TG – An Era That Passed

Image result for tarun gupta nmims

The news broke with dawn today. An era had passed. And it passed as peacefully and privately as he would have probably wanted it to. Tarun Gupta – professor to youngsters, boss and mentor to those slightly older, but ‘Sir’ to almost everyone in the vast Indian pharmaceutical industry, was no more.

As the sun rose higher in the eastern skies, so did the disbelief amongst those who knew him well. They had worked and interacted with him and were leaders and mentors now themselves. They reminisced wistfully of the days when he led and mentored in his inimitable style. The young who had transitioned from being his students to junior and mid-level positions in the industry, spoke with awe of the pearls of wisdom that they received from him. In an era where pharma leaders are few and far between, Dr. Gupta had left behind a humongous footprint.

Like those who create legacies, TG – as he was fondly called – was a man you either loved or hated, but never ignored. His love for simplicity was disarming. He preferred simplicity in life and in work. He often said he was successful because he stuck to basics. That, and his ability to communicate ideas in a simple way.

TG’s greatest gift to the pharma world is even after 40-plus years, a ubiquitous tool in pharma selling – the visual aid. He was loved by medical reps for giving them a tool that was simple and helped them communicate effectively with doctors about their medicines. He was hated by product managers who were forced to write detailing stories for those visual aids in less than 40 words, 4 of which were the brand name! No doctor would listen to long winding stories, he would say. Keep it short and simple. Tell the customer what he wants to hear. Wise words indeed!

Another area that TG was ahead of the pack was in recognizing the power of data and competitive intelligence. Along with another stalwart of the 70s – Prof Chitta Mitra – he set up C-MARC, an agency that churned out stellar market intelligence at a time when the only source of information to Head Office was the medical rep. TG was then the head of operations for Glaxo India, and he knew that access to this data moved his team several notches above competition. He fiercely guarded the information, striking an exclusive deal with Prof Mitra. It was only after TG moved to the Americas did his successors allow C-MARC to sell their reports to the rest of the industry. By then, Glaxo had cemented its leadership position in India for several decades to follow. Even today, Glaxo – now GSK – is the only multinational company in the list of top 10 (Abbott is the other due to the Piramal acquisition) and this is in no small measure due to TG’s foresight.

TG had his share of weaknesses too which made him human. For instance, despite being such a visionary, he completely missed out the digital wave where multichannel customer engagement and big data (his favorite topics from 4 decades ago) were challenging the long-held pharma commercial model. I met him last at a company event in March where I presented my thoughts on marketing in a digital world. In his characteristic style he walked up to me in the break and said, “I loved your presentation, but you must forgive my ignorance on the subject. I am a Gadhaaram (donkey),” and laughed heartily.

Much to my surprise, I found TG to be most upset when we discussed his greatest legacies – the visual aid and CMARC. From his perch as an academician, he pored through visual aids and marketing plans of different companies searching desperately for insights and intelligent application of data. Sadly, what he saw, pained him immensely. It pained him that something that was relevant in the 70s was still thought to be so. There were no challenges or improvisations. The industry had made it worse by declaring it indispensable.

An era has passed today. The most fitting tribute that the industry can give him is to challenge his legacy. To dissect dispassionately and intelligently what we held as sacred for all these decades. To herald in a new era. Let us pay our tributes to one of the greats by doing what he always did – tearing apart the old and heralding in the new. As they say, “the King is dead, long live the King.”

The Digital World – Be there or be square!

A few weeks ago I had the opportunity to talk to a group of mid-level pharma marketers on what marketing means in a digital world and how the rules of the game have changed. I began by asking them what they thought was the basic purpose of a marketer. They responded in their own ways and after a bit of debate, we agreed on headlining it as “promoting my product”. Didn’t that sound too much like a product-oriented approach, I asked. Isn’t that exactly your problem as a pharma marketer? That there is a clutter of products? That the market is commoditized with over 60,000 brands? Heads nodded in agreement.

As the group warmed up to the chat, they threw up the challenges that they faced every day. Customers did not see value in sales reps calling on them, hence did not give them more call time in their clinics. They often complained to senior company executives who called on them, that pharma marketing was getting dull and boring and did not provide them with information that was helpful to treat their patients better. On their part, marketers faced the constant challenge of slow sales and sought to constantly improve product sales. They wondered if the panacea for all their problems was “digital”. Is digital the answer, was their eager question.

Of course not! Digital is not the solution to all the problems that the industry faces, but it surely is the way the world is moving, so why not catch up? If the pharma industry – that for long had held up the flag of innovation – was comfortable launching new and better products, why was it such a laggard in recognizing and adopting the advancements in technology?

Digital is simply about leveraging technology

It is often misunderstood that digital means reorienting the entire company and sometimes even the business model. This is not always required. Most pharma companies have very customer-facing business models. A majority of the industry makes a sincere effort to understand and serve customers. Going digital simply means understanding technology and how it can help the company serve its customers better. It’s more about the mind-set than anything else.

