Pharma marketing (2.0) and the media: reading the tea leaves

Marketing plays an indispensable role in business operations. The unique binary orientation of marketing helps the sales force align with the market opportunities and at the same time, helps make the non-sales department employees develop sensitivity towards the customers. Thus, there is a two-way role of marketing – one directed inwards and another outwards - towards the market.

Media and marketing processes have an intimate relationship. One depends on the other. Media transports marketing messages, and in turn the media thrives on marketing support. Although, this is very evident in the case of non-pharma product promotion, Pharma product promotion too is heavily dependant on media.

Traditional Pharma marketing

Pharma marketing approaches are directed towards generating prescriptions and addressing OTC (over-the-counter) push and pull forces. The most common approach is use of human media. Medical Representatives typically carry messages to doctors, detailing products, and are responsible for ‘in-clinic’ activities. The in-clinic effectiveness is responsible for prescription generation and sales of Pharma products. In turn, MRs also transact with pharmacists to ensure product availability and influence OTC (over-the-counter) push and pull forces. In recent times, in-stall activities at medical symposias attended by doctors, have become influential to create demand for Pharma products.

In the case of USA and New Zealand, Pharma product promotion enjoys another avenue – DTC (Direct-to-customer) promotion. Advertisements in media directed to patients and caregivers are common in these countries. In the rest of the world, disease awareness marketing and therapy advertising help address the patient needs. DTC for drugs is disallowed. For eg., Schedule H and Schedule X drugs cannot be advertised as per the Drugs and Cosmetics Act, 1940, and the Drugs and Magic Remedies Objectionable Advertisements Act, 1955 in India.

The medium of printed materials is used extensively to support marketing communication activities in the form of literatures, mailers, advertisements in medical journals and magazines. Thus print media is very widely used too.

Pharma marketing 2.0!

The Internet era has revolutionized health and medical matters by putting out information in the reach of society. Web 2.0 developments such as blogs, message boards, social networking sites, newsletters, and other interactive components of the media have further revolutionized healthcare communication and marketing messaging. For eg. http://www.diabetesmine.com/ plays a major role in marketing concepts and ideas to diabetics. The distinctive feature of web 2.0 is that customers and other stakeholders are co-creators of marketing messages. Earlier in web 1.0, pharma companies would put a product website and messages as per their wisdom, and that was it. Web 2.0 goes beyond this phenomenon. Conversation marketing has come of age with prospects and customers across continents connecting to each other on Pharma products, concepts, experiences, and ideas. For instance, http://trusted.md/ is seriously in to creation of knowledge and software tools to empower patients for active healthcare decision-making. This approach has the potential to redefine the way patients connect to healthcare providers and thus access healthcare options. This is Pharma marketing 2.0 for you!

The convergence phenomenon, the web 2.0, and 3 G handsets beckon

Convergence technology is the future. The 3 G handsets are all set to rewrite the way we transact, particularly to meet health goals. Here is how convergence technology can impact the way Pharma marketers meet society’s health goals:

1) Web enabled community building initiatives centered around diseases or concepts will empower patients and care givers, such a community will significantly influence consumption of Pharma goods.
2) Internet telemedicine will pave the way for Internet telephony aided e-clinics and e-prescriptions. After all, what is stopping an Ayurvedic doctor sitting in Bangalore helping diagnose and prescribe to a patient in USA? E-clinics will enable such a reality.
3) E-clinics will lead to e-polyclinics: the concept here is an Internet enabled ensemble of online consultants from diverse specialties offering advice on health issues. This concept strengthens collaborative healthcare.
4) Holistic healthcare portals aiding healthcare consultation and advice including healthy food recipes. The portal will also aid meet the demand for alternative healthcare services like that of ayurvedacharyas, physiatrists, nutritionists, podiatrists, Health Counsel Providers (HCPs , about this concept there is more on this blog) etc.

The 3 G handsets have the potential to offer healthcare data and services like never before:

5) A parent can subscribe a free or Pharma Company sponsored mobile alert service for ensuring timely vaccinations for their children.

6) 3 G handset facilitated service that reminds the (obese or weight conscious) user through sms, on dietary restrictions, at an appropriate time of the day.

7) Mobile facilitated service on what medicines to carry and the type of clothing to carry/wear on a tour.

8) Companies can offer a service - an alert - such as this: a consumer or patient sends an sms STRESS to a number; in response the company sms says ASHVAGANDHA (Himalaya). This will facilitate the purchase of a product while offering value to the customer.

