A Sine Qua Non to Pharma Success in Digitized World

Posted on October 16, 2017 by Tapan Ray

A wind of change is now blowing at an accelerated speed – encompassing virtually anything, across the world, including India, with a varying degree, though. It leaves a profound impact on the day to day lives of many, including almost free access to a plethora of information of any kind available in the cyberspace. The way we express ourselves – connect with others – meet our various needs and requirements – make hassle-free financial transactions – increasing transparency – containing corruption, besides scores of others.

Fast evolving digital technology is predominantly catalyzing this paradigm shift. Its weighty impact can also be felt across the global business world, sparing virtually none. Digitally enabled recent GST implementation process in India is just one such example.

Newer technology driven transformation process of overall business ecosystem is sending a strong signal to all concerned to shape up – coming out of their respective comfort zones of the old paradigm, and embracing the new one. Squarely facing this challenge of change is equally critical even to one of the most conservative, tradition bound, and well-regulated pharma industry. It’s rather an absolute necessity for pharma, as virtually all its stakeholders, including the patients and governments, have already started stepping on to the digitized world. The fundamental choice is, therefore, between shaping-up and shipping-out.

In this article, I shall argue on this critical need, based on several recent, pertinent and contemporary research findings on this fascinating space.

Indian CEOs take:

The 20^th CEO Survey of 2017 titled, “Being Fit for Growth”, conducted by PwC

reveals that the term ‘digital’ evokes both excitement and a sense of apprehension among CEOs, both globally and locally. The following are some interesting findings involving the Indian CEOs, as captured in this survey:

38 percent observed that over the past 5 years alone, disruptive technological innovations have had a significant impact on competition within their respective industries.

47 percent believe that in the next 5 years, disruptive technological innovations will have a significant impact on competition in their industry.

77 are concerned about the speed of technological change.

76 percent expressed concerns about rapidly changing customer behavior.

77 percent mentioned the need to create differentiation in their products and offerings by managing data better.

Its relevance in pharma:

The relevance of taking this wind of change in stride and embracing it fast, is beyond any reasonable doubt today. The 2017 report of EY, titled ‘Reinventing pharma sales and marketing through digital in India,’ also reaffirms: ‘Digital will play an ever-increasing role in this era of profound transformations, characterized by increasingly informed patients/physicians, new range of customers and new disruptive entrants. To stay relevant, pharma companies need to adopt a nimbler approach and make data the currency of marketing.’.”.

The urgency:

A sense of urgency for this change has also been epitomized in the same report, as it underscores that digital disruption has demolished 52 percent of Fortune 500 companies, since 2000. The study further reiterates: “The pace of transformation has increased, competition has intensified and business models have been profoundly disrupted. This shift is happening at breakneck speed across industries, and pharma can no longer be an exception. Customers have already embraced technological changes, through their many digital touch points, and pharma must look toward digital to re-imagine the customer experience.”

Just changing manual processes to digital won’t suffice:

This is exactly what is mostly happening today in pharma. Concerned employees, in general, are also receiving training inputs accordingly. Vindicating this point, a recent study reiterates that just changing manual processes to digital won’t suffice, any longer. Delivering greater value to the stakeholders continuously through digitization of business is the name of the game.

The above EY report unambiguously endorses that: “Whatever was being done manually earlier is now being done digitally. But we are not adding additional value.”

While capturing in the report Indian pharma’s journey to the digital world, it articulates, though some digitization initiatives are being taken now, Indian pharma companies are still way behind their global counterparts. The survey found 53 percent of the participating companies still at the ‘beginners’ stage, while 40 percent are at the ‘conservatives’ stage and only 7 percent have moved toward the ‘explorers’ stage.

Three fundamental non-technical barriers, and the way forward:

Two important studies – one by EY, as quoted above, flagged three fundamental non- technical barriers in this area, and the other one by McKinsey & Co that proposed three strategic actions for Indian pharma to start on a digital path by leveraging its intrinsic value, meaningfully.

EY study indicated, 86 percent of the senior pharma leaders exhibited a strong positive inclination toward digital as a ‘strategic’ rather than a tactical approach. It then highlighted the following three key barriers to embracing digital:

Lack of clear digital strategy for the organization
Incremental value proposition and effective delivery
Change management

McKinsey & Co in its August 2015 report, titled ‘The road to digital success in pharma’ also indicated, though differently, lack of a clear strategic direction and focus in this area. The study noted: ‘Most pharma companies have started to build some digital capabilities, but the talent and resources for their efforts can be fragmented, often across hundreds of small initiatives. Without clear strategic direction and strong senior sponsorship, digital initiatives often struggle to secure the funding and human resources required to reach a viable scale, and they cannot overcome barriers related to inflexible legacy IT systems.’

Based on the above finding, the paper proposed three strategic actions for pharma companies to place it on the right trajectory, capturing the differential value of digital, as follows:

Develop the right organization for new business models with significant value addition from digital. This, I reckon, would involve a cultural shift.

Focus on two or three flagship initiatives, such as building a digital ecosystem for patient adherence to a blockbuster drug.

Run collaborative experiments, and then scale what works, such as putting the right people from IT, business compliance, and outside partners in a ‘war room’ to run quick test-and-learn cycles of a well deliberated digital strategic initiative. Where results are positive, scale those up.

Personalization in every facet of the value delivery system:

As we move ahead, personalization in virtually every facet of the value delivery system is unlikely to remain optional for the Indian pharma players. With this wind of change gathering further momentum, many will eventually witness a mind-boggling level of personalization – spanning across from personalized diagnosis of serious ailments based on complex genomics, doctors’ writing personalized medicines to tech savvy pharmacists dispensing 3D printed individualized formulations.

This trend will continue evolving with an ascending trend of outcomes, breaking all conceivable barriers. Accordingly, services to patients and physicians would also demand more personalization, along with the other stakeholder engagement process.

Most of these may appear no more than a figment of imagination today, or probably a science fiction to many – just as what the incredible narrative of unleashing unfathomable potential of the Internet appeared to so many, not so long ago. Indian pharma players may prefer to wish away this emerging scenario, but at their own peril.

Conclusion:

The Indian pharma industry is currently passing through a phase of transition to move into the digitized world. Just doing digitally whatever is being done manually now or earlier, won’t suffice, any longer.

Giving shape to a robust, comprehensive digital strategic game plan for the organization, as a whole, is the need of the hour. Pharma CEOs would require leading their respective core teams to the drawing boards for charting out this digital pathway, without further delay.

This would be a game changer, as constantly delighting the stakeholders with the best possible value addition in business, emerges as the primary means for sustainable organizational excellence. Long term success in this effort, would call for constant upgradation of the state of the art digital platforms and tools.

This is sine qua non to pharma success in the digitized world – offering a strong foothold as the new paradigm ushers in. Envisioning, what all-round excellence in business would entail in a rapidly evolving digitized world, and championing its effective implementation on the ground, sooner, is now a critical accomplishment factor for pharma CEOs in India.

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.

Indian Pharma: Optimism, Concern and Retaining Trust

Posted on October 9, 2017 by Tapan Ray

As many would know, the significance of trust is profound. It is virtually all-pervasive. Building trust is fundamental in retaining any relationship – be it in the family, society or even in business, such as pharmaceuticals. For long-term success and sustainability of any enterprise, trust is of strategic importance, and will continue to remain so.

In that sense, it is interesting to note that a growing number of Chief Executive Officers (CEOs) of a variety of corporate business entities, including pharmaceutical and also from India, have started experiencing a new challenge in a new paradigm, more than ever before. The rapid pace of evolution of the state of the art technology is further complicating the quagmire. CEOs, in general, are realizing the hard way that ‘in an increasingly digitalized world, it’s harder for businesses to gain and retain people’s trust’, keeping their nose to the grindstone of the conventional business process.

This feeling has been well-captured, among other issues, in the 20^th CEO Survey titled, “Gaining from connectivity without losing trust”, conducted by PwC. The participating CEOs mostly believe that social media could have a negative impact on the level of trust in their industry over the next five years. With this trend, ‘as new technologies and new uses of existing technologies proliferate, they envisage new dangers emerging – and old ones getting worse.’ 1,379 CEOs were reportedly interviewed from 79 countries, including 106 from India in PwC’s 20^th CEO Survey.

In the context of Indian pharma sector, the above finding is unlikely to raise many eyebrows, rather be construed as an obvious one. In this article, keeping the above as the backdrop, I shall discuss what the Indian CEOs recently expressed regarding their near-term business performance. After analyzing their confidence level on business growth, together with critical concerns, I shall try to gauge the quality of interconnection between the critical success requirements for business growth, and the optimism they voiced, drawing relevant data from PwC’s 20^th CEO Survey, and other important sources.

Indian CEO confidence in business growth:

CEOs confidence, or optimism or pessimism about the business growth prospect of their companies is often used as a measure of ‘Business Confidence’. Financial Times defined ‘Business Confidence’ as “an economic indicator that measures the amount of optimism or pessimism that business managers feel about the prospects of their companies/organizations. It also provides an overview of the state of the economy.” A score above 50 indicates positive confidence while a score above 75 would indicate strong positive confidence.

According to published data, ‘Business Confidence’ in India increased to 64.10 in the first quarter of 2017 from 56.50 in the fourth quarter of 2016 with an. average 58.08 from 2005 until 2017, reaching an all-time high of 71.80 in the first quarter of 2007, and a record low of 45.70 in the third quarter of 2013.

