FDC Ban - What's Right and What's Wrong?
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The April 2016 issue of Medicinman discusses the need for a comprehensive revamp of healthcare in India, emphasizing the importance of collaboration between the government and the Indian pharmaceutical industry. The editorial critiques the recent ban on irrational drug combinations for its haphazard execution, which has caused chaos among pharmaceutical professionals and patients. It calls for the industry to be seen as a valuable partner in healthcare delivery, exemplified by campaigns like Janssen Pharmaceuticals' anti-MDR TB initiative.
![Salil Kallianpur | Markets and Morals in Pharma
19 | MedicinMan April 2016
Fixed Dose Combinations (FDCs) – con-
venient or deadly?
So what is it with FDCs and its appeal with doctors?
Recently, about a 1,000 of these products were
shown to be irrational, which means that they
could potentially harm patients who consumed
them. Commentators have pegged FDCs to consti-
tute nearly 50% of the $15 billion domestic Indian
pharma market.
It is impossible to believe that such a large market
can exist without consumer demand to match. And
this has happened for years – in some cases, over
30 years. But this doesn’t make it legitimate. What
is wrong is wrong and one should not defend it.
What one should definitely do though, is debate
how to make things better. Why were irrational
combinations approved? What systemic shortcom-
ings should be plugged to ensure that this doesn’t
happen again?What kind of punitive action should
be forthcoming?
Instead of debating such questions, the discussion
in the public domain has been completely moralis-
tic. Companies have been labeled greedy and cor-
rupt. They have been accused of caring nothing for
human lives and focusing only on making profits
instead. This is not to absolve companies at all, but
what seems to irk some commentators more is that
no laws were broken and so it is difficult to lay the
blame squarely on one party. To confound matters,
the courts immediately granted stay orders on the
ban. Some commentators have wondered if com-
panies bent the rules. Why else have state regula-
tors – who approved most of these products – not
stood up to defend their case? Instead of such con-
jecture, should we not seek to understand why this
was allowed for so many decades?
... the discussion [about FDCs]
in the public domain has
been completely moralistic.
Companies have been labeled
greedy and corrupt. Instead of
such conjecture, should we not
seek to understand why this was
allowed for so many decades?](https://image.slidesharecdn.com/medicinman-april-2016-160407060243/85/FDC-Ban-What-s-Right-and-What-s-Wrong-19-320.jpg)
FDC Ban - What's Right and What's Wrong?
- 1. MEDICINMANField Force Excellence April 2016| www.medicinman.net Since 2011 “HealthcareinIndianeedsacompleterevampbutithastobedonethrough well-thought-out measures.The Indian Government needs to make Indian Pharma a partner in delivering healthcare, not to mention a key driver of “Make-in-India”.” L ike India, the Indian Pharma Industry is also as di- verse as it can get. There are the world-beaters - first rate companies Like Sun Pharma, Cipla, Dr. Reddy’s and Serum Institute in the top 10 as well as small, bouquet companies like British Biologicals, Human Bio- logicals Institute and Apex Laboratories, who have done India proud. The MNCs in India have contributed both to making healthcare better and to grooming and developing in- dustry professionals – companies like Pfizer, GSK, Eli Lilly, Merck and MSD are virtually centres of learning and de- velopment. Janssen Pharmaceuticals recently flagged off a brilliant campaign in collaboration with Government of India to develop new modalities to treat MDR TB. Thus, to paint the entire industry with the same brush whether it be through the FDC ban or the recent slew of policy measures that have hit the industry like a tsunami – is mindless, to put it mildly. EDITORIAL: FDC Ban PARTNER, DON’T PUNISH
- 2. True, healthcare in India needs a complete re- vamp – but it has to be done through well thought out measures. Not in ham-handed ways that do not make a distinction between the good, bad and the ugly. A ban on irrational combination of drugs was long overdue but the execution was haphazard, creating pandemonium for pharma, physicians and patients. Salil Kallianpur, a founding-mem- ber of MedicinMan editorial team, writes on the topic as eloquently as he has always done (see page 18). We plan a series of such articles on ur- gent issues that affect Indian Healthcare. The Indian government needs to make Indian Pharma a partner in delivering healthcare, not to mention a key driver of its “Make-in-India” pro- gram. The Jannsen Pharmaceuticals anti-MDR TB campaign amply demonstrates the scope for such meaningful partnership. MedicinMan plans to conduct a CEO Conclave to discuss these and other burning issues and ar- rive at insights for action that can lead to better government–industry interaction and partner- ship in the interest of the Nation’s health. Do write in with your thoughts. - Anup Soans Editorial A ban on irrational combination of drugs was long overdue but the execution was haphazard, creating pandemonium for pharma, physicians and patients. Connect with Anup on LinkedIn | Facebook | Twitter Anup Soans is an Author, Facilitator and the Editor of MedicinMan. Write in to him: anupsoans@medicinman.net Meet the Editor
