Yogi nation, bhogi nation, and the middle path

I got the above images from here (Swami Ramdev), here (Vijay Mallya), and here (Indra Nooyi).

IT IS ALSO A GREAT PLEASURE AND HONOR TO BE RECOGNIZED BY RENOWNED PHARMALIVE BLOGGER CHRIS TRULOVE WHO HAS RECOMMENDED MY BLOG AS A MUST-READ IN THE PHARMA-HEALTHCARE BLOGOSPHERE. THANKS, CHRIS. PLEASE CLICK HERE.


As every healthcare marketer knows, the consumption of healthcare products and services depends on lifestyle. In fact, the avowed goal of marketers is to influence the lifestyle based on marketed products and services. Thus, trend mapping is a key element of strategy creation. Marketers normally peg marketing strategies, promotional approaches, and tactics to the broader market trends. There are three discernible trends in Indian society: they can be called YOGI NATION, BHOGI NATION, AND THE MIDDLE PATH.

Yogi nation: The poster 'boy' or icon of the Yogi nation trend is Baba Ramdev. He has revolutionized healthcare - both preventive and therapeutic healthcare, through pranayama and Yoga based techniques. What is unique about the evangelical marketing of his brand of healthcare is EVIDENCE BASED APPROACHES. Swami Ramdev talks purposefully on including pranayama and Yoga as a part of one's daily regimen. He collaborates with and exhorts allopaths and other healthcare practitioners to include Yoga & pranayama as a part of the therapeutic approach. His strategy is to promote traditional healthcare systems like Ayurveda too. His brand of healthcare and lifestyle has a very large following particularly among the middle class urbanites, and people living in semi rural and rural places. His franchise is predominantly in India and the Indian diaspora. However, in rural South India where Hindi speaking is not prevalent, his influence is not that strong. The reason is, Baba Ramdev speaks mainly in Hindi. He is now attempting to put forth his programs in vernacular TV channels too, other than the main Hindi channel Aastha. However, what is important from the marketers point of view is that, BABA RAMDEV REPRESENTS A TREND IN INDIAN SOCIETY AND THE INDIAN DIASPORA TO GO BACK TO ONE'S TRADITIONAL HEALING ROUTES, PREVENTIVE HEALTHCARE, AND USE OF DIETARY SUPPLEMENTS. Hence, we see advertisements for various health foods, healthcare products, and other products based on Ayurveda on Aastha. He is also openly critical of the tactics used by MNCs to market their soft drinks and the pharmaceutical products based on Western Medicine (or allopathy). However, since many Indian allopaths and those of Indian origin residing abroad have starting accepting pranayama and Yoga with an open mind and even collaborating with Baba Ramdev to implement to willing patients in their practice, Baba Ramdev seems to softening his stand vis-a-vis allopathic marketing. Baba Ramdev reiterates his commitment to make Indian society and the world as a whole 'NIROG' ie., disease free, through lifestyle changes: ie., based on Pranayama, Yoga, Ayurveda, vegetarianism, abstinence from tobacco and alcohol consumption, and living a balanced life.


Bhogi nation: In Hindi, Sanskrit, and other vernacular languages, Bhoga means luxuries, comforts and material enjoyments. Vijay Mallya represents the successful business man who has made tons of cash through providing alcohol beverages - an important item of 'bhoga'. Vijay Mallya who has a honorary doctorate and likes to be called Dr. Vijay Mallya, owns India's largest beer brand - Kingfisher. By this same brand name he runs India's only five-star airline - Kingfisher airlines (which unfortunately is loss making). Vijay Mallya's passion is style and brand building. He does it through using fashion, beautiful models, formula car racing, and other premium image building icons for his alcohol beverage brands. Vijay Mallya's intent is to command premium for his products by creating aspirational values in the brand.

Wherever there is 'bhoga' and an encouragement to a Bohemian culture, illness and disease go hand-in-hand. Excessive consumption of alcohol beverages leads to hepato-gastrointestinal disease, kidney and cardiovascular disease, cancer, and alcoholism. Here lies the great pharmaceutical opportunity. People belonging to the bhoga concept are more susceptible to increased frequency and intensity of various diseases. No wonder, as per ORG IMS Aug 2008 report, for the month of Aug 2008, Liv 52 is India's third largest brand. And it is interesting to note that Corex, which unfortunately has a lot of addiction market (the bhoga concept again) is India's largest pharmaceutical brand with nearly Rs. 160 crores annual sales value.


The MIDDLE PATH: The bulk of the Indian population probably cannot wallow in the bhoga concept. Nor will they fully live by the Yogi concept. These Indians will continue to have the occasional beer, soft drinks, and eat 'junk food' on and off. They will like to consume 'fun-for-you foods' now and then. However, they are hooked on to the healthcare bandwagon. It is based on this aspect that Indra Nooyi - the dynamic and risk taking lady of Pepsi - has launched three categories of products: 'fun-for-you', 'good-for-you', and 'better-for-you'. This is pragmatic and sagacious thinking where in she attempts to combine her products with the evidently robust healthcare trend in society. Thereby two birds are shot with one stone: a) image building and better market acceptance in the stormy Indian market, and (b) market expansion. Nevertheless, there is a strong element of risk-taking in promoting on the health platform. Sceptics will certainly comment: SHE IS DIVERTING RESOURCES FROM THE MARKETING SPEND ON CASH COWS LIKE SOFT DRINKS TO 'WANNABES'. And it is possible that financially it may backfire in terms of decreased profits. So perhaps keeping the fingers crossed, the top management team at Pepsi are looking to increasing market share and profits through this diversion strategy. And mind you, intelligent Indra announced this product strategy in India, where all her top global managers had assembled in Delhi. As such, given the conundrum that soft drinks are in the Indian market, Pepsi has taken the logical route out to increase their market share. But this approach of positioning the products from Pepsico on the health and fun platform requires courage and vision. Indra Nooyi has demonstrated this.

