Vladislav Gurin :: BioTech & Pharma consulting

How branding affects drug prescription

Editor-in-Chief — Thu, 14 Aug 2008 20:52:08 +0000

Brands create value both for the company and to those that decide to use them. This is done by a dual quest of differentiation on tangible dimensions but also on intangible dimensions.
This quest is often not simultaneous: most brands start as the mere name of a product innovation. Once they achieve success, they are copied and the intangible dimension created by the communication of brand identity creates a form of protection: products may be similar but consumers choose one brand instead of another. This is the effect of habit, of proximity, of leadership and pioneering aura, and essentially of the need for reassurance. However, protections do not last: there is a need to recreate a material differentiation by innovation that delivers tangible benefits through improved products or services.
Very few sectors demonstrate the value of branding as much as the pharmaceutical sector. This sector is dominated by the ideology of progress through science. Those prescribing drugs are rational and make what they perceive as the best choice for the patient. Normally this should imply a product-driven market, in which brands are a forbidden word.
Recent research has shown however that medicines have a personality, as do all brands.
‘Personality‘ means that both generalist physicians and specialists find it possible to attribute human personality traits to medicines.
Not only did they not refuse to answer questions about brand personality, but statistical data analysis showed that some of the personality traits they ascribed to drugs were correlated with prescription levels.
You will see that the anti-ulcer medicines that are most prescribed are described as more ‘dynamic’ and ‘close’ than other forms of medication. A product, an active ingredient cannot be dynamic or close; a brand can. Thus brands of drugs do have a mental existence and influence in the minds of the prescribers. Interestingly too, although they recognised the products themselves as being totally identical and saw two brands as fully similar in the functional benefits they delivered, respondents prescribed one three times more frequently than the other. However the chosen one was endowed with significantly more ‘status’ than the less chosen one. Status is an intangible dimension created by impressions of leadership, of presence, of proximity to the doctors, of intensity of communication. It is created by marketing once the drug has been developed. Once created, this serves as competitive edge against ‘me-too’ products, at least before a new drug replaces the existing one as market leader.
This example illustrates the fact that even in the high-tech sector, brands are a psychological reality, which operate even in the context of rational decision makers who are disposed to make optimal rational decisions.
Choice is always a risk: products increase the range of choice, and thus of perceived risk.
Brands make choice easier by reducing the likelihood of choosing alternatives to the market leader.
The choice of the English word ‘likelihood’ here is interesting because it implies both a statistical concept (probability) and the mediating process by which alternatives are being more chosen (they are more ‘likeable’).
Branding is thus a consumer-oriented response to the problem of decision making in opaque and dense choice environments.
Brand spontaneous awareness and positioning (linking to a need) are short cuts that are very helpful for decision making. Brands do create a decisional bias: as such they facilitate choice and reduce perceived risk.
These examples illustrate the relationship between the product and the brand: there is a natural interaction between them. Brand mission determines what products or services should be created. These innovative products endowed with a value-adding identity create attractiveness, and encourage trials, repeat sales and loyalty despite incoming copies and low-cost alternatives. However, new disruptive innovations may shift clients’ value curves, hence change their preferences. This means that the brand cannot be defended only through intangible values: even the much admired Jaguar brand went broke and had to be bought by Ford to enable it to regain the capacity to make high-quality and hightech cars for today’s exacting new affluent consumers.
Prescription therefore typically follows a ‘two-steps flow of influence’ model.
Communication with leaders creates status and reputation, which then makes it necessary for people to be informed about this brand that everyone is talking about: familiarity with the product follows this desire
created by its reputation. Tomorrow, for certain chronic illnesses, it will be even easier to carry out direct to consumer (DTC) information advertising, mentioning the laboratory and the active ingredients of the drug, but not the brand.
Today, the role of the internet in the dissemination of information to patients, who know more on the subject than their general practitioners do, and interrogate them about the new brands and compounds, is being measured. When updating this research, the patient’s own point of view should be included as a new lever in medical prescription. Thanks to the internet, patients arrive at their doctor’s office already well informed: they have heard about this treatment or that drug on a blog, a forum, a website, in a women’s magazine and so on.
Doctors need to generate loyalty among their clients and are reluctant to act against the patient’s wishes, even if they can. For chronic illnesses, the patient’s feelings on the unpleasantness of the treatment also play a part. Price should also be integrated as a new lever: in fact, the preoccupation with reducing health expenditure is now shared by doctors themselves.
Another studies showed how certain facets of the laboratory’s image can directly influence medical prescription. This is why, in today’s global drug marketing, it is first necessary to establish the laboratory’s credibility, one country at a time. In this way it can then enjoy the source effect.