- 4. CONTENTS MedicinMan Volume 6 Issue 4 | April 2016 Editor and Publisher Anup Soans CEO Chhaya Sankath Chief Mentor K. Hariram Editorial Board Salil Kallianpur; Prof. Vivek Hattangadi; Shashin Bodawala; Hanno Wolfram; Renie McClay Executive Editor Joshua Soans Letters to the Editor: anupsoans@medicinman.net 1. Three Simple Ways to Step Up Your Role as a Firstline Leader ..................................................6 Using Empathy, Focus and Presentation to earn the confidence of your team and produce outstanding results. Vivek Hattangadi 2. What Makes a Brand Management Strategy Successful? .......................................................11 What every Pharma Brand Manager needs to know about crafting a successful Brand Strategy over the lifecycle of a product. Genesh Kuriakose 3. Application of Porter’s 5 to Pharma Marketing ........................................................15 A tried-and-tested competition analysis framework, applied seamlessly to pharma. Pankaj Mehrotra 4.MarketandMoralsinPharma?.....................18 Free markets are by nature amoral. To get moral (or ’just’) outcomes from an amoral market requires a well-developed governance system - which India presently lacks. Salil Kallianpur 5. NOT Business as Usual ................................23 How the New Generation of Pharma Professionals Will Embrace Change and Disruption. Jay Mehta We’ve changed the formatting of articles to make the PDF more mobile-friendly. Tell us what you think: anupsoans@medicinman.net
- 5. PHARMINTECH 2016. THE STRONG HEART OF ITALY’S PHARMACEUTICAL INDUSTRY The international rendezvous dedicated to the pharmaceutical, parapharmaceutical and nutraceutical in- dustry celebrates its 15th anniversary in excellent health. The fifth edition will take place during the Pharma Week, from 13 to 15 April 2016, alongside Cosmofarma. In this manner, the entire supply chain for the pharmaceutical world will converge into a unified rendezvous. Anup Soans - Editor, MedicinMan will be present at Pharmintech as a representative of the Indian Pharma Industry as well as to report on the proceedings. Visit pharmintech.it for more
- 6. 3 SIMPLE WAYS TO STEP UP YOUR ROLE AS A FIRSTLINE LEADER. Using Empathy, Focus and Presentation to earn the confidence of your team and produce outstanding results. 6 | MedicinMan April 2016 W alter Isaacson in his biography of Steve Jobs describes the 3 Principle’s that drove Apple Inc. – ‘The Apple Philosophy’. These 3 Principle’s have influenced me greatly. »» Empathy »» Focus »» Presentation How can these 3 Principles be used by the phar- ma first-line leader (FLL)? Here is my interpreta- tion. The case histories are drawn from real-life epi- sodes, although the names have been changed. Empathy Empathy is ‘the ability to understand and share the feelings of another person’. For a leader, it is to understand the medical representative’s world fully and to let them know that you un- derstand it. If you are an empathic FLL, you will care for your medical representatives. If they feel valued and appreciated they will go beyond the call of duty. Empathy fosters positive feelings, and is funda- mental to effective leadership. Vivek Hattangadi
- 7. A client of mine, Maheshbhai Patel, the MD of a growing pharma company in the I.V. fluid segment, observed that a newly joined lady receptionist had come to office on her old, battered Luna, without a helmet. Privately he asked her why she wasn’t wearing a helmet. She innocently told him: “I come from a lower middle-class family and will be the only bread winner once I get my first salary. I can’t afford it today. I will certainly buy one with my first salary.” During lunch, Maheshbhai’s chauffeur came to her with three helmets and asked her to choose one which fitted her best. “It’s for you from our MD. He cares for everyone in this organization and wants you to be safe.” The same evening while returning, she met with an accident. The helmet cracked but the girl was not hurt seriously. When she related her experience, I was moved and my respect towards Maheshbhai soared. This is empathy. Not surprisingly, the attrition rates in this organization are very low. Focus Do you know the difference between the sun and a laser beam? The sun is the all-powerful fountain- head of energy. It delivers to planet earth billions of kilowatts of energy every day. However, with a cap, or an umbrella, medical representatives can work in the sun. This is because the sun dissipates its energy. On the other hand, the laser is a weak source of energy. Yet its applications are where power is re- quired. A laser-beam can cut metal, diamonds and even replace the surgeon’s knife. The principle of the laser is simple. It amplifies and concentrates light over and over again until it emerges into a very powerful beam. This is focus – the power of focus. A narrow focus becomes a powerful driving force. 7 | MedicinMan April 2016 If you are an empathic FLL, you will care for your medical representatives. If they feel valued and appreciated they will go beyond the call of duty. Vivek Hattangadi | 3 Simple Ways to Step Up Your Role as a Firstline Leader