More recently, as per Press Release dated September 22, 2017 of the National Council of Applied Economic Research (NCAER), ‘Business Confidence’ Index fell by 2.5 per cent in July 2017 over April 2017 on a quarter-on-quarter basis, for different reasons.

PwC’s 20^th CEO Survey, by and large, captures similar optimism, as it says: “Nearly three quarters of India’s CEOs are very confident about their company’s prospects for revenue growth over the next 12 months as opposed to 64% in the previous year. In terms of optimism, CEOs in India surpass their global counterparts (38%) and their counterparts in China (35%) and Brazil (57%).”

Interestingly, as the report says, the motivation behind high CEO optimism is primarily driven by those factors, which are being widely discussed, at least, over a decade, such as favorable demographic profile, rising income levels and urbanization.

A mismatch:

Remarkably higher confidence level of the Indian CEOs on business growth, as compared to their global counterparts, is indeed encouraging. Nevertheless, while exploring the reasons behind the same, a glaring mismatch surface between high level of CEO optimism and their concern on uncertain economic growth, as PwC’s 20^th CEO Survey indicates. 82 percent of Indian CEOs expressed concern about uncertain economic growth in the country, in this study. A staggering 81 percent of them perceive over-regulation and protectionist policies and trends, as serious threats to their growth ambitions. Intriguingly, 64 percent of CEOs in India are concerned about protectionism as opposed to 59 percent globally, as the report flags.

The concern about uncertain economic growth in the country has also been voiced by many economists. For example, in an article, published by The Times of India on October 04, 2017, Ruchir Sharma – Chief Global Strategist and head of the Emerging Markets Equity team at Morgan Stanley Investment Management, wrote: “The global economy is enjoying its best year of the decade, with a worldwide pick up in GDP and job growth, and very few economies have been left behind. India is one of the outliers, with GDP growth slowing and unemployment rising.”

Sharma further added: “The Organization of Economic Cooperation and Development (OECD) says that all 45 economies that it tracks will grow this year, the first time this has happened since 2007, the year before the global financial crisis led to a worldwide recession. Moreover, three quarters of all the countries will grow faster this year than they did last year; India is in the slumping minority, with GDP growth now expected to decelerate this year.”

This mismatch throws more questions than answers.

Wherewithal required to meet expectation:

It goes without saying that Indian CEOs must have required wherewithal to achieve whatever growth they think is achievable in their respective businesses. Besides financial resources, this will also involve having both, soft skills – which are basically ‘people skills,’ and the hard skills – that include an individual’s technical skill set, along with the ability to perform specific tasks for the organization.

A. Soft skills:

Indian CEOs identified ‘leadership’, ‘creativity and innovation’, ‘adaptability’ and ‘problem solving’ as the four important soft skills required to achieve the key business goals, according to the 20^th CEO Survey, as quoted above.

A mismatch:

Here again, a strong mismatch is visible between the ‘importance of the skill’ and ‘Difficulty in recruiting people with skill’, as experienced by the CEOs:

Skills	Importance of the skill	Difficulty in recruiting people with skill
Leadership	98	73
Creativity and innovation	95	74
Adaptability	98	66
Problem solving	99	64

(Source: PwC’s 20^th CEO Survey)

B. Hard skills:

Adaptation of any technology involves people with required hard skill sets in any organization. Currently, various state of the art technology platforms and tools, including digital ones, are absolutely necessary not just in areas like, research and development or manufacturing, but also for charting grand strategic pathways in areas, such as sales and marketing.

This is quite evident from PwC’s 20^th CEO Survey data. While 76 percent of Indian CEOs participating in the survey expressed concerns about rapidly changing customer behavior, 77 percent of them highlighted the need to create differentiation in their products and offerings, by managing data better. Both these can be well addressed by digital intervention. Interestingly, 81 percent of CEOs in India have stated that it is important to have digital skills, and 66 percent have already added digital training to their organizations’ learning programs.

A mismatch:

The intent of having adequate hard skill, such as digital technology, within an organization is indeed laudable. However, here too a key mismatch stands out regarding their overall perception of the digitizes word. This is evident when 73 percent of CEOs participating in this survey felt that it is harder for businesses to keep and gain trust in an increasingly digitized world.

On the contrary, a 2017 report of EY, titled ‘Reinventing pharma sales and marketing through digital in India’ says: “Digitization can not only enhance trust, transparency and brand equity, but also generate new revenue streams beyond the pill.”

The report further says: “Since 2000, digital disruption has demolished 52% of Fortune 500 companies. These companies have either gone bankrupt, been acquired or ceased to exist. The pace of transformation has increased, competition has intensified and business models have been profoundly disrupted. This shift is happening at breakneck speed across industries, and pharma can no longer be an exception. Customers have already embraced technological changes, through their many digital touch points, and pharma must look toward digital to re-imagine the customer experience. The urgency of acting is acute. It is time that pharma companies in India took a step back and re-envisioned digital as a core strategic enabler.”

I am, therefore, not quite sure about the thought process behind this perception of the CEOs in the digitized world. Instead, by increasing business process transparency, digitized world helps gaining and retaining trust not just of the customers, but all stakeholders, including the employees and the Government, further strengthening the relationship. This is now a well-established fact.

Conclusion:

While analyzing the optimism of Indian CEOs for business growth in the near future, alongside the key concerns, it appears, they are quite perturbed on retaining trust of the stakeholders, especially the customers. More importantly, a telltale mismatch is visible between their level of business confidence, and the reality on the ground – including wherewithal needed to translate this optimistic outlook into reality.

Such incongruity, especially in the Indian pharma sector, calls for a quick reconciliation. Ferreting out relevant facts for the same, I reckon, will be the acid test for evaluating the fundamental strength behind CEOs’ confidence for near-term business growth in India.

In tandem, reasonable success in creating a high degree of trust and transparency in the DNA of their respective organizations, will undoubtedly be pivotal for this optimism coming to fruition. The name of the game for business excellence in this complex scenario is – breaking status quo with lateral thinking.

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.

Pharma’s Late Realization

Posted on August 14, 2017 by Tapan Ray

Technology, by and large, is impacting almost every part of our life. Interestingly, some of these, like mobile phones and desktop computers, found their initial uses, mostly as trendy status symbols of relatively rich and high ranking corporate honchos, before getting merged as essential tools in our everyday life, as it were.

Today’s digital world empowers people to virtually doing anything – literally, such as getting an online education, communicating with people – both in audio and video format, getting any routine medical test or household work done, transferring money, making any bill or other payments, buying travel-theater-concert tickets, or ordering any item online from home or wherever one chooses to, besides umpteen number of other things. A large global population now spends more time on communication in the virtual world, than face to face communication with physical presence.

Similarly, application of technology, especially digital, has radically transformed for the better, the way several companies in many industries have rewritten their respective playbooks of critical business processes. It starts from the generation credible data of humongous volume, critical analysis of those before initiation of the planning process, spanning across the endpoint of making consumers pay for the products or services willingly, while achieving both financial and non-financial business goals. In tandem, available cutting edge digital technology is being leveraged by these companies for developing both new products and processes, including the rejuvenation of many stagnating businesses.

Whether the pharma industry, as well, has started leveraging digital technology optimally or not, was discussed in the A.T. Kearney Report – “New Medicine for a New World, Time for Pharma to Dive into Digital”. It aptly captured the overall situation in this area for pharma a few years ago, by saying: ‘Pharma’s customers increasingly live and interact in a digital world. The industry has been dipping a toe in the digital waters, but now it’s time to take the plunge.’

In today’s article, I shall discuss on the current-status in this area, as some respected pharma veterans, still nurturing ‘traditional thought pattern’, keep displaying skepticism in this area, though indirectly. Nevertheless, directly they seem to keep their feet in two boats, probably for obvious reasons.

A disruptive change that can’t be ignored:

It’s a reality that we now live in a digital world. The speed of which is fast gaining momentum, and that too as a critical disruptive change agent. Interestingly, this is happening despite the existence of a digital divide, which I discussed in one of my previous articles.

That this trend is so recent has also been underscored by the above A.T. Kearney Report. It reemphasized, the way we interact has changed more in the past 10 years than in the previous 50, and this change is reshaping the society itself. It’s hard to believe that apps, social media, and everything that surrounds them date back to no earlier than 2007. With the expansion of interconnected Internet-enabled devices, the boundaries between the real and the virtual are increasingly getting more obscure.

When it comes to pharma industry, as various research studies highlight, an intriguing cautious approach for embracing digital prevails, unlike many other industrial sectors. This is despite facing numerous challenges in navigating through external business environment, and meeting stakeholders’ changing expectations.

“But the industry has now reached a tipping point: it has to put an end to hiding behind the challenges of engaging with its stakeholders digitally and stop treating digital as an add-on to existing operations. Rather, it needs to embrace a digital first engagement model with fundamental consequences for its organization and capabilities,” suggests the above A.T. Kearney report.

This fast-evolving disruptive change, I reckon, can only be ignored at one’s own peril. Nonetheless, the good news is, some pharma players have now slowly but surely, started embracing digital to transform their business processes, in search of excellence.

‘Digital India’ initiative to facilitate the process:

Recognizing the increasing importance of digital even across the public space, on July 2, 2015, ‘Digital India’ campaign was launched by the Government of India. This is intended to ensure the availability of public services for all, by making everybody in the country digitally-empowered. The campaign is expected to make India a leader in digitally delivering health, education and banking services, according to information released by the government.

