FUNCTIONAL FOODS: future perfect

Functional foods and nutraceuticals

Human quest for the disease free body and mind is eternal. It is an innate instinct of humans to be healthy, beautiful, and young. The quest for eternal health and beauty is timeless.

Sickness management is the typical healthcare business. Pharmaceuticals and medical services concentrate on delivering value to sick persons. Healing is the goal of such healthcare activities.

The value offered by functional foods and nutraceuticals is not limited to sickness management. These entities have emphasis on wellness management too. The role play of functional foods is beyond clinical management to the ambit of day-to-day healthcare management with preventive properties.

Here is a review on functional foods:

Functional foods are foods designed to provide a specific and beneficial physiological effect on health, performance and/or well-being extending beyond the provision of simple nutrients. The effect should be documented scientifically.

The functional food concept stretches the borders of nutrition. Whereas classical nutrition focuses on essential nutrients and their significance regarding diseases due to deficiency, functional food science focuses on the physiological effects. These effects may be mediated by nutrients, but also by non-nutrients such as dietary fibre and various bioactive compounds, as well as by probiotics and other food qualities, e.g. structural properties.

Functional food science deals with knowledge providing opportunity to prevent diet-related diseases, e.g. metabolic syndrome, type II diabetes, coronary heart disease, obesity, hypertension, certain types of cancer, gastrointestinal diseases and osteoporosis.

Functional food science also includes knowledge on the positive effects on physical and psychological performance, e.g. cognitive function.

Nutraceuticals:

The term "nutraceutical" was coined from "nutrition" and "pharmaceutical" in 1989 by Stephen DeFelice, MD, founder and chairman of the Foundation for Innovation in Medicine (FIM), Cranford, NJ.¹ According to DeFelice, nutraceutical can be defined as, "a food (or part of a food) that provides medical or health benefits, including the prevention and/or treatment of a disease.

In one sense, we can use the two words nutraceuticals and functional foods interchangeably.

Functional foods industry: a sunrise sector in India

India is at a tipping point for creation of a robust functional food industry. There is hectic activity in the healthcare food biz space. The functional foods industry is said to comprise of functional beverages and teas, fortified cereals and breads, soya foods, functional snacks and candies, and miscellaneous foods (like cholesterol lowering enriched foods and other functional processed foods).

Pharma companies have traditionally played a role in pioneering health food marketing – under the banner of food supplements. Complan, the range of products (B-Protin, Pulmocare, D-Protin, Menopro etc) from British Biologicals, and other food supplements from Novartis and Wockhardt are already in the ethical (ie. Promotion of products for prescriptions) food supplement space.

Thus, based on the marketing formats, we have two distinct groups of health foods:

a) Those that are promoted directly to consumers eg.: Amul range of products (including probiotics) and malted beverages (like Horlicks, Complan etc)

b) Those that are promoted to doctors for prescription support (ethical promotion)

So which marketing format do we use?

India is at an exciting phase in its economic situation. The per capita income is up leading to greater healthcare spends (in fact more than that for apparel). The healthcare boom is set to gain strength. In fact, The Times of India, dated - 13.8.2007, has reported that the maverick serial entrepreneur C Sivasankaran who has the uncanny ability to spot a trend before it becomes a mainstream business is said to enter the healthcare biz. Rumors are that he will import olive oil from Jordan, and promote it as a cooking medium in India from Jan 2008. Similarly, the Bangalore based bio-nutritional company Avesthagen backed by big names like Godrej and Tatas, is slowly yet surely developing products for the healthcare market. Nestle and Avesthagen are working on futuristic products for the diabetic market (India has the unfortunate distinction of being the diabetic capital of India). Danone and Avesthagen are co-ordinating efforts for bolstering the organic food brand Stonyfield. Avesthagen’s division, Avesta Good Earth is looking for further strengthening its muesli bars, cereals and crackers.

