Saturday, May 24, 2008

Telling great stories

I got the above nice picture from HERE. Perhaps it is about a great marketing story on the phone.

: Telling a great story is to be perceived positively. In India, we often say 'telling stories' to mean saying lies. In marketing however, telling stories means a great pitch - an impelling story that connects with the target audience, and enhances consumption of the product or service.

For successful marketing, telling impelling stories is an important competence. It is the stories that create the buzz and increase the consumption, which is the core of marketing. And it is exactly why the pranayama-Yoga system being promoted by Swami Ramdev is becoming a phenomenal hit. The Indian diaspora is firmly with his health program on TV channel Aastha. The USP of Swami Ramdev's program is the right-before-your-eyes case studies being shared by the Yoga participants. The stories are impelling. The program is full of verve, purpose, and fun. The TV program is a successful presentation of a good pranayama-Yoga concept by Swami Ramdev.

Products and services become successful in the marketplace not only on the basis of the merit of the product; it is good marketing of meritorious products or services. THE ESSENCE OF GOOD MARKETING IS GOOD STORY TELLING.

Swami Ramdev is not only a honest, sincere, and purposeful Yogi - he is very intelligent. Swami Ramdev has understood the importance of good story telling to market his mission and gain audience share. Swami Ramdev's stories on Yoga are inspiring and guiding. Even more sagacious is his strategy of story telling to co-create stories along with the Yoga practitioners in the audience. This engages the audience even better, creates the word-of-mouth (which is again an important goal of marketing), and finally Swami Ramdev ends up producing lifestyle change - which is THE GOAL OF ALL MARKETERS.

Good story telling is the crux of many of allopathic successes and leadership in the marketplace. Every allopathic product is launched with years of research to establish the molecule's safety and efficacy. This creates the fodder for a good story. It is in-depth material. The fodder gets mathematical treatment, in terms of statistical analysis of the pre-clinical and clinical data. And finally, when the molecule and formulation is unveiled, the narrative brings in instant success.

Take for eg., the historic and mega successful launch of Viagra. The story telling starts with the interesting point that the PDE - 5 inhibitor was being investigated for its future application as an antihypertensive vasodilator. Sildenafil citrate's property to help overcome erectile dysfunction or impotence was itself a side effect, that became the product's promotional platform. The narrative of story is interesting right from the brand name potency - VIAGRA (coming from vigor and Niagara). The product finally took off not just because of the clinical trial data back-up to persuade prescribers, it was the worldwide frenzy of media buzz that created the hype, positive imagery, and word-of-mouth for Viagra. The product was seen as HOPE in physical form. True marketers it is said do not sell products or services, they sell ideas, imagery, and HOPE! And the story of Viagra is just that. The story telling of Viagra has been successful even though the emphasis was not on impotence - but the then less popular term erectile dysfunction; the use of this term, created an educational component to the Viagra story telling too, and as they say, rest is history.

Pharmaceuticals and healthcare is yet to see such a successful launch campaign and story telling, after the stupendous success of lifestyle prescription product Viagra.

That is why we say,
good stories create eddies that disrupt established trends

The core of good story telling is not the narrative - it is the idea and the novelties. For instance, when Lupin launched their brand of atorvastatin, it was as a heart shaped tablet; the entire internal and external launch marketing campaign was centred on the heart (including cutting a heart shaped cake at inaugurals). The idea of a story is the appeal, it added to brand differentiation. The idea serves as the foundation of story telling.

Good stories trigger enthusiasm and are infectious. The ultimate goal of good stories is to bring about a change in the prescribing or usage pattern with respect to product categories. For eg., when a MR details a good story on how nutrients promote wound healing with clinical reports and clinical case studies, the story becomes impelling and produces the required change in the target audience.

When stories appeal to the intellect and the heart, they persuade, create customer confidence. Stories can grip the target audience. And the required change is produced in the target segment, and the business objectives achieved.

