tequila lies in the way it is consumed. The wikipedia way: first, take in some salt by licking it off from near the palm of the hand, where it is applied, and then down the entire drink all at once. After downing the first shot, a lemon slice is quickly bitten.
An alternative method, is placing some salt on the back of the palm, squeeze some juice from a slice of lime on to the salt, gulp the drink at one go (bottoms up!), and then lick off the salt + lime.
Well, whichever way you follow, you will realize as you down the hard- drink in one go, it is really hot on the throat and it hits you really fast and hard!
Question: Hey, but what does the Tequila drink have to do with healthcare products?
Answer: The Tequila punch is required for new product launches.
Explanation: Today doctors are burdened with a plethora of new brands and product concepts. Each day, atleast one MR launches a me-too brand or a new product concept. And all this hectic new product launch activity has made the doctor inured to new product (whether new concepts or me-too brands) launches. Thus, it has become a 'nightmare' for a healthcare or pharma marketer to get the new brand consumed by way of prescriptions.
The way out? Give the Tequila punch!
Giving the Tequila punch does not mean literally pouring the alcoholic drink down the doctor's pharynx (ie., throat).
Apply some salt first: Tease the doctor with a campaign to evoke the attention and interest in the product or brand concept. There is a need for a logic in the product launch, some important emotive points in the promotion, and a lot of marketing gimmicks to engage the doctor. That is the salt.
Then, give the drink: The doctor will surely not take to the product - it needs to be sort of made-to-gulp by the doctor, even if the 'drink is hot in the throat', and the product should give a never before high to the doctor. It should excite him.
Do not forget the lime: The doctor ought to be then exposed to the 'lime of another marketing gimmick' or the brand will slip out of his or her mind.
Today, no doctor will come out of his or her 'comfort zone' and experiment with a new product concept or brand concept in his or her clinical practice very easily. Only the Tequila shot or Tequila punch will get him or her to shift his prescribing behavior.
Some live examples from the marketing lore are given below:
Here are two marketing concepts (live case studies) that have rocked the market. Both are examples of product launches by Wockhardt.
Launch of a brand of lipid lowering agent: In this case, to preselected target doctors, the MR visited with a bright big gift package. After a small pre-detailing pep talk the doctor was requested to open the bright big gift package.
The doctor would obviously have opened the package with glee. Imagine his surprise, when on opening the lid of the package, a hydrogen filled balloon with a string tied, rose up, and hit the ceiling.
The enterprising MR then went on to detail thus: 'Dr., when the lipid levels in blood go up, please recommend ........ brand which reduces (etc)'.
While detailing all the points, the MR was to slowly pull the string down with every detail point of the brand, and finally the MR puts back the balloon in to the box and closes, triumphantly announcing that Brand X reduces lipid levels to normal levels.
Needless to say, the brand became a success.
Launch of Freecad: Wockhardt was a rather late entrant in to the booming antioxidant market. To gain mindshare, a very novel strategy was implemented to the early adopter and innovator opinion builder doctors.
Each MR had to select 3 to 5 such doctors in his territory. And he had to take permission to visit the doctor's house early morning on a particular date.
The MR visited with a pigeon in a cage. The doctor was asked to come out of the house or on the terrace, the doctor was asked to release the pigeon. The doctor would have perhaps done it with a lot of questions in his mind! May be he would have been flabbergasted too!!
Anyway, as soon as the pigeon was released, the MR would then announce that the doctor has now ensured 'freedom from coronary artery disease' through Freecad. And the MR would detail the product. Needless, to add this marketing brand gimmick ensured that the product went on to become a big hit in the antioxidant market.
Hey, wait do not raise holier-than-thou points that clinical aspects govern the prescribing behavior, and not such 'SILLY MARKETING GIMMICKS' as described above.
Let us understand, buddy, doctors are human. They have enough of pharmacology and scientific evidence bombarded from every direction - through MRs, peers, mags, journals, internet etc. NOW WHERE IS THE FUN?
It all comes from such interesting MR activities. And they influence brand sales significantly. Marketing requires one to wear the green cap of creativity (green is for creativity as per Edward de Bono - the messiah of lateral thinking). And this can lead to transformational results.
Hope this blogpost was as exciting as a Tequila punch! Please scroll down and read all other posts, do click on older posts to read all other blogposts. Thanks for your time. (PS: this blogpost is put up from nearby cyber cafe at 7.36 pm)
Tuesday, October 14, 2008
The world over there is a buzz on the pharma and healthcare front. However, an economic slow down in developed markets, is shifting the focus to rapidly developing economies like India. Thus, the scene for pharma and healthcare, in India is indeed vibrant.
So what is alluring about pharma India?