Shifting the mindset

If the dominant mindset in a company is “promote my products”, digital does play a role, but the purpose of digital adoption might be slightly different as compared to another company where the mindset is “engage or serve my customers”. If more and more customers have an increasing digital presence, does it make sense for the company to not be there? Like an old adage goes, “fish where the fish are!” If all the fish are downstream, looking for them to bite upstream might be stretching the optimism a bit, wouldn’t it? So, if your customers are looking for information online and using digital tools and platforms to update themselves, would it make sense for you to not be there? As they say in America, be there or be square.

Misplaced obsession with sales

A “promote my products” mindset betrays an obsession with product sales. While this is not necessarily bad, it misses a crucial point. You can sell only to those who engage with you. If the idea is to simply push your product all the time, it won’t necessarily work. However, if the customer is engaged and sees value in engaging with you, they are already sold to. Engaged customers don’t need to be sold to, they already love your company and your product. Sometimes, they are even willing to pay more for your product because they love it so much. While this may set off alarm bells in the howling winds of price control, the point is that engaged customers become agnostic to price. This means that you will succeed even if you have a premium-priced product. Provided you have engaged your customer base very well and consistently. Digital provides you with tools to do exactly that!

If today the only way you engage your customers is through your sales force, why then would you ignore or avoid more channels of reaching and engaging them? Instead of just the visual aids that reps carry, technology allows you to create content in multiple different ways (graphics – simple and in 3D, videos – short and long, using augmented and virtual reality and a lot more) that bring novelty and value to customer interactions. Platforms allow you to host all the wonderful content that you create and apps allow that content to be distributed in the most efficient manner to your customers – at a time and place of their choice. And the best part is that all of this augments the efforts of the sales force. Where you have one channel (the sales force) to engage your customer, technology allows you multiple channels. Hence, multi-channel marketing or MCM.

Marketing in a digital world

In an almost totally digital world, marketing is therefore about:

  1. Engaging your customers and not merely promoting your product.
  2. Providing to customers what they want to see and not what you want them to see
  3. Personalizing content – each individual (your customers are individuals too) has different likes and dislikes. Personalise by curating content. There is a ton of it already created, so don’t waste your time creating more (as much as you would like to think otherwise, your visual aid bores your customer. So show her what she wants to see or someone else will).
  4. “Pulling” customers. Pulled customers look for excuses to engage. They wait for more content, new products and are willing to pay more for it.

I asked the group to imagine a world where they could provide their customers a fast, personalized and frictionless experience. They had difficult imagining it, so I asked to think of the kind of experience that they had while searching for information, buying or selling something and completing banking transactions online. All at a time and place of their choice. That’s the kind of experience your customers seek in the digital world. It is your role to give them that experience. So, dear pharma marketers, be there, or be square!

Digital Darwinism

Digital Darwinism is when technology and society evolve faster than an organization can adapt. Digital Darwinism is a fate that threatens most organizations in almost every industry, but particularly those in the pharmaceutical industry in India.

Evolution of technology will make it tougher for pharma companies to differentiate, engage customers and compete, unless they master digital evolution.

Digital Evolution

 

 

Selling in a digital era

Recently I decided to buy a laptop. As I looked around for the right one, I realized how little I knew about hardware. Having always used a company provided one, it was one of the things I had never bothered to educate myself on. As I always do for most things that I know nothing about, I spoke to friends. From what they told me, I did a lot of research online. Armed with information of an ideal laptop, I decided to “look and feel”. I headed off to an electronics store and spent the better part of an hour ‘testing’ a few models with the help of the friendly salesman before I bought the one I wanted. Do most of us shop this way? Maybe!

As you see, in my ‘journey’ the human element came in just once – to seal the deal. With so much information available online, I had already made up my mind before I went into a store and bought what I wanted to. This was a case of laptops and dummies, but is this very different in the case of drugs and doctors?

In such an era, pharma companies invest a significant amount of money into hiring and maintaining large sales forces. This component is, in fact the largest part of a company’s selling expenses. This is driven by the decades-old belief that nothing compares to a salesman calling on a doctor to convince him of a company’s product. Yet, in reality, the idea that reps will soon be obsolete is constantly reinforced by reducing in-clinic time for them, as doctors see lesser and lesser value delivered. There is also the constant pressure on profit margins as companies negotiate a fluid regulatory environment. These factors are as true in India as they are overseas. What is yet to be determined is if ‘non-rep’ models are bust-cycle fads that will reverse in soon to follow boom-cycles?

