Sunday, June 23, 2019

Inevitably, digital pharma


Go Generic: a non-jan aushadhi generic store (at Mumbai near Andheri East station, photo: 9.6.19)

Market is merciless, yet the market is kind to the market – savvy.  This means having a keen focus on the goings-on in the market and adapting to the trends.  It is simple truth that most of the marketing honchos in top management are the MRs who started in the 1970s, or otherwise in the 1980s/early 90s.  Those were the non-mobile times; era of trunk call and STD (standard trunk dialling) phone booths.  Plying doctors with more and more samples and gifts was sufficient to achieve the sales targets.  Today, it is these MRs or people with trunk call and fax mindset who are running the pharma show! 

No wonder all are clueless.  Each monthly sales closing is a new challenge.  Even doctor mindsets’ are different today.  Those earlier days were the times of highly egoistic and authoritarian doctors.  Today, most doctors are market savvy down-to-earth and business-like.  Ego has no place in medical business practice.  Social media has blown the cover off many manipulative medical practices.  Dr. Google has empowered patients.  Even though doctors want patients to keep Dr. Google away, they simply can’t.  It is the era of digital penetration, and digitalization cannot be wished away by anyone – even demigod doctors and non-doctors. 

Besides this, a strong trend towards alternative medicine, traditional medicine, yoga, naturopathy and non-allopathic methods of wellness and healing are trending.  So market is not easy to operate – exploitation of gullible nature and naiveté is out!!

Era of multiple touchpoints

Imagine you are a diabetic.  Whatever your monthly income may be, a smart phone is in your pocket.  So a diabetic guy is just not going to listen only to the ‘prescription voice’.  The diabetic will listen to podcasts, see you tube videos, and read many many articles on diabetes.  This empowered patient is not going to follow the doctor advice blindly.  He may discuss with the doctor or tacitly avoid discussions but follows his self-reasoning. 

Even the PM: Mr. Narendra Modi is vouching for yoga and jan aushadhi kendras or shops.  Generic non-jan aushadhi shops are also providing lower cost medicines from standard pharmaceutical companies.  Just outside Mumbai Andheri East local railway station is a non-jan aushadhi generic medicine store and is doing great business (my foto of 9.6.19, when I was in Mumbai for a meeting).  These developments are stunting the growth of traditional pharma brands.

So as a pharma marketer can I depend only on the doctor’s prescriptions?  Will my brand not have influential touchpoints at pharmacies and in the internet?  How can I ethically influence prospect and consumer patients on the mobile internet?  Can I ensure patients who take my brand of medicine to register on the website and get periodical health advice so they are inclined to buy my brand?  What sort of after-prescription services can I offer to brand purchasers through digital means?  Is it possible to wean away my brand purchasers from generic (jan aushadhi and non-jan aushadhi) products? 

Earlier the brick and mortar pharmacies were the only places of retail sale.  Today online pharmacies are showing growth – so patients are buying from them.  Is it possible for my brand to penetrate the online pharmacy sector?  Many doctors are having attached pharmacies – every doctor wants samples, gifts and also a cut from the attached pharmacy.  So how is it going to work out financially for me?  Boy, the market complexities are galling.

And we have the same strategy of the 1990s mindset going round: appoint more and more MRs, more incentives, give more and more samples, provide more and more gifts and sponsorships…spray and pray for results.

Or should I go on intensifying my promotional role at doctor chambers and pharmacies: more and more retail bonus offers, more samples, more gifts to doctors, more sponsorships and more CRM activities to doctors?  How much more?  The doctor is besieged by atleast 20 medical representatives (MRs) per day.  These MRs are from all types of companies: PCD (propaganda cum distribution) companies, semi PCD companies, ethical PCD companies, national Indian companies, regional companies, different divisions of pharma companies (eg., 16 divisions operate from Micro Labs, Bangalore), franchisee marketers who are promoting tail-ender brands of top companies, and MNCs too.  And all these MRs are plying samples, gifts, and other pampering sponsorships.  Spray and pray!!!