- 8. For an FLL, focus means to eliminate the numerous unimportant things, and invest time on important tasks. You need to understand your priorities so that important issues get precedence - rather than end up doing a ‘fire-fighting’ job when important tasks become urgent. Learning to prioritize and then focusing on import- ant issues is a skill which FLLs must develop. Ram Negi, a recently promoted first-line manag- er did exactly this. His focus was on the most im- portant task - of developing and training his peo- ple – not the urgent task of meeting numbers. At times, when he missed the monthly numbers, he got a mouthful from his bosses. He didn’t let mind- less criticism detract him from his sharply focused goal of developing people. Within a year, he never missed numbers. He was the most relaxed first-line leader on the sales-closing day. In less than two years he was promoted to the next position. In the expansion program which followed, four of his six medical representatives were promoted. Ram Negi today is the Vice President in his organization. Presentation “People do judge a book by its cover”. So also medical representatives judge the strength of your leadership based on the signals they receive when interacting with you. You as an FLL may have the best of the technical competence, and communication of the highest quality. However, if you present yourself in a slip- shod manner, you may be perceived as an FLL with poor leadership skills and competence. If you pres- ent yourself in a professional manner, you will be perceived to have the qualities of an excellent FLL. Abhiman Gokhale, a FLL of a mid-size pharmaceu- tical company used to be shoddily dressed, always chewing betel nut and invariably unpunctual. De- spite his good communication skills, a high degree of technical competence and superb EI, his career stagnated. Because of his appearance, he was nev- er taken seriously or accepted as a leader . 8 | MedicinMan April 2016 A laser-beam can cut metal, diamonds and even replace the surgeon’s knife... This is focus – the power of focus. A narrow focus becomes a powerful driving force. Vivek Hattangadi | 3 Simple Ways to Step Up Your Role as a Firstline Leader
- 9. Vivek Hattangadi | 3 Simple Ways to Step Up Your Role as a Firstline Leader The HR Chief asked him to do a self-assessment and take stock of his strengths and shortcomings. Abhiman understood his deficiencies and decided to change. He gave up his low-quality habits and requested for a transfer to a totally new zone where he was not known. In his new District, Abhiman Gokhale presented himself as true professional and an ideal FLL. He was promoted to second-line leader within two years. To sum up: 1. Have empathy for your people – make sure ev- ery little thing you do helps to develop them. 2. Focus – forget about everything else except the most important task. 3. Send the right signals so that you present yourself as a strong leader. M 9 | MedicinMan April 2016 ...if you present yourself in a slipshod manner, you may be perceived as a FLL with poor leadership skills and competence. If you present yourself in a professional manner, you will be perceived to have the qualities of an excellent FLL. Vivek Hattangadi is a Consultant in Pharma Brand Management and Sales Training at The Enablers. He is also visiting faculty at CIPM Calcutta (Vidyasagar University) for their MBA course in Pharmaceutical Management. vivekhattangadi@theenablers.org
- 10. App Store: https://itunes.apple.com/us/app/medicin- man/id1077336476? Google Play: https://play.google.com/store/apps/de- tails?id=com.medicinman.apps DownloadtheMedicinManapptogetvideos,photos,snippets,big ideasandkeytakeawaysfromFFE&BrandStorm2016everyweek. MEDICINMAN Field Force Excellence CEORountableatFFE2016 (L-R) Darshan Patel, Partner, PwC; Krishna Singh, Founder-CEO, GlobalSpaceTechnologies;Vikas Dandekar, Editor - Pharma & Healthcare at The Economic Times; YS Prabhakar, CEO Sutures In- dia; CT Renganathan, Managing Director RPG LifeSciences; Ali Sleiman, General Manager India, Merck Serono Sankar Dass, COO & Director, CURATIO Healthcare. Sankar Dass has more than three de- cades of experience during which time he has built major brands like Omez, Razo, Nise, Ketorol, Stamlo, Mintop, Ve- nusia and others. Prior to his current role, he was the Vice President in Dr. Reddy’s Laboratories. BrandStorm2016Keynote FFE2016Keynote Darshan Patel, Partner, PwC Darshan is a Partner leading the Forensic Services practice in Mumbai with substantial investigative and forensic accounting experience in USA and India. He has been with the organization for over 22 years out of which, he spent 9 years as part of the forensics practice in New York. He has over 14 years of work experience across practice areas of Forensic accounting, Disputes & Litigation.