MUCH LEARNING AND CHANGE IN CONSUMER BEHAVIOR, PRESCRIBING BEHAVIOR, AND PURCHASE BEHAVIOR IS BASED ON STORY TELLING. It is for this reason that books like Made in Japan, Akio Morita, or any of the business books that chronicle organizational successes become big hits in the marketplace. The world likes great and impelling stories. When marketers use all the promotional tools available, apply the marketing techniques and tell a great story, the product becomes a success.

Most of the successful products are simple. But they tell a great story.

Thanks for reading the above blogpost, hope it was an impelling story! Please scroll down and do read all other blogposts. Please click on OLDER POSTS wherever required.

Sunday, May 18, 2008

The healthcare trend

It is said that one third of the world is afflicted by TB. Many cases abound in India too. Top picture of a TB patient is taken from here.

Trends matter for marketers

A trend is a general tendency or direction. A popular taste of the times. It is something that is in vogue. Marketers constantly sift reports, looking for trends. For instance, the current trend of buying a car for family purpose. Or the famous trend in India is of eating-out (families, relatives and, friends eating-out; oops hope George Bush is not reading this blogpost!!). A major movement in Indian society today is the healthcare trend.

The Pranayama-Yoga-Ayurveda trend created by Baba Ramdev

Ramdev Baba's success is not that of an individual cashing on a trend, it is the ultimate way of a societal leader creating a trend. Ramdev Baba's Pranayama-Yoga program telecast live on Aastha TV channel and the live Yoga camp starts at 5.00 am in the morning. And you have crores of viewers from across 125 countries tuning at that early hour - in India. People brave the weather and conquer sleep to reach his camp at wee hours of the morning for the pranayama - Yoga routine. And the camp attendees are anywhere between 50,000 to 1.25 lakh at each morning camp conducted by Swami Ramdev Baba. And his Yoga camps are more about health, universal love, self-belief, and patriotism rather than abstract spirituality. His pranayama routine is of 7 types and this routine helps people conquer and control chronic disease (cardiovascular and diabetes), cancer, rheumatoid arthritis etc and establish health. Swami Ramdev conducts Yoga-pranayama health camps and not mere abstract religious or spiritual camps. Watch the fervor for establishing good health by tuning on to Swami Ramdev's telecast every day morning at 5.00 am (IST) onwards, on Aastha and you will realize that healthcare is not just a concern or even a mere trend, it is in fact a mega trend ... or more appropriately, a mass movement in India.

The camps conducted by Swami Ramdev are free. This Baba has dedicated his life to popularizing Yoga-pranayama in a scientific way. It is a national and international awakening to the potential benefits of Yoga-pranayama.

The above healthcare movement in India is the opportunity for marketers.

Preventive approach to healthcare pays: the OTX (over-the-counter plus prescription) and OTC (over-the-counter) markets are picking up

The mass awareness on healthcare through the powerful free media in India, and the rising costs of medicare is ensuring that people are considering preventive healthcare to a greater extent than before. A stitch in times saves nine, after all.

FMCG (fast moving consumer goods) and FMHG (fast moving health goods) have been quick to cash in on the healthcare trend in India. Pepsi now has IMA (Indian Medical Association) endorsement for some of its products. Glaxo SmithKline Consumer Healthcare (GSKCH) sales are growing at high double digit rates (25.7% for the Jan - March 2008 quarter) and a net profit growth of 34% as per ET, 7.5.2008, The attraction of this healthcare space is that non-drug healthcare goods do not attract price ceiling diktats from Govt. bodies. Innovative non-drug healthcare goods thus get the double benefit of a mass market (not just prescription market) and freedom from price control. Thus, GSKCH has increased the price of Horlicks and Boost by 7% due to inflationary trends. In the FMHG space, GSKCH is banking on its pharma parentage and looking for increased growth, Glaxo is also launching a slew of specialist nutrition products.

Another case study reflecting the strong trend of healthcare in India is Amway, which has in a decade reached an annual turnover of Rs. 1000 crores riding on a strong wave of nutrition and wellness (as per ET, 7.5.2008, It is interesting to note that for Amway, Kerala is the fastest growing market (probably due to 100% literacy, high per capita income, and health awareness).