9) Mobile commerce is all set to redefine the way payments are made for purchase of healthcare products or for availing diagnostic services. This is the eCash concept.

10) Music therapy through mobile music concept.

11) Psychological & healthcare counseling (sponsored by Pharma companies and paid services – call charges can be higher) over 3 G handsets.

12) 3 G handset doubling up as instruments of body parameters – eg. Blood pressure, pulse, temperature, blood sugar etc.

13) Accessing an automatic emergency number through a single button on the 3 G handset for emergency medical services including calling for ambulance and advice on first aid matters.

14) Accessing health care search engines on the Internet for instant informed decision-making on purchase of health care and fitness equipment, dietary supplements, and other healthcare items.

Although convergence technology and the 3 G handset technologies seem to have a lot of potential, there is a note of caution at this site: http://www.emergic.org/

The convergence phenomenon is not just about convergence technology, but also the convergence of marketers and customers on a platform. Today, the customer is a co-creator in the marketing process. Blogs and message boards are reflective of the trend.

Today the customer is playing a key role in essaying the brand story telling process. So if a compelling marketing success is required, a key element of the same is customer centric conversational marketing. Traditionally, Pharma marketing, by the very nature of the medical professional being an informed target customer has indulged in dialogues with the target audience and hence conversational marketing. Today this has to be expanded to include other stakeholders since health is not only in the ken of doctors. The community is itself a custodian of health.

Although the nature of marketing and its complexities have changed over time, with technology and social changes bearing influences, the basics of marketing have not changed. From the enterprise perspective, marketing function is to identify and address market opportunities, create, communicate and deliver value to customers. In the Internet age, it has become CO-CREATE, communicate and deliver value to customers and other stakeholders. Marketing is a key force in demand management and increasing consumption. Marketing helps increase brand and corporate equity. In short, marketing is any activity that facilitates the SALE TRANSACTION.

Pharma marketing 2.0 will in a sense be a child of web 2.0, 3 G technologies, convergence technologies, mobile commerce and new media.

IMPORTANT NOTE: THIS BLOGPOST WAS POSTED AT 10.15 PM IST FROM MY SISTER'S HOUSE, ON FRIDAY.

Welcome to depression 2.0

The concept of depression 2.0

The P V Narasimha Rao Govt. ushered economic glasnost in India. The present Prime Minister of India, Mr. Manmohan Singh, was the Finance Minister then (check our Prime Minister’s biodata – CLICK HERE. No wonder, Mr. Singh is regarded a genius). It was, in fact, the challenging economic situation of India that goaded the Central Govt. of India to begin dismantling the license-permit-quota raj and start speeding economic liberalization.

Celebrated economist Ajit Ranade has written:

By the end of June 1991, foreign currency reserves had dwindled down to USD 975 million, hardly enough to pay for two weeks of imports. India had to ship part of her gold reserves and pledge it as collateral to be able to access the international overnight market and avoid a loan default. Export growth had turned negative and foreign commercial lenders had shut the door to India. Industrial growth was negative 1.3 per cent and inflation was soaring above 16 per cent. GDP growth for FY92 was less than 1 per cent. The predicament that India found herself during the summer of 1991 was the culmination of fiscal profligacy during the 1980s, and the legacy of inward looking and high cost import substitution policies combined with excessive controls followed in the past. The immediate trigger for the balance of payment crisis in 1991 was the oil price shock and sudden drying up of remittances from the Middle East caused by the gulf war. The situation was compounded by a quick succession of changing governments.

Ten years later in May 2001 the picture provides a sharp contrast. Foreign currency reserves are now USD 43 billion, equivalent of nine months of imports. The debt service ratio at 16 per cent is the lowest in ten years, the current account deficit is close to 1 per cent of GDP, and GDP growth is itself among the highest in the world, having
accelerated to 7.25 per cent by the mid 1990s. Foreign direct investment during the decade has been about USD 18 billion, and a much larger quantum stands approved. During this decade the economy has successfully withstood several harsh tests, which
included negative agricultural growth due to adverse weather (FY96), the Asian financial crisis during 1997-98, the international sanctions following India’s nuclear tests in 1998, and considerable volatility in world commodity and oil prices during 1998-2000.

(The complete article is availablehttp://www.abnamro.co.in/Research/pdf/decade-of-reforms.pdf.)

This economic resurgence of India (by the end of 2001) also coincided with the start of web 2.0 era (the web 2.0 era too is said to have started at the end of 2001).