So the great Indian healthcare and the pharmaceutical market in particular, rolls on ... other pharmaceutical players are in the meantime betting big on biotech, with Biocon even announcing continued research on the oral insulin concept. So let us see how the patterns in the Indian healthcare and pharmaceutical scenario unfold.

Thanks for reading this blogpost, please do read all others by scrolling down, and clicking on OLDER POSTS wherever required. Thnks once again. OBITUARY: BANGALORE HAS LOST ONE OF THE STALWARTS OF THE PHARMACEUTICAL PROFESSION: MR. GHEVARCHAND SURANA, FOUNDER OF MICRO LABS, RECENTLY PASSED AWAY. WE PRAY THAT HIS SOUL MAY REST IN PEACE.

Santa Claus comes calling!

America falling, India calling!

America is at an interesting phase in its economy, particularly in its election year! As such, America is a high consumption economy, now in a crisis. Wherever, there is high consumption there is high credit availability. It is a thumb rule. The current status reflects that the Americans are spending more than they are earning. They are takin' credit, spending, consuming, the production system pumps in more products and services, more credit lines are opened up, and the Americans spend more! This vicious cycle goes on and on. So you raise more money and credit, and unique financial products are created to help consume more... finally, the cycle goes bust...AIG, Lehmann and other infallible institutions collapse on the weight of debt. AMERICA FALLING!!

In fact, Chidanand Rajghatta, who writes cutely, says that AIG episode is akin to nationalization of banks - which had happened in our country in the late 1970s.

So what do marketers do? Rush to the emerging economies. And it is easier today as it is a globalized economy. So marketers will engage prospects and customers in the marketplace of rapidly emerging economies like India.

India calling!

It is rush hour, comparatively, in India. The Indian Pharma market (as per Market Intelligence report of ORG IMS, June 2008), is one of the top 3 growing countries, the global rank is 15th, and the growth in the past year is CAGR of 15%. By June 2008, the Indian Pharma market is Rs. 32776 crores with a value growth of 14%. As per this report from ORG IMS, the Indian pharmaceutical market has 400 organized pharmaceutical companies, some 47,000 packs are promoted to more than 5 lakh doctors, who generate nearly 100 crore prescriptions that are honored at more than 5 lakh chemists.

The contract manufacturing market scene is hot. As per KPMG, the Indian contract manufacturing market is expected to touch 2.46 billion USD by 2010, with a CAGR of 41.7% from 869 million USD in 2007. The next level of this market is when along with conventional dosage forms, injectables and biologics will enter this activity.

A Mckinsey study says that the Indian healthcare market is expected to grow 190 billion USD in the next two decades. As per this report, India has now, about 5 lakh doctors, 7.3 lakh nurses, but the country requires an additional 6.71 lakh docotrs and 18.7 lakh nurses.

Business India, Sep 21, 2008 issue on page no. 36 says that the new buzz words in the Indian pharmaceutical industry are dietary supplements, functional foods, vitamins and herbal products. The market, world over for these products is estimated to be approx. 120 billion USD, and in India it was Rs. 1900 crores at the end of 2007 (as per a FICCI background paper). An industry expert has noted in the report, that the global market in this segment has gone from 60 billion USD to 120 billion USD in the past five years. Large beverage companies and even Merck (with its focus on Emblica and aamla) are betting big on this market. The nutraceutical or natural product hype is on in India, Japan, China, Taiwan, and USA.

The New Medical Representative a book by James Pancras says in the foreword of his book: India has about 120000 pharmaceutical representatives. The no. of retail chemists is estimated to be about 5 lakh. (Apollo pharmacy chain feels that the highly fragmented pharmaceutical retail market has about six lakh pharmacies). The no. of pharmaceutical manufacturers is estimated to be 20000 to 25000. And the no. of brand formulations being promoted to doctors, is estimated to be 70000. This book in chapter nine reiterates that even the biggest companies may be able to contact about 150000 potential prescribers. The universe of potential allopathic prescribers may be about 5 lakh (chapter 13). Only about 25% of the billion plus population are said to access allopathic medicines. Regarding doctors, in Chapter 2, estimates are there are some 1125000 doctors licensed to practice. The allopathic doctors are estimated to be around 450000. This is classic book and one-of-its-kind on the Indian pharmaceutical industry, it is published by Masterman (jamespancras@rediffmail.com).

The ORG IMS and Mckinsey reports cited above probably refer to only the allopathic doctors, as the no. is 5 lakh. YOU CAN GET SOME VERY EXCITING VIEWPOINTS ON THE INDIAN PHARMA SCENE IN THE PHARMA MARKETING NEWSLETTER SEPT. 2008 ISSUE. MY ARTICLE IS PUBLISHED THEREIN, THANKS TO MR. JOHN MACK.

Every one likes Santa Claus! The pharmaceutical industry has its own Santa Claus!

The Santa Claus of the pharma industry is the medical representative! This charming and smiling guy or gal, walks smart, and talks smarter. Doctors love to have good and charming MRs around. These MRs smile a lot, unlike the patients they encounter. The MRs give a lot positive strokes. They provide and reiterate important information. They prime doctors on latest medical and therapy issues. They are a great break from the hectic surgical and clinical practice.

But the MR is not just about talking smart and charming the docs. He carries a cute leather bag. It is a bag of goodies. Samples, prescription pads, and other small and cute gifts come out of the bag. The MR is also an important contact point for the doctors to access the vaster marketing budgets of pharma companies. The doctor through the MR can strike sponsorships, CMEs, conference sponsorships, and personalized gifts from the pharma company. And all with a smile.

In India, today the MR is like a concierge service too. The MR very often handles the problems of doctors and provides tangible and intangible services. Its like the doctor then says Thank you Santa Claus!

Consider the following real-life examples:

The MR enters the clinic and finds the fan not working. The MR after taking the doctor's permission organizes the repair, very often sponsored by the company.