- 11. T he biggest challenge facing healthcare marketers is how to make their brand sustainable when the brand manager has limited control on employee attrition, doctor/ chemist/patient perception of medical sales pro- fessionals, guidelines, and many more. Today, brands are built either through prod- uct innovation or creating product loyalty and product “alliances” in the minds of doctors and patients. Product Innovation For Indian pharmaceutical companies drug dis- covery may be difficult but product innovation in rational combinations and micro-macro nu- trients is very well possible. Product innovation can happen in any small organization by cre- ating a knowledge-sharing platform because most innovation happens when we understand the minute failures in the currently available op- tions. 11 | MedicinMan April 2016 Genesh Kuriakose WHAT MAKES A BRAND MANAGEMENT STRATEGY SUCCESSFUL? What every Pharma Brand Manager needs to know about crafting a successful Brand Strategy over the lifecycle of a product.
- 12. Genesh Kuriakose | What Makes a Brand Management Strategy Successful? 12 | MedicinMan April 2016 One example is the prevalence of Hyperhomocys- teinemia (well known risk factor for vascular dis- eases) in India. As per a recent report, Hyperhomo- cysteinemia is prevalent in 92.85% of Indian men and 81.60% of Indian women1 . We can very well conclude that those Indian com- panies who identified the potential of Hyperho- mocysteinemia and its pharmacological treatment (Methylcobalamin, L methylfolate and Pyridoxal 5 phosphate) have done their job in product inno- vation. Yet another example is carica papaya leaf extract for Thrombocytopenia. ADA recommends medical nutrition therapy for all patients with type 1 and type 2 diabetes as part of treatment plan2 . Indian food habits and nutri- tional deficiencies are peculiar and specific, hence addressing the deficiencies using the knowledge sharing innovation platform could lead to a suc- cessful product innovation. Product Alliances This is where brand managers and marketing teams can contribute majorly. An organization can- not rely solely on short-term brand management plans. It needs both short-term and long-term plans for business generation. In simple terms, a short-term plan can be defined as any promotional strategy to get immediate business, while a long- term plan needs to focus on creating product al- liances. Humans tend to align to a certain routine. For example, we generally prefer to go to our place of work and come back by the same route even though multiple routes are available. Similarly brand alliances get the doctor to prescribe a prod- uct by routinely associating it as a solution to a disease problem.The steps to creating product alli- ances is as follows: Humans tend to align to a certain routine... Similarly brand alliances get the doctor to prescribe a product by routinely associating it as a solution to a disease problem.
- 13. Genesh Kuriakose | What Makes a Brand Management Strategy Successful? 13 | MedicinMan April 2016 Identification of core value Core value is not just a positioning line; it has to be identified based on product and organization com- petencies. Correctly identified core value should be practiced in all process associated with the brand. A living example of a core value practiced is“Think Different”of Apple Inc. Reflecting the core value Creating a reflection of identified core value in the customer’s mind without stating the same is the stepping stone of brand building. The reflection is cerated through the sales representative’s dressing style, body language, literature, sample pack, prod- uct pack, patient experience, distributor level, etc. Reflecting the core value is like wearing a perfume - wherever one goes the fragrance follows. Similar- ly the product core value is expected to get reflect- ed at every point of its movement. Consistency Consistency can happen only with standardization. Standardization of colour, pattern, font, language, etc is the basics of consistency and is considered as the foundation of product alliance. Brand Lifecycle Management3 Interestingly, 50% of recent launch successes was from brand extensions. To build brands, pharma- ceutical players need to proactively manage their brand during various phases: »» 0 to 4 years of launch – Generate prescription momentum, establish credibility and compet- itor edge »» 4 to 8 years – Broaden the portfolio (line exten- sion and newer indications) »» Beyond 8 years – Product life cycle manage- ment What happens to the patients for who a particular combination that worked to relieve cold and fever is suddenly pulled off the market? Shouldn’t consumers have a way of lending their voice too?
