To Reduce Disease Burden India Launches A New Study On Access to Affordable Drugs

As India is struggling hard to come out of economic meltdown, and more – while navigating through the Covid-19 pandemic, the issue of reducing the National Disease Burden (NDP) with comprehensive measures resurfaces. According to a World Bank study, with ’17.5% of the global population, India bears 20% of the global disease burden.’

It’s also a well-reported fact that one such critical measure in this area is expanding access to affordable medicines to a vast Indian population. This is essential, despite some laudable measures taken by the country in this space. Which is why, it has attracted the government’s focus – yet again, even in the new normal.

This is evident from the Notification of the Department of Pharmaceuticals (DoP) dated 13.01.2022. This pertains to the DoP’s request for Proposal (RFP) from reputed companies, “To study the drug pricing policies of different countries/ region and lessons learnt from these countries/ regions in terms of access to medicine at affordable prices.” The selected company will conduct the study, on behalf of the government to understand the drug pricing methodology adopted in at least 10 countries, it said.

According to the RFP document, a minimum of ten countries/regions that should be covered are – Sri Lanka, Bangladesh, China, EU, UK, Australia, USA, Brazil, South Africa, and Thailand. It also mentioned, after selection – the chosen company has to submit its final report in four months, besides quarterly progress report during this period.

This article will focus on the relevance of a renewed government focus on access to affordable medicines, after the third wave of the pandemic, even after various recent measures undertaken by the government in this direction.

What does ‘access’ mean in the healthcare context – a recap:

Although, ‘access’ is a well-used word in the health care scenario, let me recapitulate the same to be on the same page with my readers in this discourse. According to the Agency for Healthcare Research and Quality (AHRQ): Access to health care means having “the timely use of personal health services to achieve the best health outcomes.” It has four components, namely:

  • Coverage: facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health status.
  • Services: provides a source of care, associated with adults receiving recommended screening and prevention services.
  • Timeliness: ability to provide health care when the need is recognized.
  • Workforce: capable, qualified, culturally competent health care personnel.

Let me emphasize again that the purpose of recapitulating what does healthcare ‘access’ mean, is to give a sense of how are we positioned in India, in this regard.

Key reasons for inadequate access to healthcare, especially in India:

Following are three fundamental reasons for lack, or inadequate access to healthcare, as relevant to India:

  • A large section of the population cannot access healthcare owing its cost relative to their respective income.
  • Many others can’t access, as no quality and affordable facilities are located nearby where they live.
  • Most importantly, a large Indian population can’t have adequate access to quality health care, because they don’t have any healthcare coverage. This point was flagged by the AHRQ, as well.

It is, therefore, noteworthy that to ensure access to quality healthcare, either free or affordable, health coverage for all – public or private, is critical for any nation. Whereas a large Indian population still remains without any health coverage, as the recent government publications vindicate.

Despite high OOPE a large population is still without any health coverage:

On this issue, NITI Aayog report, published in October 2021, shared some important facts. A staggering number of over 400 million Indians, still live without any financial protection for health. This is despite the launch of ‘Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)’ launched in September 2018, and State Government extension schemes, the paper says. Notably, ‘the actual uncovered population is higher due to existing coverage gaps in PMJAY and overlap between schemes,’ the report added.

Interestingly, the paper acknowledged: “Low Government expenditure on health has constrained the capacity and quality of healthcare services in the public sector. It diverts most individuals – about two-thirds – to seek treatment in the costlier private sector. “As low financial protection leads to high out-of-pocket expenditure (OOPE). India’s population is vulnerable to catastrophic spending, and impoverishment from expensive trips to hospitals and other health facilities,” it observed.

The government spending on public health at 1.5% of GDP, remains among the lowest in the world impacting reach, capacity, and quality of public healthcare services. It is compelling people to seek treatment in the costlier private sector. Almost 60% of all hospitalizations, and 70% of outpatient services are delivered by the high-cost private sector, NITI Aayog highlighted.