Looking at the potential of healthcare, organized Pharma retailing that forms about 2% of the total Pharma retail business in India today, is taking off and growing at 30 to 40%. For eg., the new entrants to the Pharma retail space Hetero and Reginix chains are owned by the pharma manufacturers Hetero Drugs and Grandix Pharma (that owns Reginix).

Welcome to healthcare clutter in the future

But will it mean consolidation? (it is doubtful, read on why...)

With more and more players entering the healthcare sector the inevitable clutter will happen and may see a round of consolidation. But given the penchant for entrepreneurship in Indians and the fact that Indians like to build businesses for the future generations of the family rather than cashing out, consolidation as a trend will not be as pronounced as it happens in the Western markets. There is a basic difference in the psyche of Indians and Westerners. It is not unusual for Westerners to sell off businesses to highest bidders. Then retire and enjoy. But the Indian mentality is different. Indians sell off businesses if their children are not interested in continuing the business or if there are no heirs for the business enterprise. This is the funda. So consolidation will not be easy. And in case some people sell off their businesses, it is only to restart another enterprise sooner or later. That is the entrepreneurial itch in Indians, and the psyche to create businesses for future generations of the family rather than just enjoying the wealth. For Indians, creation and running enterprises are a pooja (or an act of worship) for the well being of one's family and future generations. That is the basic truth of Indian business mindset.

So which way out?

The only way out is sticking to the innovation mantra (ie. doing something novel, the newness factor is important - this novelty value can be related to products, processes or services). It is in this context that the book by C K PRAHALAD AND M S KRISHNAN THE NEW AGE OF INNOVATION becomes important. C K Prahalad is the same management thought leader who inspired entrepreneurs like the Tatas to look for a fortune at the bottom of the pyramid. In a way, C K Prahlad has also added grist to the microfinance movement.

Innovation helps business corporations face and shape the future. Innovation requires application of information technology to harvest information through analytics and create knowledge and generate ideas. Innovation comes through collaboration, co-creation of value with customers, digitization, understanding demographics - technological shifts - and customer shifts, connectivity, and convergence of industry and technology.

Innovation does not require big moolah. An innovative approach to marketing is Pepsi's first to get IMA endorsement for its juices and oats. It is for the first time that Pepsi has used such an approach (three cheers: Indra Nooyi!!!), no where in the world does Pepsi use the health platform as much as it does in India. Similarly Jagdale Industries Ltd., has innovated the electrolyte energy drink category through its thundering success of electrolyte energy drinks ( Many big time players have evinced interest in this range and are in talks with Jagdale Ind. Innovation has created this segment. Innovation is required for differentiation - which is good business strategy. Differentiation helps take on clutter and commoditization of products and services. Innovation is not just about big moolah.

Thus, it is clear that only courageous innovation (fortunes favor the brave) that will help players of the healthcare trend in India survive and win in the market place.

Thanks for reading this blogpost, please scroll down and click on OLDER POSTS wherever required to read all other blogposts.

Saturday, May 10, 2008

Vive-La-Medical Darpan

This blogpost is not about the mainstream Pharma media in India. It is more about the unsung side of the Pharma business. This blogpost is about a Hindi monthly "MEDICAL DARPAN".

Medical Darpan is a Hindi monthly tabloid published from Bulandshahar, a place in Meerut Dist. of Uttar Pradesh. Medical Darpan is straight and hard hitting. No fancy management jargon here. It reflects the raw unbridled spirit of entrepreneurship of Indians in Pharma business. No Kaizen, CRM, or US FDA terminologies. It is straight business talk. Trade, as it really is.

Consider some of the advertisements in the March 2008 issue:

1) Pentachem, A GMP revised schedule M and ISO 2001:2000 unit in Excise free zone, 1% CST zone. This company offers distributors on monopoly basis has a generic division 125 products, PCD (propaganda cum distribution division) or franchise division offers products in attractive packing, competitive pricing inclusive of promotional materials. Also undertakes contract manufacturing.

2) From Chickpet, Bangalore, Invision offers various products: tablets, capsules, syrup, sachet, dry syrup, injectable, ointment, lotion and IV fluids, over 400 products, for franchisee marketing (similar to PCD marketing).