It is generally expected that the creation of a robust digital ecosystem within the country, would facilitate the Indian pharma players, as well, while leveraging this state of the art technology for a quantum leap in business productivity.

The current status – Global pharma industry:

The July 11, 2017 article titled, “Pharma turns to big data to gauge care and pricing”, appeared in the Financial Times, highlighted an interesting point. It described, how the global pharma industry, which has been slow in responding to the fast-evolving digital environment, is now realizing its critical importance. This reckoning gets more strengthened, as it confronts tough external challenges, such as pricing pressures, huge volume of patient data, and more empowered consumers. The article also points out, how digitization has started changing the way pharma players used to interact with doctors, patients and other important stakeholders.

The seriousness in approach of several global pharma majors in leveraging digital technology, to take a quantum leap in the business productivity, is fast increasing. It is evident from the leading drug makers seeking out different skills and personality traits in employees to lead such digital transformation.

Moving towards this direction, Germany based Merck appointed its first chief digital officer, last year. The person holds a degree in biomedical engineering, with a tech background. Following a somewhat different approach, Boehringer Ingelheim – Europe’s biggest private pharma player, hired a new Chief Financial Officer from Lufthansa, who oversees a new digital “lab”, recruiting data specialists and software developers.

Similarly, Swiss drug major – Novartis, also appointed its global head of digital business development and licensing. The head of Human Resources of the company has reportedly expressed, “We’re already seeing how real-time data capture can help analyze patient populations and demographics, to make it easier to recruit patients for clinical trials, and how real-time data-capture devices, like connected sensors and patient engagement apps, are helping to create remote clinical trials that aren’t site-dependent.”

GlaxoSmithKline (GSK) too, reportedly employs more than 50 people to run webinars with physicians – a “multichannel media team” that did not exist five years ago. It has also begun hiring astrophysicists to work in research and development, keen to deploy their ability to visualize huge data sets. According to GSK, these qualities are especially important as the company seeks to use artificial intelligence to help spot patterns and connections amid a mass of information.

That said, global pharma industry still has a considerable distance to cover before it exploits digital technology as successfully and automatically as many other sectors, the article concludes.

The current status – Indian pharma industry:

Veeva Systems Inc.– a leader in the cloud based software for the global life sciences industry, has well captured in a recent report the current status of the Indian pharma industry on the adaptation of digital technology in business.

The report titled ‘The Veeva 2016 Industry Survey: Digital in Indian Pharma’ focuses on the current state of application of digital technology in the business processes of pharma companies in the country. The survey represents the views of respondents from commercial excellence, marketing, sales and IT at domestic and multinational pharmaceutical companies operating in India.

It highlighted, though the pharma companies have remained mostly Rep centric, several of them now realize the importance of increasing focus on customer engagement. Moreover, while the desired access to important physicians has gone down, expectations of the Health Care Professionals (HCPs) have increased, significantly. Alongside, the Government is bringing in more regulations, besides price controls.

The report also captures, though digital technology is slowly making way in the pharma marketing tool kit, it has been more an incremental effort to various Sales Force Excellence projects of the respective companies.

The key findings of the study are as follows:

Nearly two-thirds of respondents agree digital is yet to become a part of their overall pharma DNA, and one-third believe digital is well integrated within their organization.

While companies have initiated digital activities in various silos, one-third of the respondents believe these are tactical in nature, rather than strategic.

21 percent of respondents feel digital should be driven by management, along with 24 percent voting for Digital Marketing. However, with customer relationship at the core of business activities, 31 believe Sales Force and Commercial Excellence are also responsible for the transition.

With integrated digital strategy, pharma companies aim to increase customer touch points through multichannel (93 percent) and improve customer engagement (79 percent). The other benefits of integrated approach are a greater competitive advantage, reduce execution gaps, improve content creation and delivery, and enrich customer data.

59 percent of the respondents believe the industry will see a digital transformation in the next 1-3 years.

69 percent of survey respondents agree it’s time for Indian pharma to think about digital strategically.

The top two challenges that pharma companies face in institutionalizing digital were identified as

Organizational readiness
Lack of digital as a strategy

This latest India specific survey brings to the fore that pharma players will have to move over from patching up old systems or building incremental solutions. They need to realize that digital opportunity is not an incremental approach.

Keeping this in perspective, the study suggests that pharma companies’ approach to digital needs to change substantially in India. This is essential to truly leverage the power of digital that will open the new possibilities to more meaningfully engage, communicate, and be relevant to all the stakeholders for business success.

The traditional face to face “visits” are just not enough for desired productivity, and deriving an adequate return on investments. On the contrary, a time has come to critically evaluate whether various Sales Force Excellence programs are producing increasingly diminishing rate of return on investments, Therefore, this communication process ought to be augmented with innovative digital interventions, for the reasons explained earlier.

With a few organizations leading the way, digital is expected to become a mainstream conversation, ultimately. Thus, Indian pharma players need to think about digital from a long-term perspective, as opposed to the current way of setting short term goals, which may actually become barriers in your digital success, as the survey concludes.

Conclusion:

Pharmaceutical industry, in general, is yet to keep pace with many other sectors, first in acknowledging the game changing power of digital technology, and then adopting it with a crafty application of mind. Nevertheless, the good news is, some drug companies, especially in the global arena, have increased their focus in this area, as elaborated above.

In India, as the recent survey indicates, over 66 percent of respondents admit that digital is yet to become a part of the overall pharma DNA, while the remaining ones believe that digital is well integrated within their organization. Interestingly, even in that group, many would require moving over from patching up old systems or building incremental solutions. It is important for them to realize, sooner, that digital opportunity is not an incremental approach.

‘Digital India’ campaign of the incumbent Government, assures fast strengthening of desirable digital ecosystem in the country. Expected consequential strong wind on the sail must be made use of, effectively. As the saying goes ‘better late than never’, pharma’s late realization of the game changing power of digital technology is much better than no realization at all, which many naysayers indirectly pontificate, of course, under a facade.

By: Tapan J. Ray

Rebalancing Skill Sets In Pharma Sales And Marketing

Posted on May 29, 2017 by Tapan Ray

A disturbing trend against much needed more job creation across the world, has been well captured in a May 2016 MIT article. It concluded through several complex mathematical models that: “As more tasks performed by labor are being automated, concerns that these new technologies will make labor redundant have intensified.”

However, despite well-hyped concerns in this area, ongoing rapid advancement of technology and other related innovation haven’t yet caused any alarming level of unemployment anywhere in the world, nor it possibly will. Several instances of gradual reduction in the number of routine and traditional jobs due to such automation, are generally related to a lesser level of hard skill sets. As we shall see below, many industries require doing so in the modern times, for long term sustainability of business.

In tandem, promising high tech jobs requiring state or the art hard skill sets are getting created too, though are fewer in number. Nevertheless, the number of brilliant startups has increased by manifolds, during the same period. This change is inevitable, mostly in any science and technology driven industry, e.g., banking sector, where most of human operated bank tellers have made way to ATM machines.

A recent vindication:

Vindicating this point, as it were, on May 18, 2017, Reuters reported that Swiss pharma major Novartis, as a part of its “ongoing global transformation” initiative launched last year to create a unified operating model, will cut around 500 traditional and routine jobs in Switzerland, and add 350 in high-tech areas. Immediately thereafter, for similar reasons, the company announced the elimination of another 250 jobs in the United States.

Jobs are important to all for a living. Any job loss, irrespective of the nature of business compulsion, is indeed unfortunate. That said, whether we like it or not, such evolving trends are the stark realities, and expected to continue or even accelerate in the years ahead for higher growth in productivity, especially involving the routine and traditional tasks.

Pharma industry, though a science-based one, loss of routine and traditional jobs due to technological advancement is fortunately still much less as compared to other similar industries. This is primarily due to the continuation of the traditional business models in the pharma sector, requiring a huge number of human intervention, which call for a different balance of soft and hard skill sets.

However, crystal gazing the future, it appears quite likely that there will be a strong need to rebalancing the required soft and hard skills in the drug industry. The contour of my discussion in this article will be on pharma sales and marketing.

Skill – the ability to do something well:

The Oxford dictionary defines ‘skill’ as ‘the ability to do something well’. Similarly, the term ‘ability’ has been defined by it as ‘possession of the means’. Thus, ‘skill’ means ‘possession of the means to do something well’. It is an absolute must in all professions, including pharma sales and marketing.

Skills broadly fall into two categories – hard and soft skills. Hard skills involve specific knowledge and teachable abilities that can be defined and measured and are usually quantifiable.

Hard skills are individual proficiency in various scientific, technical, mathematical and even some artistic areas of creation, besides other related ones. In pharma sales and marketing arena of the near future, these include, among others, robust scientific knowledge-base to understand various aspects of drug molecules, content creation with astute market understanding, data generation and analysis through state of art analytics and research, software programing, digital savviness and social media expertise. Many of these skills are related to the Intelligent Quotient of an individual.

Soft skills, on the other hand, are less tangible and quantifiable, such as etiquette or personality development; work ethics, getting along with people, ability to listen patiently, overcoming objections, persuading others and a deep sense of accountability. Many of these skills are usually related to emotional intelligence of an individual.

Which one is more important?

Both hard or soft skills are useful, valuable and important. However, the mix of these two skills for high performance of any individual professional will generally depend on success requirements of a job in a specific macro business environment.

