Does Healthcare Feature in Raisina Hill’s To-Do List?

Does Healthcare Feature in Raisina Hill’s To-Do List?

At the Capitol Hill, while addressing the joint session of the United States Congress, on June 08, 2016, our Prime Minister Mr. Narendra Modi well articulated the following, in his inimitable style:

“My to-do list is long and ambitious. It includes a vibrant rural economy with robust farm sector; a roof over each head and electricity to all households; to skill millions of our youth; build 100 smart cities; have a broadband for a billion, and connect our villages to the digital world; and create a 21st century rail, road and port infrastructure.”

This ambitious list is indeed praiseworthy. However, as the Prime Minister did not mention anything about health care infrastructure, while referring to rapid infrastructure development in India, it is not abundantly clear, just yet, whether this critical area finds a place in his ‘to-do’ list, as well, for ‘We The People of India’.

This apprehension is primarily because, no large scale, visible and concrete reform measures are taking place in this area, even during the last two years. It of course includes, any significant escalation in the public expenditure for health.

Ongoing economic cost of significant loss in productive years:

“The disease burden of non-communicable diseases has increased to 60 per cent. India is estimated to lose US$ 4.8 Trillion between 2012 and 2030 due to non-communicable disorders. It is therefore critical for India to transform its healthcare sector,” – says a 2015 KPMG report titled, ‘Healthcare: The neglected GDP driver.’ 

This significant and ongoing loss in productive years continues even today in India, handicapped by suboptimal health care infrastructure, and its delivery mechanisms. Such a situation can’t possibly be taken for granted for too long. Today’s aspiring general public wants the new political leadership at the helm of affairs in the country to address it, sooner. A larger dosage of hope, and assurances may not cut much ice, any longer.

Transparent, comprehensive, and game changing health reforms, supported by the requisite financial and other resources, should now be translated into reality. A sharp increase in public investments, in the budgetary provision, for healthy lives of a vast majority of Indian population, would send an appropriate signal to all.

As the above KPMG report also suggests: “It is high time that we realize the significance of healthcare as an economic development opportunity for national as well as state level.”

Pump-priming public health investments:

With a meager public expenditure of just around 1.2 percent of the GDP on health even during the last two years, instead of rubbing shoulders with the global big brothers in the health care area too, India would continue to rank at the very bottom.

Consequently, the gaping hole within the healthcare space of the country would stand out, even more visibly, as a sore thumb, escaping the notice, and the agony of possibly none.

With around 68 percent of the country’s population living in the rural areas, having frugal or even no immediate emergency healthcare facilities, India seems to be heading towards a major socioeconomic imbalance, with its possible consequences, despite the country’s natural demographic dividend.

According to published reports, there is still a shortage of 32 and 23 percent of the Community Health Centers (CHC) and the Primary Health Centers (PHC), respectively, in India. To meet the standard of the World Health Organization (WHO), India would need minimum another 500,000 hospital beds, requiring an investment of US$ 50 Billion.

Moreover, to date, mostly the private healthcare....

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Recomposing Notes Of Pharma Marketing Playbook

Recomposing Notes Of Pharma Marketing Playbook

The global management guru Peter Drucker, in one of his management classics – “The Practice of Management”, published in 1954, that created the discipline of modern management practices, had underscored the following: 

“As the core purpose of any business is to create a customer, a business has two, and only two functions, marketing and innovation. Only these two produce business results. All the rest are costs.”

The Harvard Business Review also had rated ‘The Practice of Management’ as Drucker’s best book on the managerial profession. Far more crisp than the larger compendium on Management, nicely balanced between precept and example, this book is eminently practical yet of genuine intellectual breadth. If Drucker’s work holds anything of immediate value for you, you will most likely find it here…”

Thus, Peter Drucker’s above concept is so fundamental that the pharmaceutical business can’t be any exception to it, in any way. That the old customers need to be retained, and the new customers are to be created on an ongoing basis, even in the modern times, still remain a basic requirement.