(CLICK HERE for more on the web 2.0 concept)

So, to sum up, there are three cardinal forces that have shaped India in the recent past –

(a) Economic liberalization - authored by the World Bank, IMF and Govt. of India
(b) Social liberalization through the internet and media revolution, and
(c) The IT-software-BPO-KPO-telecom revolution, which created a grand socio-economic growth and boosted the purchasing power in India. The success of this segment has had a tremendous multiplier effect, on the socio-economic scene. For eg., during a journey recently, this month, by bus, from Hassan to Mysore, I happened to talk to an interesting gentleman, Mr. Venkatesh, my co-passenger, who was among various things such as a coffee planter, a micro artist too. This gentleman paints on raw rice grains. These are then sold as micro art abroad and to corporates like iGate for their corporate gifting activities. In fact, Mr. Venkatesh has named his firm TANDULA (this means rice grain in Sanskrit). Mr. Venkatesh is also a regular traveler to European countries to promote his micro art products. During conversations, Mr Venkatesh reiterated that the way foreign buyers and people interacted with him in 2000 and in say 2005 saw a sea of difference. In 2005 he observed that he commanded better attention with his European prospects thanks to the remarkable image of global India ushered in by the new economy companies. It is this multiplier effect both in India and abroad that the digital age companies have created.

These three cardinal forces have helped swell the numbers of the celebrated Indian middle class. The ‘middle class’ is indeed very important for the Indian society since it is the middle class people who supply the quality educated workforce, and they are the most important contributors of taxes to the Govt.

The above three cardinal forces have awakened Indians to competition and consumerism; dared Indians to dream and court despair too; compete, win, lose and hope... In this pot pourri of emotions a single strand of negative emotion is gaining currency – DEPRESSION. This clinical condition was certainly present in the pre-economic liberalization phase of India. However, it was hidden, neglected, shunned, under diagnosed, stigmatized, and never acknowledged unless it gained ‘schizophrenic proportions’ – pun intended. Today in digital era India, new trends are seen at the clinical and societal level. Chronic illnesses such as diabetes, cardiovascular diseases, geriatric diseases (dementia to arthritis), CNS ailments, anxiety, sadness and overwhelming sadness (or depression) - that are closely related to affluence, nuclear families, and a sedentary lifestyle - are overshadowing infectious diseases. And this new era of clinical depression in India has its genesis in the start of the economic liberalization process, which incidentally coincided with the start of web 2.0 revolution. So I reiterate WELCOME TO DEPRESSION 2.0 in India.

Rise and shine, dear Sertraline

Sertraline is an anti depressant. This molecule created a media sensation in India recently, with its rapid growth. Look at this report from the Times of India –

Not so long ago, men and women suffered depression silently. This appears to be changing — instead of getting bogged down by low moods, people are combating it to go ahead with their demanding, stress-laden lives. The result: there's a spurt in the sale of anti-depressant drugs.

Check this out — Dr Reddy's Lab, which makes bulk anti-dep drug Sertraline, recorded a stunning 258% increase in sales in 2005 –06. Sales of Sertraline for Dr Reddy's to major markets in India and worldwide, are pegged at Rs 50 crore alone in 2005-06. According to IMS data till January 2007, Sertraline is the fastest growing drug in the segment, showing over 40% sales growth for Pfizer and 16% for Unichem over the corresponding period last year. There are 8-10 brands marketing Sertraline in India, with Pfizer (Daxid) and Sun Pharma (Zosert) being major players. Overall, the Rs 300-crore anti-depressant market registered a growth of 12%, with Abbott's drug Prothiaden (Dothiapin) leading the pack with a market share of 6.1%. Industry sources say, with over 200 brands fighting for a share, the anti-depressant market has seen some aggressive and innovative promotion.

The panacea anti depressant (?)