Value-added influencers

Editor-in-Chief — Mon, 26 May 2008 21:47:28 +0000

The more complex a product becomes, or the higher the value ascribed to it, the greater the opportunity for value-added influencers to make a significant impact.

Consumers are influenced consistently and substantially by professionals. The real choices or decisions facing us are too difficult to take. We need shortcuts. Sometimes their advice is sought, other times it comes at us uninvited. Nevertheless, consumers listen to. It’s easier if the expert makes the decision for us. The professions that customers listen to are varied, not restricted to the white collar professions. They are listed below:

Doctors
Lawyers
Financial advisers
Builders
Teachers
Journalists
Academics
Taxi drivers
Hairdressers
Dentists
Gardeners
Architects
Council officials
Hotel concierges
Travel kiosk staff

Especially in the biotech, biochem, pharmaceutical and medical sectors, the role of specific academics can be extremely influential. Not only do some educational institutions play a prominent part in the day-to-day fabric of some sectors, but the major vendors lean heavily on their academic links in order to leverage the kudos of perceived thought leaders. Besides academics are rarely even considered by sales or marketing staff as having any effect on a company’s profits and expectations. They’re often wrong. The answer is that we tend to believe people with expertise and professional standing. Academics have been proven for decades to be heavily influential.

When you start branding…

Editor-in-Chief — Tue, 06 May 2008 21:30:51 +0000

Unlike the product launch, the brand launch is, from the very beginning, a long-term program.
Such launch will modify the existing order, values and market shares of the category. It aims at establishing a new order and different values and at impacting on the market for a long time. This can only be achieved if people are convinced of the brand’s absolute necessity and are ready to give it all they have.
In order to keep staff, management, bankers, clients, opinion leaders and salespeople mobilised for the long term, the company must be driven by a real brand project and a true vision. The latter will indeed serve to justify, internally and externally, why the brand is being launched and what its essential purpose is.
Creating a brand implies first drafting the brand’s programme, which underlies the brand identity and positioning. Presenting the brand in a programmatic format (Table 1) is fruitful.

Table 1. Underlying the brand is its programme.

1. Why must this brand exist?
What would customers be missing if the brand did not exist?

2. Global vision.
What is the brand’s vision of the product class?

3. Ambition.
What does the brand want to change in people’s lives?

4. What are our values?
What will the brand never compromise on?

5. Know-how.
What is the brand’s specific know-how? Its unique capabilities?

6. Territory.
Where can the brand legitimately provide its benefit, in which product categories?

7. Typical products or actions.
Which products and actions best embody, best exemplify the brand’s values and vision?

8. Style and language.
What are the brand’s stylistic idiosyncrasies? Its semiotic invariants?

9. Reflection.
Who are we addressing? What image do we want to render of the clients themselves?

It indicates where the brand stems from, where it draws its energy, what big project lies behind the brand. This is useful as a step in the brand thinking process itself, before the brand identity prism and brand positioning are defined.
Many brands no longer know why they exist, so they would be quite unable to answer questions such as those in Table 1 defining the brand programme. Such questions reflect a philosophy at the opposite of niche tactics.
Only those who are driven by a grand project within can actually set out on the long trip of brand making.