That said, it is important to note that most of the hard skills are taught and learnt mostly before a person’s entry into science, technology or various other craft or design based jobs. The related hard skills are essential for getting selected for specialized jobs. Whereas, softer skills are usually learned on the job, and through experience by all those who want to grow in the profession.

In this context, it may not be a bad idea for all pharma sales and marketing professionals to take a hard look at our own current soft and hard skill sets again, against rapidly changing demands of the business environment. Regardless of where we are now, it will be worth writing down on a piece of paper the type of each of these two skills, in order of their strengths, that we individually possess, which are good enough for achieving sustainable excellence in business performance and personal career progression. It may provide a broad sketch of where we stand today in the VUCA world.

The years ahead for pharma won’t be quite the same:

A strong wind of change has already started signaling that the years ahead for the pharma industry, won’t be quite the same as the bygone years nor like what it is today. Some, industry professionals have picked up this cue, while many are still in pursuit of replicating the traditional past with some digital tweaking here and there, whatever may be the reasons.

The current mix of skill sets of the sales and marketing professionals, quite perceptibly, tilts more towards sharpening the softer skills of the employees, as the traditional pharma business models prompt so.

Future need – rebalancing the skill sets:

To be a successful in the days ahead, pharma companies would need to dive deep into the cyberspace – just to be on the same wavelength with its important stakeholders, including, the Government.

Looking around, one witnesses many patients going digital at a faster pace than ever before. They enjoy the cyberspace while embracing the new ways of living life, such as – communicating digitally, chatting in WhatsApp sharing patient’s experience, interacting with online patient communities, and preferring data mining to know more about anything of interest. These activities also get them a sense of the differential advantages of various health care products, services and their cost, before or while consulting doctors and deciding what they can afford.

Similarly, many medical professionals are also not depending solely on the company representatives now to get relevant details on any medicinal product, device or services. Besides frequent interaction with their peer groups, they get such detail information from various websites run by independent, and credible expert groups.

Thus, one of the common arena for pharma stakeholder engagement and interaction would soon be the enigmatic Cyberspace. As the changing days come nearer, there is likely to be greater emphasis on the acquisition of talent having specialized hard skills in this area of sales and marketing.

This emerging scenario prompts rebalancing the mix of soft and hard skill sets with much greater care, and hire young sales and marketing professionals, accordingly to give shape to it. This process should commence now, as the present makes way for the future. This is so important because, the current trend of tweaking with many digital tools and devices mostly as interfaces, or for complementing in-person product detailing or for better field management, or even to draw up marketing and sales plans, may not yield the desired business results any longer, even for survival, as we move on.

Becoming digital natives?

According to the 2015 A.T. Kearney Report titled, “Time for Pharma to Dive into Digital”, pharma sales and marketing professionals must also become digital natives, providing content that is both up-to- date and appropriate for multiple digital channels. Moreover, they will have to be familiar with advanced analytics to monitor and measure actual consumption pattern, besides capturing in real time a huge sample of relevant data for deeper customer insights.

The new normal:

One of the biggest challenges would be in the approach to content development and management. Creating an interactive detailing toolbox for truly responsive customer engagement, requires a good deal of thought and quite complex coding. This would necessitate centralization of marketing content production, which is traditionally decentralized in many sales and marketing organizations. Similarly, the major focus of the sales force will shift from maximizing physician-call rates, to becoming a team of digital communication specialists, and coordinators who would ensure that the right channels are used at the right time.

As the November 2016 Accenture Report titled, ‘The Rebirth of The Pharmaceutical Sales Force’ underscores, the most successful pharmaceutical sales teams in the future will be those willing to define and servicing customers in new ways… and will use digital advances to change the conversation, and position themselves as committed to helping physicians improve health outcomes.

This expected change, I reckon, will put in place a new normal for pharma sales and marketing success in the years ahead.

In conclusion:

Young aspirants wanting to make a career in the pharma industry, may wish to take note of this evolving trend of inevitable changes. They may wish to get well-considered views on the same of a couple of experts’ having no conflict of interest, for a careful and independent personal assessment. These budding strivers should realize that the final actionable decision on developing requisite hard and soft skill sets for a successful take off in their respective working lives, should preferably be taken only by themselves, and none else.

An August 2015 article of McKinsey & Company titled, “The road to digital success in pharma” articulates that the pharma companies, though can play a central role in the digital revolution of healthcare, are running hard to keep pace with changes brought about by digital technology. But soon there may not be any other option left for achieving business excellence.

While the nation is taking strides to transform itself into ‘Digital India’, the pharma companies operating in the country can’t possibly afford to remain far behind. Willy-nilly, they will soon need to realign their business processes accordingly, as there may not be any further scope for individual pharma players to operate within the same old cocoon of tradition bound activities, and still survive.

To meet the new and tougher demands for excellence in pharma sales and marketing, the urgent need of the changing time lies squarely outside the box. To usher in a requisite transformation in the current business model, it calls for a series of well-calibrated, much researched, and bold steps – skillfully rebalancing the crucial soft and hard skill sets, achievable within a realistic and self-determined timeframe.

By: Tapan J. Ray

Indian Pharma To Stay Ahead of The Technology Curve

Posted on May 22, 2017 by Tapan Ray

In the ever-changing business environment, many industrial sectors have now started leveraging different cutting-edge technological platforms to improve overall strategic and operational effectiveness, keeping a sharp focus on better stakeholder engagement for greater customer satisfaction.

These companies have accepted the inevitability of a paradigm shift in the algorithm of the traditional business process. It has dawned on them that it may not be possible to be in the pole position by tweaking the existing process with multiple incremental changes – a time is just right now to take a quantum leap in this direction. Placing the company ahead of the technology curve to acquire the critical X-factor in outperforming the competition is going to be the new mantra. This is likely to happen even in the sales and marketing domains, much sooner than one can possibly imagine, as the marketplace becomes increasingly tougher.

Moving closer to this direction, Artificial Intelligence (AI) based digital tools, I reckon, is likely to be one of the key game changers. The term AI was coined in 1956 by John McCarthy at the Massachusetts Institute of Technology (MIT) and is usually defined as the science of making computers do things that require intelligence when done by humans. AI helps to ferret out critical answers to many real-life issues and gain a competitive edge in business management, by creating and then effectively analyzing a huge pool of real life data.

AI is the fulcrum of business operations for several leading companies of the world, such as, Apple, Amazon and Uber. It has already started replacing human intelligence in a number key business operations in various industries. As a widely-known Indian business leader recently said, anything that can go digital will go digital. This wave is unstoppable in this modern era.

In this article, I shall restrict the scope of discussion to the application of AI in pharma sales and marketing.

A recent illustration from India:

The application of AI via a digital tool, called Chatbot – the short form of ‘Chat Robot’, is one of the ways in this direction. It is a complex computer program that simulates human conversation, or chat, through auditory or textual methods. Various industries have now started developing the Chatbot dialog application systems for a specialized purpose of human communication, including a variety of customer interaction, information acquisition and providing a range of customized services to the target group.

To illustrate the above point, let me draw upon a recent example from the banking sector of India. On March 05, 2017, a leading bank in India announced the launch of an AI-driven Chatbot named Eva, coined from the words Electronic Virtual Assistant (EVA), to add more value to their services for greater customer satisfaction.

According to reports, Eva is India’s first AI driven banking Chatbot that can answer millions of customer queries on its own, across multiple channels, immediately. It assimilates knowledge from thousands of sources and provide answers in a simple to understand language format in under 0.4 seconds. This is a good example of taking a quantum leap in improving operational efficiency by delighting the new generation of customers. “Within the first few days of its launch, Eva has answered over 100,000 queries from thousands of customers from 17 countries across the globe” – the bank reportedly claimed.

To do routine services more efficiently with a customer-centric approach, this AI-based Bank OnChat combines a disruptive technology platform for a human-like conversation, powered by AI, and the Bank’s deep domain expertise and long acquired insight of banking related customers. Earlier this year, for a similar customer-oriented initiative using AI and Robotics technologies, the same bank launched an interactive humanoid called Intelligent Robotic Assistant or IRA.

Although, these are just illustrations in the Indian context, an important question that surfaces: if these can happen in the banking industry, why not in the pharma sector of India?

Resisting changes versus finding innovative means to overcome challenges:

Coming back to the pharma industry, we all are aware that this knowledge sector, over the last four and a half decades in India, has been navigating through umpteen challenges, none of which has been easy, by any measure.

Nevertheless, as compared to the past, I notice a palpable difference today. Significantly more number of shrill voices with fierce resistance to changes are now outnumbering the out of box mindset, desire and efforts to still thrive, by overcoming those critical challenges. Since the formative years of the Indian pharma industry, it has been successfully overcoming the challenges of change, which are unavoidable though.

Such kind of indomitable ‘animal spirit’ within many leaders of the Indian pharma industry, created today’s national pharma behemoths like, Sun Pharma, Lupin, Cadila, Dr. Reddy’s, Alkem and many others. They are thriving despite continuation of immensely challenging business environment and tough socioeconomic demand in the country. By the way, the second richest person in India is from the Indian pharma industry and grew from a scratch, during this very period.

Making creative changes help, moaning doesn’t:

While facing the newer sets of challenges today, many industry greenhorns, I reckon, need to spend more quality time to effectively overcome these turbulences – provided of course they possess the requisite mindset, knowledge and other wherewithal.

Acquiring new insight through modern technological platforms, such as AI, will pay a rich dividend. Better customer engagement and relationship management with new genres of AI tools, furnishing stimulating and modern web-based content with personalized access, would help achieve the desired strategic goals in the changing paradigm – but just moaning won’t, surely.