For many decades in India we have had a topper pharma brand that also induces euphoria on misuse. This well-known brand is the Rs. 100 crore plus brand - COREX. The anti-tussive codeine phosphate is an important active ingredient in Corex. The other ingredient is the CNS depressant and antihistaminic chlorphenaramine maleate. This wiki: http://en.wikipedia.org/wiki/Corex reiterates the well-known truth about Corex – 90% of its sales in India come over-the-counter and not via prescriptions, although Corex is technically a prescribed medicine. This also reiterates one of the home truths of the great Indian pharma market. The reality is that the Indian pharma market is OTX (over-the-counter plus prescriptions). Market savvy companies like Mankind and Laborate have understood this undiluted reality and are registering scorching growth. Micro Labs, Bangalore, Ranbaxy, and Cipla are past masters in the operations of this complex OTX pharma Indian market. Nevertheless, success of Corex as the top most brand of India is an anachronism in the practice of 21st century modern allopathic medical science. It is a wonder Govt. authorities and NGOs in India have not asked – aren’t there any better alternatives to codeine phosphate syrup as an anti-tussive. I can volunteer a safer alternative of the semi synthetic narcotic class – dextromethorphan HBr. Innovator company Pfizer, markets Corex in India, Pakistan, Bangladesh, and a few South Asian countries - http://en.wikipedia.org/wiki/Corex - (we are the lucky few). Why is Corex not a # 1 brand in European countries or USA? Why are the patients of USA denied the benefits of Corex for the management of dry cough? Oh, may be there is more of productive cough there. Corex has had a safe run unlike nimesulide, which apparently, in hindsight, ran in to unjustified rough weather on an allegedly extraordinarily worrisome adverse effect profile. Right now, both Corex and nimesulide are doing very well in the great Indian pharma market.

Codeine phosphate is an opiate, well absorbed by the GIT, undergoes very less first-pass metabolism in the liver (morphine undergoes extensive first-pass metabolism) and interacts with the mu receptors of the brain giving the same CNS effects of morphine – creates a sense of contentment. Codeine gets converted to morphine in the brain. You will enjoy reading more on codeine phosphate here: http://opioids.com/codeine/codeinefaq.html

Now the question is - did Corex syrup create a sense of contentment in the era of depression 1.0 (?). That is a question to mull over.

High potential for HCPs

Big money wants more money. If depression 2.0 is a goldmine opportunity for pharma companies, lifestyle change promotion is the last thing on the mind of big money. It is going to be sertraline promotion all the way – and for the less privileged it is glug-glug.

So who will fill the void in helping patients make active informed decisions about depression management? I still would say health counsel providers (HCPs). For eg., yoga has profound positive influence in depression management. And so do some ayurvedic drugs like tagara, ashvagandha, brahmi…

In the Times Wellness section of The Times of India, Bangalore dated 19.5.2007; there is a report that Bangalore alone has 6000 cases of brain tumor. The report shows that brain tumor diagnosis can be tricky as the signs are often subtle. So this is where HCPs can step in aiding patients and guiding them to appropriate specialists.

The 3 G (third generation) mobile technology mainly based on the CDMA 2000 and wideband CDMA are rewriting convergence. A 3 G handset in the near future will allow users to talk, and obtain services like news, music, games, ticker services, streaming music, weather, videos, movies or audio books. Now you can also add the possibility of health counsel. For eg. Dr. Nikil Jain, CTO, Qualcomm India (reference – Business Standard, Weekend section, 19/5/2007 & 20/5/2007) says: “Men and women could probably seek visually interactive medical aid at the press of the button”. Now that is the eHCP (electronic HCP) like the eMR concept that was seen in an earlier blogpost.

Closing remarks:

The depression 2.0 period has begun in India. While sertraline and other anti depressant drugs look to have a rosy future, Indians with their long tradition of Yoga, spirituality, innate love and respect to traditions and elders, and Ayurveda will certainly look for lifestyle modifications. In essence the Gen X and Gen Y will rediscover their roots. Ancient India resurfaces.

Want to take a online test for depression? CLICK HERE. No wonder I call it depression 2.0!

(Thnks for the very warm appreciative comments on the blogpost COFFEE WITH DR. RANGESH, please also read all other blogposts. sunilchiplunkar@gmail.com)

COFFEE WITH DR. RANGESH

In the above photographs you can see Dr. Rangesh and his family. Dr. Rangesh reiterates that his wife is a pillar of support and his children inspire him. Read about him on this blog post. Enjoy and get inspired!