Major part of OOPE goes for buying drugs:

According to the W.H.O’s health financing profile 2017, 67.78% of total expenditure on health in India was paid out of pocket, while the world average is just 18.2%. Moreover, the Union Health ministry had also reported that ‘medicines are the biggest financial burden on Indian households.’ Around 43% of OOPE towards health, reportedly, went for buying medicines and 28% in private hospitals.

Thus: ‘Much of this problem of debt can be solved if medicines are made available to people at affordable prices. The National Health Policy 2017 also highlighted the need for providing free medicines in public health facilities by stepping up funding and improving drug procurement and supply chain mechanisms,” the report added.

Access to affordable drugs continues to remain a top priority today:

The above point was also emphasized in the Annual Report 2020-21 of the Department of Pharmaceuticals. It underscored: ‘The Government is now contemplating to introduce a new National Pharmaceutical Policy, where – ‘Making essential drugs accessible at affordable prices to the common masses,’ featured at the top of the policy objectives, as follows:

  • Making essential drugs accessible at affordable prices to the common masses.
  • Providing a long-term stable policy environment for the pharmaceutical sector.
  • Making India sufficiently self-reliant in end-to-end indigenous drug manufacturing.
  • Ensuring world class quality of drugs for domestic consumption & exports.
  • Creating an environment for R & D to produce innovator drugs;
    Ensuring the growth and development of the Indian Pharma Industry.

What happens when all will come under health coverage, if at all:

Even when, and if, all Indians comes under health coverage – public or private – drug cost will continue to play a major role even to the institutional payers. This is mostly to ensure the cost of health coverage remains reasonable, and affordable to all. This can possibly be done either through:

  • Price negotiation with the manufacturers, or
  • Price control by the government

In any case, there needs to be a transparent mechanism for either of above two, which the government seems to be refocusing on, as it appears today.

Conclusion:

Thus, to reduce the burden of disease in India, especially after going through a harrowing experience of the Covid-19 pandemic, where co-morbidity posed a major threat to life, India is likely to up the ante, as we move into the new normal.

From this viewpoint, a brand-new study, as mentioned above, initiated by the government to facilitate expanded access to affordable medicines, is a laudable initiative for all Indians. It’s a noteworthy point for the drug industry, as well, especially, the research-based pharma and biotech companies. As I wrote before, they should also pick this signal to focus on all 3 areas of innovation for affordable access to innovative drugs, not just on costly patented drugs for only those who can afford.

By: Tapan J. Ray    

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

 

Why Is ‘Empathy’ Central In Pharma’s Digital World?

While pharma industry’s late realization of its slower pace of reform is widely criticized, it did demonstrate a resilience in facing several challenges of change, caused by Covid-19 pandemic to keep the business going. This was witnessed in many areas of customer-value delivery systems of various companies, also in India.

That said, digitalization notwithstanding, a critical soft skill has now emerged as central for a long-term success in the patient engagement process. A transformation is now much warranted in this area, as it remains generally neglected, even today. This space involves – target-audience specific marketing communication – with well-researched, and contemporary content materials that each patient can relate with one’s needs and expectations from a brand.

Many marketers may be missing out on this nuanced, yet a critical space while striving to make their stakeholder engagement more productive for business. In this article, I shall focus on the art of leveraging this critical soft skill set – ‘empathy’, to fetch better dividend from such initiatives of pharma marketers.

An empathetic intent of what customers need and expect is critical: 

‘Empathy’ isn’t totally a revolutionary idea in marketing. But Covid-19 related disruptions in peoples lives and livelihoods, have brought the issue at the center stage of even pharma marketing. In depth understanding or an empathetic intent of what the customers need, expect and are looking for, has emerged as a key requirement of today’s marketing success.

According to studies, with changing patient expectations, preferences, and power to influence treatment decision-making choices, traditional ‘source dominated messages’ are making lesser business impact to their ‘receivers’. The old way of ‘talking at’ the stakeholders with brand messages, gives many receivers a feel that the message is brand biased. It doesn’t encourage them to express their point of view on the same.