Thus, the question bugging functional food marketers and entrepreneurs is which marketing format do we use? The marketer can either promote products to doctors (as healthcare foods or nutraceuticals or food supplements) for prescription support or advertise and market the produce to end consumers.

The OTX marketing route is an interesting one

Marketing to doctors alone is becoming that more difficult. There are no doubt, some 11 lakh doctors and 3 lakh odd chemists. But there are also 1,25,000 Medical Representatives wooing the doctors. There is brand clutter at both the doctor’s end and chemists. Brand differentiation based on ingredient differentiation alone is not winning the battle for mindshare, chemist retail space, and prescription share.

The importance of doctors lies in the fact that they are very important opinion builders for healthcare products. Thus, it is perilous to ignore doctors while building the market for healthcare products.

The other emerging market is the OTX market (a combination market in which products are promoted to doctors and simultaneously promoted subtly to the end consumer through the doctors). This can be through interesting in-clinic activities where the product is connected to patients through the doctors. For eg. for Vicks Vaporub, one can organize talks on touch therapy for patients by the doctor (in his or her clinic) and subtly Vicks Vaporub can be promoted. Similarly, Pediasure can organize for direct-to-consumer product promotion through in-clinic activities.

The other component of OTX marketing is through attractive in-pharmacy activities. Tying up product promotional activities with chains like Manipal Cure and Care or Trust is a win-win situation for the company and the retailer (who benefits through increased footfalls and increased noise level in the market for his pharmacy).

The OTX marketing route is an emerging trend keeping in line with the increasing end consumer consciousness on healthcare, and cashing in on the potential of doctors and pharmacists as opinion builders for healthcare products. The OTX marketing route seems to be the best suitor among various marketing approaches for the new age healthcare functional foods in the first phase of the launch process. The new launches can later be taken to the nonchemist retailers after consolidating the sales base at pharmacies. This will help the new launch functional foods dominate the continuum of the healthcare market.

This blogpost is very interesting isn’t it? Please do read all other blogposts including the older ones as they are all very interesting. Thnks. I am Sunil S Chiplunkar, sunilchiplunkar@gmail.com Ph.: 9448216237. This blogpost is dedicated to Avesthagen. The photo of the founder Dr. Patell is shown in this blogpost.

DEMOGRAPHICS AND GENERATIONAL HEALTHCARE MARKETING

Demographics

Demographics is an approach to grouping of prospects or customers based on certain characteristics. The demographic data is a very vital tool for target specific marketing strategies and approaches, and thereby gain the best bang for the buck. For eg., one can group GPs (General Practitioners) based on whether they are in the age group of 40 plus years or below 40 years. One can develop a separate marketing model for the 40 + age group – promoting brands that are well established in line with their conservative thinking, and introduce newer brands to the aggressive yet cautious below 40 years GPs.

Demographic trend data gathers information on a population group over time.

For marketers (including Pharma marketers) the most populous age groups shape the marketing environment. For eg. Mexico has a young population, thus the important products for marketing are milk, diapers, and toys. Japan is an older population, and thus adult products have a bigger market here - including anti aging products like bioactive-based nutraceuticals and functional foods; Japan is one of the biggest markets in the world for nutraceuticals. If the genetic characteristic is taken in to consideration, then India is the largest market for anti diabetic products, as the genetic susceptibility to diabetes is very high for Indians. Already, India has the unfortunate distinction of being the diabetes capital of the world. Thus, Pharma marketers will get the best business results by understanding the nature of the market including the demographics.

A glimpse of demographics

The marketing guru Philip Kotler, in the book Marketing Management, Millennium edition, p.no.141, describes some cohorts or groups of significance in USA, to marketers.

a) Those born between 1946 and 1964 are described as “baby boomers”. They are about 78 million people and one of the most powerful forces shaping the US marketplace. The baby boomers grew up with TV advertising and thus very receptive to healthcare DTC (direct to consumer) TV product promotion.

b) Those born between 1965 to 1976, are the Generation X (also called shadow generation and baby busters). There are some 45 million of them in USA.

c) The third cohort is the baby boomlet generation born between 1977 and 1994; they are about 72 million strong, and a very important group. This generation has grown up with computers and digital technology, and thus they are very receptive internet based product promotion, and digital savvy messaging.