It was a warm late evening on 10th May, 2007, when Dr. Rangesh and I entered Café Coffee Day at Rajajinagar (opp. Shri Raghavendra Math, Dr. Rajkumar Road, Bangalore) for tête-à-tête over a cup of coffee. It was indeed a pleasure and honor to spend some time with Dr. Rangesh Parmesh MD. A down-to-earth scholarly and pious person, Dr. Rangesh is an MD in Ayurveda. He is now with The Himalaya Drug Co., Bangalore as a Senior Medical Advisor. Mr. Nikhil Shirali another senior manager at Himalaya describes Dr. Rangesh as a true Himalayan! In the past, Dr. Rangesh has served as a well acclaimed teacher of Ayurveda at two Govt. Ayurveda colleges - in Bangalore and Mysore. Dr. Rangesh has guided more than 20 research projects. He is an Ayurveda Consultant Physician in Switzerland and Germany too. He conducts regular seminars in Germany for physicians practicing western medicine. He has been a resource scientist of the company to address target audiences in public forums, physician associations, and pharmacists, sales executives in South East Asia, Latin America, Pacific, Middle East, China and Mongolia. He has been a Resource Person and Presenter of various Radio Talks and Television Serials on Medicinal Plants and Health related topics in Ayurveda for lay public. Presently he is also a ‘Radio Doctor’ at All India Radio, Bangalore. Our lovable doctor has many more feathers in his cap, and for me it was a great joy to share his insights on health and Ayurveda - over a cup of good coffee.

Interestingly, Dr. Rangesh does not drink coffee or tea! Dr. Rangesh drank a rasayana of hot water with lime at Café Coffee Day!

Sunil: Sipping coffee with you at Café Coffee Day! It is indeed a moment to treasure!

Dr. Rangesh: It is my pleasure!

Sunil: How did you get in to Ayurveda? Allopathy is usually the first choice of medical aspirants!

Dr. Rangesh: It is thanks to my father that I am in to Ayurveda. When I was very young, my father suffered from duodenal ulcer and was recommended for surgery. However, one Ayurved physician known to my father intervened and helped heal my father’s duodenal ulcers and avoid surgery. It was my father and this elderly doctor, who motivated me to take to Ayurveda.

Sunil: What is your philosophy of medical practice?

Dr. Rangesh: It is as you say practice – this means we are constantly contributing our learning to patients and at the same time self-learning takes place continuously. I follow Charaka’s principles of medical practice – 20% for the sake of the profession, 20% for friendship or relationship, 20% for wealth, 20% for fame, and 20% for ‘practicing the practice’ – it is a lifelong learning process. While I counsel and treat patients, I follow Charaka who has advised doctors to consider patients as children or disciples.

Patient counseling is very important and it ought to be a two-way traffic while communicating with patients. Patient counseling is important to ensure a patient gets confidence and knowledge of his health status; the doctor gets the right data on the signs and symptoms.

Sunil: So that is why, I guess, you were very happy with my blog post on the HCP (Health Counsel Provider) concept. And I express my thanks to you for the affectionate feedback.

(Dr. Rangesh after reading the post on the HCP concept had replied to me thus by e-mail:

Dear Mr. Chiplunkar,
FANTASTIC CONCEPT!!!! This is what I have endeavoured for >25 years of my Ayurveda practice in trying to help patients take informed decisions than selling or prescribing a medicine or a remedy. Although I did it for charity with a profound faith in the statement of Vagbhata - "naarthartham naapi kaamartham atha bhuta dayamprati" i.e this medical profession was neither for money nor for desire, but for the concern and care of the unwell.
I am simply moved by your tremendous vision of introducing the HCP concept, indeed a unique one and my dream as well for the rest of my life after my encumbrances are over.
With kind regards,Yours truly, Dr. Rangesh.)

Dr. Rangesh: Yes of course, moreover, patients are also ‘my teachers’ when I practice. You see each case is individual and unique, and we learn from each case. That is why we say doctors ‘practice’ and not do a job! Secondly, through patient counseling ‘lifestyle management’ is possible. Today, lifestyle management is the in-thing and WHO also talks about lifestyle management. However, Ayurveda has always believed in lifestyle management from time immemorial.

Sunil: Lifestyle disorders today include obesity, stress, hypertension, diabetes, and even infertility in women and men (due to stress)!

Dr. Rangesh: Ayurveda uses a multipronged approach including Ayurvedic drugs, and patient counseling for lifestyle disease management. Recently my talks at TCS were met with great success, when I addressed software engineers on lifestyle management (some listeners were even standing as the seats in the hall were full!) – the audience listened with rapt attention for over one hour! That is thanks to Ayurveda and its emphasis on holistic healing.

Sunil: Do you see the potential for the HCP concept as a call centre activity ie. as a KPO (Knowledge Process Outsourcing)?

Dr. Rangesh: Surely – like a BPO (Business Process Outsourcing). It is better to use internet telephony for communication while handling calls or the e-mail queries on health related matters.