My personal opinion is that in any selling process, a human element is never obsolete, but the effectiveness of that element is maximized when it is introduced at the most appropriate moment in the ‘customer journey’.

old to new model

It is quite well known that in the new era, 70% of the buying decision is made before the first contact with a supplier is made. By the time I walked into the electronics store, I knew which laptop I wanted to buy, its specifications, its size, color and add-ons. I walked into that store just to see how that laptop actually looked and to understand the deals that the store would offer on my purchase. The salesman at the store already had a ready and willing customer and his sale was efficient and quick even though I made a big show of looking and evaluating other options. The actual amount of time he spent on making the deal was not more than 15 minutes of that hour.

Such efficiency is needed in pharma sales as well since the rep model is currently under stringent evaluation. Companies seeking operational efficiency are critically analyzing all major costs and are looking for alternatives. In such a scenario, instead of considering a ‘no-rep’ model, companies should consider a ‘low-rep’ model. This means downsizing a bulging force to just the optimal number of people needed to quickly and efficiently close deals. An example is illustrated below:

customerjourney

As companies build websites, apps, videos and other digital content, is this a ‘customer journey’ that they have at the back of their minds? Are they willing to prime a customer as much as they can using their formidable online resources and connect a medical rep as the final point of contact to seal the deal? If this is how it can be done, how would the medical rep’s job evolve? What kind of training would such sales forces require?

Of course, this isn’t an easy process. Moving away from a decades-old mindset of building armies of medical reps isn’t going to be easy. And to be sure, such models will probably not be the best in every single situation. For example, a new product launch will require a different strategy compared to a more established brand. The fact of the matter is, evolving technology provides superior alternatives to creating value for customers without having to compromise traditional sales metrics.

I am pretty sure the salesman at the electronics store was half-relieved that I knew what I wanted when I walked in. It saved his time and allowed him to refocus his energy to other dummies who wanted laptops. Wouldn’t drug reps and doctors feel the same way?

 

 

 

Is Digital Transformation Difficult?

Over the last few weeks, I had the opportunity to interact with several senior executives of the pharmaceutical industry in India. Among other things, I was keen to understand how their organizations were preparing for or participating in the digital era.

As I gently broached the topic, I expected animated discussions on the need for such a transformation in pharma, but was pleasantly surprised that none were required. Of course the concerns stayed the same – navigating internal compliance mandates, defining return on the investment, building the required capabilities within their teams and shrinking promotional budgets. How does an organization lead a transformation while facing such headwinds they wondered? The transformation process is a slow one and not an overnight change as most people perceive it to be.

This is because leaders perceive that jolting a time-tested structure that supports a multi-crore business is risky. So why create more risk than what the environment already presents? Yet, leadership acumen is put to test more often than not, because success depends on anticipating market trends and responding quickly. It lies not so much in the structure of the organization but in the way that structure behaves and responds to emerging market trends.

Transforming an organization to make it digitally capable is not as overwhelming a task as most leaders perceive. As illustrated below, it can be done in a four-step process that does not disturb any ongoing activity and yet can gradually transform a business into a more digitally capable one.

 Digital Transformation - 4 steps

 

  1. Use existing structure to begin digital activities

Assuming the existing structure is digitally naïve, it will have the hierarchy oriented in an old-economy framework with little experience of promoting via newer online channels, and the huge size of the business adds its own complications. Leaders can look at using existing strengths in this model to gradually initiate digital activities. Sales teams love to interact with each other and would probably already have vibrant message groups on WhatsApp or similar IM tools. Encourage them to do more of it. Appeal to their competitive spirit by letting them know how their performance compares to the best teams in the country. Think of ways in which more can be done using digital channels that teams are comfortable using. For example, we know marketing teams are comfortable using emails. Can they make (at least a part of) their communication IM-friendly to leverage the comfort of the sales teams instead of expecting them to read long, boring emails?

  1. Encourage experimentation to build digital capabilities

A key aspect of the strategy-execution gap is often a one-size fits all approach. Sales leaders always talk about rigidity in the strategy that doesn’t allow it to be applied in the most effective manner. Leaders can attempt to solve this by allowing a bit of “managed improvisation” of a digital plan therefore bringing in a mindset shift on two critical success factors – a) dropping a one-size fits all approach b) encouraging marketers to give up control. Partially giving up control is a very essential feature for success using digital channels since the idea is to engage and converse with customers rather than ‘push’ messages to them. Why not encourage marketers to experiment? Ask them to co-create a digital plan with the sales teams and encourage them to improvise as they implement. This managed improvisation could be partial to begin with and more control can be imparted as the team gets comfortable doing it. As a leader, ensure that governance strictures don’t get in the way of these experiments.