Is the modern day doctor a digital aficionado?  Most of the 1990s and pre 1990s mindset marketing personnel - believe that doctors are not digital.  Yes, doctors are not digital!!  They do not do whatsapp, they do not go to medical and social websites!!??! But look at a website like pediatricsoncall (https://www.pediatriconcall.com/ ) – content is mindboggling, very engaging style and gets big hits from paediatricians across the universe!  The way forward for medical content is digital because nothing expires there.  There are no back issues to locate.  Even if there are back issues, it is all digital available there for permanence.  So which way are we going to participate in the digital marketing realm?  And how to influence doctors, pharmacists and patients!

Smart companies like Group Pharmaceuticals with OTX profile products like toothpastes and oral medical products have launched digital strategies through facebook and other media – their online brand toothpaste Elsenz is creating waves, across geographies. 

Pharmacies are great underused touchpoints

Every pharmacist is powerful – he can influence purchase behaviour of patients and other buyers.  It is possible, provided he has the relevant knowledge and communication skill.  But who will improve the knowledge and communication skill?  Will the GoI or Pharmacy Council do it?  Will pharmacist do it on his own?  No!!

Welcome to the new era where pharmaceutical and healthcare product companies will develop community retail pharmacists on knowledge and communication skill.  Because such an empowered pharmacist will help push and persuade or be the influencer for the brand!  Yes, this day is not far off.  Digital medium will enable such pharmacist development programs.  It may also happen that continuing pharmacist education credit programs (CPE) will be sponsored by pharmaceutical and healthcare companies.

Eg., Evion 400 CPE credit program offered digitally – Vit. E and diabetes management.  A pharmacist empowered through this program will surely endorse or recommend Vit. E (Evion) to the diabetic patient!

Next level: Imagine a doctor has a tie-up relationship with netmeds the online pharmacy or practo online pharmacy.  After taking the patient’s consent what if the doctor provides the e-prescription to netmeds or practo or both and they provide a bundle of offers to patients for online purchase and home delivery?  And where will it lead the neighbourhood brick and mortar pharmacy to?

Next level: Elsenz from Group Pharmaceuticals is an online international brand.  The traditional ground level medical representative oriented brick and mortar market brands like Glowdent continue their way.  Elsenz is also available in pharmacies.  Omnichannel marketing is happening for Elsenz.  

Has Elsenz shown the way forward?  However, Himalaya was the pioneer...

From the 1970s to 1990s to 2019 the pharma market has changed significantly.  Pharma marketers cannot operate today the way we operated in 1970s and 1990s.  The mindset has to change.  Digitalization of pharma is on, and the digital pharma company avatar is inevitable.

Disrupting distribution channel

While we are aware various disruptive distribution patterns are on to reach the consumer, here is MEDIBOX a B2B marketplace for OTX, OTC and Rx products connecting distributors and retailers.  https://www.medibox.in/

While many such entities are putting their plans to have their B2B marketplace, what if pharmaceutical companies launch their own distribution and fulfilment centers?  Eg., Cipla B2B marketplace for their entire range of branded generics promoted to doctors, branded and unbranded generics not promoted to doctors and other products.  What is stopping pharma companies adopting this e-commerce model?  HIMALAYA has already shown the way: you can buy their consumer products on their website HIMALAYA Liv 52 is already available on various e-commerce websites like netmeds and practo.  And yes, you can buy Liv 52 from their OFFICIAL HIMALAYA website too!! 

So get ready for a different inevitable digital pharma India!!

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Saturday, February 23, 2019

Awesome 'patientcentricity' through bottle-pack tablets

Pharma marketing domain is always in a flux.  With social media, internet and other IT enabled technologies drawing new contours, pharma marketing is now on a patient-centric mode. 

The Indian pharma marketing sector has gone through several phases:

a) MR-centric pharma marketing: this happened in the 1960s and 1970s, where the champions of pharma product sales was the MR (Medical Representative).  The MR enabled adoption of the marketed brand through his in-clinic activity, chiefly persuasive scientific detailing (with or without a visual aid).  The change-agent who transformed the sales of a pharma brand was the medical representative and his talent.  However, by early 1980s, it gave way to...

b) Chemist (pharmacy) - centric pharma marketing: With more MRs from newly launched companies entering the pharmaceutical market, to make a quick mark, some companies at first - and then more companies launched bonus offers to the pharmacies.  Hitherto, retail bonus offers was an unheard practice.  Many 'snooty companies' looked down on the practice of offering bonus offers to pharmacies during the initial time.  Later on, they too got down to business through retail bonus offers!

