FISH-FORK MODEL

FISH-FORK MODEL OF PHARMA MARKETING PRODUCT PROMOTIONAL PRACTICE

Pharma digitization is the silent juggernaut on a roll.  Automation and digital tools initially penetrated production and quality departments of the pharma firm.  Then it was the distribution department, which got digitized, when the ERP (Enterprise Resource Planning) wave started.  The level of software penetration in big companies has increased today, with wholesalers having software that communicates the holding rack stock and secondary sales (goods movement from wholeseller to retailer) on a daily basis with the company’s main server.  Thus, the medical representative in companies like Pfizer no more supplies the monthly secondary stock and sales statement to the company; it is the company, on the other hand, which provides this data through a smartphone app to the medical representative!  The tables have turned!!!  This data roll - out is truly the phenomenon of ‘democratizing data’!!

Insights and knowledge from data is driving efficiency and effectiveness in companies.  Top companies are in a position to analyze the main purchasing medical shops (pharmacies) in every pincode, due to the secondary sales being mapped through software.  Subsequently, they are able to chalk out sharper doctor coverage strategies so that the doctors who feed prescriptions to these pharmacies are not ignored and coverage is optimized.

There is limited time, money and other resources; it is the digital wave that is helping optimize the usage of these resources in marketing teams to ensure the best bang for the marketing buck!  Digital wave is helping in rationalizing activity, streamlining processes and activities, provides prompt reports and feedbacks, and optimizing resource allocation.  Eg., if sales of product A is high in certain pincodes or talukas of a MR area, why do we give the same amount of sampling to all MRs?  Many such calls are being taken on the basis of such digitally driven insights.

Imagine a scenario:

Dr. Medha, a leading derma specialist in Varanasi gets the Glenmark MR and support team into the clinic at the appointed hour.  They set up the telemedicine equipment with practiced jiffy.  The medical representative has already ensured that the partner GP clinic from an interior like Rehati, has collected derma patients who will require further consultation advice.  And one by one the remote consultation begins – the telemedicine equipment aiding the magic of derma-healing.  This approach is perfectly suited for derma remote consultation, and all in the chain engage in win-win relationship.  Dr. M get her professional knowledge being put to use, patients who otherwise would find it difficult and costly to go to Varanasi find this consultation better, they can obtain their consultation at the local GP clinic, Glenmark gets brand advantage, and the GP gets a better status.

To provide this approach for other specialities is a challenge, however, the above telemedicine approach is perfectly suited for derma practice.

Digitization, for the competitive advantage

It is the sagacity of pharma marketing practice to put digital technology and enhance value delivery.  However, practical and non-abstract methods of pharma digital practice are need of the hour since; marketing is all about numbers and deliverables.  It is not just ‘feel-good’ that works in marketing, at the end of the month; it is the numbers that save the situation.  Hence, digital marketing practices such as the above involving the derma field, makes the cut as it directly impacts and creates improved sales outcomes.

The fish-fork model is the current status of today’s pharma marketing practice (note, the fish-fork has three prongs, as shown below, the regular fork has four prongs):

The first prong (or tine) of the fish-fork model of pharma marketing product promotional practice: Medical Representative (MR) and his in-clinic, in-stall, in-pharmacy activities; and the campaigns, taxi tours plus CMEs that he executes, which fetch sales results.  The MR is the human touch in each territory.  This adds the hi-touch to the hi-tech dimension of field work.  Today, most top pharma marketers provide a tablet PC loaded with short videos of product activity, powerpoint and other such formats for e-presentations to the target doctor.  Digital touch has replaced the paper or card visual aid.  Collaterals that aid communication practice have gone digital.

The second prong (or tine) of fish-fork model of pharma marketing product promotional practice: This approach of providing reminders through email, special scientific personnel providing field work to selected target doctors, courier of samples and other useful items to doctors, provides excellent engagement with doctors.  This happens when the items being couriered are personalized.  Eg., a personalized doctor table top calendar for the year 2019 (with the doctor’s name and other aspects on each month page of the table top calendar eg., anniversary foto on the month when his marriage anniversary falls!).

The third prong (or tine) of fish-fork model of pharma marketing product promotional practice: represents the thoughtful digital methods of engagement (eg., the Varanasi case of remote derma practice consultation).  Or sponsoring a webinar where like-minded doctors from different geographies discuss therapy approaches and case studies.  Or email marketing of case studies with a quiz that will help the doctor get CME points, and so on.

Challenge is marketing cost optimization

With more layers added to marketing activity, and limited resources including budgets, it is inevitable that only those approaches are selected, which provide improved sales outcomes.  Depending on what programs are being envisaged in the three prongs of the fish-fork model of pharma marketing product promotional practice, marketing budget allotment may be made so that ROI is acceptable to finance department of the pharma firm.