3) Another very interesting ad without name of company states (however, the contact no. is given): Best deal for Pharma professionals, earn more with promising future by doing own business, a fast growing Pharma company with wide range of excise free top quality branded Pharma products - tablets, capsules, liquids, syrup, injectable, ointments, proteins supplements etc) with immense scope. Promotional materials like visual aid, literatures, catch covers (ie. of samples), reminders, visiting cards, order book (ie. the personal order book) etc are offered. "You reach breakeven point with Rs. 15000 approx, stockist price, per month by earning a profit of Rs. 9000/- - an average salary of MR, if you generate Rs. 50,000 per month you get a profit of Rs. 30,000 (approx.) per month after using 950 samples, and 10% bonus deals (ie. sales promotional offers) on all the products to the retailer."

There are many such advertisements in Medical Darpan soliciting contract manufacturing in excise free zones (even small batches with inventory of just Rs. 5000/-), franchisee marketing tie ups and PCD tie ups. Some of the other companies advertising are Ban Pharma (for Ayurvedics), Bionova Lifesciences of Bangalore for biotech formulations, Amaxy Laboratories of Chandigarh, Lenit Pharmaceuticals of Kangra (Himachal Pradesh), Auspi Medicaments of Delhi, Botons & Blues a part of Invision, Bangalore offering nutraceutical formulations containing hot demand extracts like biotin, lycopene, alphagalactosidase, grape seed extract, Gingko biloba extract etc; Magnus Biotech for antibiotics etc; Imparish Pharmaceuticals of Roorkee UP etc (many many more companies are there). There are many many more companies with biotech products, nutraceutical formulations, antibiotics, various types of formulations including mouthwashes, toothpastes, and gels, allopathic, ayurvedic, food, gym and body builder products, with marketers brand name and monopoly rights, and other latest molecules in Alu-Alu pack, injectables etc in excise free zones, and revised Sch. M. and cGMP manufacturing plants.

This is the market that is unsung but very vibrant - away from the media glare of Economic Times, Business Standard, Financial Express, Express Pharma Pulse, and Chronicle Pharmabiz. But this market is well connected through Medical Darpan and other such media. This vibrant market is not known to many of the top executives of big Pharma companies nor does Medical Darpan reach them. Medical Darpan is not a fancy tabloid, it is raw business. This market reflected by Medical Darpan is not mapped by ORG. Consequently, many top executives do not even know the names of these companies. But their activities are taking Pharma products to the nook and corner of the country, reaching out to the far flung interior and micro interior based RMPs. Healthcare - Pharma business is in full swing.

How do these franchisee and PCD companies succeed despite the might of the Pharma biggies?

Simple it is CRM in action. It is empowerment in practice. It is entrepreneurship in full swing. It is a bottom-up marketing strategy model at work. Let us suppose a MR of a STANDARD COMPANY goes for work. What does he do? He implements the company strategy - meets 10 to 12 doctors, details, samples, gifts, and negotiates some deals based on the guidelines of the company. Does personal order booking at the retailers as per company guidelines. What does the PCD MR do? The PCD MR is the empowered MR. His goals are clear. His resources and limitations are well known to him. This MR has complete knowledge of the profile of the doctor. He services the doctor based on the needs of the doctor, not as per any strategy or guidelines of the company. Thus, the PCD MR can strike better. If the PCD MR visits a clinic and sees a fan not working in the clinic, he gets the fan repaired on the spot. The standard company MR does not have the flexibility based on the values, ethics, and practices of the company. Thus, the PCD MR will win many battles - the standard MR may win the war - but the PCD MR is satisfied with the spoils of winning his battles. The PCD MR for obvious reasons, has a higher sense of ownership in his marketing activities. And there are many such PCD MR operators in the market, they expand the market, nibble at the big Pharma market share, and are the unrecognized forces in the big picture. But they matter. Their market is not accurately mapped. So the size is anybody's guess. Indian Pharma market has brand clutter, generic generic clutter, commodity chatter ...