- 14. Genesh Kuriakose is Technical Director - Smarkus Solutions Genesh Kuriakose | What Makes a Brand Management Strategy Successful? 14 | MedicinMan April 2016 In this competitive healthcare market, pharmaceu- tical players need to think beyond disease manage- ment and patient management. Strategies should be formulated to enhance disease awareness, doc- tor personal branding, and hospital product/ser- vice branding and corporate branding. Industry needs to move from a one-size-fits-all, ap- proach to customized product offering by under- standing the unattended areas in current disease management. Tomorrow’s business accomplishment depends on creating a platform for product innovations and branding techniques for product alliances. M References 1. Kamdi SP, Palkar P. Prevalence of hyperhomocyste- inemia in healthy Indian doctors. Bioinformation. 2013;9(4):193-196. doi:10.6026/97320630009193. 2. American Diabetes Association. Standards of medical care in diabetes—2015. Diabetes Care. 2015;38(suppl 1):S1-S93 3. India pharma 2020: propelling access and accep- tance realizing true potential, by Mckinskey In this competitive healthcare market pharmaceutical players need to think beyond disease management and patient management. Strategies could be formulated to enhance disease awareness, doctor personal branding, and hospital product/ service branding and corporate branding
- 15. P orter’s 5 forces, was a tool created by re- nowned management thinker Michael Porter to analyze the competitive advan- tage, attractiveness and likely profitability of an industry in 1979. For more than 16 years, Porter’s Five Forces tool has enabled managers to conduct a simple, powerful and disciplined examination of a com- pany’s competitive advantage by examining the way in which an organization can compete ef- fectively to strengthen its market position. The tool structured the concept of competitive advantage by defining the 5 parameters and their impact on an organization’s performance and profitability. Porter’s 5 Forces encapsulates: Analytical framework: The strategic implica- tion of 5 competitive forces includes the analysis of competitors, buyers, and suppliers; Identifi- cation of strategic clusters and a framework to forecast business evolution. Action: Guidance for strategy formulation and reacting to competitive moves. 15 | MedicinMan April 2016 Pankaj Mehrotra APPLICATION OF PORTER’S 5 TO PHARMA MARKETING A tried-and-tested competition analysis framework, applied seamlessly to pharma.
- 16. Pankaj Mehrotra | Application of Porter’s 5 to Pharma Marketing 16 | MedicinMan April 2016 Review: Decisions taken by your organization/sub units and reasons behind differences in their per- formance and examine the competitor’s past and present decisions in context of 5 forces. 5 important forces identified by Michael Porter that determine competitive pow- er in a business situation are: 1. Supplier Power: Factors influencing the suppli- er power to control prices are: the number of sup- pliers, the uniqueness of the product, the cost of switching from one to another etc. 2. Buyer Power: Power of buyers to control prices of products and services is driven by the number of buyers, the market share of individual buyers, the cost of switching from one to another supplier etc. 3. Competitive Rivalry: The ability of competitors to offer equally priced products with similar effi- cacy and quality impact the bargaining power of both suppliers and buyers. 4.Threat of Substitution:The factors like availabil- ity of substitutes like molecules/ products/brands, their comparative effectiveness and safety profile, current treatment protocol, emerging treatment trends influences a supplier power. 5. Threat of New Entry: The ability of new com- petitor to compete effectively is influenced by mar- ket size; entry barriers like government policies, technology, cost of entry, manufacturing and the number of both supplier and buyers influences the decision of others to enter a market.