Another recollection is that of a doctor who arrives at the Bangalore railway station at about 11.00 pm from an interior place, and finds the autorickshaw drivers very irritating, and its getting difficult to go to the new Bangalore International Airport for an onward journey to Calcutta. The doctor immediately calls up a known MR. The MR is the knight in shining armor. The MR assures the doctor not to worry and stay put in a nearby cafe. Using his speaking skills and contacts with a taxi driver the MR ensures that a taxi comes to the doctor and safely drops the doctor to the airport. All this is done thanks to the mobile phone revolution in India!

Smart MRs provide busy and rich doctors with financial tips: best mutual funds, shares and other financial instruments to invest on. In fact, some companies now provide sponsorship to mutual funds too.

The lady doctors? Oh, they just like smart MRs. The MRs are smart, look good, smell great, they provide excellent courtesies, and make the lady doctor feel like a queen. They provide top notch and thoughtful gifts, like handbags, cosmetics, and even jewelery. And in times of need, there is help round the corner through company services like CMEs, arrangements for travel and stay during conferences - the MR arranges it all, with a smile.

And at the end of all this, what does the MR want? Just a few prescriptions. COME WHAT MAY, let the pharma marketers cook up various avenues of pharma communication: courier marketing, web based marketing and what not... the MR will just continue to be there. The GOOD MR WILL ALWAYS PROVIDE THE HUMAN FACE OF THE PHARMA COMPANY HE REPRESENTS. In an era of hollow relationships, the charming MR will always be there for the doctors, with a smile, with his charm, a great presence, and never ever wearing a frown, even if the MR's wife is hospitalized, or his child in suffering, or his monthly salary cheque has not come from the company or if his manager has harassed him (for not reaching the sales quota) or if the incentive ie., commission amount has not reached him, or if the MR has traveled arduously to an interior in a stinking bus - still he will be fresh, smiling, charming and smart in the clinic, to represent his company to the target doctor. LONG LIVE THE MR!

THIS IS THE REASON WHY MR. JOHN MACK IN THE SEP 2008 ISSUE OF PHARMA MARKETING NEWS SAYS:FRIENDLY PHARMA SALES REPS EARN MORE BUCKS WITH FEWER SALES CALLS. Alvin Toffler the famous futurologist has in fact said, that the futuristic trend in business will be HI TECH - HI TOUCH. So MRs will engage target doctors with smart gadgets like multimedia mobile phones, tablet PCs, and laptops. The pharma marketer will use web 2.0, web 3.0 and other tech tools to engage the doctor too. Still the MR will be there because HE IS THE SANTA CLAUS, THE PHARMA SANTA CLAUS!!

Thnks for reading this blogpost, click on older posts wherever required, and please do read all other blogposts. The above image is from HERE.

Publicity - the emerging 'P'

I GOT THE ABOVE IMAGE FROM HERE.

The explosion of media (including new media) in the modern age is creating new and urgent importance for laying emphasis on 'publicity' - the P factor - in the promotional mix in pharmaceutical and healthcare communication strategies. Traditionally, pharmaceutical marketing has not laid high importance on publicity. The marketing communication efforts concentrate on doctors, and chemists. With doctors having complete control over patient behavior, influencing prescribing and recommending behavior of doctors has always been given prima donna importance by pharma companies. While this will continue to have the #1 priority in pharmaceutical communication efforts, the factor of PUBLICITY will now have to be addressed more keenly and delicately. This is mainly due to the explosive growth of media, its connectivity to the masses, and ability to influence patient or prospect behavior.

Publicity and Wyeth's pneumococcal vaccine

The startling effect of publicity on marketing efforts was felt recently when Wyeth's pneucomoccal vaccine made waves in national newspapers for the wrong reasons. On 8th Sept., 2008, front page news in the leading daily of India (The Times of India - which incidentally is one of the largest media brands in the world) questioned whether this vaccine was relevant to India. The report in The Times of India, is excellent where points being emphasized include that the vaccine does not decrease clinical pneumonia, the cost of vaccine just does not justify, and that WHO itself talks of its side effects... CLICK HERE PLEASE. In India, IAP (Indian Academy of Pediatrics) has two classifications for vaccines - those that need to be given compulsorily like DTP, Hepatitis B, BCG etc., and another class of vaccines that the patient has to discuss with the doctor and administer to the child (this class of vaccines are popularly called optional vaccines). Wyeth has been working hard to put the PCV (pneumococal conjugate vaccine) from optional vaccines category to compulsory vaccines. The media reports suggest that the PCV (pneumoccal conjugate vaccine), a patented product from Wyeth (hence, having monopoly market in India) does not justify the expense, is not very effective in 'clinical pneumonia', and can even increase incidence of asthma. The media sources cite WHO reports in support. FROM A MARKETING POINT-OF-VIEW, THIS IS NOTHING LESS THAN A PUBLICITY DISASTER. Drug Action Forum - Karnataka has asserted that the pneumococcal vaccine should be withdrawn from WHO immunization programs. DAF - KARNATAKA has written an open letter to WHO questioning the usage of the vaccine on a broad front. THIS IS ABSOLUTE UNINTENDED 'DEMARKETING' OF THE PNEUMOCOCCAL VACCINE FROM WYETH. From an economic point of view for the company, these media publicity happenings are a serious blow. The spill over effect will naturally be felt on other products of Wyeth as it represents a loss of goodwill. This media publicity related WYETH'S CASE OF PCV holds a great lesson for pharma marketers.

A second boat was rocked slightly by the media

Media reports on the promotion of letrozole to treat infertility by Sun Pharmaceuticals, recently created ripples. However, what is striking about this case of media activism (?) is that MIMS has questioned the wisdom of DCGI (Drugs Controller of India) in permitting Sun Pharmaceuticals to legally market the drug for infertility management. MIMS questions the preclinical and clinical procedures followed for permitting letrozole promotion in infertility. This is perhaps a case of splitting hairs. Scientific debate can always be encouraged and the room for improvement in case of clinical studies is always big. However, there is nothing hard core to point out in the case of letrozole that the safety and efficacy factors of a medicine's use has compromised patient well being. Moreover, in India, off-label use of drugs based on the prescriber's wisdom and experience is a common phenomenon.