Consider this: my friend's acquaintance - basically a young engineer who is in to consultancy, training and development in the IT and ITES field, has with his friends floated a small company Madhuban Naturals that is now manufacturing and marketing herbal singles ie. plain Ashawagandha extract, Shatavari extract etc in capsules. Their USP (unique selling preposition) is pomegranate fruit powder extract in capsule form. There must be many such Madhubans in India. Away from the glare of the top media and big companies. That is the unmapped market of healthcare and Pharma India.

I asked such a PCD MR how he sells say, diclofenac in the face of aceclofenac. His answer was interesting. "What diclofenac does is reduce pain and swelling, so does aceclofenac. Some advantages may be there with aceclofenac. But diclofenac does not have such awful disadvantages that it will be discarded by the doctor. So generic diclofenac will continue to sell, the doctor will not replace all his diclofenac prescriptions in favor of aceclofenac. It is ultimately rates (ie. price and margin to retailer and dispensing doctor) and other benefits to the prescribing or dispensing doctor that matter." So that is the bottom line.

Long live Indian entrepreneurship. I dedicate this blogpost to Indian entrepreneurship. Thanks for reading this blogpost, please do read other blogposts, by scrolling down and clicking on 'older posts' when required.

Sunday, May 4, 2008

Kidney disease: the silent new epidemic of India

The first image is of the lower back showing the positions of the two kidneys. I got this image from here. And why is Swami Ramdev's image here? Please read on to find out why?!

Consider two very recent conversations that I had ...

A worried colleague shared her concern with me. Her brother-in-law, a diabetic, was found to have kidney failure, and was undergoing dialysis every alternate day. The cost of dialysis was Rs. 4000 (per dialysis). It was no doubt a financial burden to her sister's family along with the emotional agony.

Similarly, a long time field colleague of mine (who is now a first-line field manager in a top Pharma company) shared his anxiety: his aged father a long time insulin dependent diabetic was now undergoing dialysis thrice every week due to failing kidneys.

It is sad but true - India the country with the largest no. of diabetics in the world is on the throes of a yet another silent epidemic - kidney disease. It is not sensationalizing an issue. But open your eyes and ears to the incidence of kidney disease in your social circles, the incidence will shock you.

It is a costly disease

The burden of chronic kidney disease or kidney failure is far too much for the average person to bear. Each dialysis costs about Rs. 4000. Moreover there is a shortage of dialysis machines. It is said that there are just 3000 dialysis machines in India. Another colleague of mine shared his experience in Kerala. At a particular centre, where his sister was treated, he was shocked to notice the long line of people waiting for their turn for dialysis. The situation is getting very grave.

Kidney disease is insidious

The main hazard of kidney disease is that it is a silent killer disease. Almost symptomless. The disease overwhelms the person and announces its arrival only at the last stage.

I asked my first-line manager friend how this deadly disease was diagnosed in his father's case (a chronic insulin dependent diabetic)? He replied: 'Sunil, as such the main complaints were pain in the calf muscles, with spasms, itching, weight gain and a bulky or puffy profile and back pain. There were no 'initial symptoms'. It was, hence, difficult to diagnose at the early stage. The doctor too said that kidney disease does not cause any clear cut initial symptoms. So diagnosis is mostly at the advanced stage and are dialysis cases. It is a very scary picture, Sunil, the doctor said that there is worrying trend of increasing kidney disease cases. He suspects, hyperglycemia and pollutants as causing this problem'.

What my first-line field manager friend added was even more worrying ... "dialysis is a sort of palliative or supportive measure. Although it helps reduce morbidity there is no significant prolongation of life in such patients. It is in fact a sort of business now here in Bangalore. You have got to shell all that cash', he added with frustration, 'yet you know it is not something that can go on like this...'. I could understand my friend's depression.

The only option is education and early detection

The importance of early detection is highlighted here in this link. The most important facts to educate on are:

Kidney disease occurs mainly due to:

a) diabetes (which will hit 57.2 million Indians by 2025 AD) ie. diabetes nephropathy (the obvious leading cause of end stage renal disease in India)
b) hypertension (high blood pressure)
c) iatrogenic kidney disease (or kidney disease as a side effect of drugs like chronic use of pain killers eg., by arthritics); and kidney disease due to inflammation and infection.