A few global pharma players are now fathoming the scope and depth of this area, most others are still not sure about its usefulness for customer engagement and interactions, and commensurate real-life data requirements for AI related analytics.

A predictable pattern of a series of unpredictable challenges and developments:

According to Eularis, integrating AI based analytics with a pharma product offerings can provide substantial benefits including, among others, the following:

Identification of both tangible and intangible enhanced value proposition
Enhanced competitor differentiation
Optimal resource allocation for maximum market share gain, revenue and profit
Ability to see which levers to pull to maximize growth
Customizing sales and marketing messaging for greater customer engagement
Automation of sales and marketing messages and channels.

In my view, while moving in this direction, AI based analytics are now far more reliable than any human analysis of the humongous volume of different kinds of data. Doing so is sometimes beyond the capacity of any conventional computers that a marketing professional generally uses for this purpose. The prime requirement, therefore, is not just huge volume of data per se, but good quality of a decent volume of data, that a state of the art analytics would be able to meaningfully deliver to meet specific requirements of pharma marketers for creating a cutting-edge marketing strategy.

This will be an absolute necessity in the complexity of an evolving new paradigm in the cyberspace. In a similar context, as I wrote even earlier, any such technology-driven changes would usually follow a predictable pattern of a series of unpredictable challenges and developments in the business environment, which has already commenced in the pharma industry.

The Market:

According to an April 2013 article, published by the McKinsey Global Institute, applying big-data strategies to better inform decision making could generate up to US$100 billion in value annually only across the US health care system, by optimizing innovation, improving the efficiency of research and clinical trials, and building new tools for physicians, consumers, insurers, and regulators to meeting the promise of more individualized approaches.

Mandatory generic prescriptions won’t make pharma marketing less important:

Even if the much talked about mandatory prescription in generic names comes to fruition, the new paradigm won’t make pharma marketing less important. This would, however, be more about providing patient-centric, credible and tangible disease management or treatment solutions or both, rather than just selling a drug giving a trade name to it.

Thus, the need for interaction with physicians by the pharma players, besides some additional new target groups, would continue to remain important. Nonetheless, the message – mostly its form, substantive content, the targeting process and the usage of various tools for delivery of the same, would undergo substantive modifications. These changes would generally be prompted by fresh thinking, together with a fresh pair of eyes and mind, in the prevailing business environment, at any given point of time, well supported by data and tested with state of art analytics. The depth and gravity of environmental changes may also hasten the process of digital transformation of pharma sales and marketing, in various ways.

Those who are still trying harder to milk the traditional prescription demand generation process to the extent possible, despite its lesser and lesser yield, would need to introspect now, if they are able to. The time, and the prevailing pharma business environment probably demands jettisoning the conventional mindset faster, and search for the best-suited and most innovative modern tools to hit the bull’s eye. The young pharma professionals with a ‘can do’ spirit to effectively navigate through the strong headwind, are likely to emerge as early winners – provided of course their seniors and diehard ‘trainers’ don’t block their required elbow space.

‘Virtual Representatives’:

Deploying ‘Virtual Representatives (VR)’, well- supported by analytics for key target customers that QuintilesIMS is recommending, could be one among several other important examples in this area. VRs are appropriately equipped to take any doctor’s call online, for any product or related information, at any time the physicians find convenient – during or after their busy practicing hours.

The ‘push-pull’ balance between the doctors and the pharma players for such engagements can also be appropriately configured, and that too at a fraction of the current cost incurred to for similar purpose. This process and the technology used will be quite close to Chatbot, that has recently been introduced by an Indian bank, as illustrated above.

In conclusion:

Despite the rapidly changing business environment, pressing socioeconomic demands and a national dream for ‘Digital India’, the pharma industry hasn’t demonstrated any significant appetite for a change in the process of doing the business in the country. Individual players, by and large, have remained mostly consistent in strictly adhering to much tried processes and tools, though in their multiple permutations and combinations, especially in the domain of sales and marketing.

Other industries, like banking – also facing different types of tough challenges, are making efforts to stay ahead of the technology curve for operational excellence and greater consumer satisfaction. Fast scaling up of digital applications, such as Chatbots, Humanoids and the likes, vindicate this point.

Notwithstanding the availability of a large gamut of cutting-edge technological platforms, such as those based on AI, most players within the pharma industry continue to be rather slow in adopting these important and innovative resources. Could it be due to dearth of requisite talent, especially in pharma sales and marketing leadership within the industry? Well, many may argue so – some may also feel otherwise. Nevertheless, finding the right answer for a slow response of pharma in this domain still remains elusive.

That said, amid a gradually shifting paradigm, Indian pharma companies may wish to consider imbibing innovative technological interventions, such as, AI-based digital applications in sales and marketing. This has a great potential to successfully sail through many uncertainties, not just the latest one. It would also help changing the traditional ball game with a flexible, multitasking and contemporary one – right from conceptualizing – to charting out a customer-centric sales and marketing strategy – and then its immaculate execution, catapulting the company to a new and fascinating growth orbit altogether. Thus, staying ahead of the technology curve by the Indian pharma players, assumes critical importance for a long-term business sustainability, more than ever before.

By: Tapan J. Ray

Disruptive Digital Innovation To Reduce Medication Need?

Posted on May 1, 2017 by Tapan Ray

Application of digital technology in various spheres of not just business, but in our individual day to life also, promises a disruptive change for the better, from the traditional way of doing things and achieving goals – freeing a lot of precious time for us to do much more, and even faster. An impending tsunami of this digital revolution, as it were, is now all pervasive, with various digital application platforms becoming increasingly more cost effective, quite in tandem with the fast pace of cutting-edge innovation. This is so different from what is generally witnessed in the pharma business.

Interestingly, despite high demand for cost effective health care from all over the world, not much progress in this area is still visible within this industry, in general, and particularly in the pharma business. Various reasons may be attributed to this apathy, which I shall not venture to go into, today.

On the other hand, sniffing a huge opportunity in this largely vacant space, many tech giants and startups are investing heavily to make health care of people easier, and at the same time reap a rich harvest, far outpacing the big pharma players.

As I connect the different dots on world-class digital initiatives in the health space, a clear trend emerges on the global scenario. The way Internet revolution, to start with, followed by smartphones and many other wireless digital services is changing the rhythm of life for many making it much easier, is just amazing. These include a plethora of everyday ‘must-do’ and several other functions, such as, precise need-based information gathering, online banking, tax-filing, shopping, payment, social networking, cloud computing and storage, besides a gamut of other digital services.

Similar disruptive digital innovations are expected in the health care space too, involving many long-awaited patient-centric areas, such as, significant reduction in the cost of medication. I discussed a similar issue in one of my earlier articles, published in this blog. However, today, I shall focus on this specific area, in view of its possible huge impact on the traditional pharma business model.

May reduce need of medication:

That tech startups are developing digital tools that reduce the need of medication, was very recently reported in an article titled, ‘Digital disruptors take big pharma beyond the pill’ published in the Financial Times on April 24, 2017. For example, a California-based startup, has reportedly come out with a digital device, smaller than an iPhone and fitted with a cellular chip, that can keep instant and accurate track of blood sugar levels. If the readings fall in the danger zone, an appropriate text message will be automatically generated for the person, such as – “drink two glasses of water and walk for 15 minutes”. The individual can also seek further help over the telephone from a trained coach – a highly-qualified dietitian for further guidance, the article highlights.

The whiz kid developers of wearable digital devices and apps are now intently working on many innovative health care solutions. Many of these can help early disease detection, and chart the risk profile of persons prone to various ailments, based on an enormous amount of well researched scientific data, significantly reducing the need of medication through effective disease prevention and management protocols. For example, there are umpteen evidences, demonstrating that specific moderate physical exercises help control diabetes just as well as medication, when detected early.

Thus, I reckon, such wearable digital devices and apps carry a huge promise to detect many diseases like, diabetes at its very onset or even before, and influence the person to take the necessary measures. In case of diabetes, it could be like, walking a certain distance every day, along with regular dietary advices from a remote center. Won’t such digital interventions work out far cheaper and convenient than lifelong visits to physicians and administration of anti-diabetic drugs?

The notes of the pharma business playbook need to be rewritten?

Let me quickly elaborate this point with an example of a common chronic ailment, say, diabetes. For effective management of this disease, global pharma players prefer to focus on better and better antidiabetic drug development, and after that spend a fortune towards their effective sales and marketing for generating enough prescription demand. Branded generic manufacturers are no different. This is important for all of them as most patients will have to administer the medicines for chronic ailments for a lifetime, incurring significant recurrent expenses for effective disease control. The first access point of such disease management has always been a doctor, initially for diagnosis and then for lifelong treatment.

Disruptive digital innovation could change the first point of intervention from the doctors to various digital apps or devices. These digital tools would be able to check and capture the person concerned predisposition to chronic diseases like, hypertension and diabetes, besides many other serious ailments, including possible cancer. When detected early, primary disease management advice would be available to patients from the app or the device itself, such as, the above-mentioned device for diabetes. If the preventive practices can manage the disease, and keep it under control, there won’t be any serious need to visit a doctor or pop a pill, thus, avoiding any need of active medication.