The lesson from the above case studies

The important lessons to be drawn from the above recent happenings is that PUBLICITY is now emerging as an important element of the promotional mix in pharmaceutical marketing. Traditionally, pharma marketing has concentrated on personal selling, advertising, and packaging in its communication strategy. Perhaps, only The Himalaya Drug Company (a leading herbal and Ayurvedic manufacturer and marketer) has laid emphasis on PUBLICITY or PUBLIC RELATIONS as an important element of the promotional mix. This company has done admirably well on the PR front whenever Ayurveda has been rocked by the now familiar and frequent news of heavy metal toxicity in formulations or other issues. However, on the whole, Indian pharma companies ought to change their mindset to include the publicity dimension in the marketing promotional mix to avoid any unsavoury news and uninvited DEMARKETING of products. For example, many Indian pharma and healthcare companies do not have a MEDIA KIT, (an information packet about a business or product), which is the basic element of good publicity. That is a good place to begin with!

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Pharma retail market characteristics

I GOT THE ABOVE IMAGE FROM HERE. YOU CAN GAUGE ITS IMPORTANCE AS YOU READ BELOW.

In society there are three main types of organizations: GOs (ie., governmental organizations), NGOs (non governmental organizations) and business enterprises. With the integration of the global economy marching ahead, and free market economies becoming all important, business enterprises are gaining in importance as societal organs. In a mixed economy, Govts., or governmental organizations are important entities supplying products and services to the society. In free market economies, private and public listed business enterprises are very important entities supplying products and services to the market. The key word to all business enterprises here is the MARKET. Understanding the market: its composition and characteristics, is vital for marketers.

MUCH HAS BEEN WRITTEN IN THE MEDIA ABOUT THE FREEBIES AND SPONSORSHIPS GIVEN TO DOCTORS BY PHARMA MARKETERS TO GENERATE PRESCRIPTIONS IN FAVOR OF THE PROMOTED BRAND, HOWEVER, THERE IS ANOTHER IMPORTANT CHARACTERISTIC OF THE INDIAN PHARMA MARKET, IT IS CALLED 'BONUS OFFERS FOR CHEMIST RETAILERS':

Chemist retail bonus offers and pharma brand substitution

The Indian Pharma Market is controlled mainly by prescribers and to a large extent by the chemist retailers too. This is a special characteristic of the Indian Pharma market. A medical representative's job dosen't end with generating prescriptions. It entails managing the chemist retailers too. After all, the retailers should honor the prescriptions - if the prescription gets substituted with a competitor brand, the MR's efforts are in vain. Substitution of prescriptions is a peculiar phenomenon of the subcontinent. There is no guarantee that the brand prescribed is the brand dispensed. There can be understandings between the prescriber and the chemist as to the brand that needs to be dispensed. If a doctor has gained favors from a pharma firm or if the chemist has informed the doctor that a particular brand is available with very high 'bonus offers' ie., certain percentage of goods will be given free on purchase of the brand, for eg., for Brand X buy 10 bottles then get 2 bottles free, buy one box of a particular sildenafil citrate brand and get two or three boxes of that sildenafil citrate brand free; then that brand-on-the-scheme will 'run more on the chemist counter'. This approach is called offering retail schemes or retail bonus offers. There are newsletters mailed to chemists that advertise the bonus offers. Why is this done? Well, mere offering the retail scheme dosen't guarantee that the stockist (or wholesale distributor) will part with the scheme to the retailer. The wholesaler may part the scheme selectively, and get to enjoy the free goods himself. The goods are not marked as free, they come along with the MRP. So the stockist can bill these goods to the retailers too. Thus, to ensure that the retailer gets to know of the scheme, mailers and newsletters to retailers inform the details of the scheme, and the retailer can demand the scheme goods from the stockist sales boy. Pharma companies too prepare special leave behind literatures on scheme details that are distributed by the MR to the retailers. The obvious tendency of the chemist retailer is to dispense that brand on which he earns more, through the freebie goods. This is the pharma brand substitution characteristic of the Indian pharma market. Particularly in semi urban and rural areas, the 'retail offers' work magic in increasing the sales. In the case of dispensing doctors or doctors who have 'attached chemists', bonus offers work the magic in increasing the sales.

The retailer can also can get samples from MRs in lieu of 'official schemes' or in addition to the special retail offers, and these samples can be sold off to the unsuspecting or ignorant patient. This is called in local parlance 'chemist adjustment'. This approach of chemist and doctor adjustment with samples also helps the MR get POB (personal order booking) for his brands.

Briefly there was a season for generic-generics. This means generics that are unbranded. Normally, generics as such, are unbranded, however, in India, most generic medicines are branded. Generic-generics, there was a lot of hoopla about this concept a few years back, which has died down now, are not promoted to doctors. They are sold to retailers at low cost and on scheme too. However, these generic-generics have a high MRP. So the realization or mark-up for the chemist is very high - as high as 200% or even more! So the retailer dispenses these generic-generics and earns more from them. The patient is reassured about the content of the generic-generic and the quality if the patient inquires about the apparent substitution. However, the hoopla has died down after the Govt., took certain steps to suffocate this market. Nevertheless, today, a small generic-generic market continues to operate.

Retailer controlled sales

In USA, there are over-the-counter drugs (that which the patients asks for and buys legally), behind-the-counter drugs (where the pharmacist is authorized to dispense certain drugs, without any prescription from the patient; as such there is a talk that this category of drugs will be created shortly), and the prescription only drugs - they are dispensed on prescriptions only. In India, every thing is virtually over-the-counter and behind-the-counter. Thus, retailers in certain areas - where patients are not very educated, or in lower economic areas - the retailer gets to control the pharma market to a very large extent. Hence, in metros and urban areas, where retailers do not dominate the pharma business as much, MNCs get to dominate the market. In non urban areas, retail control on pharma business is very high.