Nevertheless, the marketing process of doing so needs to change, according to the changing market dynamics. Continuation of playing the same notes from the grand old marketing playbook, with minor alterations here or there, would no longer suffice to keep pace with the changing market, and to effectively address the new stakeholders’ needs and wants.

Need to recompose notes of the playbook:

Both the current processes of pharma marketing and the patent claim for any type of drug innovation that the majority of the global pharma companies is currently following, have become highly contentious over a period of time, to say the least.

Even otherwise, in my view, both these processes have already hit the ceiling of the famous ‘law of diminishing returns’, where very simply put, the level of profits or benefits gained is less than the amount of money or energy invested.

Therefore, the question that comes up: Are the notes of the pharma marketing and innovation playbook fair, right, inclusive, and sustainable? However, in this article, I shall focus only on contemporary pharma marketing, and the opportunities that are coming up along with waves of changes in the business environment.

An example of ‘Change the logo’ saga:

Going by my personal experience, I have worked with many pharma marketing professionals, some of whom are still working in the industry. Post recruitment in the new company, having gone through a rigorous screening process, most of them would probably give a similar feedback that an anonymous quote captures as follows:

“The optimist says, ‘the glass is half full’; The pessimist says, ‘The glass is half empty.’ The marketing consultant says, ‘The glass needs resizing and a different logo.” 

On a lighter vein, I am using below an example of one ‘change the logo’ approach. This is just one of many of my real life experiences. This may give you a panoramic view of how things generally are. The stretching of the same old marketing paradigm beyond its elastic limit is rather common, of course, with some sporadic digital tweaking. Nonetheless, the notes in the marketing playbook remain almost the same, producing the same tunes for some, and noise for many others.

This ‘logo change’ saga may sound quite familiar to many of my ex-colleagues of not so distant past. This approach exemplifies the limitations of a new recruit for a senior position to identify the core issues that would lead to the organization’s performance improvement.

It does not surprise me at all, when I find some top managements, who were an integral part of that selection process, promptly buying these shallow, and at the most peripheral ideas. It is quite evident that some of these top management members also suffer from similar analytical and management myopia.  It is needless to mention that such things usually happen during the ‘honeymoon’ period’ of the new recruits. 

Accordingly, the ‘logo change’ takes place in no time, paying a huge sum to the creative agency. Commensurate hype is simultaneously created around the new logo, backed by massive efforts to communicate its ‘ethereal design’ to as many targets as possible, often with no tangible outcome. Alongside, attempts are also made to change as many old things as possible, generating a multitude of seemingly high-voltage activities, though the performance on the ground remains unchanged, or rather deteriorates.

I fully understand, there is nothing wrong in changing anything, including a logo, that is not working or has outlived its time. However, when this assumes the top priority of a new and a top recruit, immediately after assuming office with a new responsibility, it somewhat doesn’t gel, and very often does not achieve the desired purpose.

Pharma marketing over-dependent on the likes of ‘Surrogate CMEs’? 

Today, when there is a need to hear more from all the major stakeholders, one sided ‘telling my story’ mostly to the doctors continues to occupy a major part of pharma marketing, besides company sponsored or allegedly surrogate ‘Continuing Medical Education (CME)’ even for old branded generics............

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The Stakeholder-Mix Has Changed But Pharma Marketing Has Not

The Stakeholder-Mix Has Changed But Pharma Marketing Has Not

We try never to forget that medicine is for the people. It is not for profit. Profits follow, and if we have remembered that, they never fail to appear.”

In 1952, George Wilhelm Herman Emanuel Merck, the then President of Merck & Co of the United States said this. He was then aptly quoted on the front cover of the ‘Time Magazine’, epitomizing his clear vision for the company: “Medicine is for people, not for the profits”.

The globally acclaimed Management Guru – Peter F. Drucker had also clearly articulated in his management classics that, “Profit is not the purpose of business and the concept of profit maximization is not only meaningless, but dangerous.” He further said, “There is only one valid purpose of a business, and that is to create a customer” 

As this is an ongoing process, in the pharma perspective, it may be construed as ensuring access to new drugs for an increasing number of patients.