- 17. Pankaj Mehrotra | Application of Porter’s 5 to Pharma Marketing 17 | MedicinMan April 2016 TheartofusingPorter5forcestodesign competitive strategy in pharmaceutical marketing lies in: »» Factoring in the importance of Physicians and their associations; distribution channels and trade bodies »» Role and place of molecules in the treatment cycle »» Identifying 3 or 4 main factors, quantifying their impact »» Identify resources like money, manpower and their availability »» Patents »» R & D costs Porter 5 forces is a comprehensive framework of analytical techniques to help an organization sys- tematically analyze the industry and predict the industry’s future evolution, to understand its own position versus competitors and use this analysis to formulate a competitive strategy. The competitive advantage is not limited to cost leadership, CRM activities, coverage and geograph- ical reach of an organization but encompasses the entire value chain of an organization. A firm can influence the balance of forces through strategic moves in value chain to improve relative position of its products and services. The more sustainable the competitive advantage, the more difficult it is for competitors to copy and neutralize the advan- tage. Competitive advantage strengthens the abil- ity of an organization to outperform over the rivals in the competitive market. M Pankaj Mehrotra is a Product Group Manager at GlaxoSmithKline Pharmaceuticals. His views are personal.
- 18. 18 | MedicinMan April 2016 O f late, the pharmaceutical industry has been in the news for all the wrong rea- sons. The government intervened to bring in large groups of medicines under the price cap to make them more affordable to the sick. Companies were caught overcharging for some medicines in violation of the prices set by the national price regulator and more recently - and infamously – fixed dose combinations (FDCs or products containing two or more medicines in a single dosage form) were banned en masse by the government. All these decisions caused observers to declare that the free market had all but failed. Salil Kallianpur Free markets are by nature amoral. To get moral (or ’just’) outcomes from an amoral market requires a well-developed governance system - which India presently lacks. MARKETS MORALS IN PHARMA &
- 19. Salil Kallianpur | Markets and Morals in Pharma 19 | MedicinMan April 2016 Fixed Dose Combinations (FDCs) – con- venient or deadly? So what is it with FDCs and its appeal with doctors? Recently, about a 1,000 of these products were shown to be irrational, which means that they could potentially harm patients who consumed them. Commentators have pegged FDCs to consti- tute nearly 50% of the $15 billion domestic Indian pharma market. It is impossible to believe that such a large market can exist without consumer demand to match. And this has happened for years – in some cases, over 30 years. But this doesn’t make it legitimate. What is wrong is wrong and one should not defend it. What one should definitely do though, is debate how to make things better. Why were irrational combinations approved? What systemic shortcom- ings should be plugged to ensure that this doesn’t happen again?What kind of punitive action should be forthcoming? Instead of debating such questions, the discussion in the public domain has been completely moralis- tic. Companies have been labeled greedy and cor- rupt. They have been accused of caring nothing for human lives and focusing only on making profits instead. This is not to absolve companies at all, but what seems to irk some commentators more is that no laws were broken and so it is difficult to lay the blame squarely on one party. To confound matters, the courts immediately granted stay orders on the ban. Some commentators have wondered if com- panies bent the rules. Why else have state regula- tors – who approved most of these products – not stood up to defend their case? Instead of such con- jecture, should we not seek to understand why this was allowed for so many decades? ... the discussion [about FDCs] in the public domain has been completely moralistic. Companies have been labeled greedy and corrupt. Instead of such conjecture, should we not seek to understand why this was allowed for so many decades?
- 20. What can we do better? If FDCs were irrational, why were they authorized in the first place? If the rules stipulated that licens- es obtained from state regulators be validated by the central regulator, why were there no checks in the system to make sure that was done? Obvious- ly, there isn’t an appropriate approval system that seeks proper documentation. There is no prop- er adverse event reporting (AER) system in place that helps gather real-world evidence of the harm caused by such medicines. Absent all these sys- temic check-points, the government action seems ham-handed and open to moralistic judgment. This is probably why 40% of doctors disagreed with the ban in an informal survey carried out by a lead- ing business daily. The governance system is severely underdevel- oped in India. When a PIL was filed in the Supreme Court of India, the judges threw the case out saying something to the effect that they had bigger prior- ities to work on! With this context, does a ban seem like the best solution to the problem? The ban is based on the fact that these FDC products aren’t approved by the US-FDA. This is simply because the single medicines used in creating the com- binations are often under patent protection and belonged to different companies. It would take extraordinary effort for these companies to forge deals to create such combination products. India does not recognize these patents and therefore In- dian companies can easily formulate combination products. Salil Kallianpur | Markets and Morals in Pharma 20 | MedicinMan April 2016 The ban is based on the fact that these FDC products aren’t approved by the US-FDA. This is simply because the single medicines used in creating the combinations are often under patent protection and belonged to different companies... India does not recognize these patents and therefore Indian companies can easily formulate combination products.