Retailers also dispense several drugs over-the-counter to patients directly for the management of routine types of infections and illnesses, and also certain other products. Particularly in the case of sex rejuvenators and sexual health related products like ayurvedic sex rejuvenators, sildenafil citrate, and mifepristone (which is a huge OTX or over-the-counter plus prescription market; some of the top Indian pharma brands like Unwanted and MT Pill are mifepristone brands. This market is growing rapidly.) - the retailer is the 'sale generator'. Most often than not, the patient goes directly to the pharmacist to get the medicine. The pharmacist educates the patient on how to use the medication. Thus, retail offers are very high in this segment.

These are examples of market characteristics that are not textbookish. You go out in to the field and get to learn of them. Earlier, ORG the key market research organization for the pharma market, used to print 'blue books' of the market data, which used to have a compilation on the official bonus offers on various brands.

An important fall out of this retail bonus offers phenomenon is that competition between pharma companies gets fierce at the retail counters but the patient does not get any thing in return unless the retailer on his own, due to inter-chemist competition, offers discounts. This is one reason why chemists including chains like Medplus offer flat 10% discount to the patient.

Why are pharma retailers so powerful in India?

This has to do with a bit of history of medical profession in India. In the days of yore, doctors were responsible for diagnosis and dispensing of the medicines. In fact, among doctors who practice Ayurveda, the traditional form of medicine, most of the doctors are dispensers. This is in fact a subcontinental practice, as can be seen in Sri Lanka too, where dispensing doctors is a common phenomenon. Pharmacists to dispense only is a Western phenomenon, and has taken roots in India only after independence. Hence, today, the patient expects that pharmacists too dispense medicines on their own just as they do not mind doctors dispensing the medicines. Hence, addressing the characteristics, needs, and wants of pharmacists in a judicious way is inevitable to operate in Pharma India. THIS NATIVE INTELLIGENCE IS RESPONSIBLE FOR THE RAPID GROWTH OF COMPANIES LIKE MANKIND.

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Fortified water

I GOT THE ABOVE IMAGE FROM HERE.

JUST THINK FOR A MOMENT... WHICH IS THE LARGEST ORALLY CONSUMED SUBSTANCE? IS IT SUGAR, COFFEE, TEA, RICE, BEER, ... IT IS OF COURSE - WATER - EITHER DIRECTLY OR INDIRECTLY THROUGH OTHER FOODS AND BEVERAGES.

WATER IS ORALLY, THE MOST CONSUMED SUBSTANCE. SO LOGIC DICTATES THAT THIS BASIC SUBSTANCE OF LIFE SHOULD BE THE LARGEST BUSINESS OPPORTUNITY!! IT ONLY REQUIRES SOME IDEAS AND CONCEPTS TO BRING FORTH A NEW MOMENTUM IN THE DRINKING WATER BUSINESS.

THE DRINKING WATER BUSINESS IS AN EVERGREEN BUSINESS. AS LONG AS THE HUMAN BEING LIVES, THERE WILL BE A NEED FOR WATER, AS PLAIN WATER, COLD WATER, FORTIFIED WATER, WATER-IN-BEER, WATER-IN-TEA, WATER-IN-COFFEE, WATER-WITH-SODA ETC.

Momentum is an important word in business. Momentum implies change, it indicates a sequence of events. And the right momentum in businesses leads to increased profits and customer delight – the two important end points of every business activity. Creating momentum in business activities makes exceptional growth of business possible. So the concept is 'momentum leadership'.

Packaged and Drinking Water Business in India

Water is at an exciting phase of business activity in India. Earlier the emphasis in India was provision of clean and potable water through the drinking water taps. Then came the packaged drinking water concept to the masses. And along with it the water purifier equipment market grew. Today, this emphasis continues – however, parts of the drinking water market in India are ready for a momentum – something new to take it forwards. To create the buzz and expand the market further.

The packaged water drinking market is slated to shoot to Rs. 10000 crores by 2010. Bisleri and Bailey dominate. However, this market is commoditized with lots of regional players. The market is set to expand further, given the fact that prosperity levels are increasing, health consciousness is ever increasing, and along with it aspiration levels in India are also on the rise. The confidence on the growth of the packaged drinking water is also because comparatively, South East Asian countries with a similar climate profile and a smaller population have a larger market for packaged drinking water!

Water purification systems like Aquagard, Kent RO, and Pure It are creating waves and the market is increasing fast. In fact, Pure It has targeted doctor clinics. Pure It is kept in patient waiting rooms, where the product serves to fulfil the thirst needs of patients and is a great advertisement for the product too, since the opinion builders of Indian society on healthcare products, ie., doctors themselves use the product.

Modern lifestyle is characterized by a sedentary lifestyle, increased creature comforts - conveniences, comforts and luxuries; and increased consumption of fatty foods, sugar, salt, and meat. And this has led to the so called lifestyle diseases – cancer, diabetes, atherosclerosis, and endothelial dysfunction (which are vascular diseases – in the former blood vessels become inflamed, hardened, thick, with loss of elasticity; the latter is the first stage of atherosclerosis, where in the inner most layer of blood vessels become dysfunctional). In fact, obesity particularly abdominal obesity too is a disease of the modern society.

The modern era has redefined the consumption of water. Water with caffeine and kola nut ext., ie., the cola drinks sell in large volumes. The energy drinks market too is promising. Thus, the need for water in various forms or avatars is universal. Water is indeed great business, and a very profitable one provided it undergoes value addition. Today, packaged drinking water and the mineral water business is ever expanding. Besides, water purification systems like Pure It and Aquagard have created a water business segment in the home segment. Today, the drinking water business is mature enough to evolve further value added segments.

Fortification of food and water

Fortification of food is a well established approach. Fortification creates talking points for the brand and consumer pull. For instance, folic acid fortification in bread is an approach that has contributed to avoiding neural tube defects.

The Indian packaged drinking water market and the water purifier market is ready for WATER FORTIFICATION.

Water fortification is the addition of micronutrients to packaged water or through water purifiers to create additional value in the water for the customer, so that the products can command premium pricing and ensure higher customer delight.