  1. Create digital innovation team in parallel

This step is a bit tricky and a few of the executives I spoke to pointed it out to me. Why waste time with the first two steps if real digital innovation will happen in parallel? Why not jump straight to this step? The answer is simple. Digital transformation is as much about building capabilities as it is about embedding them deeply within the organizational DNA. An organization can only metamorphose with some gene editing. The innovation team can help with that. It can create some serious imagination that the organization otherwise lacks to understand the full scope and power of technology. After all investing in capabilities means building support systems that span the traditional BU structure. Something to be wary of is not to get caught in cost-benefit metrics. Defining the benefit of a new capability is not easy to do and the discussion therefore must be on the value that it brings to achieving strategic advantage.

  1. Gradually embed innovation into the existing structure

Through a clever mix of experimentation (through the existing structure) and innovation (with the new one), an organization gets used to doing things better as well as doing better things. It takes a lot of effort to overcome organizational inertia, to re-orient and re-calibrate and to pull oneself away from engulfing yet mundane activity. Some quick and early successes can help to set the mood to adopt new practices. Modify governance structures to support and enable customer engagement in innovative ways.

This four-step method that I suggested during some of the conversations seemed to get the executives to wonder whether they were doing enough of all this in their organizations. They promised to think hard on how much of the difficulty in transforming their companies was really true and how much was merely perceived. Nothing about transformation is easy but it isn’t impossible. It requires an adaptive environment which empowers individuals and allows constant improvisation. The environment is a constantly evolving one. Can companies help but transform?

Technology enabled Learning

Yesterday, a colleague asked me to make a short video on my thoughts on notable trends in the learning ecosystem. Knowing that he was more passionate than I on the influx of technology into the work-space, I decided to speak a bit on how technology is/will disrupt learning and development.

Learning is essentially getting a good grasp on one’s environment. Like most things in the environment, technology is the big disruptor. The influx of technology-enabled learning will throw up many new and exciting avenues. For a start, it will make learning:

Personalized – Learning is always different for different people as each individual experiences and grasps his/her environment uniquely. As a consequence, no one-size-fits-all approach will work here. Just as individual preferences of different forms of entertainment threw up the “entertainment on demand” industry, learning too is increasingly becoming “education on demand”, catering to individual choices and preferences. MOOCs and video-based lessons from Khan Academy or TED talks are great examples of how learning has become personalized.

Participative – Each individual wants to participate and shape his/her learning. They want to choose their sources of learning, actively selecting people who they want to learn from. People create their ‘personal learning networks’, which are often technology enabled in the era of the ubiquitous web. These personal networks act as an individual’s greatest source of the latest and most relevant information. The use of Yammer, WhatsApp groups etc, show how people choose and actively participate in groups they want to learn from and contribute to.

Power-packed – As learning has moved on from formal full-day classroom sessions to more informal and ‘just-in-time’ information gathered from trusted sources, people get comfortable consuming power-packed chunks of information rather than massive data downloads. The popularity of Twitter, small videos on Facebook amply demonstrate this. Moving forward, technology such as Google Glass or its adaptations will allow individuals to pull up exactly the piece of information that is most relevant at that moment.

People learn from everywhere. From other people, from networks and from each other. They learn all the time. They observe and process information on the move. They choose their devices and applications. Technology has enabled exciting times ahead. How organizations and leaders shape up to face this future, will be interesting to observe.

Watch my 1-min video here.

Pharma in India and challenges MNCs face

 

Executives from foreign multi-national companies (MNCs) in India have often compared themselves to boxers entering the ring with one hand and one leg tied and a blindfold on their eyes, to take on a heavyweight champion. While this is definitely an exaggeration, it attempts to underscore the feeling of competing in a market which is not perceived to be a level playing field. While they are entitled to their emotional outbursts, a more rationale look reveals a slightly different reason to be upset, if at all.

Product – Are MNC portfolios truly aligned to the needs of the Indian patient? Or are they more aligned with their parent organizations?

Price – While MNC executives complain about having to price their products premium, they seldom complain about a lack of passion in their marketing, to explain that premium price to patients. And if patients, at the end of the day, consider every white pill the same, then should they be blamed? Of course, there is the odd value creating campaign which creates the odd blockbuster, but then this is more an exception than the rule.

Promotion – Complain about Indian company driven “CRM” here as much as you will, but the fact is that it is only the rare MNC marketing program that really leaves a mark with HCPs and patients.

Place – The complex distribution system in India does mean that a lot of value stays locked in. The system stays complex because of the unionized nature of the people who control it. Despite their global clout and expertise in negotiating with large purchasers in the developed world, MNCs do precious little to bring in that expertise into India. Until the pharma lobby in India has different faces representing MNCs and domestic companies, one can expect precious little to change.

Overall, in more cases than in fewer, MNCs treat India as just a market and rarely place a premium on its development and progress. Older executives I have interacted with, speak wistfully about the 70s, 80s and even the 90s when they had “more freedom” to align portfolios and prices for the Indian patient.

The question to answer then would be, is aligning with parent organizations – and the reduced leverage that offers – a far larger challenge than what MNCs are willing to admit?