Many bright pharma marketers have started understanding the need to listen to and ‘talk with’ them – before and after messaging – to prepare the right personalized content for key customers, and evaluate their business effectiveness, thereafter. This is a nuanced, yet a critical area, which we all need to accept and act upon to ensure a fundamental change in the customer engagement process.

The fundamental difference between the two:

Various experts have acknowledged and explained a fundamental difference between ‘talking at’ and ‘talking with’ conversations. Some these are as follows:

“Talking at someone” is generally used when the message doesn’t intend to offer a reasonable scope for exchange of ideas, or to engage in a conversation, or to express a contrarian viewpoint on a brand or service. Probably, the content doesn’t encourage or elicit any kind of response, especially the negative ones.

Whereas ‘talking with someone’ intends to start a conversation with the brand between the company and the stakeholders. I hasten to add, there are occasions when these two terminologies are interchangeably used. That doesn’t really matter. What does matter is – ‘talking with someone’ requires a critical soft skill. This is called ‘empathy.’ It is so essential – because of today’s need to establish an emotional connect with customers – for any brand or service.  

Empathy is essential – remote or digital marketing notwithstanding:

This point was captured in the IBM article, published on August 12, 2020, as it highlighted the Covid pandemic induced rapid transformation in the digital behavior of many consumers in different business areas. This triggered several rapid, path-breaking, and consumer-friendly innovation, even in the health care space. As a result, people witnessed, among many others, a wider use of telehealth, rapid adoption of e-commerce/e-pharmacies, besides a significant swing towards the digital-first economy.

The IBM article also underscored the need of similar transformation in some other critical areas, like marketing, especially to keep pace with the change in digital behavior and expectations of a growing population. ‘People are increasingly demanding authentic connections, helpful information and personalized support from brands,’ as the paper added.

Meeting this demand and further nurturing the same, send a clear signal to pharma marketers to gain deep insight of ‘this new consumer journey,’ the paper reiterated. Thus, in the contemporary business scenario, the marketers would require – ‘to create a sense of empathy and personal connection by scaling your brand voice, delivering valuable content and recommendations, and learning directly from your consumers in the digital ecosystem’- the author emphasized.

It’s now visible in the customer engagement process of several industries:

If one carefully notices a company’s messaging – both its content and the format, it won’t be difficult to sense a transformation taking place in this area for most other industries. The content of the message and the communication format/platform, now appear to be quite dynamic, personalized, and built on a robust pillar of the critical soft skill – empathy, or rather – empathy-based marketing.

Shifting from marketing-centric thinking to customer-centric thinking:

According to an expert group in this area: ‘Empathy-based marketing is about walking into your customer’s shoes to understand their experience and how we can better help them get what they want. You don’t want to think like the customer. You want to BE the customer.’

While trying to do so, a marketer would need to move away from marketing-centric thinking to customer-centric thinking and speak from the customers’ perspective and at their motivational level. Empathy-based marketing, therefore, encompasses the following ideas:

  • Empathizing with target-customer’s experience by going into their world.
  • Thinking like them while solving a problem and understanding each step they may take to solve it.
  • Looking for ways to help customers make their lives better.
  • Providing customers with what they want by understanding what motivates them and not what you want them to have.
  • Helping them identify and solve problems.
  • Empowering employees who are directly in touch with customers and provide them resources, training, and tools, accordingly.

In pharma – its personal or in-person selling – but the messaging is not:

As we know, in pharma the selling process is generally personal. Company representatives personally meet individual customer to deliver a brand message to generate prescription demand. Patient engagement processes too, remain broadly the same, at times with minor variations, though. Despite a great opportunity to deliver unique personalized messages through empathy-based marketing that recognizes individual value and expectation – traditionally, one-size-fits-all type of contents continue to prevail.

Leverage technology to create empath-based marketing:

The challenge is moving towards a whole new digital world order. In this space marketers would require working with a huge volume of credible and contemporary data on target customers, markets, the interplay of different emotional factors. A well thought through analytics-based study, would play a critical role to get a feel of empathy for selected customers. This would, then, be the bedrock to strategize a productive and personalized engagement with them. Leveraging modern technology would be essential to attain this goal.