Groupings based on significant events in a time frame

One the most common ways of developing cohorts or groups is based on significant happenings in the environment that has influenced thinking and thus generated commonalities for grouping. For eg., those in the 20s who experienced the Great Economic Depression in the USA form a group with certain common characteristics that can be taken in to cognizance by the Pharma marketer while strategizing.

In India, June 1991 was a tipping point

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

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 complete article of above extract is available http://www.abnamro.co.in/Research/pdf/decade-of-reforms.pdf)

Those born in 1991 are about 16 years now, and raring to go. They see a different India. Those who have started their careers before 1991 would remember the difficulty in getting credit, home loans, and other personal loans. Today internet, web 2.0, capital formation, economic liberalization, death of the license-permit-quota raj (the death took place in June 1991), and the IT-ITES-BPO-KPO sector have created a totally new India for the educated, particularly in the semi rural and urban regions of India: India shining – India leading – India positive.

The aspirations and characteristics of the generation born in the year 1991 or after 1991 are different. Their healthcare requirements are consequently different. They look for value added healthcare services and products. Wellness management is their need, and not just sickness management.

Similarly, the demographics of Kerala based doctors are different. Kerala (is a state of India) gives better recognition and reception for wellness and natural based products (like Ayurvedic drugs). Thus, product-positioning approaches for the states of Kerala and Delhi would vary.

The competitive era created through economic liberalization in India has created a better market for products that promote mental well-being, and stress management. Click to this link for an exciting concept on Depression 2.0: http://pharmaceuticalshealthcare.blogspot.com/2007/05/welcome-to-depression-20.html

Demographic data or group behavior data of patients, and doctors is a very critical insight that helps shape more potent marketing strategies.

Thank you for reading this post. Please go through all other posts including the older posts as they are worth it.

JAI HIND: today is 60th anniversary of Indian Independence

Today is the sixtieth anniversary of Indian Independence. It was a historic and unique struggle for gaining Independence from British colonial rulers. Mahatma Gandhiji helped inspire a freedom struggle based on the principles of non-violence and non-co-operation with the British.

Today, although there are a lot of pluses for us in India, there are a lot of minuses too. Perhaps we have carried on the non-co-operation bit too far – even after gaining Independence we are not co-operating with each other for the progress of our country! Nepotism and corruption are bhai-bhai with India! Gandhiji probably is still saying Hey Ram! at the state of India from the heavens.

On the healthcare front, India is promising to make history. This is thanks to India’s talent pool, and the fortitude of the post reform generation (a new Indian spirit was created after June1991 when the balance of payment crisis authored the economic reforms). The foreign exchange crisis of June 1991 was a blessing in disguise as it gave way to market reforms and a new Indian spirit was born. The license-permit-quota raj went to hell. Please also see: http://pharmaceuticalshealthcare.blogspot.com/2007/05/welcome-to-depression-20.html This new Indian spirit and the post – 1991 generation is giving rise to a new India. This generation has also helped India rise in the BPO-IT-ITES revolution. Now the great Indian spirit is on the anvil of writing a KPO success story too.

It is mainly USA and then Europe that has helped India in this new resurgence through mutually beneficial commercial ties. On behalf of all Indians I thank all world citizens for co-operating with the growth of India. In this era of collaborations and a wikiworld, we need to strengthen the bonds further for mutual progress. Long live Indo- US friendship and global goodwill.

India is continuing its journey of strengthening healthcare: http://www.expresshealthcaremgmt.com/200605/market01.shtml

India will contribute the world through indigenous systems of medicine, medi-tourism, KPO activities in the healthcare space, high quality and cheap generics, medical transcription, nursing and other professionals, and a new collaborative Indian R & D in pharmaceuticals and healthcare. Everyone in the world are having a CHINDIA (China and India) strategy. There is immense potential for Indo-US collaboration in the healthcare sphere. 80% of the Indian healthcare needs are met through private resources.