In that sense, as the above FT article has articulated, ‘rather than buying a pill, people might buy an overall solution for diabetes’ can’t be more relevant. When it happens, it will have a multiplier effect, possibly impacting the volume of consumption of medicines, just as what disease prevention initiatives do. Consequently, the notes of the pharma business playbook may have to be rewritten with right proactive measures.

As reported, the good news is, at least a couple of global pharma players have started fathoming its impact. This is apparent from Sanofi’s collaboration on digital devices and patient support for diabetics, and to some extent with Pfizer on immuno-oncology, using expertise in data analytics to identify new drug targets.

The key players in this ‘healthcare value chain’:

When the digital health care revolution will invade the current space of traditional-health care, it will create both the winners and losers. This was clearly highlighted in an article titled, ‘A digital revolution in healthcare is speeding up’, published by ‘The Economist’ on March 02, 2017.

From this article, it appears, when viewed in the Indian context that primarily two groups of players are currently ‘fighting a war for control’ of this ‘healthcare value chain’, as follows:

Traditional innovators: These are pharma companies, hospitals and medical-technology companies, such as, Siemens, GE and Phillips.

Technology insurgents: These include Microsoft, Apple, Google, and a host of hungry digital entrepreneurs and startups – creating apps, predictive-diagnostics systems and new devices.

Where is the threat to traditional pharma innovators?

This emerging trend could pose a threat to traditional innovators as the individual and collective knowledge base gets wider and wider – the above article envisages. With the medical records getting increasingly digitized with new kinds of patient data available from genomic sequencing, sensors and even from social media, the Government, including many individuals and groups, can now get a much better insight into which treatments work better with avoidable costs, on a value-based yardstick. For example, if digital apps and wearable devices are found even equally effective as drugs, with the least cost, to effectively manage the menace of diabetes in the country, notwithstanding any strong ‘fear arising’ counter propaganda, as we often read and here and there, those will increasingly gain better acceptance from all concerned.

The moot question, therefore, arises, would the drug companies lose significantly to the emerging digital players in the health care arena, such as, Microsoft, Apple and Google?

Tech giants are moving faster:

In several disease areas like, cancer and diabetes, the tech giants are taking longer and bigger strides than the traditional pharma innovators. For example:

Microsoft has vowed to “solve the problem of cancer” within a decade by using groundbreaking computer science to crack the code of diseased cells so that they can be reprogrammed back to a healthy state.

Apple has a secret team working on the holy grail for treating diabetes. The Company has a secret group of biomedical engineers developing sensors to monitor blood sugar levels. This initiative was initially envisioned by Steve Jobs before his death. If successful, the advance could help millions of diabetes patients and turn devices, like Apple Watch, into a must-have.

Verily – the life sciences arm of Google’s parent company Alphabet, has been working on a “smart” glucose-sensing contact lens with Novartis for several years, to detect blood glucose levels through tears, without drawing any blood. However, Novartis has since, reportedly, abandoned its 2016 goal to start testing the autofocus contact lens on people, though it said the groundbreaking product it is “progressing steadily.” It has been widely reported that this could probably be due to the reason that Novartis is possibly mulling to sale its eye care division Alcon.

Calico, which is also owned by Google’s parent company Alphabet, has US$ 1.5 billion in funding to carry out studies in mice, yeast, worms and African naked mole rats for understanding the ageing process, and how to slow it, reports MIT Technology Review.

No wonder, why an article published in Forbes magazine, published on April 15, 2017 considered these tech giants as ‘The Next Big Pharma’. It said, ‘if the innovations of Google and Apple are another wake-up call for the life science industry, which oftentimes has relied on the snooze function of line extensions and extended-release drugs as the source of income and innovation.’

In conclusion:

An effective disease treatment solution based on different digital platforms has a key financial advantage, as well. This is because the process of generation of huge amounts of credible scientific data, through large pre-clinical and clinical trials, establishing the efficacy and safety of new drugs on humans for regulatory approval, is immensely expensive, as compared to the digital ones. Intriguingly, no global pharma player does not seem to have launched any significant digital health care solution for patients to reduce the overall cost of disease burden, be it prevention or management.

In that context, it’s encouraging to note the profound comment of the Chief Operating Officer – Jeff Williams of Apple Inc., made during a radio show – ‘Conversations on Health Care’, as reported by ‘appleinsider.com’ on January 06, 2016. During the interaction, Williams reiterated that the rapid progress of technology in this direction is very real, as ‘Apple’ and other smartphone health app developers are stretching the commoditization of computer technology to serve health sciences. In not so distant future, with relatively inexpensive smartphones and supporting health apps – the doctors and researchers can deliver better standards of living, even in severely under-served areas like Africa, where there are only 55 trained specialists in autism.

Thus, it now looks reasonably certain to me that disruptive digital innovation on various chronic health care solutions is ultimately going to reduce the need of medication for many patients, across the world, including India, significantly.

By: Tapan J. Ray

Prescriptions in Generic Names Be Made A Must in India?

Posted on April 24, 2017 by Tapan Ray

Would prescriptions in generic names be made a must in India?

Yes, that’s what Prime Minister Modi distinctly hinted at on April 17, 2017, during the inauguration function of a charitable hospital in Surat. To facilitate this process, his government may bring in a legal framework under which doctors will have to prescribe generic medicines, the PM assured without any ambiguity whatsoever.

“In our country doctors are less, hospitals are less and medicines are expensive. If one person falls ill in a middle-class family, then the financial health of the family gets wrecked. He cannot buy a house, cannot conduct the marriage of a daughter,” he reiterated.

“It is the government’s responsibility that everybody should get health services at a minimal price,” the Prime Minister further reinforced, as he referred to the National Health Policy 2017. His clear assurance on this much-debated issue is indeed music to many ears.

Some eyebrows have already been raised on this decision of the Prime Minister, which primarily include the pharma industry, and its traditional torch bearers. Understandably, a distinct echo of the same one can also be sensed in some English business dailies. Keeping aside these expected naysayers, in this article, after giving a brief backdrop on the subject, I shall argue for the relevance of this critical issue, in today’s perspective.

Anything wrong with generic drugs sans brand names?

At the very outset, let me submit, there aren’t enough credible data to claim so. On the contrary, there are enough reports vindicating that generic drugs without brand names are generally as good as their branded equivalents. For example, a 2017 study on this subject and also in the Indian context reported, ‘93 percent of generic and 87 percent branded drug users believed that their drugs were effective in controlling their ailments.’

Thus, in my view, all generic medicines without any brand names, approved by the drug regulatory authorities can’t be inferred as inferior to equivalent branded generics – formulated with the same molecules, in the same strength and in the same dosage form; and vice versa. Both these varieties have undergone similar efficacy, safety and quality checks, if either of these are not spurious. There isn’t enough evidence either that more of generic drugs sans brand names are spurious.

However, turning the point that generic drugs without brand name cost much less to patients than their branded generic equivalents on its head, an ongoing concerted effort of vested interests is systematically trying to malign the minds of many, projecting that those cheaper drugs are inferior in quality. Many medical practitioners are also not excluded from nurturing this possible spoon-fed and make-believe perception, including a section of the media. This reminds me of the famous quote of Joseph Goebbels – the German politician and Minister of Propaganda of Nazi Germany till 1945: “If you tell a lie big enough and keep repeating it, people will eventually come to believe it.”

The lower prices of generic drugs without brand names are primarily because their manufacturers don’t need to incur huge expenditure towards marketing and sales promotion, including contentious activities, such as, so called ‘Continuing Medical Education (CME)’ for the doctors in exotic locales, and several others of its ilk.

Thus, Prime Minister Modi’s concern, I reckon, is genuine to the core. If any doctor prescribes an expensive branded generic medicine, the concerned patient should have the legal option available to ask the retailer for its substitution with a less expensive generic or even any other branded generic equivalent, which is supposed to work just as well as the prescribed branded generic. For this drug prescriptions in INN is critical.

Provide Unique Identification Code to all drug manufacturers:

When in India, we can have a digitally coded unique identification number, issued by the Government for every individual resident, in the form of ‘Aadhaar’, why can’t each drug manufacturer be also provided with a similar digitally coded number for their easy traceability and also to decipher the trail of manufacturing and sales transactions. If it’s not possible, any other effective digital ‘track and trace’ mechanism for all drugs would help bringing the wrongdoers, including those manufacturing and selling spurious and substandard drugs to justice, sooner. In case a GST system can help ferret out these details, then nothing else in this regard may probably be necessary.

Past initiatives:

In India, ‘Out of Pocket (OoP) expenditure’ as a percentage of total health care expenses being around 70 percent, is one of the highest in the world. A study by the World Bank conducted in May 2001 titled, “India – Raising the Sights: Better Health Systems for India’s Poor” indicates that out-of-pocket medical costs alone may push 2.2 percent of the population below the poverty line in one year. This situation hasn’t improved much even today, as the Prime Minister said.

Although, ‘prescribe drugs by generic names’ initiative was reported in July 2015, in the current context, I shall focus only on the recent past. Just in the last year, several initiatives were taken by the current Government to help patients reduce the OoP expenses on medicines, which constitute over 60 percent of around 70 percent of the total treatment cost. Regrettably, none of these steps have been working effectively. I shall cite hereunder, just three examples:

On February 29, 2016, during the Union Budget presentation for the financial year 2016-17 before the Parliament, the Finance Minister announced the launch of ‘Pradhan Mantri Jan-Aushadhi Yojana (PMJAY)’ to open 3,000 Stores under PMJAY during 2016-17.