Sunil: In fact in response to an article The Art of Health-Knowledge Creation, Evolution and Use by Dr. Steve Beller, on his web site, I had left a comment on the HCP concept on his web site. Dr. Beller was enthusiastic about the HCP concept and he has commented thus:

YES!!! HCPs are an essential element ... and they ought to be assisted with a new generation of knowledge tools!
In fact, for the past six months, we have been developing a very similar concept and are building a business plan to turn it into a reality. These prior posts give insights into our vision:Informing and empowering the modern customer and Personal Health Applications I'm eager to go to your blog, Sunil, to learn more your concept and engage.
Steve Beller, PhD

http://wellness.wikispaces.com

So what I infer is that there is space for the HCP concept and it will require certain tools, software, and an organized knowledge database for taking the HCP idea from concept to reality.

Dr. Steve in his article ‘informing and empowering the modern consumer’ has hit the nail on the head and sets the ground for the HCP (Health Counsel Provider) concept.

Further, there is an interesting web development: http://wellness.wikispaces.com . This web site is hosted by Dr. Steve and I feel it can translate in to a KPO/BPO Health Counsel Provider center like a call center in its physical form. The revenue for the same can come from calling charges or sponsorships. Moreover, in the above web site Dr. Steve has done a lot of in – depth planning and given a structure or road map for such a health service.

Mayo clinic has also done a good deal of effort in empowerment of patients through their website: http://www.mayoclinic.com/ . There are a lot of health knowledge tools including ones on Alternative medicines and complementary therapies in this Mayo Clinic web site. I would even suggest a Mayo Clinic BPO for handling patient queries through trained HCPs (certified by Mayo Clinic)! The knowledge base on healthcare matters, put in to public domain, by the Mayo Clinic is truly enormous.

Moreover, nowadays, podcasts are redefining the potential for patient counseling and I have listened to podcasts by BBC and Mayo Clinic on health matters. They are impressive.

In fact, Google with its avowed objective to organize human knowledge has done superbly with its services such as the Google search engine, news-search engine, etc however they can make a ‘health search and patient empowerment engine’ too since health is a subject that shows high information search behavior.

Sunil (continues): Dr., now let’s discuss some thing on Rasayana or the Ayurvedic rejuvenation therapy. In today’s lifestyle related diseases like stress and other pathological manifestations like diabetes, hypertension etc; they do require a lot of rejuvenative therapies don’t they?

Dr. Rangesh: Sure, the greatest contribution of Ayurveda in modern day dimensions is rasayana or rejuvenation (very intimately related to geriatrics) and vajeekarana (sexual rejuvenation or reproductive medicine).

Sunil: I was also wondering if it would not be a good idea to have a Rasayana dept. for convalescents and the aged in each and every hospital – whether allopathic or ayurvedic.

Dr. Rangesh: This will be the greatest happening in modern day times. In fact, with medical tourism in full swing in India, we can add the rasayana therapy touch and this will lend value to medical allopathic treatment plans.

Sunil: I feel one approach we could try would be to have a panel of Ayurvedic experts working to make presentations to hospital administrators to influence them to set up rasayana depts. in hospitals. For eg., if Manipal Hospital, Mallya Hospital, and Narayana Hrudayalaya have such rasayana depts., Ayurveda would get a great boost! This concept of rasayana in Allopathic hospitals would lend a USP (or Unique Selling Preposition) to the allopathic hospitals when they market their hospital abroad. Further, Ayurvedic companies can also step in by setting up sponsored rasayana depts. in hospitals so that the concept of Ayurveda itself gets strengthened and consequently the sales of Ayurvedic products.

Dr., I also see a lot of potential for the kashaya concept too.

Dr. Rangesh: Kashayas have a vital role for well-being, health protection and wellness. In fact, I personally recommend it as a substitute for even coffee and tea drinking. For the benefit of readers I would like to offer a kashaya recipe for regular drinking:

Kashaya recipe:
Rejuvenating Rasayana Drink
In a heavy saucepan, bring to a boil:
½ -cup whole milk
½ -cup water
1 ½ -teaspoon sugar
1 ¼ -tsf ground raisin
1 ¼ -tsf ground dates
½ tsf fresh grated ginger
¼ tsf Ashvagandha root# powder
¼ tsf Satavari root^ powder
Cover, turn the heat to low, and simmer for about 2 minutes. Strain into a teapot, pitcher, or directly into a cup. Add 5 – 10 drops of Saffron water* to the serving cups on the top.