It really worked: 

In those days, driven by such visionary leadership, the pharma used to be one of the most respected industries and Merck topped the list of the most admired corporations in America. It is clear that pharma leadership at that time wanted to make ‘inclusive growth’, both in the letter and spirit, as an integral part of the organizational progress, moving with time.

Thus, it worked. The sales and marketing growth of the global drug industry at that time was not lackluster, either, in any way. The R&D pipeline of the drug companies used to be also rich, with regular flow of breakthrough new products too. 

Straying away from ‘inclusive’ to ‘self-serving’ strategies:

Much water has flown down the bridges, since then, so is the change in the public and other stakeholders’ perception about the pharma industry, in general. 

Sharply in contrast with George W. Merck’s (Merck & Co) vision in 1952 that “Medicine is for people, not for the profits”, in December 2013 the global CEO of Bayer reportedly proclaimed in public that: “Bayer didn’t develop its cancer drug, Nexavar (sorafenib) for India but for Western Patients that can afford it.” 

It appears that the focus of the pharma industry on ‘inclusive growth’ seems to have strayed away to ‘self-serving growth’, with the passage of time. As a result, a large majority of the new stakeholders started harboring a strong negative feeling about the same industry that continues its active engagement with the very same business of developing new drugs that save many precious lives. 

Granted that the business environment has changed since then, with increasing complexities. Nonetheless, there does not seem to be any justifiable reason for straying away from ‘inclusive growth’ strategies.                                         

As are regularly being reported, both in the global and local media, mindless arrogance on fixing exorbitant high new drug prices severely limiting their access, unabated malpractices in drug marketing and escaping with hefty fines, releasing only favorable clinical trial data, just to mention a few, are giving the industry image a strong tail spin.

Stakeholders changed, but pharma marketing did not:

Keeping the same strategic direction and pace, overall pharma brand marketing strategy also continued to be increasingly ‘self-serving’, and tradition bound. Success, and more success in building relationship with the doctors, whatever may be the means, is still considered as the magic wand for business excellence, with any pharma brand. Thus, since over decades, building and strengthening the relationship with doctors, continue to remain the primary fulcrum for conceptualizing pharma marketing strategies. 

It does not seem to have not dawned yet for the pharma marketers, that over a period of time, the market is undergoing a metamorphosis, with several key changes, and some of these would be quite disruptive in the traditional pharma marketing ball game. Consequently, the above key the fulcrum of pharma marketing is also gradually shifting, slowly but surely.

In this article, I shall deliberate only on this area.

A new marketing paradigm:

The key customer in the pharma business is no longer just the doctors. That was the bygone paradigm. The pharma stakeholders’ mix is no longer the same as what it used to be. 

The evolving new paradigm constitutes multitude of important stakeholders, requiring a comprehensive multi-stakeholder approach in modern day’s pharma marketing game plan.

Patients, governments, policy influencers, health insurance providers, hospital administrators, social media, and many others, have now started playing and increasing role in determining the consumption pattern of pharma brands, and their acceptability. More importantly, these not so influential stakeholders of the past, are gradually becoming instrumental in building overall pharma business environment too. This necessitates customized engagement strategy for each of these stakeholders, with high precision and relevance.

Changing mindset is critical: 

An effective response to this challenge of change, calls for a radical change in the marketing mindset of the top pharma marketers. The most basic of which, is a strong will to move away from the age old ‘one size fits all’ and ‘self-serving’ initiatives with some tweaking here or there, to a radically different ‘inclusive marketing’ approach.  In this game, both the types and the individual customer concerned, would occupy the center stage for any meaningful interactions on the brands and associated diseases, besides many other areas of relevance.

Multi-stakeholder – Multi-channel approach:

For a multi-stakeholder customized engagement, innovative use of multiple channels would play a crucial role, more than ever before.............

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