The market growth, increase in GDP, and the huge population of India are indeed very alluring to pharma marketers. 1.1 billion is a big big number – now, that is the estimated population of India.
This listed company is a very interesting case study. It is a multi product and multi category company. Its pedigree is very sound. The TTK group was established by the famous T T Krishnamachari. However, in the market, TTK Healthcare is perceived as a stable and very conservative company. As per the annual report of 2007 – 2008, the Chairman is Mr. T T Jagannathan, an elderly distinguished person, a B Tech GOLD MEDALLIST from IIT Chennai. He also has a Masters from Cornell University, USA.
The company views the lifestyle disorders, growing demand for herbal products, and the OTC market for healthcare and beauty products as an attractive market. Besides they are into veterinary care, biomedical devices (including heart valves) and food products. Woodwards gripewater and Eva range of body fragrance products are their popular brands
The pharmaceuticals segment in 2007 – 2008 on a net sales (after deduction of Excise Duty) of Rs. 96.16 crores, has a profit of Rs. 11.52 crores. The consumer division with all the hype and brand visibility on a net sales of Rs. 79.38 crores has a loss of Rs. 3.45 crores. The entire company (including pharmaceuticals, medical devices, consumer products, printing and other divisions) has a net sales turnover of Rs. 199.04 crores and profit of Rs. 21.99 crores. Just look keenly at the above figures, you will see that the pharmaceuticals division is contributing almost 50% of the profits, even though the sales is not even one third of the total sales
IF THIS IS THE STORY OF A CONSERVATIVE COMPANY YOU CAN WELL IMAGINE THE BALANCE SHEETS OF AGGRESSIVE BIGGIES AMONG INDIAN PHARMA. THAT IS THE LURE OF PHARMA!!
This company too is an interesting case study. Wanbury has a focused approach and operates mainly on two platforms: one, Wanbury concentrates on the OBG segment, and secondly, Wanbury looks to NDDS (ie., novel drug delivery systems) or other differentiated branded product offerings to make a distinguishing cachet in the pharma marketplace. By concentrating on the OBG segment Wanbury seems to get a better bang for the buck. It is this specialist-focused approach that worked for companies like Torrent, Intas, and Sun Pharmaceuticals too when they began their operations. In fact, this DNA has not changed for these companies – they have divisionalized and the specific divisions continue to have the basic focus.
Wanbury has created waves through a powerful launch of C-pink - the hematinic brand. Wanbury growing at 87% has just launched sustained release delivery based NDDS nitrofurantoin for management of UTI - particularly in gynec cases (there is the OBG focus once again). This market is again not crowded and has good potential as UTI in women is a chronic, frequent and recurring problem. The basic USP of Nitrofur SR (Nitrofurantoin-100mg, sustained release) is patient compliance.
The lure of pharma is profits, sales, financial health, feel-good feeling for the promoters, an excitement
From time immemorial, herbal and Ayurvedic products have been the sheet anchor of healing systems in India. While most companies looked to cash in on the opportunity through allopathic or Western Medicine products, few companies like Himalaya Drugs endeavored to present the ancient remedies in a modern scientific format, backed by clinical trials that are acceptable to modern physicians. Liv 52 continues to be a star brand of the Indian pharma market. In recent times, Himalaya has started an approach that can redefine its financial performance. Realizing the untapped rural potential (since most of the herbals are consumed in rural sector, and the fact that 70% of the Indian population is rural, and constitutes 21% of the total market), a new division of Himalaya is focusing on this market segment particularly in the Hindi belt where Ayurveda rocks most. In fact, evangelical marketers of Yoga and Ayurveda like Baba Ramdev are contributing to the market expansion of Ayurvedic pharmaceuticals.
Another very interesting dimension of this market is the possibility to address the end-consumers legally. Patient education strategy is meticulously adopted by Ayurvedic marketers, to enhance revenues through the OTX positioning.
The lure of Indian pharma is in its huge market potential.
Healthcare supplements market is exploding
There is a healthcare wave and this has caused a rush market for authentic healthcare supplements and services. Cashing in on this wave are companies like Juggat Pharma, Merck, and Mankind that have launched electrolyte energy drinks concept brands (in a ready-to-drink format), and creating ripples in the pharmaceutical and healthcare market. In fact, Juggat Pharma has pioneered the concept and contract manufactures the brands marketed by Merck and Mankind (email@example.com).
All in all, hail the rise of Indian Pharmaceutical and Healthcare market!! The lure of Indian Pharma and Healthcare is irresistible!!!
This weekend there will not be any other blogpost due to preoccupations. Thanks for reading this blogpost, please do scroll down, click on older posts wherever required, and continue reading all other posts.