What would ‘empathy’ construe in pharma marketing:

According to MM+M: “Empathy includes making sure your brand not only understands the condition that a patient has, but also the experience of having that condition, encompassing both the physical and emotional impact.’ People are expecting a reflection of empathy from the pharma players in their engagement process. Patients and consumers can figure out an empathetic message when they see it. They know when a brand ‘gets it’ and when ‘it doesn’t.’ Thus, it’s important that ‘marketers don’t just preach empathy, but they also practice empathy themselves, the paper highlighted.

Today’s marketing mostly addresses the fundamental needs of patients: 

As the above MM+M paper highlighted - at a fundamental level, patients just want to get better and feel better and manage their condition effectively. On this premise, most patient engagement initiatives, basically, try to address these fundamental needs, in different ways. However, as the research reveals, the above approach would not generally try to empathize with the target audience. Companies now move beyond the hard facts of medical conditions – their symptoms and relief.

According to the above study, today’s marketers would, simultaneously need to: “Find out what life is like for them. Is it a long, complex, frustrating process to access their treatment? What emotional toll does the disease have on them? On their loved ones? Are they scared? Depressed? Like a method actor, I will soak up everything I can about this person and close my eyes and become them.”

Conclusion:

In the contemporary changing market` dynamics, pharma markers can boost the brand performance either by generating increasingly more prescriptions from the existing brand prescribers, or by creating new prescribers. This is an eternal truth and is expected to remain so, as one can foresee today.

As this metamorphosis keeps rolling on, it will necessarily require healthcare marketers to gain contemporary and data-based customer insight – with an empathetic mindset. It’s essential for them to create the ‘wow factor’ – for patients to get the ‘wow feeling,’ because they will be getting a workable solution that they were looking for – to get relief from an ailment. It will, in turn, help most drug companies to overcome the trust-barrier, giving a feel to the customers that the brand and the company do care for them – not just serve the corporate vested interests.

Thus, empathy-based marketing leadership, armed with this critical skill, will also build a long-term and trust-based relationship with stakeholders for better business outcomes. According to a recent research study, published in the Forbes Magazine, on September 19, 2021, ‘empathy’ emerged as one of the most important leadership skills, especially, in the post pandemic business environment, for various reasons.

Consequently, in today’s scenario, only science-based brand engagement with patients can’t possibly help achieve the desired goals any longer. Thus, I reckon, honing the unique soft skill – ‘empathy’, has become central for pharma marketers’ professional success in the digital world – more than ever before.

By: Tapan J. Ray    

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

 

 

Why Do Drug Companies Now Need More Focus On The 5th “P” Of Marketing?

Astute marketers understand that over several decades, the much-known phraseology – ‘marketing mix’, has remained the bedrock of marketing a product or a service. The ‘Father of Modern Marketing’ - Philip Kotler defined this terminology as the “the set of controllable variables that the firm can use to influence the buyer’s response.” In this context, the controllable variables are referred to as the 4 ‘P’s - Product, Price, Place and Promotion, which remained the basic focus areas in the brand building strategy of pharma marketers, as well.

With an unprecedented transformative impact within the pharmaceutical and biotech industry during the Covid-19 pandemic – for various reasons, ‘purpose’ is fast slotting itself as the 5th fundamental ‘P’ of the marketing-mix. The changing market - triggered by changing customer dynamics, entails the need to clearly define, to the satisfaction of customers, the”purpose” of a business, brand, or service.

As it is increasingly critical to achieve business excellence in the changing paradigm, in this article I will focus on this area from the point of view of goal-oriented pharmaceutical marketing. Although, I wrote before on the need of creating purpose driven brands, this discourse is with a different perspective.