*To make Saffron water, ½ teaspoon ground saffron dissolved in 6 tablespoons hot water.
# The dried roots of Withania sominifera also known as Winter cherry roots
^ The dried roots of Asparagus racemosus also known as Wild Asparagus roots.

Category Drink
Servings 1 cup
Serving Size 207 ml / 7 fl. Oz.
Calories 102
Protein 3 g
Fat 2.8 g
Carbohydrates 15 g

This drink is not only a rejuvenating one but also an Adaptogenic tonic, which helps fight stress, fatigue, low immunity, common cold, and sleep disturbances.

Sunil: As a marketing person, I can’t help commenting that it would be purposeful to set up a dedicated KASHAYA TEAM of thought leaders like you and the objective of this team would be to make influential presentations to math leaders, and hoteliers like Adigas, and the Shanti Sagar network in Bangalore. The math leaders can recommend kashaya drinking in society while hoteliers can offer the kashaya drink in their hotels just as they sell coffee and tea drinks. In future posts I hope I will be able to present some concrete achievements on this front.

Dr. Rangesh: Sure I am also enthused by these marketing concepts and let us do some concrete work on the same.

Sunil: Dr. Rangesh, many thanks for this conversation and your co-operation. With all sincerity and respects I wish you well in your endeavors and your personal life.

Dr. Rangesh: My pleasure! And thanks Sunil – you are doing a good job in your blog. It is very innovative. Keep it up!

(Note: This blog is published at 7.50 PM IST on 15.5.2007)

A novel concept: HCP

Market dynamics ensure nothing is static. This is why opportunity knocks - but does not linger! Here is an exciting new concept of business - HCP or Health Counsel Provider (ideated by me this weekend). To get a hang of this concept, just read the hypothetical conversation below:

Patient (P): Hi! I was passing by, couldn't help noticing your board NUPATH HEALTH COUNSEL CENTER. So what do you do here?

Health Counsellor (HC): Hi! Welcome to Nupath Health Counsel Center, Helping patients take informed decisions. As you can observe, we are a patient empowerment agency. We believe the days of blind faith in the neighbourhood doctor are over! This is the age of information. Health related decisions are increasingly information search oriented. Patients look for unbiased health information and therapy options. We provide this here at this center and we fill the information void in a patient's life. Our health counsellors provide private, confidential information service and thus help patients' take informed decisions regarding therapy and other health related matters. We are a Health Counsel Provider - you can trust us. We build confidence in patients and empower patients with information and direction.

P: Sounds interesting, can you illustrate?

HC: Sure! Is there any health issue that interests you?

P: Yeah! Actually I am a diabetic...

HC: Come let us sit and go through your needs in a seperate confidential cabin. (HC leads P to a cabin; the cabin is well appointed, has comfortable chairs, a desk, a LCD projector and screen, laptop linked to internet and a good audio system).

HC: How did you get diagnosed?

P: I would feel giddy many times, was irritable and would feel very tired after work, when I returned home. So I went to the neighborhood doctor, he did blood tests and so on and diagnosed me as diabetic. Right now I am on oral antidiabetic drugs, but he was saying that I may have to start with insulin therapy.

HC: Was it all as easy as you say?

P: No actually, I was disappointed, felt sad, and even scared as I recollected my couzin who died of kidney damage. He was a diabetic.

HC: (puts the LCD projector on and taps his laptop) Well, don't worry much - you are one of the 20 million diabetics in India and you will be surprised to note India has the maximum number of diabetics - even more than China, which is the most populous country in the world. Let us watch this short film on diabetes.

P: (after watching the interesting film, looks impressed and interested). So diabetes is controllable and we got to be careful of diabetic complications. The video was informative and motivating. So do I have to get on insulin - do any nutritional supplements work?

HC: The doctor will decide on the therapy. However, I should say there are a number of nutritional supplements, ayurvedic approaches, and homeopathic drugs in this sector. (Shows a book containing various dietary supplements pack shots with composition).

P: Can I meet an Ayurvedic doctor?

HC: Sure we have a panel of doctors, not in this building, but we can refer you to them. Meet and discuss with an Ayurvedic doctor on the right approaches, inform him that you are on allopathic drugs.

The discussion continues where the HC highlights the basics of Ayurveda and some herbs like Karela, and Meshashringi that are helpful. The patient is very interested and feels empowered. He gets information on nutrition and gets to connect to a nutritionist too.

P: So you kind of play a strategic role - sort of friend, philosopher and guide on health and therapy!

HC: We help patients realize his or her health goals by informing and helping the patient connect with different healthcare providers and other resources that society provides.