On August 04, 2016, it was widely reported that a new digital initiative of the National Pharmaceutical Pricing Authority (NPPA), named, “Search Medicine Price”, would be launched on August 29, 2016. According to NPPA, “Consumers can use the app before paying for a medicine to ensure that they get the right price.”

In October 2016, a circular of the Medical Council of India (MCI), clearly directed the medical practitioners that: “Every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs”

A critical hurdle to overcome:

Besides, stark inefficiency of the MCI to implement its own directive for generic prescriptions, there is a key legal hurdle too, as I see it.

For example, in the current situation, the only way the JAS can sell more of essential generic drugs for greater patient access, is by allowing the store pharmacists substituting high price branded generics with their exact generic equivalents available in the JAS. However, such substitution would be grossly illegal in India, because the section 65 (11) (c) in the Drugs and Cosmetics Rules, 1945 states as follows:

“At the time of dispensing there must be noted on the prescription above the signature of the prescriber the name and address of the seller and the date on which the prescription is dispensed. 20 [(11A) No person dispensing a prescription containing substances specified in 21 [Schedule H or X] may supply any other preparation, whether containing the same substances or not in lieu thereof.]”

A move that faltered:

To address this legal issue, the Ministry of Health reportedly had submitted a proposal to the Drug Technical Advisory Board (DTAB) to the Drug Controller General of India (DCGI), for consideration. In the proposal, the Health Ministry reportedly suggested an amendment of Rule 65 of the Drugs and Cosmetics Rules, 1945 to enable the retail chemists substituting a branded drug formulation with its cheaper equivalent, containing the same generic ingredient, in the same strength and the dosage form, with or without a brand name.

However, in the 71st meeting of the DTAB held on May 13, 2016, its members reportedly turned down that proposal of the ministry. DTAB apparently felt that given the structure of the Indian retail pharmaceutical market, the practical impact of this recommendation may be limited.

The focus should now move beyond affordability:

In my view, the Government focus now should move beyond just drug affordability, because affordability is a highly relative yardstick. What is affordable to an average middle class population may not be affordable to the rest of the population above the poverty line. Similarly, below the poverty line population may not be able to afford perhaps any cost towards medicines or health care, in general.

Moreover, affordability will have no meaning, if one does not have even easy access to medicines. Thus, in my view, there are five key factors, which could ensure smooth access to medicines to the common man, across the country; affordable price being one of these factors:

1. A robust healthcare infrastructure
2. Affordable health care costs, including, doctors’ fees, drugs and diagnostics
3. Rational selection and usage of drugs by all concerned
4. Availability of health care financing system like, health insurance
5. Efficient logistics and supply chain support throughout the country

In this scenario, just putting in place a legal framework for drug prescription in generic names, as the Prime Minister has articulated, may bring some temporary relief, but won’t be a long-term solution for public health care needs. There arises a crying need to put in place an appropriate Universal Health Care (UHC) model in India, soon, as detailed in the National Health Policy 2017.

Brand names aren’t going to disappear:

Prime Minister Modi’s assertion to bring in a legal framework under which doctors will have to prescribe generic medicines, probably will also legally empower the retailers for substitution of high priced branded generics with low priced generic or branded generic equivalents.

This promise of the Prime Minister, when fulfilled, will facilitate making a larger quantum of lower price and high quality generic drugs available to patients, improving overall access to essential medicines. Hopefully, similar substitution will be authorized not just for the JAS outlets, but by all retail drug stores, as well.

Brand names for generic drugs will continue to exist, but with much lesser relevance. the Drugs & Cosmetic Rules of India has already made it mandatory to mention the ‘generic names or INN’ of Drugs on all packing labels in a more conspicuous manner than the trade (brand) name, if any. Hence, if a doctor prescribes in generic names, it will be easier for all retail pharmacists and even the patients, to choose cheaper alternatives from different available price-bands.

Possible changes in the sales and marketing strategies:

If it really happens, the strategic marketing focus should shift – from primarily product-brand marketing and stakeholders’ engagement for the same, to intensive corporate-brand marketing with more intense stakeholder engagement strategies, for better top of mind recall as a patient friendly and caring corporation.

Similarly, the sales promotion strategy for branded generics would possibly shift from – primarily the doctors to also the top retailers. It won’t be unlikely to know that the major retailers are participating in pharma company sponsored ‘Continuing Pharmacy Education (CPE)’ in similar or even more exotic places than the doctor!

There are many more.

International examples:

There are enough international examples on what Prime Minister Modi has since proposed in his speech on this issue. All these are working quite well. To illustrate the point with a few examples, I shall underscore that prescribing in generic name or in other words “International Nonproprietary Name (INN)’ is permitted in two-thirds of OECD countries like the United States, and is mandatory in several other nations, such as, France, Spain, Portugal and Estonia. Similarly, pharmacists can legally substitute brand-name drugs with generic equivalents in most OECD countries, while such substitution has been mandatory in countries, such as, Denmark, Finland, Spain, Sweden, Italy. Further, in several different countries, pharmacists have also the obligation to inform patients about the availability of a cheaper alternative.

However, the naysayers would continue saying: ‘But India is different.’

Impact on the pharma industry:

The March 2017 report of ‘India Brand Equity Foundation (IBEF)’ states that Indian pharmaceutical sector accounts for about 2.4 per cent of the global pharmaceutical industry in value terms, 10 per cent in volume terms and is expected to expand at a Compound Annual Growth Rate (CAGR) of 15.92 per cent to US$ 55 billion by 2020 from US$ 20 billion in 2015. With 70 per cent market share (in terms of value), generic drugs constitute its largest segment. Over the Counter (OTC) medicines and patented drugs constitute the balance 21 percent and 9 percent, respectively. Branded generics constitute around 90 percent of the generic market. In my view, if the above decision of the Prime Minister is implemented the way I deliberated here in this article, we are likely to witness perceptible changes in the market dynamics and individual company’s performance outlook. A few of my top of mind examples are as follows:

No long-term overall adverse market impact is envisaged, as ‘the prices of 700 essential medicines have already been capped by the National Pharmaceutical Pricing Authority (NPPA). However, some short-term market adjustments are possible, because of several other factors.

There could be a significant impact on the (brand) market shares of various companies. Some will have greater exposure and some lesser, depending on their current sales and marketing models and business outlook.

Valuation of those companies, which had acquired mega branded generics, such as Piramal brands by Abbott Healthcare, or Ranbaxy brands by Sun pharma, may undergo considerable changes, unless timely, innovative and proactive measures are taken forthwith, as I had deliberated before in this blog.

Together with much awaited implementation of the mandatory Uniform Code of Pharmaceutical Marketing Practices (UCPMP) sooner than later, the sales and marketing expenditure of the branded generic players could come down significantly, improving the bottom-line.

Pharma marketing ballgame in this segment would undergo a metamorphosis, with brighter creative minds scoring higher, aided by the cutting-edge strategies, and digital marketing playing a much greater role than what it does today.

A significant reduction in the number of field forces is also possible, as the sales promotion focus gets sharper on the retailers and digitally enabled patient engagement initiatives.

The above examples are just illustrative. I hasten to add that at this stage it should not be considered as any more than an educates guess. We all need to wait, and watch how these promises get translated into reality, of course, without underestimating the quiet lobbying power of the powerful pharma industry. That said, the long-term macro picture of the Indian pharma industry continues to remain as bright, if appropriate and timely strategic interventions are put well in place, as I see it.

In conclusion:

It is an irony that despite being the 4th largest producer of pharmaceuticals, and catering to the needs of 20 percent of the global requirements for generic medicines, India is still unable to ensure access to many modern medicines to a large section of its population.

Despite this situation in India, Prime Minister Modi’s encouraging words on this issue have reportedly attracted the wrath of some section of the pharma industry, which, incidentally, he is aware of it, as evident from his speech.

Some have expressed serious concern that it would shift the decision of choosing a specific generic formulation of the same molecule for the patients from doctors to chemists. My counter question is, so what? The drug regulator of the country ensures, and has also repeatedly affirmed that there is no difference in efficacy, safety and quality profile between any approved branded generic and its generic equivalents. Moreover, by implementing an effective track and trace system for all drugs, such misgiving on spurious generic medicines, both with or without brand names, can be more effectively addressed, if not eliminated. Incidentally, reported incidences of USFDA import bans on drug quality parameters and breach of data integrity, include many large Indian branded generic manufacturers. Thus, can anyone really vouch for high drug quality even from the branded generics in India?

Further, the expensive branding exercise of essential medicines, just for commercial gain, and adversely impacting patients’ access to these drugs, has now been questioned without any ambiguity, none else than the Prime Minster of India. The generic drug manufacturers will need to quickly adapt to ‘low margin – high volume’ business models, leveraging economies of scale, and accepting the stark reality, as was expressed in an article published in Forbes – ‘the age of commodity medicines approaches’. Even otherwise, what’s wrong in the term commodity, either, especially when generic medicines have been officially and legally classified as essential commodities in India?

Overall, the clear signal from Prime Minister Modi that ‘prescriptions in generic names be made a must in India ‘, well supported by appropriate legal and regulatory mechanisms – is indeed a good beginning, while paving the way for a new era of Universal Health Care in India. God willing!

By: Tapan J. Ray

Digital Divide And Indian Pharma Industry

Posted on March 13, 2017 by Tapan Ray

Over the last one and half decades of this new millennium, despite making significant headway in digital literacy, fueled by consistent progress in the penetration of broadband Internet and availability of more affordable smartphones, a large section of Indian population is still not digitally literate, not even in its importance and awareness, creating a sharp digital divide in the country.