Excerpted from an article published in the February 2017 issue of MedicinMan

 

 

Donald J. Trump is POTUS

Initial reactions of the stock market to Donald Trump’s victory in the US Presidential Elections is one of joy as witnessed by the jump in share prices. This is obviously a very unmuted reaction to the settling down of the anti-pharma rhetoric offered by Hillary Clinton. While investor sentiment is obvious, what I find surprising is that the industry lobby bet more on Hillary going into the White House than Trump. Despite all the recent anti-pharma rhetoric from her, they still preferred the staid Democrat (by funding her campaign) over the wildly unpredictable Republican.

This might have been because in his manifesto, Trump spoke little of drug pricing but more about importing medicines to reduce their cost to American citizens (“Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers”). How he intends to increase medicine imports while curtailing international trade will be interesting to watch. He also spoke of following free market principles to broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.

So, does this mean that he will loosen up IP laws, make it easier for generic companies to manufacture on American soil (or encourage drug imports despite his claimed abhorrence for trade) and increase competition in the sector thereby bringing down prices of healthcare in general and medicines in particular? This seems plausible as a solution that he hasn’t yet explicitly offered, while promising to do away with the Affordable Care Act ‘on day one’. If he can pull that off, he just might go down in history as a great President.

If Trump really backs up his rhetoric with action then it indeed augurs well for the Indian pharma industry which stands to gain the most. Also, since Big Pharma has not exactly backed him so far, he might take a more serious look at easing up imports to tighten the screws on them.

The critical thing that I will look out for is 1) the stand he takes on IP laws and 2) easing up local manufacturing for pharma. On the first point, his view on IP will be particularly interesting since he vocally opposed the TPP and TTIP – two of President Obama’s biggest attempts to create a near universal acceptance of US IP law. On the second point, although quite unlikely, if he makes local manufacturing easy, Indian companies can make a windfall profit given that they are more comfortable with FDA procedures and requirements than they were a few years ago.

Overall it does seem net positive for Indian pharma unless Trump’s famous unpredictability comes in the way.

Slaying the Digital beast

Digital technology is an amazing system whereby information (words and images) are stored in the form of code. This enables unimaginably vast amounts of information to be compressed on small storage devices that can be easily preserved and transported. Digitization – or converting information to code-  also quickens data transmission speeds. This technology has transformed how people communicate, learn, and work.

It is quite understandable how folks confuse between what is digital and what is not. Largely that’s because they just use the term digital and do not suffix it with either ‘marketing’ or ‘technology’. While ‘digital marketing’ is a new buzzword at least in pharma, ‘digital technology’ is not. Digital technology has been used in phones (landlines) since the 1980s, when the newer models (portable phones versus the old black telephones) were introduced. In the 1990s, digital technology enabled satellite television to enter Indian homes with a variety of 24X7 content instead of the boring, fixed time single channel DD. In the wider context, digital technology transformed information (as libraries digitized books), the airline industry (as more sophisticated air monitoring systems came into vogue).

Once we understand what ‘digital’ and ‘digitalization’ means, it is easier to understand that this is the process and everything else is the channel. Social media sites such as Twitter, Facebook and LinkedIN have used digital technology to create platforms for engagement over the internet. The amazing part of these social media outlets are that unlike traditional media such as newspapers and TV news channels, online sites do not create any content of their own. They merely provide platforms where it is easy for the layman to create his/her own content and engage with like-minded people from around the world. This is called user-generated content where users actually generate the content instead of the website. A more formal example is Wikipedia.

While social media is about humans interacting with machines (computers, mobile phones etc), the Internet of Things (IoT) uses digital technology to make machines interact with machines and humans. This is how a device on your hand can tell the app in your phone how much you walked or ran this morning. Or your laptop at office can switch on the coffee maker at home so that hot coffee awaits you as you drive in. Or the dashboard of your car can inform your doctor if you had a hypoglycemic attack and an accident. This is fascinating stuff and you can imagine how endless the possibilities with digital technology are. IN our business of selling medicines, the applications can be massive and can change the way disease is managed and treated.

Q: Is digital like a photocopier that is used by all the functions in a company or is it something only for the marketing and sales functions?

“Digital” – if it refers to technology – is used by almost everyone in a company. If you’re using a laptop or a phone or a scanner, then you’re using digital technology. However, if this refers to using digital channels to market your product or an activity to support your brand, then this is largely the domain of the marketing and sales team. The success of a digital campaign, in my opinion, is when it steps out of the domain of a marketer. Of course, the concept and execution still stays with them, but if colleagues in office don’t engage with the activity, or if the online campaign is too doctor-focused, then we aren’t leveraging the power and the reach of the medium.