The most common concept is water fortification with vitamins. These vitaminized waters have a health attribute. Flavor is an important tool to increase water consumption, satisfy thirst, and enhance 'water brand loyalty'. Flavor comes through natural and artificial sources. Flavor, salts (including common salt), minerals, vitamins, and other micronutrients can create a product to ensure brand differentiation and strengthen brand markets. In fact, the category of electrolyte energy drinks is an avatar of the basic need of humanity - water. After all, which mother wouldn't like to give her children vitaminized waters, or which wife wouldn't want her husband to drink healthy waters?!

Water fortification has gone to a new high in USA. There are special branded waters for menopausal women, for heart patients, and even special waters for enhancing sex activity!

An open for all market in India: the Eldorado is waiting to be tapped!

The demand by the market to use water as a medium to deliver micronutrients and functional ingredients will only increase in India, as prosperity and health consciousness rises. Today, this enhanced waters market is an open field in India. There is an opportunity of first-mover advantage available for the bold and entrepreneurial pioneers. The trick is to enter through opinion builders and the OTX format. So you look to healthcare professionals to indirectly or directly endorse and recommend the product, and look for over-the-counter sales and 'through prescription' (a-la-Revital) sales. This will create the demand and the market pull. The market is there for cherry picking!!

India is the home to the largest diabetic population. And these people are health conscious. Many of them are obese. This segment is susceptible to diabetic complications like kidney damage, and eye damage. These patients are already primed to receive healthcare concepts - so products like antioxidant waters, vitaminized waters, or waters with extracts that help reduce blood sugar (eg., Gurmar or Gymnema sylvestra extracts in water) or waters with extracts to help slim (eg., Malabar tamarind or Garcinia cambogia extracts in water)... will find takers in the diabetic segment.

India is also a home for cardiovascular diseases. And here is the Magnesium in water concept. The advantage is a fund of good benefits of magnesium (along with calcium) in atherosclerosis. Or one can consider heart friendly herbal extracts in water.

Can water purification systems use water fortification strategies? The answer is YES! The concept is to have a system to have a dispenser put in contact with the water in the purifier, that will slowly diffuse out water soluble vitamins like Vitamin C and low levels of folic acid or vitamin B complex (provided taste is not unpalatable). The blessing is that water soluble vitamins will not cause toxicity. Particularly Vitamin C is required in high amounts and can even slow down aging through antioxidant action. There! You have antiaging water through a water purifier!! The technology is already available. Consider Flushkleen, this product is a system that has a dispenser which is put in to the flush tank. The dispenser slowly releases the antiseptic substance and pigment through diffusion out of the dispenser. The same system can be applied to permit diffusion of water soluble vitamins from the dispenser in to the water purifier's water tank. This is a concept I am elucidating. This addition to Aquagard, or Kent will only increase its importance in a home. So one can expect this water purifier home appliance to be as ubiquitous as the iron box, TV, washing machine or refrigerator, when the health benefits are appreciated by the target buyers.

Value addition in water has, as we see above, a vast scope. WATER FOR LIFE AND WATER FOR A GOOD BUSINESS!!

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The 24 hour VACCINATION BOOTH AND VACCINATION ADVISORS

I got the above interesting image of HIV vaccines (Indo-Jap collaboration) from here.

After completing a century of blogposts, here is my 101st blogpost! The focus is on the vaccines market in this blogpost.

As things stand now, the highly commoditized vaccine market of India is a pure doctor-centric business. The main focus is on pediatricians and and to a lesser extent, the GPs. Global majors and Indian companies who manufacture and market vaccines are in a sort of conundrum - although the potential is very high (India is the largest human vaccines market), thanks to the population and the demographic picture of India, commodity vaccines sell more than the unique ones and there is a high cost of sale. The leader Indian companies not only supply vaccines (veterinary, poultry, and human) to the Indian market, they are leaders in export too. The global vaccines market is estimated to be about 10 billion USD, and growing in double digit figures.

Marketing vaccines is mostly a freebie based CRM approach. The focus is on pediatricians and loading the target doctor with as much vaccines stock as possible based on a lot of freebies like a free refrigerator, or free goods along with sales stock. This will block the entry of other competitor vaccine products or brands for some time at the concerned doctor clinic. The normal practice is for the doctor to administer the vaccines from the stock he or she has. The practice of giving prescriptions for specific vaccine brands is rare. So the vaccine marketing concept is doctor-centric. In case, the doctor does not stock the vaccine. It is the adjoining chemist who does it. This chemist or pharmacist is invariably hand-in-glove with the doctor in the sense, there is financial understanding between the doctor and the chemist retailer.

The Hepatitis B vaccine marketing saw a new era with a HEPATITIS B VACCINATION CAMP marketing approach. The thrust of all the Hepatitis B vaccine marketers was to organize mass vaccination camps in collaboration with the doctor(s) and sometimes with social organizations like the Rotary club and Lions club. The net result was MARKET BUILDING for the Hepatitis B vaccine product. Doctors particularly pediatricians saw this as a social marketing opportunity for thier clinics, through the Hepatitis B vaccination camps. Hence, today there is a great acceptance of Hepatitis B vaccination and in large part has possibly influenced IAP (Indian Academy of Pediatrics) to include this as a must-to-be administered vaccine. In all, some 25 vaccines are available in India with a major focus on the pediatric segment. Tetanus toxoid, polio, DPT, typhoid and Hepatitis B vaccines are the biggest markets in Inda.

How to grow the vaccine market?

Vaccines undoubtedly have a great role to play in healthcare. These products contain live (attenuated ie., weakened) or dead antigens of pathogens. On administration, the immune system is primed to produce specific antibodies. The primed immune system thus has circulating antibodies and can produce more antibodies on reexposure to the antigen. This gaurds the body from the disease attributable to the antigen. Thus, Hepatitis B vaccine gaurds people who have taken the vaccine from the dreaded Hepatitis B disease.

The first quest is to popularize the true concept of vaccines. For a majority of Indians, the idea of a vaccine is that it is a product meant primarily for infants and children, as a protective agent. However, we ought to know, vaccines are available for adults too. Today vaccines are being developed for various diseases. For instance, Cuba has a vaccine against lung cancer. SO TO GROW THE VACCINE MARKET, THE FIRST APPROACH IS TO MASS EDUCATE THE COMPLETE POTENTIAL BENEFITS of vaccines. For eg., the awareness of Wyeth's pneumococcal vaccine is not as high as the Hepatitis B vaccine. It just one of the optional vaccines...