The importance of education and early detection is a prime opportunity for social marketing initiatives for marketing antidiabetic and antihypertensive drugs. Direct-to-patient campaigns and patient education campaigns through the prescriber or pharmacist or any other healthcare professional like the nurse, will not only serve to educate the target audience, it will also help in brand building.

The other aspects to educate on: proteinuria (presence of protein in urine, which indicates diabetic nephropathy) and regular urine creatinine level measurement.

Chronic disease caused about 54% of deaths in India in 2005. The fact is that the Pharma market for chronic diseases is booming in India. No wonder that Mixtard a brand of human insulin is one of the top three brands in India. Biocon a company focused on lifestyle and chronic disorder segment is experiencing more that 50% growth. Atorvastatin and ramipril are among the top selling drugs in India and are growing at very high rates. Cardiovascular disease, diabetes, cancer, and chronic respiratory disease are the main chronic diseases... BUT HIDDEN IS THE SILENT EPIDEMIC of CHRONIC KIDNEY DISEASE. READ MORE BY CLICKING HERE.

A focus on prediabetes and prehypertension is required

The words prediabetes (or impaired glucose tolerance) and prehypertension are yet to enter the common man's lexicon. High bp and High blood sugar have already entered the common man's vocabulary. The need to highlight on prediabetes and prehypertension is very important. We have a publicity savvy (and controversy kicking: Dr. Venugopal controversy of AIIMS, smoking and alcohol consumption controversy) Union Minister for Health Dr. Anbumani Ramdoss, perhaps he can pick up this as a theme campaign. While social marketing campaigns of Pharma companies can focus on prediabetes and prehypertension, to bolster their antidiabetic and antihypertensive brands, perhaps big stake holder Pharma companies of the diabetes and hypertension markets can come together, create a common fund, hire a good advertisement agency, and unleash a market building and national awareness campaign on prediabetes and prehypertension. It makes good economic and social service sense.

Liver and kidney disease

As was highlighted by the earlier blogpost, the liver is a strategic organ. Liver is an important organ of detoxification. The load of toxins in the blood is increased by liver stress. So logic dictates that incidence and severity of kidney disease increases in patients with hepatic dysfunctioning or fatty liver or cirrhosis of liver. Hence, it is observed clinically that alcoholics particularly diabetics who consume significant alcohol suffer from kidney disease to a greater extent.

Angiopathy (vasculopathy) and kidney disease

Angiopathy refers to disease of the blood vessels. The first stage is endothelial dysfunction - the integrity and functioning of the first innermost layer of the blood vessel is affected. Endothelial dysfunctioning leads to atherosclerosis (hardening of the blood vessel walls and consequent loss of elasticity). Angiopathy causes impaired blood flow to an organ. Imagine angiopathy in the blood vessels of the kidney and the one connecting to the kidney (ie., renal artery). Renal angiopathy has disastrous consequences on kidney functioning.

Now, one of the complications of diabetes is angiopathy. So add the grave situations together ... angiopathy, liver stress, hypertension, and diabetes. The dangers are very formidable. It is a challenge before our nation.

The problem with insidious diseases

The major problem with insidious diseases like osteoporosis, kidney disease, and angiopathy, is Oh! I do not think it will happen to me. And once it happens the cycle of denial, depression, and acceptance. Insidious diseases come unannounced and curse the sufferer. Beware.

In Yoga we trust

Swami Ramdev (who regularly features in Aastha channel at 5.00 am) is revolutionizing healthcare through pranayama and Yoga. And it works. It is said to work for kidney disease and diabetes too. No harm trying it. PLEASE CLICK HERE. That is why I have put a image of Swami Ramdev at the top of this blogpost obtained from here.

In Ayurveda, punarnava and gokshura are said to support kidney function. And even help revive kidney functions.

Thanks for reading this blogpost, please do read all others by scrolling down and clicking on older posts wherever required.