Pharma marketing is always on shifting sands

Pharma marketing - delivering value is always on shifting sands.  What did well in 1970s, will not work in 2018.  Appoint a MR, provide him with a bag full of samples, printed literatures, freebies and the paper visual aid; ask him to meet 10 doctors and 5 chemists; and expect growth in sales - month after month.  The market reality is more complex.  There are atleast 10 MRs meeting each doctor per day; each MR gets 15 seconds to 120 seconds per doctor.  The doctor is bombarded with 750 brand names per month by all pharma sales personnel.  Each pharma marketer is trying to create a WOW moment in the in-clinic activity.  Quality and regular visits by MRs are a means of survival, taken for granted.  How much more can the pharma marketers offer as promotional value and product value to pharmacies and patients (not just doctors) has become the real question. 

The ethical marketers have to spar with PCD operators and semi-PCD companies.  In any major town there are atleast 300 to 500 PCD and semi-PCD operators.  They are all local operators.  With digital penetration to patients, the pharma marketer has another imbroglio to solve: how much of marketing resources, efforts and time allotment to doctor/pharmacy/patients?

Chatbots are another source of disruption in healthcare field.  Check this link: https://medicalfuturist.com/top-12-health-chatbots 

So growth is not easy in the current societal and technological context.  Patient empowerment has changed the dynamics between doctor and patient.  Right Sugar and other antidiabetics too are advertised in newspapers.  Ayurvedics and nutraceuticals are available for order through the web.  FENFURO has seen geometric growth in sales through amazon.in (FENFURO has relied on the third prong of the fish-fork model of pharma marketing product promotion).

Conclusion: how to use the fish-fork model of pharma market product promotion?

The fish-fork model of pharma product promotional practice puts into perspective various generic approaches possible to reach buyers of Rx and non-Rx products produced by pharma companies.  Which prong of the fish-fork model of pharma product promotion, how much, what sort of programs…all this depends on the SWOT of company and its operating market.  It depends also on the management - their gut-feel and wisdom and response behavior.  In any case, a one-pronged approach will create a lame horse.  Better use the three pronged fish-fork model of pharma product promotion!!!

Thanks for reading this blogpost, do feel-free to roll down the cursor and read all other posts; take a moment and recommend this blog to your friends/colleagues … have a great Dec 2018 (last month of the Gregorian calendar).

Here is a closing limerick:

Fish

To catch a fish

Patience one should relish

Many have cast their lines

Fishing is not improved by whines

Use imagination and intellect to fish or perish!

THE WEARER KNOWS WHERE THE SHOE PINCHES

THE WEARER KNOWS WHERE THE SHOE PINCHES

(A short narrative poem on the despondent pharma employee's work life)

In search of a job

He turned the door knob

During the interview

They liked his view

Selected to work

He joined as a young Turk

Contributions he made

His outputs did not fade

All new concepts

With daring he accepts

And executes with aplomb

To the liking of all along

Alas, his work did not protect his role

Diluted now, his role has taken the toll

Others get more pay and benefits

They ride on my work and are less fit

Such a fate does never happen to a contributor

Yet it is my fate, to bear this, for I am a family ‘pater’!

I pray to the Almighty

To give deliverance from this - blithely

For justice done to me shall favour the master

Quality work is central to the matter

The wearer has a pinching shoe with no hope

Only the Lord above has to give strength to cope

 - Sunil S Chiplunkar (6.7.18)

This poem is dedicated to all those who can be in the shoes of the above person, and to the many many family breadwinner employees, I know who are silently coping  the goings-on in their pharma life, for the sake of their family.  

REPURCHASE

Repurchase is one of the strong points for success of above brand from AIMIL, this Ayurvedic company has a very vibrant e-commerce website too: https://www.bgr-34.life/

Digital marketing is playing a major role in engineering repurchases!

Another very interesting concept product is SATVAM HERBAL DRINK, as such, it is a herbal water product.  Their interesting website is here: http://hardikherbals.com/about/

Satvam Herbal Water too has a bounty of repurchase potential, adding to its success!!

The word REPURCHASE OR REPEAT SALES is significant for enduring pharma marketing success.  When there are repeat prescriptions, or when patients embrace repeat purchase of products, or when there are autopurchases of products (direct purchasing by patients or users), the significance of word REPEAT, becomes apparent to marketers for experiencing ongoing marketing success.