I think it is also very important to understand that digital never drives strategy. It is always the brand strategy which decides the channel. Does a leave-behind piece or a visual aid decide the strategy of a brand? Of course not. They are just tools that a marketer uses to achieve an overarching brand objective (like create higher brand awareness amongst a specialty of doctors). It is the strategy of the brand that decides on which tools you want to use. It’s the same with digital – these are just channels or tools that one uses as one deems fit. I have always been amused when brand leads come to me and say “I have a Facebook strategy”. You can’t have a facebook strategy. You have a brand strategy. Using Facebook or not using it depends on that strategy.

Q : How can digital lead to better engagement with doctors and patients?

Digital technology allows innumerable options to engage with doctors and patients. As you would know customers engage most effectively with organizations or products that solve a pain point or what we call as an ‘unmet need’. One of the larger ones in health care for quite some time is ‘information asymmetry’ or the lack of availability of information that can be easily understood for patients or care-givers. This prevents them from understanding their choices and making informed decisions. Websites like iodine.com attempt to bridge that gap.

Some other pain points are when patients want to consult another doctor to take a second opinion. This is very different from ‘doctor shopping’. Again there are websites that allow such discussions. Today finding the right doctors, setting up appointments, using mobile/digital prescribing and having medicines home-delivered through online orders reduces costs (makes it easier, sometimes cheaper) for health care transactions.

All this is possible through the use of digital technology. Pharma may not probably play in all those spaces. Yet, in its core area, pharma is making major changes to its operating model to wrap it around the possibilities that digital tech creates. Globally, there is a move to use big data to glean sharper and more relevant insights into patient and doctor thinking and behavior. There is also a realization that the industry must move away from monologues or ‘pushing’ information to engaging in a conversation or creating a ‘pull’ for information. This engagement of course will be required across all the possible channels (omni-channel) and must occur almost in real-time. No customer will wait if he/she receives an auto-response saying “Thank you for your email, you will receive a response from us in 7 working days”. Those days are long gone!

Considering the constrained environment that the industry operates in, it is little wonder that pharma is taking so long to institutionalize these changes. However, stellar examples in digital engagement can be found from companies such as Pfizer, BI, AZ, J&J, GSK and some more. These convince me that the industry is surely headed in the right direction. In the future, I think we will see more tie-ups and collaborations to create better and user-friendly products. That will make health care democratized (of the patient, for the patient and by the patient) in the true sense.

Q : How well prepared are professionals in terms of skill levels to facilitate digital adoption by companies?

Not much at the moment. There is too much of entrenchment into the traditional style of operations. We see human capital being built up within organizations but it is too focused on execution at the moment. There is limited play of digital natives within executive teams where decision making lies. That’s probably why we rarely see brand managers or business heads evolving their plans to wrap around the massive opportunities that digital creates. There is no ‘new-orbit’ thinking at the moment and therefore we see pdfs of visual aids on iPads, aspirations to create mobile apps (with little understanding of what end that will achieve) and 2-hour long CMEs distributed over web streaming platforms, once or twice a year. This belies little or no understanding of either the medium or the consumer of such content. This is the typical “monologue” or “push” mode that pharma is so comfortable with.

One could argue that reverse mentoring can help move understanding up the chain, but like most things that try to defy gravity, such initiatives rarely gain altitude. I am waiting for the day when pharma hires a CEO from a tech company. Someone who is told, “We are in the health care (not pharma) space and we need your help to do better in the new age economy.” That will be the day.

Q : Any good examples of digital adoption by pharma – global and domestic?

There are quite a few examples that are isolated (brilliant iPad campaigns or SM engagement etc.) but I want to focus on a couple of them. One of them is the “Don’t turn your back on it” campaign by Abbvie. This is for lower back pain and it is phenomenal in its omni-channel presence and the way it is being executed. I do not know the result of it, but I am sure it is good. Another such campaign in India is the “Knowledge Genie” project that Abbott rolled out in India a few years ago.

There are definitely many more such examples, but the reason I picked out these two campaigns are because of their distinct uses and I think there are lessons here for us. The Abbvie campaign is a glocal one – designed and created by the Global team but executed by individual markets. This shows a great alignment of the ‘go-digital’ spirit through the entire breadth of the organization. This is a brand-oriented campaign.

The Abbott India campaign is different in the sense that this is a doctor engagement campaign and not a product/brand-oriented one. Both these are long-term engagements that require a tremendous amount of capabilities and alignment within the organization and therefore worthy of mention.

Q  How useful are platforms like Docplexus, Curofy and others to Clinicians? 

This is a tough one for me to answer considering that I am neither a clinician nor a part of these platforms. However, I think the need for such platforms exists in terms of a neutral discussion forum for doctors to exchange ideas and to network. Recently I saw another such platform which advertised its USP to be “pharma-independent”. Of course, this may be done to differentiate this platform from the others who engage pharma; but I see a lesson here.