The current marketing communication approach is aimed mainly through the pediatrician, by the vaccine marketers. The visible aspects of this approach is posters and patient information leaflets kept in clinics. This is read by some of the patients. And that is it. The doctor administers the vaccine brand he or she wishes to. The patient does not practically have a choice. Even doctors are wary of over-recommending any optional vaccine or specific brand. If doctors do this, it is possible that he or she may lose the patient.

IT IS HOWEVER, IN THE BEST INTERESTS OF THE NATION, PATIENT, AND MARKETER THAT MORE AND MORE AWARENESS NEEDS TO BE CREATED ON THE VACCINATION CONCEPT AND THE PLETHORA OF VACCINE BRAND CHOICES AVAILABLE.

Thus, a marketing approach would be:

a) for a comprehensive website that provides details of vaccination and each and every vaccine brand available. This website ought to serve as a single window of information on the vaccination concept and vaccine brands in India.

b) the next is to have 24 HOUR VACCINATION BOOTHS, that provide information, vaccine brands, and facilities to administer vaccines to interested people. This would really create market building for vaccines.

c) the third important approach is to have VACCINATION ADVISORS manning these booths. The vaccination advisors concept is similar to education counsellors of computer education companies, beauty advisors of companies like Lakme, and insurance advisors of various insurance companies. The vaccination advisors should be informed and trained personnel who will advise interested people on various vaccination issues, and even conduct seminars or go about visiting 'new parents' to talk on vaccination issues and help make a proper vaccination choice for thier new born. It should be noted that vaccination is often a once in a life time affair and can make a big difference to the future of the neonate. So a proper ecosystem for information and vaccination administration should be created and the VACCINATION ADVISORS along with 24 HOUR VACCINATION BOOTHS concept WILL HELP in this direction.

It is not healthy to have a purely freebie based CRM approach to vaccination. And it is impractical to expect that the pediatrician or the GP will have time to educate the patient on various vaccine brand options and help the patient make his or her choice.

IN INDIA, 24 HOUR VACCINATION BOOTHS AND VACCINATION ADVISORS WILL SERVE AS VITAL LINKS AS DIRECT-TO-CONSUMER ADVERTISING ON VACCINE BRANDS IS NOT PERMISSIBLE UNDER LAW.

Thus, to build a robust market for vaccines the actual consumption of the brands should take place, for this the market should expand. If this is to happen, then, patient empowerment is a must. The road to patient empowerment and vaccine market expansion is through VACCINATION BOOTHS AND VACCINATION ADVISORS, and a knowledge campaign through dedicated workers. Such vaccination knowledge dissemination cannot happen through busy doctors, a bunch of patient information leaflets, and posters on some clinics.
There is a lot of ignorance regarding the CHICKEN POX VACCINE AND TYPHOID VACCINE. Pushing more patient information leaflets and posters on these vaccines is not going to help the cause of marketing these vaccines nor is it going to help the prospective patients who would benefit from these vaccines. A lot of persuasive information needs to go through specific trustworthy personnel such as vaccination advisors.

Will vaccination advisors be trusted?

As long as the pitch of the vaccination advisors is related towards information and empowerment, it will work, and any selling activity is best left to the sales persons.

A good vaccination empowerment ecosystem is vital for the future

In years to come, quite a few breakthrough vaccines will be introduced in India. For instance, Gardasil, the cervical cancer vaccine. There are segments in the Indian society who will be benefited by these vaccine, and there could be more useful vaccines forthcoming in to India. How to market them? The vaccination advisors and 24 hour vaccination booths will help the cause.

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Post 61st anniv. of Indian independence: start of a new era of Technology in Pharma India

We have just celebrated the 61st anniversary of Indian independence. The golden lining (not silver lining!) is that AB (not Amitabh Bacchan, but ABHINAV BINDRA) got our country the first ever individual gold medal in modern Olympics at the Beijing Olympics in the 10 m Air rifle shooting event (on 11.8.2008). This gold medal win has a great lesson for us in India. One that we can be winners on the world stage. And, two, it requires great nurturing of talent to make a world-class winner. Full credit goes to the devoted wealthy parents of Abhinav for creating this victorious moment for us Indians (you can see the photo of AB with his parents above). It also shows the way to the lakhs of wealthy crorepathy Indian families on how they can use their wealth intelligently to create good children - very often children of the wealthy are spoilt ... spending most of their time with beer (alcoholic beverages) and negative activities. The victory showcased by AB is a lesson to all wealthy crorepathy Indian parents!

The dawn of AN ERA OF PHARMA TECHNOLOGY IN INDIA

Today, Indian pharma industry is highly commoditized. It is an era where CRM power is the muscle power of a company. The marketing orientation is towards intense CRM activities. The marketing and sales cycle is simple: contact the doctor-detail-sample-gift-negotiate and provide specific gifts and sponsorships (including celebrations of birthdays and anniversaries) in return for prescriptions or POBs (personal order booking) related sales. The moot point is how long can this go on and to what extent? Pharma companies today provide prescribing doctors with groceries, provisions, movie tickets at multiplexes, white goods (like DVD players, washing machines and refridgerators), sponsored vacations under the garb of seminars and symposia, clinical oriented gifts, pens, payment of electricity bills, cash, samples, schemes (ie., free goods with sales stocks) and what not... Earlier it was a minority of pharma companies that indulged in no-holds barred CRM and it was a minority set of doctors who indulged in taking any and every thing that a pharma company provided. Today, the situation is converse. Almost all pharma companies do intense CRM and majority of doctors demand the kind of items (gifts and freebies) they want to be serviced with. Doctors themselves lament that today the situation is not what it was say in the 1970s ... SO WHAT IS THE NET RESULT FOR PHARMA COMPANIES? Events like the sale of Ranbaxy to Daiichi Sankyo ... C'MON, THAT IS FAR FETCHED!! HOW CAN CRM RELATED SALES AND MARKETING ACTIVITIES MAKE A COMPANY WEAK ENOUGH TO BE TAKEN OVER BY ANOTHER COMPANY? THE ANSWER IS HERE...