A classic concept gets a fresh impetus in Covid pandemic:

Peter Drucker, whom the Business Week magazine termed as ‘The Man Who Invented Management,’ in 2005, once wrote: “The aim of marketing is to know and understand the customer, so well the product or service fits him and sells itself… The aim of marketing is to make selling superfluous.” I reckon, this vision epitomizes the core concept of ‘purpose driven marketing.’

Understanding ‘purpose driven marketing’:

In an article, published on February 01, 2021, Ad Council wrote that after 22 years – a recent CEO roundtable deliberation decided to amend the definition of ‘purpose-driven marketing.’  The previous one was centered around ‘maximizing shareholder return.’ Whereas the amended one, in addition to serving shareholders, defined ‘purpose-driven marketing’ as ‘a strategy used by an organization to center its external communication efforts around a social cause that aligns with its core values. The goal of purpose-driven marketing is for an organization to develop a deeper rapport with their consumers by creating authentic connections based on shared values.’

This new statement reflected the changing culture in the days before the Covid-19 pandemic, when many people are more vocal about their expectations and spending. For which, they are even switching brand or service preferences in line with their values.

Covid prompts consumers rediscovering the value the industry delivers:

Covid -19 crisis has driven the positive consumer sentiment way up, as people are rediscovering the value the industry delivers to meet their new reckoning. This was also articulated in a related article. This was published in the Fierce Pharma, on August 13, 2020, as the pandemic overwhelmed the world. The same consumer sentiment also gets reflected in a first of its kind global study - ‘The 2020 Zeno Strength of Purpose Study,’ published on June 17, 2020.

The survey was carried out against the backdrop of the Covid-19 pandemic, covering 8,000 consumers across eight countries - United States, Canada, United Kingdom, France, China, India, Singapore, Malaysia. The findings of the research ‘sheds new light and unequivocal proof that the companies leading with Purpose will prevail.’ Vast majority of the respondents ‘have spoken and stand ready to give their hearts, voices and wallets in support of Purposeful brands.’

Especially, the healthcare consumers are now stepping up to stand for something more than hard facts on the features and benefits of products and services – something very meaningful that can influence positive changes in their minds. When it happens, the companies’, in tandem, will also be positively impacted to significantly improve their bottom-lines.

Some key findings of the study:

After in-depth study over 75 brands, the researchers of the above study found that:

  • 94 percent of the respondents value the companies with a strong sense of purpose and are willing to reciprocate through brand loyalty.
  • They are 4 to 6 times more likely to trust, buy, champion, and protect companies with a strong purpose over weaker ones.
  • Only 37 percent believe today’s companies are reaching their potential on this front

The paper concluded, ‘it has never been more important for companies to not only articulate their Purpose, but to consistently demonstrate that Purpose – how they operate, support issues and engage with all stakeholders.’ As the above Ad Council article articulated, the above findings also ‘mean that purpose-driven marketing can’t be cosmetic. It must be reflected in every aspect of a brand’s business model and culture, or that brand or organization can expect to be called out for hypocrisy – more on that later.’

Who’s driving the ‘purpose driven marketing?’

As I wrote in my previous article, today’s new generations, such as, Millennials - regarded as ‘digital pioneers,’ and Gen Z – the true digital natives, approach their health care in drastically different ways with new sets of expectations. These are quite different from the members of the Silent Generation, Baby Boomers, or Gen X. As the core concept of ‘purpose driven marketing’ is meeting Gen Z’s one such expectation, this population is regarded as the key driver of ‘purpose driven marketing’, in the pandemic-driven changes in the paradigm of the old normal.

I quoted in the above article, ‘Gen Z people are likely to turn the health industry on its head with their unique expectations for how healthcare should be delivered.’ Moreover, this genre of growing population is slowly but steadily gaining a critical mass to hasten the process of change that pharma marketers should take note of.

According to a paper of the World Economic Forum, published on November 08, 2021, there are 1.8 billion Gen Z around the world, equal to 23% of the global population. Yet, another paper of August 11, 2020, reconfirms that Gen Z comprises 1.8 billion people, making up for almost a quarter of the global population. India stands out with a population that includes 375 million Gen Z people – 27% of the total. Thus, Gen Z and millennial populations are considered at the forefront of shaping this new purpose-driven culture.