If pharma not participating in such platforms is considered a boon, then there is something seriously wrong. The industry which has to be an enabler of such initiatives is considered unwanted. It’s a shame since it signifies how wrong we have gone with our understanding of our customers’ needs and wants.

Who are the others new players in healthcare – what do companies Practo signify for healthcare?

There are many new players and it excites me tremendously. When Sergey Brin famously said that health care is ‘over-regulated’ he expressed the angst of millions of people amongst who are hundreds of innovators. I was afraid that these words from the co-founder of Google would scare off many of them. Fortunately, it hasn’t.

I have been fortunate to have the opportunity to coach a few startups in India and the energy, enthusiasm and never-say-die attitude that these youngsters have is just phenomenal. It is such a refreshing change from my day job.

“Startups” – as the new entrants in the space are referred to – are run by very smart youngsters who have identified “white spaces” in the health care arena. White space is jargon for an area in the sector that has a potential (and lucrative) customer pool but nobody to service them. To illustrate that, take the example of knowing the right doctors to meet when there is an urgent medical need. While this was a very obvious unmet need, the established players (hospitals, doctor organizations or pharma) did nothing for years. It took one determined youngster to begin a company that specialized in that area and then built around that core proposition.

This is what companies like Practo signify for healthcare. These companies have the potential to disrupt the health care space. They can create efficiencies in processes that established players have little incentive to reform. If and when they do that, it won’t be very pretty for the incumbents. We are seeing start ups all across the value stream – from data analytics to R&D, clinical trials, manufacturing straight up to managing the end-user experience. Almost every area in health care is looking at potential disruption. How soon will it happen? Only time will tell.

Q : Will tech products like Uber and Ola mean a better deal for doctors and patients? How can pharma partner with such players?

This has been a fascinating question and one asked quite often. To elaborate on your analogy – Uber and Ola are aggregator organizations. This means that they use digital technology to bring a cab to a customer. The beauty of the model is that they neither own the cabs, nor are the drivers their employees. In health care, the likes of Practo bring patients to doctors and the likes of Nightingales bring doctors to the patients.

While on the face of it, it seems like a good idea to have a service of bringing additional patients to doctors, this hasn’t really gone well with doctor organizations (who protested their members advertising on a website) or with the govt who cannot get themselves around to regulate these new-age services. To answer your question specifically – any program or company that reduces transaction costs for consumers to seek health care of their choice is definitely a better deal for everyone.

Since pharma still focuses on pushing its pills, and will continue to do so for the foreseeable future, I think what it can seek to benefit from these tech players is Big Data. Many of these companies over time will accumulate information on the beliefs and behavior of health consumers. Pharma can glean out great insights from that information. Now whether the tech players will want Pharma to monetize that information or want to do it themselves will be interesting to see.

Q : Is there an increased understanding of digital by Indian Pharma? How do you look at digital adoption by Indian Pharma?

Oh yes of course! Adopting digital channels to engage with doctors has picked up rather well in India as it has around the world. I am aware of some very interesting things that Indian pharma is doing on this front.

When we speak of adopting digital, there are two ways in which I would see it – the first way is to evaluate the use of content across channels. I would be very impressed to see content created and customized for multiple channels. I think this has a lot to do with understanding the functionalities and the scope of each channel and how that helps to promote the chosen story/message.

The second way to view digital adoption would be to see if content across multiple channels carries the same message or storyline. Most often I see messaging created for Twitter being quite different from Facebook which is itself far removed from website banner adverts. It would seem odd to customers if they’re unable to see the same message or connect the dots when they view that content over different channels. This, in my opinion, is quite key to superior engagement of digital technology. Of course all of this stems from the broad strategy for the brand/company.

That said, its great to see marketers finally accept this technology for its scope and power. One must experiment with it to learn how to use it best.

Q : Is there is need for education in digital adoption by way of workshops and what should these workshops focus?

Education is always useful. It helps to know what the industry is doing at large. Of late, I have noticed that fewer pharma managers are skeptical about non-pharma examples and this is a very encouraging trend. Earlier, I would see people rejecting any great example from non-pharma without understanding that the principle is more important than the example. The change means that pharma managers are opening up their minds and this augurs extremely well for the industry.

I don’t think workshops on digital technology would work in isolation. Since technology only adds further scope to engage with doctors and patients, the workshop should examine marketing plans to see if they have really built in the use of technology to optimize results. Ideally this exercise should happen a few weeks before the marketing team begins to work on their brand plans. If they understand the technology available, its functionalities, scope and results it can bring, I am sure marketing managers will understand better how to use it in their work.

Current and Future Trends for Pharma

We live in exciting times. New technology and innovation that can change the way we live, is pouring out at unprecedented frequency. It is well known that although the pharmaceutical industry is considered to be very technologically advanced, it is also one that is quite inward focused and therefore stuck in the past. Therefore, it has been of great interest to me to understand how advances in technology and innovation are shaping trends and how ready the industry is for those trends.