We are one with the world, we love the world, and the world loves us. JAI HIND.

This blogpost is done from the nearby cybercentre. Today is 15th AUG 2007 and the time of putting up the blogpost is 7.55 pm. (I have certain mixed emotions may be I will reveal them later on another blogpost.) Please read all other blogposts too.

Healthcare DTC promotion through pharmacies (in-pharmacy activities)

The power of the Pharmacist

In India, sales in the Pharma market, is heavily influenced by the medical shop owners (also called chemist shops or Pharmacies). In fact, the alleged bane of the Indian Pharma Market is that Pharmacists behave more as traders, than healthcare professionals. Brand substitution and OTC (over-the-counter) push sales at medical shops or chemists for Schedule H and Schedule X drugs, is common. The Times of India, Bangalore edition, dated, 8.8.2007, in fact, highlighted this point. While one way of looking at it, is seeing the situation as regulatory challenge for implementation of The Drugs and Cosmetics Act, 1940; the other understanding is that this mirrors the reality that Indian Pharma market is OTX (a combination of prescription and over-the-counter). For Pharma marketers and the society, this scenario highlights the importance of the power of Pharmacies as healthcare providers.

Knock, knock, Hello There: there is another promotional avenue for Pharma and Healthcare companies here

Currently, Indian Pharma companies are obsessed with in-clinic product promotional activities. The doctor is at the center of the Pharma product promotional universe, due to a hyper thrust on ‘ethical promotional approach’ or product promotional approach to doctors only for prescription generation. This hyper focus has led to a scenario where the Pharmacist power to influence healthcare product consumption is UNGUIDED by Pharma companies. All that the Pharma companies do is give bonus offers or free goods or discounts or other freebies in a bid to address OTC PUSH (over-the-counter push) for Pharma products and get some brand substitution sales or this is done to avoid brand substitution cannibalization.

THE PHARMACISTS ARE HUGE UNGUIDED HEALTHCARE FORCE

This overt and hyper focus on in-clinic activities and mere schemes or bonus offers to chemists is not in tune with the OTX character of the Indian Pharma market. The Pharmacist is like a huge powerful unguided force influencing consumption of healthcare goods. There are an estimated 3 lakh plus chemist retail stores in India. To rub salt on the wound, Pharma companies treat the chemist shop owners as traders and strengthen the trader mentality by offering even more bonus offers and schemes on medicines. It is left to the Pharmacist to ‘push medicines’.

Wake up to the DTC (direct-to-consumer) product promotional opportunity through the Pharmacist

The fact is that there is a void here in the Pharma chambers that can be filled up by introducing healthcare product promotional opportunities.

For eg: Vicks Vaporub, is a time honored product, in India, for management of cold and cough, particularly in babies, children and other family members. Out of the 3-lakh medical shops in India, let us say Vicks Vaporub marketers choose 50,000 shops, and create exciting in-pharmacy activities to attract and engage customers and prospects. The themes for in-pharmacy activities can be touch therapy, different ways of massage using Vicks Vaporub for effective action, and the Pharmacist would be only too happy to co-operate as this will strengthen the word-of-mouth publicity for his pharmacy and increase the footfalls to his pharmacy

The catchword is in-pharmacy activities

The catchword here is IN-PHARMACY ACTIVITIES to be conducted along with in-clinic activities to shore up the brand equity and sales of healthcare products.

Use the in-pharmacy product promotional approach for Revital

Revital from Ranbaxy is a topper Pharma brand (among the top 40) in India. Today, the product promotional approach for Revital is an exciting one based on the OTX nature of the Pharma market. While doctors are in the loop for product promotion of Revital, the end consumer is also targeted in the marketing communication activities. This is called the Rainbow Coalition strategy by them. This can be further bolstered through exciting in-pharmacy activities for Revital – through stress measurement interactive activities for patients etc.