The Gen Z populations prefer companies contributing to social causes:

The third annual, international study of Gen Z, conducted by The Center for Generational Kinetics and commissioned by WP Engine, launched on July 07, 2020, reveals some interesting facts. These relate to new expectations for the web by Generation Z in comparison to other generations, including Millennials, Gen X, and Baby Boomers. The findings reiterate, ‘72% of Gen Z are more likely to support a company that contributes to social causes.’ It further emphasized, Gen Z is acutely aware that in today’s digital world, anyone can use their voice to ignite change, and that includes those brands which don’t take explicitly socially responsible stand in their branding strategy. Thus, imbibing ‘purpose driven marketing’ is likely to help pharma players to effectively engage this new breed of the target audience for desired long-term financial returns.

Further, based on the same logic, it is not difficult to fathom that ‘stakeholder-trust’ will also play a pivotal role, while delivering consumer expected value, and demonstrating the purpose driven actions of the business – to the Millennial and Gen Z population.

Stakeholder ‘Trust’ is critical in a value and purpose driven business:

This is a new reality, as vindicated by several recent global surveys that include India too. According to Edelman Trust Barometer 2022, ‘business holds on to its position as the most trusted institution, with even greater expectations due to government’s failure to lead during the pandemic.’ This survey – conducted against the backdrop of the pandemic, involved 36,000+ respondents in 28 global markets, including India to look at how institutions are trusted against the backdrop of the pandemic.

Some key findings of this latest study:

  • All stakeholders want business to fill the void, with nearly 60 percent of consumers buying brands based on their values and beliefs,
  • Almost 6 in 10 employees choose a workplace based on shared values and expect their CEO to take a stand on societal issues,
  • 64 percent of investors looking to back businesses aligned with their values.
  • Most respondents (59 percent) said they tend to distrust until seeing evidence that something is trustworthy,
  • 64 percent believe people in their country lack the ability to have constructive and civil debates.
  • Technology (74 percent) was the most trusted sector, followed by education (69 percent) and healthcare (69 percent). Social media (44 percent) continued its decline with a 2-point slide, solidifying its spot as the least trusted sector.
  • While Germany (65 percent) and Canada (65 percent) remained the most trusted country brands, India (36 percent) and China (34 percent) remain the least trusted.

The evolving trend indicates that the new generation, ‘wants to be a part of something bigger than themselves and they are looking to their employers to curate a fulfilling, stimulating and purpose-driven environment,’ as the article underscored. In that sense, ‘purpose-driven marketing’ has also the potential for pharma players to attract the best talents of the new generation. Conversely, it is quite likely that any organizations inability to do so, willingly, or otherwise, could help gather rust, blunting its cutting-edge for performance excellence.

Conclusion:

There isn’t any doubt that Covid-19 pandemic has initiated a paradigm shift in the expectations of the stakeholders, especially the customers and the employees from the companies. They no longer expect the organization just to focus on profit goals. Alongside, most of them also want the employers to focus, in equal measure, stakeholder value, expectation, dignity, besides social purpose and goals.

When a pharma player is seen solving societal issues, e.g., protecting the patient-health in a patient friendly manner, or saving the environment - with concrete, quantifiable measures, it creates a competitive edge for the company, fetching significant business returns from stakeholders. Surly, the pandemic is further augmenting expectations of the growing population of Gen Z – for responsible business operations = driven by value, purpose, and goals of the society – where we live in.

Consequently, it’s now becoming clearer that sustainable business excellence of pharma players can no longer be just on ‘maximizing shareholder’ returns, in terms of profit. Thus, it calls for the purpose-driven marketing, where organizational contribution to society would provide a significant competitive advantage. From this perspective, in my view, the Indian pharma marketers would now need much greater focus on the 5th ‘P’ of the marketing-mix – more than ever before.

By: Tapan J. Ray    

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.