From my viewpoint, in the last few years, the industry has defined its success on how it handles the following three trends:

  1. Increasing Role of Generics

A record number of patents expired in the last few years. As soon as a drug goes off patent, generics force drug prices to drop by almost 85 percent. Pharmaceutical companies have responded to the generic threat in several ways.

It was thought that the most promising approach is drug companies getting into “branded generics” themselves. The logic was that these branded versions of their original drugs sell for higher prices than unbranded generic equivalents but are less expensive than the true branded product. While this didn’t work for ‘innovator companies’, it did throw up a vast generic industry globally with companies such as Teva, Valeant and Mylan growing into industry dominating positions as governments around the world preferred cheaper generics.

  1. Emerging Markets

Rapid growth in emerging markets is a beacon of hope for the pharma industry. The Indian and Chinese drug markets could grow even more rapidly. However, drug firms’ traditional approach of creating drugs in the West and then pushing them in the East is not likely to work any longer for a several reasons.

First, there is a significant price pressure in these emerging markets, which argues for a stronger role for branded generics. Second, drugs developed in the West are not always relevant in emerging countries. Virally induced cancers, for example, are rare in Europe but common in China. Finally, the insurance and payment systems in many of these markets are quite different from those in the developed world.

  1. Outcomes – based medicine

Pressure on healthcare costs is rapidly pushing pharma to enter into outcomes-based pricing deals with payers. While there have been a few noteworthy ones so far, companies are likely to add more to that list soon. A majority of health plans want to ink outcomes-based contracts with companies, particularly in the high-end, niche and ultra premium priced therapies such as hepatitis C, oncology, multiple sclerosis and rheumatoid arthritis among others. Even drugs for widespread chronic conditions–such as cardiovascular medicines–are also on payers’ radar.

Unless the preference for outcome based drugs picks up faster, the industry is due to commoditize itself. As the blockbuster model becomes less dominant and the market becomes more competitive, commoditization has led to business models to become more customer-centric.

We have seen medical costs increase per capita even though the industry has commoditized. With costs increasing, and patients expected to pay for innovation on their own (as payers fail to keep up with technology and innovation), the following three trends are set to change the way health care will be consumed. How cognizant pharma is to these trends will probably decide how it moulds itself for the near and foreseeable future.

  1. Personalized Medicine and Empowered Patients

Personalized medicine and targeted therapies can significantly increase the effectiveness of new drugs in specific patient groups. Drugs that would be deemed ineffective in typical clinical trials now have a chance to show high degree of success among certain patients.

This changes the economic model of firms and calls for highly specialized marketing. Some experts argue that this specialization may force the industry to move away from its vertical structure and focus instead on a few core areas such as drug discovery or development. It also calls for drug firms to take a larger role in diagnostic procedures. This trend is very promising, and is fast expected to come of age.

Unless payers place a premium on outcomes-based, patients will have to self-finance this innovation. How will pharma react to it? When patients pay for innovation, they research it, gather information around it and update themselves regularly. Here lie opportunities for pharma to engage with empowered patients.

  1. 3-D printing of drugs

The first 3-D printed drug was approved by the US-FDA in 2015. If the trend catches on – and it surely will – patients can print their pills on their own and completely bypass pharma. All they need is to use the algorithm or procedure that will become available on the internet and use a 3-D printer at home.

Business savvy pharmacy chains may sell these procedures to patients instead of pills. In its current state the pharma industry has no control on 3-D printing and no coordinated action to counter it. Does it have a scenario with an action plan ready? And if you think it sounds like science-fiction, be aware that human organs that were made using 3-D printers have already been used for transplants.

  1. Supercomputers

Google announced recently that it launched a feature called symptom search which seeks to use its vast computational prowess to help patients self-diagnose their symptoms. In its current mode, this is unthinkable in pharma that always tells patients to consult their doctors.

Google’s use of combining big data to mine zillions of patient records and match symptoms search words to throw up the most relevant answers is a show of how artificial intelligence and big data can be harnessed through the power of supercomputers. Another example is IBM’s use of machine intelligence to scan through zillions of doctor notes and available medical literature to throw up diagnosis and treatment plans for treating diseases. Imagine the impact this can have on pharma which prides itself as the sole owner of information on disease and drugs. This, it considers, is its sole value proposition to its health care professional customers. With supercomputers, artificial intelligence and big data, pharma risks losing the very value that drives its customer interactions and therefore its business. Does pharma have a plan to counter or harness this development?

The challenges facing pharma due to developments in the outside world are not routine ones in the traditional sense. The solutions will revolve around ‘unlearning’ a lot. It will be very interesting to see how a traditionally technologically advanced sector surfs the wave unleashed by rapidly developing non-traditional technology.