In-pharmacy product promotional campaigns will be welcomed by Pharmacy chains

Indian retail scene is undergoing a revolution. Malls, and retail chains - unimaginable a decade back in India, are dotting the national retail landscape. The Indian Pharma field too is on the verge of being revolutionized by Pharmacy chains – Apollo, Trust, Medshop, Health and Glow, Pill and Powder, Reliance Wellness chain, Manipal Cure and Care, are some of the big names in this field.

What these Pharma retail chains are looking for, is to increase the footfalls, and this can only come by way of campaigns to excite target audiences and thus make them come over to the Pharmacy. They would more than welcome and partner campaigning activity by Pharma and Healthcare firms.

The KPO companies will be the catalysts for in-pharmacy activities

India is a great place for talented knowledge workers; this availability has led to the KPO (knowledge process outsourcing) revolution in India. Companies like Indegene and Bioquest are doing a great job by partnering with healthcare and Pharma companies to offer a better world. These KPO healthcare and marketing agencies can act as catalysts to the in-pharmacy product promotional revolution by seeding Pharma and Healthcare companies with this concept.

Recently, Nestle has launched the probiotic curd: NesVita

A classic case for an in-pharmacy product promotional approach can be Nestle’s Nesvita - the probiotic curd. In a pharmacy you would have a ready health-conscious target audience. So an attractive campaign for NesVita would be: the taste NesVita campaign and register your rating vote in the electronic taste vote machine. By registering a vote, get an introductory 5% discount coupon. This would certainly help create the buzz on the brand and help create a lifestyle based on using NesVita.

The marketing mix menu has expanded: please include in-pharmacy product promotion

The Pharma marketing mix has therefore expanded to include IN-PHARMACY promotion. The other elements of the Pharma marketing communication mix include in-clinic activities, in-stall activities (at trade shows) and media activities (print media and digital media). The IN-PHARMACY product promotional strategic approach is more important in India, and pharmacy chains would welcome such campaigns to increase foot falls to their outlets.

This is my 40^th blogpost, put up from the neighbourhood cybercentre, on Saturday, 11.8.2007, and I request my readers to read all the blogposts including the older posts as they are worth it.

Winning trust and the era of Clinical trial 2.0

Trust is a very delicate word. It is about believing in the honesty and reliability of others. And trust is the very foundation of business relationships. When a doctor prescribes a product, no doubt it is efficacy, safety, purity, and availability of a product that matters; however, his decision to commit a prescription to a brand depends on the trust factor. When a doctor endorses, prescribes or orally recommends a product he believes in the reliability of the medicine or the healthcare product in the clinical situation. Trust is the greatest motivator of brand prescribing habits.

Today if something ails Pharma; it is a dip in the trust factor ratings. In fact, if World Bank can measure the Physical and Material Quality of Life and rate countries or states on this scale it will not be difficult for image building agencies, consulting companies, and soft skill specialist companies to come out with a measure for trust. Consider the recent happenings, Vioxx (rofecoxib) debacle and the Avandia (rosiglitazone) controversy; add to this pot pourii Pfizer’s la-affaire clinical trial at Nigeria - what does it all point to? A deep erosion of trust.

MARKETING IS ABOUT BUILDING TRUST

It is said people do business with people. It is relationships that count in the market. Trust is the cornerstone of successful marketing campaigns and relationships. All marketing endeavors work when bridges of trust are with prospects and customers. Marketing campaigns trigger of emotions and strengthen trust to forge purchasing or prescribing habits. Hence, it is said, brands are the covenants of trust.

Now after the Nigeria Pfizer's meningitis pediatric clinical trial fiasco, what is the level of trust that the corporate brand name Pfizer inspires? It is a question to introspect on. Western medicine is gaining taboo levels in Nigeria, with groups of people neglecting to administer even polio vaccine drops in the fear that it causes infertility.