- 21. Sadly, what began as an exercise to help patients reduce pill burden and increase compliance to therapy ended up in an overambitious industry ef- fort to create products, not all of which were sup- ported by science. It would be interesting to examine if patients complained about problems with these products. What happens to the patients when a particular combination that worked to relieve cold and fever is suddenly pulled off the market? Shouldn’t con- sumers have a way of lending their voice too? Have any commentators called for the formalization of patient bodies that can have a place at the table during such decisions? Also, it is common knowledge that goods with great demand that are banned by government regulation, find their way to consumers through a parallel marketplace that we commonly call the ‘black market’.The government knows this through its strict regulation on alcohol, narcotics, gold and other such goods. Sadly, it learns nothing. Should companies be absolved? Exploiting loopholes in the law is definitely not a smart business decision. History has taught us that such seemingly short-term benefits can turn out to be medium-to-long-term disasters which have often led to companies considered market leaders to disappear. Why do executives not learn from history then? Are they evil, scheming Scrooges as they are made out to be? They only answer I can think of is that corporate incentives are completely misaligned. They are skewed towards profit cen- tricity. While this in itself is not bad, it can encour- age recklessness and avarice especially in a system with a grossly underdeveloped governance infra- structure. This is no excuse at all claim observers and rightly so. What about internal ethics and gov- ernance policies? Salil Kallianpur | Markets and Morals in Pharma 21 | MedicinMan April 2016 What happens to the patients for who a particular combination that worked to relieve cold and fever is suddenly pulled off the market? Shouldn’t consumers have a way of lending their voice too?
- 22. Corporatization and Free Markets Overall, such behavior undermines the true na- ture of free markets. Popular moralistic sentiment mistakes corporate behavior as the epitome of the evils of privatization and the subsequent failure of free markets. The irony is that bans and punitive government action and interference prove time and time again that markets are NOT free at all. It can be argued that the government is forced to intervene because of reckless corporate behavior. Irresponsible action by companies forces govern- ment agencies to intervene. The key question is who will stand up and take the responsibility to break this vicious cycle? Until then, we will mis- guidedly worry about markets becoming detached from morals. Salil Kallianpur | Markets and Morals in Pharma 22 | MedicinMan April 2016 Salil Kallianpur is an executive in the pharmaceutical industry currently working for GlaxoSmithKline Pharmaceuticals. This article is written in his personal capacity and is not endorsed by his employers. The views are personal.
- 23. I nnovation has constantly transformed man- kind, revolutionizing the way we live and work. The industrial revolution gave the world economy a new character. The internet revolution in the nineties transcended horizons, taking the world economy to the next level. Today we stand at the cusp of another revolu- tion called the disruption saga, encompassing the internet, digital technologies and artificial intelligence. This wave of disruption has em- braced many sectors. Now it will revolutionize healthcare. The core business model of Indian pharmaceuti- cal companies is gradually becoming irrelevant in this digital age and needs renovation. The earlier strategy worked while companies reaped the benefits of developing new drugs for various diseases, launching blockbuster ge- nerics and to certain extent, new drug delivery technologies. But this strategy is no longer go- ing to fetch the same return on capital. Newer models which focus on collaboration with vari- ous stakeholders need to be established. 23 | MedicinMan April 2016 Jay Mehta NOT Business as Usual: How the New Generation of Pharma Professionals Will Embrace Change and Disruption.
- 24. Jay Mehta | NOT Business as Usual 24 | MedicinMan April 2016 Today’s companies must leverage novel technol- ogies to offer more personalized, patient-specific medicines and find ways to serve the Indian mar- ket. They will need new collaborations, fresh think- ing, and all of the tools for furthering innovation. Leveraging SMAC in Healthcare market- ing: Emerging technologies for emerg- ing markets Next-gen technology is integrated marketing strat- egy for healthcare. The paradigm shift from brand- ed products to generics has demanded revolution- ary changes in the marketing strategies adopted by pharmaceutical organizations. Medical research has also augmented dramatic changes in terms of product innovations. The pool of information assembled from the social media and mHealth platforms will be significantly vast and the real challenge will be to collate the data and extract the key analytical findings. These findings will be an enabler for ethical marketing. Certain statistics about internet usage behavior of doctors is interesting. 72% of doctors use internet frequently. 26% of doctors go online during con- sultations. 52% of doctors use multiple devices to go online (Source: Via Media Health). While few can deny the promise that a robust, con- nected analytics infrastructure holds for identifying high-risk patients, targeting preventative services, and reducing hospitalizations and deadly infection rates, getting to the point of performing meaning- ful analytics is both difficult and expensive. The strategy should focus on using data intelli- gently to produce actionable insights, and taking advantage of new storage and exchange opportu- nities. Next-gen technology is integrated marketing strategy for healthcare. The paradigm shift from branded products to generics has demanded revolutionary changes in the marketing strategies adopted by pharmaceutical organizations.