When any pharma company gives CRM the highest in the priority in terms of revenue generating business activities, the focus of the entire company (right from the top management to MR level) goes towards CRM. Everything else becomes secondary. The casualty of a hyperfocus on CRM is profits. When marketing value is perceived in terms of freebies and gifts given to the prescribers the product per-se takes the back seat. And with that there is an erosion of profitability.

The medical profession too feels the pain today... doctors have seen the erosion of trust between the doctor and patient. When trust and profitability get eroded, it means business processes are becoming less effective and efficient.

Peter Drucker says that profits are a measure of effectiveness and efficiency. So what will the pharma entrepreneur do to improve profitability? Cut down on CRM budgets overnight! NO!! THAT WILL BE SUICIDAL!!!

THE ERA OF PHARMA TECHNOLOGY IN INDIA WILL BEGIN NOW (as a force of circumstance)...

The sagacious pharma entrepreneur will start putting the focus on technology - either packaging technology (for instance Juggat Pharma's ingenious application of tetra pak technology to create the product category of ELECTROLYTE ENERGY DRINKS for Rx support, for more details: info@jagdale.com) , or new drug development programs or new dosage delivery systems.... Pharma companies will exploit science further - to apply scientific precepts, concepts, and tools to improve the pharma product's safety, utility, and application. This in turn will create unique features in brands. This certainly will provide USPs (unique selling points) for the brand. This will ensure new and attractive talking points while detailing the brand to the target audience. And when a product is presented as different and better, the focus on gift based or freebie based CRM will decrease. This will ensure that profits will be better.

Without growth in real profits, a company's decline will begin. The pharma company will enter in to a vicious cycle of a freebie based CRM trap, from which it will not be able to get out fast. Today, let us say a doctor gets satisfied with a TV for his clinic and he gives a bonanza of prescriptions for a brand. However, the opium of the freebie will fade away fast, the doctor's need will rise further - he will want a LCD TV or plasma TV next. If a doctor is offered a 5 star room for his sponsored stay during a symposia, he will want the next time a seven star room facility.

Hence, the sagacious pharma company will start producing pharma goods that will create brand differentiation through technology. For instance, Zydus Cadila has collaborated for a little known technology to differentiate their erythropoietin offering - they are offering erythropoeitin which is pegylated. It is an interesting technology of combining erythropoietin with polyethylene glycol. It is described as a low hanging fruit on the technology tree. Not a very complex technology, but nevertheless a technology that can give brands some more power and real marketing value.

Another little step in this direction is the resin based system in Becosules Z (from Pfizer) to enhance the absorption and bioavailability of B complex vitamins. This differentiates the brand further from other B complex products. NOW IMAGINE, IF PFIZER LAUNCHES A BECOSULES NANO, WHERE IN THEY PROVIDE A MULTIVITAMIN USING NANO SPHERES (VITAMINS ARE PRESENT IN THE NANOSPHERES) AND THAT THIS ENHANCES ABSORPTION ... THE RESULT IS HIGHER PERCEIVED VALUE FOR BECOSULES Z AND MORE PRESCRIPTIONS. Imagine a nano based tech product for rifampicin or isoniazid that enhances absorption and bioavailability - thus, lesser drug can be used for the patient and the side effect (particularly liver toxicity) can be reduced. Value delivery through technology in pharma is better marketing sense than an overemphasis on freebie based CRM.

Application of technology in pharma will increase with the interdisciplinary approach in pharma.

End note

It is well known that technology provides companies with more financial might than freebies based CRM. Imagine for a moment - if Ranbaxy had provided as much focus on technology as it has provided for freebie based CRM, in its marketing operations right from the beginning, today probably Ranbaxy would not have got sold out to Daiichi Sankyo.

RECOLLECT THE ASIAD DAYS IN INDIA (1982), WE HAD TV BRANDS IN INDIA LIKE DYANORA, TEXLA, CROWN, EC TV, KELTRON, KEONICS, ETC. TODAY, AFTER ECONOMIC LIBERALIZATION, WHERE ARE THOSE TV BRANDS? THEY HAVE BEEN GOBBLED UP BY THE TECH GIANTS - MAINLY THE JAPANESE. TECH COMPANIES HAVE FAR MORE FINANCIAL MUSCLE. THE SAME THING HAS STARTED HAPPENING IN INDIA, DAICHII SANKYO HAS BOUGHT OUT RANBAXY ( I ESTIMATE THAT IN 3 TO 4 YEARS, IE. BETWEEN 2011 AND 2015, THE INTEGRATION BETWEEN RANBAXY AND DAIICHI WILL BE COMPLETE, AND MOST LIKELY, THE NAME RANBAXY WILL VANISH IN TO OBLIVION OR WILL BE THERE ONLY FOR NAMESAKE). AS THE INDIAN PATENTS ACT, 1970 HAS BEEN AMENDED, PRODUCT PATENTS ARE NOW VALID IN INDIA. HENCE, TECH COMPANIES WILL HAVE THE UPPER HAND SLOWLY BUT SURELY. SO THE SAGACIOUS ACT WILL BE TO PUT THE FOCUS ON TECH ASPECTS IN PHARMA COMPANIES - IT SHOULD HAVE AS MUCH PRIORITY AS MUCH AS 'FREEBIE BASED CRM' HAS IN INDIAN PHARMA COMPANIES. This is more important in current times when world over the focus is on BRIC countries. Right now, America is in a recession and Brandweek says that even the drug industry in America is in a recession, another net poll (at John Mack's blog) too says this. So where will these tech rich companies of USA focus? Yes ... of course India and China for growth. So expect more buy outs and shakeouts. Already there are reports that Takeda the #1 Jap pharma company is tryin' to buy out Torrent.

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