SOCIAL MEDIA HELPS BUILD OR DEMOLISH TRUST

The emotion called trust is exactly why the outbreak of social media is succeeding. A concerned prospect for a healthcare product would be interested in reading about a fellow obese individual’s experience with Alli or addiction potential of Corex the cough syrup, rather than the view put forth by the website of Alli or Corex, Pfizer’s premier Indian brand. In fact, vested interests, hidden agendas, and prejudices (of companies and executives) are responsible for the erosion of trust in certain modern medicines. Probably, if the marketing effort was subtle, and Vioxx was not positioned for chronic pain and its use was limited to acute pain (less than 3 weeks) – may be - Vioxx would have still been around. It is said FEAR AND GREED are the most potent motivators of human behavior. Vested interests and prejudices have their root in these emotions. It is the message boards, blogs, vlogs, and other web 2.0 appendages that have virally marketed or demarketed products. Rosiglitazone’s epitaph was written with web 2.0 technologies. Web 2.0 is helping create a leveling field for market operators. Messages are passed around at the speed of light.

REMEDIAL APPROACHES FOR TRUST BUILDING – social media assisted clinical documentation, Clinical trials 2.0, and other approaches:

a) One of the most important approaches for trust building is having a collaborative and two-way communicative approach with peer companies and other market entities as opposed to operating in silos.
b) Next, put information in to open domains.
c) Take clinical documentation, clinical experience records, case studies, clinical trials, Phase 4 post marketing surveillance studies to the web 2.0 level. Call it CLINICAL TRIALS 2.0. Create software tools and web portals where doctors, healthcare professionals, patients, and others can share their clinical experiences on the web and measure them using statistical tools, moderate them; build dialogues with the stake holders of healthcare and work out judicious solutions with a participative approach. This will insulate Pharma companies from Pfizer-Nigeria type fiascos. Particularly herbal companies will benefit from such a web 2.0 enabled clinical documentation approach. This will lead to better appreciation of folk based and traditional medicines by Big Pharma and the spin off will be a collaborative approach paving the way for better healthcare approaches. This type of a dynamic approach will lead Chinese Traditional Medicines, Ayurveda, Tibetan medicines to a new higher platform. And such a web 2.0 enabled clinical documentation approach may even lead to a new phenomenon called social media enabled clinical documentation. In fact, the recent meta-analysis clinical study that harrassed rosiglitazone was an example of an IT enabled clinical study. In a meta-analysis an actual clinical trial is not done. Clinical trial data is mined and studied using IT tools. And see the power of such an analysis. Avandia is shuddering. Now imagine if Google 2.0 offers a clinical documentation and analysis service. Pharma companies - better get savvy. It is a wired and interactive world.
d) Move away from a long patent life of products to a very short patent life. The bane of healthcare is that companies focus on gaining patents and evergreening patented healthcare products to protect huge profits and maintain monopoly markets. A shorter patent life will enhance innovation and marketing of products at a fair price. Companies will move away from a high cost R & D model to a collaborative R & D model, where R & D costs will be spread between various participants.
e) Create a global delivery model for sourcing raw materials from the most economical areas of the world; manufacture the products at locations where costs can be minimized, and pass on the benefits to customers by way of reduced prices of medicines. By this approach try and make drugs available at pennies to the end customer, and Pharma companies should continue to make dollar profits.
f) Pharma companies better get web 2.0 savvy, as social media is here to stay. Using the medium for building trust with prospects and customers is sagacious. Ignorance of the social media will not sweep the importance of social media under the carpet. Social media is here to stay, either wise up to it or get swamped by it. Google 2.0 will be the future of healthcare counseling, clinical trial documentation and clinical experience sharing. Remember, Google is one of the parents of web 2.0.

This is the 39th blogpost put up from my sister’s house, on Sunday, 5.8.2007. I invite readers to read all the posts including older posts. Today is World Closefriendship day, trust is the theme of this post, and I dedicate this post to my close friends I need their continued bestwishes and blessings.