For eg., many arthritic patients have benefited through our counselling on supportive nutritional supplements and informing about physiotherapy. In fact, through physiotherapy the benefits have been radical! I also remember a patient with low back pain who took to Yoga through our counselling efforts and today his drug usage and supportive belt has come to almost nil!

P: So from here I not only gain knowledge or rather make some sense of all the health information, I get to discuss my health goals and even connect to various therapies and specialities!

HC: Sure from here you can connect to physiotherapists, spiritualists, Chinese Traditional Medicine experts, Yoga experts, Tibetan Medicine experts, Ayurveds, Allopaths, Homeopaths, nutritionists, Siddha and Unani experts and all types of experts who will help you reach your health goals. We can inform you on aromatherapy, color therapy , gem therapy, astrologers and so on and help you realize your health goals by connecting you to experts in these fields.

P: So how do you earn?

HC: Our revenues come from (a) the patient since he pays us based on the counselling provided (by us); (b) we get 20% commission of the fees you pay to the experts you visit (only the first time) and we have taken adequate safegaurds so we don't get cheated! In fact, we have a long term relationship with our patients so they are honest too (c) our HCP offers a pharmacy (allopathic drugs, ayurvedic drugs, homeo drugs, nutritional supplements etc) and fitness equipment including special diabetic and ortho supports are available under a single roof. We also have diagnostic lab facility here. We also sell health related books, CDs etc.

Actually we HCPs have an association now, with a code of conduct, a self - regulatory framework is in place. Some of the dos and donts are -

a) We present facts without bias

b) We do not talk ill of any therapy nor do we promote specific therapies or products

c) We endeavor to demystify and present health, disease and therapy data in an easily understandable fashion, to help patients take informed decisions

d) We charge consultancy fees and obtain reference fees from experts or doctors

e) We are commited to transparency in our dealings, yet we maintain strict confidentiality on patient related matters

f) We abide by the laws of the land

g) We pray for patient well being.

We have done very good stuff here - elderly patients have benefited for management of conditions like BPH and forgetfulness through our counselling and their informed decision making regarding dietary supplements like brahmi, and saw palmetto. In fact on our counselling they have also joined laughter therapy groups. Through counselling from us patients have learnt about pranayama and this has benefitted patients immensely.

We even offer telemedicine facilities, patients can transfer medical records via satellite for second opinions from experts based at remote locations.

In fact, our leads regarding ganoderma that is sold via direct selling agents has helped many diabetics and hypercholesterolemia patients.

Some patients have gained positive results from homeopathic treatment based on leads given by us.

We have an interesting project on now: a guy from a NGO had come for his personal couselling needs. We then got talking on various issues. He was fascinated by the information provided by us that Moringa oleifera (or drumstick) leaves are very nutritious. Drumstick plants are hardy and easy to grow. So we helped him connect to agri experts and today the NGO promotes cultivation and consumption of drumstick leaves in the backward and interior districts of North Karnataka, Orissa and West Bengal to improve the health status of particularly children and men.

We have patient education seminars on topics like AIDS (just joking - we are trying to get Richard Gere and Shilpa Shetty in this session), Botox, gastric bypass surgery, Pen insulin, Exubera, ED, Viagra and other topics. We conduct health camps outside and send out newsletters.

Patients have benefited immensely with our counsel on Ayurvedic massage and Rasayana or rejuvenation concepts.

Many big pharmacies and hospitals have added HCP (Health Counsel Provider) departments.

So that's Nupath Health Counsel Center, Helping patients take informed decisions.

P: What if the patient gets confused with all this information here!

HC: Oh! No! He dosen't, we ensure that. What we do is that we counsel him or her and the patient creates a ROAD MAP that suits him to achieve his health goals. There is no hard sell here - only counsel.

P: Thanks!That was a great session!! I will tell my friends, relatives and family about HCPs and Nupath. You guys are doing a great job here.

HC: We encourage you to bring your acquaintances here to meet their healthcare needs and take informed decisions so as to achieve their health goals. Here is a free coupon for you. If you bring an acquantance here the next time for counselling, you can get your blood sugar checked here for free in exchange for this coupon.

As you will observe the above conversation is hypothetical and exposes the concept of HCP. This is a novel business idea. Do you think there is steam in this idea? I think there is viability in the novel business concept of HCP (Health Counsel Provider).

There are more interesting concepts - so scroll down and read them all! sunilchiplunkar@gmail.com (Mob.: 9980800023)