This populace with inadequate or no digital literacy spans across a large section of our society, such as those who are generally poor, many living in rural areas, or lacking in adequate digital awareness, or exhibiting strong preferences in adhering to traditional approaches of doing things, or differently abled individuals, and many elderly persons.

In the health care arena, this citizenry constitutes one of the most vulnerable segments of the society often posing serious health risks, and mostly unable to make use of various digital tools while availing several social sector benefits of the government, as and when required.

However, more concerning is the fact that this gap is not just quite significant, there does not seem to be any near-term possibility of bridging it, either, as all accompanying responsibilities now lying on the government alone. Effective measures to bridging this gap do not depend on just technology, as the issue is multidimensional in nature, necessitating participation of all the stakeholders, pharma included – for a quantum leap in the business growth too.

This should not go unnoticed and unappreciated. Addressing this scenario effectively would call for a different strategic approach – not the usual run of the mill type ad hoc measures, both by the government, and in healthcare, also by the pharma marketers. In this article, I shall dwell in this area.

What it means?

In the modern era, the term ‘digital divide’ broadly refers to the gap between demographics and regions that have access to modern Information and Communications Technology (ICT), and those who don’t or have restricted access to it. Post late 1990s, this terminology is primarily used to describe the split between those with and without Internet access, particularly broadband.

In the global perspective, according to ‘Tech Target’ – the global network of technology-specific websites, the ‘digital divide’ typically exists between those in cities and those in rural areas; between the educated and the uneducated; between socioeconomic groups; and between the more and less industrially developed nations. Even among populations with some access to technology, the digital divide can be evident in the form of lower-performance computers, lower speed wireless connections, lower-priced connections, such as dial-up, and limited access to subscription-based content. The report also points out, while adoption of smartphones is growing, even among relatively lower-income groups, the cost of various data plans and the difficulty of performing tasks and transactions on smartphones continue to inhibit the closing of the gap.

To a large extent, this is applicable to India, as well.

It’s not just a technological issue:

Bridging the ‘digital divide’ in health care is not just a technological issue. It’s rather a complex one with many dimensions. It also depends on the health literacy of individuals, or a society, or the location where they live in. The World Health Organization (WHO) defines health literacy as: ‘The cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health.’

This is not just the ability of a person to understand the health messages, it also involves the individual’s ability to look for the required information, and taking further action accordingly. As a December 2016 study of Michigan State University Extension concludes, those who are more likely to experience low health literacy are, older adults, racial and ethnic minorities, people with less than a high school diploma, people with low income levels, facing language issue for communication and those with compromised health status, such as chronic health conditions. Culture and access to resources also affect people’s health literacy. Another October 2016 study published in the Journal of Medical Internet Research, establishes the connection between low health literacy and the skepticism on health technologies.

Effectively bridging ‘digital divide’ alone, may not resolve the issue of health literacy. Neither, just addressing the health literacy can bridge the gap of ‘digital divide’, effectively. Thus, there isn’t any ‘one size fits all’ type of solution, to address both these issues, for a synergistic outcome in improving affordable access to quality health care for all.

Bridging the ‘Digital Divide’:

That said, bridging the digital divide, especially in the healthcare segment, has immense relevance in the modern days. As PwC’s Global Digital IQ Survey report of May 2016 observes, health care is arguably one of the world’s most information-intensive sectors, and the opportunities to improve quality, encourage affordability and enhance the consumer experience are vast. Wider application of digital technology can help this sector tackle many of these pressing challenges, effectively. However, the sector is currently behind the curve, the report highlights.

According to another 2016 report by PwC on Indian healthcare, the digital connectivity of the country is expected to grow from 15 percent access in 2014 to 80 percent access in 2034, with rural Internet users increasing by 58 percent annually, which presents a great potential for telemedicine and remote diagnosis in the country. This is indeed encouraging.

Can pharma industry hasten the process?

As I said before, bridging the ‘digital divide’ and improving health literacy, may be construed by many as a primary responsibility of the Indian government, through various robust initiatives backed by allocated budgetary provisions. Nonetheless, in the realm of healthcare, I reckon, pharmaceutical and other related industries can significantly help hastening the process, not just as a social responsibility, but for significant growth in businesses, simultaneously creating a win-win situation for all.

Just to cite an example out of many, various pharma companies can set up ‘digital health information kiosks’ especially in those areas where awareness and participation of the local population related to healthcare issues are poor or suboptimal. These ‘digital health information kiosks’, providing various diseases or treatment related information that a pharma company may be interested in, can be set up at convenient locations, of course, with the approval of local authorities. Such information, should encourage people to seek more and more health information digitally, explaining the whole process, and at the same time persuading them to take available disease prevention measures. and advising them to visit doctors, to initiate early treatment, wherever necessary.

I repeat, this is just an illustration, there could several other ways of achieving the same result.

Increasing relevance:

For healthcare, the above trend would mean empowering most of the population to have unfettered access to knowledge in various health related fields, especially in prevention, management and available treatment options, for various diseases, encompassing both acute and chronic conditions. Thus, this process has the potential to create a significant snowballing effect, not just on

deeper penetration of telemedicine, but also on remote diagnosis in India. In tandem, leveraging this trend early enough and in innovative ways, is likely to enable the pharma players to provide a much-needed boost to their respective business ventures.

Advantage pharma:

Rapid transformation in the complex market dynamics, coupled with increasing challenges in making productive face to face interaction with important doctors for prescription generation and consequent fast decline in the economic outcome of traditional product detailing, is likely to hasten this metamorphosis. On the other hand, this change also brings a blessing in disguise for the pharma players, by opening many new doors of opportunity based on digital platforms, and thereby paving the way for reaping a rich harvest, for all those who will choose to be early adopters.

In the above context, intimate business involvement with the digital world in many areas, such as ‘digital sales and marketing’ assumes a high priority for Indian pharma players, just as it’s being imbibed by some global players, including many in other industries. The speed of its becoming the centerpiece in pharma sales and marketing strategy formulation process ought to be directly linked to the increasing speed of broadband Internet penetration, smart phone and other digital platform usages by people of all ages with enquiring mindsets. Thus, the destiny’s call is clearly ‘Advantage Pharma’.

Key benefits:

According to a paper of April 16, 2014, published by Salford Business School, Manchester, UK, the major benefits of ‘Digital Marketing’ are as follows:

It helps businesses to develop a wider customer base as it does not rely on physical presence or interaction.
It encourages customers to interact directly with businesses.
It is not limited by conventional opening times – customers can interact at a time and place convenient for them

Calibrated increase in usage of digital platforms:

It is worth noting, traditional methods of sales and marketing, barring a few exceptions, are currently prevailing in the Indian pharma industry. In this scenario, each pharma player, must carefully evaluate its current and future product-mix, along with customer types and base, as they would decide, first to initiate, and then to scale up their sales and marketing operations in the digital space in a well-calibrated manner.

In this new ball game, the fresh entrants would need to consider only the credible research-based data, on the rapidly changing aspirational mindset of young Indians, including doctors and patients, with smart phones being a key enabler, on the one hand. While on the other, these should provide optimal digital penetration in different geographical regions or areas, together with the usage of platforms and related demographic configurations.

For example, if a region shows high smartphone usage for community or group chat within the general population, a pharma company may explore the possibility of creatively designing a smart phone based ‘digital patient chat group’ as a part of its patient engagement initiative. In this ‘digital patient chat group’, the members suffering from chronic or even acute ailments can discuss with each other the issues for which one is seeking a solution, where even the pharma companies can intervene, wherever they can add value and is legally permissible.

The effectiveness in working out a game changing crafty blend of both brand and patient-centric communication package with digital tools would separate the men from the boys. It would demand top quality cerebral inputs from the pharma marketers – a requirement that is not so easily available in the current space of pharmaceutical marketing, dominated by a wide variety of freebies.

In conclusion:

Humongous digital divide in India is a fall out, predominantly of disparate availability and access to ICT, not just between those living in rural and urban areas, but spans across several other areas such as, between educated and uneducated people, demographic and economic classes, to name a few. Nonetheless, especially, since the last one and a half decades, the country has made significant headway in gradually reducing this gap, though a lot more ground is yet to be covered in this direction.

Today in India, we witness even various political parties, which used to be very traditional in their approaches have started using a wide variety of digital marketing tools successfully by deploying astute domain experts, to achieve their goals.

For the healthcare sector, including the pharma industry, this progress throws open many doors of opportunities, both for the public, as well as for the industry. Notwithstanding this digital divide and general prevalence of an overarching traditional behavior and response patterns, displaying visible apathy or inability to embrace the promises of the emerging cyber era, several doctors and patients have already started reaping the benefits offered by various digital platforms, tools and media. The regulators governing this sector, are also not lagging far behind, with their presence visible in the digital space too, including social media.

This challenge of change should be effectively leveraged by all stakeholders in healthcare, reaping a rich harvest. Like many other constituents in this intricate, yet interesting ball game, pharma industry too needs to assume an active, pragmatic and proactive role in several innovative ways.

Flooring the gas pedal to move into the digital space of healthcare, would provide significant competitive and commercial advantages to the early movers, more than ever before. When political narratives can be made more productive by embracing the digital platforms, why not the business narratives of the pharma industry in India?

By: Tapan J. Ray

PILMAN

A Tapan Ray Website

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Digital Divide And Indian Pharma Industry