Dispensing doctors were also quick to take advantage of bonus free goods (eg., Manforce 1 box purchased + 2 Manforce boxes free to the pharmacy).  This also provided an incentive to pharmacies to substitute brands prescribed by the doctor.  Many other pharmacies started providing 'cash or kind' incentives to doctors practising nearby their medical shops (thus, the doctor would not mind brand substitution). 

Finally, in today's market, bonus offers or freebie goods is almost sine qua non.  This is to enable availability and prevent brand substitution.  Companies offer unofficial or official bonus offers or both, the entire retailer profession expects it.

The start of  'chemist-centric pharma marketing' was in the early 1980s (when as an industry observer stated: 'pharma companies slowly started mushrooming').

c) Doctor-centric pharma marketing:  It is a paradoxical phrase to state that the Indian pharma industry went through an intense phase of doctor-centricity (by its nature pharma marketing ought to be oriented towards prescribers and medical community, however, the focus on doctor-oriented services was and is so very intense, hence, the term doctor-centric pharma marketing to differentiate it from MR-centric pharma marketing). 

The MR in doctor-centric pharma marketing phase was (and is) more of a conduit to provide 'cash or kind incentives' to target doctors.  More than the MR's promotional skill, his or her ability to hook doctors to service offerings from the company became the decider of sales.  It is this practice that is now even more intensely pursued by PCD or propaganda cum distribution companies, in local markets.

The doctor-centric and chemist-centric phases in the pharma marketing sector overlap with each other.  The initial chemist-centric phase of the early 1980s became doctor-centric plus chemist-centric pharma marketing by late 1990s (upto present times 2018...).

In the MR-centric phase of the pharma marketing of 1960s and 1970s, the brightest of the academic talent took to this profession.  M Sc post-graduates, B Sc distinction and first-class students, with good personality, academic and extra-curricular profile were always preferred for the MR jobs.  This was perhaps upto the mid-1980s. However, with the advent of chemist-centric phase and doctor-centric phase in the pharma industry of  late 1980s and 1990s, right upto present times, input quality of medical representatives has seen a steady downhill.  MR's product promotional skill was not the most important quality, it was his ability to make the doctor accept the pharma company's value service offerings that took the front-seat.  The contacts of the MR with doctors was the most important aspect.

Thus, during stall activities, MRs serve coffee to doctors in stalls, MRs also offer personalised "concierge-like" services to key doctors and thus ensure prescription flow to target brands.  (In fact, I recollect a grumbling MR of a small local company who got a call from his target doctor at 11.00 pm, during 2012, asking him to come right away to a place near Jayanagar, where his car had a tyre puncture.  The doctor instructed the MR to take care of the situation and ensure the car was fixed.  The MR had to do it as part of 'customer relationship management').  Thus, CRM + retail bonus offers were more powerful demand-creating forces rather than the MR's product promotional talent.  The smaller the company, more the emphasis on CRM and retail bonus offer.  Rather, the MR's promotional talent was an enabler to obtain doctor's interest in the service offerings of the company.  Today, the situation is such: almost all pharma companies are into CRM + retail bonus offers + MR's product promotional talent to an extent. 

Due to the fact that marketing budgets are almost under strain, most of the marketing buck in companies, is now directed towards CRM services and freebie goods rather than on field personnel and development.  Gone are the days of 30 or 45 days training to MRs.  Today, most big companies manage just about 5 days after their induction and stay in the company for a month or more. 

In case, there are greater cash incentives to MRs, then it is a common market practice of the contemporary MR to invest a portion of his earnings towards personalised CRM for target doctors.

c) Patient-centric era in pharma marketing begins:  Below is the foto of Brilinta bottle pack.

WHAT IS INTERESTING ABOUT THIS PACK IS THAT BRILINTA OFFERS AN INTERESTING BONUS OFFER: 

120 TABLETS PLUS 60 TABLETS FREE!  AND THE FREE TABLETS GO TO THE PATIENT (as they are inside the bottle pack, and the freebie tablets are not enjoyed by the retailer).