Ayurvedic products, nutraceuticals and cosmetics thrive on repeat purchases by end consumers.  For example, BGR 34 as featured above.  Another classic example of auto-purchased or repurchased product is: Becosules Z, which is a significant auto-purchase item (entire Becosules range is Rs. 232.20 crores MAT value, April 2018, AIOCD AWACS report).  After a prescription is generated for BECOSULES Z, the patient becomes conscious of the choice he can make for being with the brand long-term, as the importance of vitamins and minerals for wellness is now a well-known matter.  Hence, Becosules Z is an enduring pharma success brand.  This logic applies to Ayurvedic medicines too.  Known to support disease management and wellness, autopurchase repeat buying of Ayurvedic brands such as Liv 52 has enabled such brands to become big guns in branded markets.  ORSL (now with J and J), a wellness healthcare product, too has had its tryst with success thanks to auto-purchase by patients, from pharmacies.

REPURCHASE IS REQUIRED FOR BRAND BUILDING AND SUCCESS

The word repeat is most vital for pharmaceutical successes.  Repeat doctor calls, repeat detailing of target brands by MRs, repeat purchases by channel members (stockists, sub-stockists, dispensing doctors, nursing home/hospital pharmacies and all other retailers), and repeat buying by end consumers - these are required for sustained pharma success. Products and brands aimed for repeat purchase, including management of lifestyle diseases and chronic diseases (diabetes mellitus, thyroid disease, liver disease (fatty liver & hepatitis etc), osteoporosis, osteoarthritis, cardiac diseases like hypertension and other types of chronic skin diseases) - always enjoy higher sales in the pharma firmament due to repeat purchases (some products are for life-long, as in case of antidiabetics).

Hence, two key classes of products emerge for sustained pharma success:

a)      Repeat-purchase prescription products due to chronic or longer term prescriptions

b)  Auto-purchase of products by patients for self-management of health (these may be prescription-only products, OTC products or OTX products…). 

In the former repeat-purchase prescription products class, prominent examples are antidiabetics, antihypertensives, derma products, and antiosteoporosis medications. 

In the latter auto-purchase class, we have Ayurvedic products, toothpastes and oral care range products, nutritional items (brands such as B Protin) or products called nutraceuticals, and simple allopathic brands such as Crocin, and other pain killers, multi-vitamins etc.

Among these two classes, the auto-purchase class requires increased marketing communication directed towards end-users, and relatively decreased messaging to doctors. 

To generate repeat prescriptions for antiepileptic brands, antihypertensives, antidiabetics, various injectables including pen insulin preparations etc., in repeat-purchase prescription products class, more marketing activities towards doctors, rather than end consumers - is required.

This is the FUNDAMENTAL STRATEGIC DIFFERENCE between the two classes of products - they both rely on repurchase by patients for sustaining or boosting sales.  In the prescription based products, repeat-purchase ensures sustained sales for the company, and in the case of products that do not depend much on prescriptions, the auto-purchase happens due to purchaser or user’s decision to buy the product.

Thus, there are two patterns of repurchase by end consumers

a)     Repeat-purchase of mainly prescription products: this refers to the repeated purchase of products due to the advice of doctor (eg., antidiabetics).

b)      Auto-purchase refers to the repeated purchase of products, which may not be due to advice of doctor (it could be due to influence of advertisements or virally forwarded messages or word-of-mouth advice from well-wishers or due to inferences from the purchaser’s information gathering behavior).

From the marketer’s toolbox:

-          How to use the right stratagem?

There are three main marketing plays for pharmaceutical products/healthcare goods:

a)      Rx market

b)      OTC market

c)      OTX market

Marketing success starts after understanding which marketing play matters most for the product.  If it is an injectable or specialised drug delivery system (like a suppository) or an important disease management product like antidiabetic or antiepileptic etc, the product is sure to be a pure Rx play.

Simple pain-killers, cough mixtures and other nutritionals can fall into the OTC market.

The large and interesting market is the OTX market, where marketing activities are directed to influencers like doctors and also at the end-consumer.  Nutritionals and nutraceuticals, Ayurvedic products and non-complex formulations come in this fort.  OTX is a combination of OTC (over-the-counter) and X (from Rx or prescription only).

Some products may start from Rx and move onto OTX marketing play.

Definition of repeat purchase:

The buying of a product by a consumer of the same brand name previously bought on another occasion. 

Repeat purchase or repurchase is a measure of brand loyalty.  If a doctor prescribes a brand repeatedly, or a patient/user buys a product repeatedly either on recommendation by a doctor or auto-purchase through other influences, it is a repeat purchase behavior that boosts sales.

Today’s pharma market requires many a strategy, including focusing on ensuring repurchases: repeat-purchase or auto-purchase. 

Spray and pray: is a strategy to promote brands to many prospect doctors, and pray for conversion to sales!  This strategy in today’s context, where time and resources are stretched to the last, just will not work! 

Hence, in certain geographies and for certain product types, marketing communication and product promotion activities should be more oriented towards stimulating and reinforcing repeat-purchase of prescription products or auto-purchase of products. 