- 25. Jay Mehta | NOT Business as Usual 25 | MedicinMan April 2016 Newer tools include – 1. Analytics to map channel performance, mea- surement of campaign effectiveness, customer engagement metrics and unmet needs/ re- quirements identification. 2. Strong Social Media presence by actively lis- tening to and analyzing online behavior of physicians and patients through exclusive por- tals, blogs and social networking sites. 3. Capitalizing on ecommerce to enhance online sales among manufacturers, wholesalers, dis- tributors, re-sellers, vendors and consumers. 4. IT and emerging technologies such as SMAC present opportunities for pharma companies to engage with external stakeholders such as patients, healthcare providers and gov- ernments to develop products and services designed to make the goal of ‘health for all’ a reality. 5. Digital Services need to be tapped for execu- tion of digital functions such as business rules, security, authorization, workflows, and web content management. Digital and social media is also key to understanding customer behav- ior and channel effectiveness by using appro- priate measurement frameworks. 6. Discovering new ways to engage patients and reach out to them is the next strategy. 94% of pharma and life sciences CEOs said that cus- tomers and clients influence their business strategy. So an integrated social media strategy should be on the cards.
- 26. Jay Mehta | NOT Business as Usual 26 | MedicinMan April 2016 By leveraging new age devices, pharma companies can differentiate and create a competitive advan- tage in a rapidly shifting market. First of all, effec- tive utilization of social media tools for internal col- laboration and knowledge cross over is must. A multichannel approach: In the current scenario, trade/ retail segment con- tributes to 85 % of market value. As a result, much less attention is paid to the hospital segment by pharmaceutical marketing teams. A futuristic study by IMS MIDAS predicts the share of hospitals rising from 9 % to 28% in coming years. Many Indi- an pharmaceutical companies are reworking their strategy to explore the evolving hospital segment as high potential markets. A recent count of 20,000 private hospitals and 500 corporate hospitals un- derlines the opportunity. Majority of the potential is in urban hospitals and outpatient treatments and there is an increasing preference for getting treated at sophisticated hospitals for chronic diseases, and slew of health checkup plans. The influence of hospitals over physicians is in- creasing it is important for Indian companies to understand the dynamics and align sales strategies accordingly. Distinguishing from the traditional model, there is a need to focus on providing integrated and holistic solutions and not just products. Targeting patients through education programs, targeting paramedics and physicians with newer perspec- tives on disease management and providing value -added services through technology are some ave- nues that can be explored. By leveraging new age devices, pharma companies can differentiate and create a competitive advantage in a rapidly shifting market. First of all, effective utilization of social media tools for internal collaboration and knowledge cross over is must.
- 27. Jay Mehta | NOT Business as Usual 27 | MedicinMan April 2016 Companies should invest time and resources to develop relationships with stakeholders in high -potential hospitals to ensure high recall and seek entry. Brand building initiatives hold the key to success in hospital marketing. Conclusion: There is a need for disruption in the approach and thinking of Indian pharmaceutical businesses. A platform should be given to the younger genera- tion to capitalise their idea-pool and potential. For this we need to nurture a mindset which paves the way for fresh thinking and scale up of the ideas. The time is perfect for our generation to drive the change. Indian pharma industry, however, has been slow in catching up the trends in the new age India across verticals like - marketing, manufacturing and sell- ing. Those with first-mover advantage will evolve into integrated healthcare organisations, and not just traditional pharma companies. M Jay Mehta is Sr. Product Executive, Marketing at Fullife Healthcare. He handles brand man- agement, strategy and planning for 3 brands in Dermatology & General health portfolio. He has an MBA in Pharmaceutical Marketing.