This is hot news!  Many other pharma firms are trying to do this with strip packed tablets.  The results are a mixed bag.

However, the brand with bottle packing is where the patient-oriented freebie will work.

Imagine, Liv 52 tablets or Liv 52 DS tablets (positioned as a daily health supplement) (this iconic Ayurvedic 5th largest pharmaceutical brand of India is available in bottle packing), providing such a bonus offer: 100 tablets plus 25 tablets free (inbuilt in the bottle pack of Liv 52 tablets). 

Such an offer:

a) will cause a spike in purchase quantity
b) prevent the patient from moving away from Liv 52 to competitor brands like Adliv
c) ensure patient compliance is improved
d) provides improved health outcomes to patients
e) patient will experience a perceived difference in health due to better impact of medication

Bottle pack for tablets and capsules: the future?

If bottle pack of tablets or capsules is feasible then in-built patient-centric bonus offer or freebies will create an amazing demand for bottle packing. 

There is a distinct case for a bottle-pack for repeat purchase products like Becosules Z or Shelcal or Revital with in-built free tablet scheme (inside the bottle pack), this will ensure increased patient compliance.  Further, better health outcomes will foster loyal repurchases.

Repurchase: the true pivot of sustained success

Repurchase of pharmaceutical brands is the true pivot of sustained success.  Particularly for lifestyle medicines and products like vitamins, minerals, liver protective brands, and chronic therapy medicinal products - these gain commercial might only through patient-centered repurchase.  Mere repurchases by retailers will only increase shelf-stocking and display.  However, true repurchase is when the patient buys the brand repeatedly and loyally.  This is the fulcrum of authentic success.

Current pharmaceutical strategies are tied to the chemist-centric phase of pharma marketing where repurchase by retailers and wholesellers is encouraged.  However, this era is now in its decline phase (due to saturation and mature phase).  The era of enabling patient-centric repurchase has started.  Brilinta from AZ has sowed the seeds.

Brand communication to patients

In a patient-centric era of medicinal practice, social media is the major route for strengthening brand franchise by ceaselessly talking the health preposition of the brand. 

For example, Becosules Z ought to launch a continuous strategy of untiring communication through emails, viral whatsapp images, viral videos, facebook posts, and other social media messages that will create favourable impact.  We are amidst talk of digital addiction in society.  So, how can a pharma marketer ignore the digital format of product promotion?  It is about the right content, proper presentation and health platform that will work wonder for the digital strategy of a pharma marketer.

Another analogy would be of Liv 52 DS again, where concentrated messaging in the digital format takes place to target buyer (patient or non-patient) segments, on liver health.  Think liver health: think Liv 52.  Such an option will open doors to 'patientcentricity'.

When liquid bottle preparations are marketed, for example: non-alcoholic Elemental-F haematinic syrup, free 25 ml can be offered in the same bottle pack and the same highlighted on the label or by any other means on the pack.  This patient-centric freebie offer will improve sales of well-established products too.

Pediflor (Group Pharmaceuticals) is a toothpaste brand from a savvy digitally-wise company. 

This product is available for purchase through e-commerce websites.  Pediflor is having targeted messaging campaigns on facebook and other social media hang-outs.  Through, an integrated digital communication plan encompassing influencers like dentists, prospective buyer parents and kids themselves, Pediflor is a growing up to a new sales level!

On Amazon, Pediflor 70 g + 70 g - two packs at lowered prices is available.  This is taking the product to customers in a value added way.

Last word: It takes months to find a customer...seconds to lose one (Vince Lombardi).

The edifice of a business stands on customer acquisition and customer retention.  The patient is the most important customer in today's context, for a pharma company (it is patient-centric phase in pharma marketing), the doctor in the loop too is a vital influencer.  The chemist earlier held the key to sales.  Today, the empowered patient and customer/buyer is a vital entity to improved sales outcomes.  Out-of-box thinking and pragmatism ought to guide strategy, this is because the patient-centric phase in pharma marketing is sneakingly gaining traction!

Here is a closing limerick (enjoy it!):

Market tide

Market is awash with many a tide
Marketers can ill afford to hide
The real action is in the bazaar
We can't see it, if we are afar
Ride the market tide, be not by the side!

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