THE BEST FORM OF SALES SUCCESS COMES WHEN THE PRODUCT OBTAINS sales that are from: REPEAT!  REPEAT!!

Limerick: 

Repurchase

Sales success is not easy

Dosen’t come if you are only breezy

Strategists ought to focus on repurchase

It is, to get a confident face

‘Repeat-purchase’ and ‘auto-purchase’ saves the day – avoids being cheesy!

Quotable quote:

Make a customer, not a sale: Katherine Barchetti

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2018: the year of Old-age companion robot (OCR)

Happy New Year 2018, dear reader!!

I was at ASICON 2017, Jaipur (25.12.17 to 30.12.17), an All India General Surgeons' Conference, for official booth activity and, while conversing with a doctor about laparoscopic surgery and its steady growth in India, I asked him: "What next?"  He replied: "Robotics in surgery!"

Robotics, and AI shall have a deep impact on surgery and healthcare delivery.  In fact, there is a big market for the 'Old-age companion robot' (or OCR)...by the way - this is my abbreviation and concept.

Robotics for elderly is a technology subject that is already on the move:

Above image from here: click!

However, the positioning ought to be about companionship through robots rather than care-giving for the elderly.  Companionship is a broader term, which can include care-giving.

Across India and the world, nuclear families are putting the elderly in a tight spot.  Even fit elders face the challenge of loneliness.  Earlier, in the joint family system, elders played the role of patrons of family life for their children and grandchildren.  Today, there is a different scene: living together for grown up children and their parents may not be practical...for instance, the younger ones travel and live away for occupational reason,s or may want to be separate due to change in generational values. 

This is where robotics can provide the supportive and companionship role (including care-giving).  So what can a robot do?

a) To begin with, in the morning: the OCR (Old-age companion robot) can wake up the elderly person at a predefined time and remind him of the work or activity as entered by the elderly person himself or his doctor for the morning.  For instance, the OCR (Old-age companion robot) can provide the wake-up alarm input at 7.00 am and wish him well for the day... perhaps the pre-recorded voice of his/her daughter can be used for the same, and remind him or her to do 20 minutes of kapala bharati pranayama exercise.

b) The OCR (Old-age companion robot) can simultaneously play the elderly person's favourite compatible music from its robotic body while the gent or lady is doing the exercise and pranayama regime.

c) The OCR (Old-age companion robot) may also be able to check the blood sugar reading through a pin prick from a particular slot...and provide the electronic reading.  Similarly, by placing the finger tips the blood pressure and heart rate could also be measured.

d) Sensors in the OCR (Old-age companion robot) should be developed so that a watchful eye is on the elderly person's gait, and breathing...if there are any abnormalities, the OCR (Old-age companion robot) can send an emergency ring/message to the nearest healthcare provider and relative.

e) Taking medicines and food on time, is complicated by inertia, weakness, slight depression and forgetfulness of the elderly person.  The OCR (Old-age companion robot) should be programmed to provide the reminder input for the same and confirm it to the caregiver or relative through auto sms.

f) The OCR (Old-age companion robot) should be enabled to provide mobile telephony.  This way the elderly person should only request the OCR (Old-age companion robot) to ring up the relative or children, thereby enabling easy communication.

g) The OCR (Old-age companion robot) ought to also do small jobs such as bringing a glass of water!

h) The mobile OCR (Old-age companion robot) would be very useful if it could be a multimedia device, providing access to internet, having a small screen for viewing TV or internet telephony and generally helping in accessing the world and communicating.

i) Jokes, humour, small puzzles and stories (including news stories) provide uplifting interactive moments for the elderly, an OCR (Old-age companion robot) giving this fare will surely make the robot very relevant to the person.

Elderly life among couples is further complicated due to irritability, inability to help one another due to personal health issues, and the presence of bad or reduced communication between the two.  Thus, the OCR (Old-age companion robot) becomes handy for the elderly couple to meet their needs without getting into daily quarrels.

Care-giving robots is a higher concept; it is more interactive, clinical oriented and supportive.  But the need is for firstly, the OCR (Old-age companion robot) concept, which helps make the elderly person's life easier, it need not be care-giving, the OCR should smartly be making the life of the elderly smoother and happier, filling the mental void and providing a moving smiling presence in the elderly individual's life.

I hope robot manufacturers understand this need in the elderly segment, and declared 2018 as the year of OCR (Old-age companion robot) for elderly.  Affordable models of such robots will surely be gifted by the children to their elders.  This smart robot machine can make the life of elderly happier and easier, while soothing the sensitive hearts of their children.

Endquote:

"To care for those who once cared for us is one of the highest honors" - Tia Walker

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