Project management skills in R&D

Editor-in-Chief — Sun, 27 Apr 2008 18:36:29 +0000

Having dealt with the selection and evaluation of projects for R&D, the steps in the Innovation Chain and the importance of time compression management in the introduction of new products with particular emphasis on the managerial skills that are essential. Of the many skills required in Project Management the following are the key:

Team Selection and Management
Project Definition
Resource Allocation
Methodology: Planning and Controlling

Another possible way of looking at this is to imagine it as a complex of WHAT, WHEN, WHO and HOW questions to be answered:

WHAT is to be delivered by the project?
WHEN is it to be delivered?
WHO is going to deliver?
HOW is it going to be delivered?
What CONSTRAINTS are there on the project?
WHEN will they be placed?
WHO will place the constraints?
HOW will they be applied?
What RESOURCES will be required?
WHEN will they be required?
WHO will supply the resources?
HOW will they be supplied?
WHAT will control the project?
WHEN will control be applied?
WHO will control the project?
HOW will we know the project under CONTROL?

Amazing nutritional guideline for health and longevity

Editor-in-Chief — Sun, 27 Apr 2008 17:18:59 +0000

The aim in composing this article is to share with you simple, but critical, steps for keeping up an optimal quality of life throughout your lifetime, regardless of your current age and the genes that you inherited from the parents. In fact, if you begin to follow the suggestions, within days and weeks you will most likely experience the following, no matter how old you are:

An increase in your energy levels
An enhanced enjoyment of the life and daily activities
A noticeable upsurge in the sharpness of your mind
A stronger sex drive

Your pathway to optimal health and youthful vigor via nutrition may differ from someone else’s, depending on your individual preferences and the foods available to you:

Improve the heart-healthiness of your diet. Both French fare and a Mediterranean diet offer distinct health benefits. Particularly, the latter diet with its high content of olive oil, fish, and red wine is heart healthy.
Eat fish at least 4 times per week. An increased intake of essential omega-3 fats may reduce your risk of heart disease, memory loss, and other health problems. Good types of omega-3-rich fish include salmon, mackerel, sardines, and herring.Drink alcohol in moderation. One to two alcoholic drinks per day appear to be more beneficial than none, but don’t drink in excess of this amount.
Eat at least three to five vegetables and two to three fruits a day. Choose colorful fresh or frozen produce, and eat whole fruits rather than drinking juices that lack fiber.
Increase fiber-rich foods in your diet. Fiber lowers blood sugar levels and cholesterol. Good sources include berries, dried beans, prunes, whole wheat bread, brown rice, bran, fruit, vegetables, and nuts.
Drink plenty of liquids. Try to drink at least four to six glasses of liquid each day, and eat foods with higher water content, like melons and vegetables.
Spice up your foods. Onions, turmeric, black pepper, cinnamon, ginger, thyme, cumin, oregano, basil, sage, curry, and garlic all have positive effects on health.
Eat more yogurt. The probiotic effect of yogurt with live cultures may improve your health by preventing illness andlimiting inflammation.
Consider using select herbal or other remedies. A limited number of herbal preparations may be effective in treating specific problems, such as ginger for vertigo and alpha-lipoic acid for diabetic neuropathy and possibly memory loss.

Experience with Direct-to-Consumer Advertising

Editor-in-Chief — Sun, 09 Mar 2008 11:18:06 +0000

Prior to the passage of the U.S. Federal Food, Drug and Cosmetic Act in 1938 that legitimized physicians as “learned intermediaries” and required a physician’s prescription for a pharmacist to dispense a drug to a consumer, Direct-to-consumer advertising (DTCA) was the overwhelming communications vehicle for promotion. Following passage of the 1938 legislation, DTCA declined sharply. The 1962 Kefauver-Harris Amendments to the Federal Food, Drug, and Cosmetic Act shifted regulatory jurisdiction from the U.S. Federal Trade Commission (FTC) to the U.S. Food and Drug Administration (FDA), which to this day has responsibilities for regulating prescription drug promotional materials, both for physician- and consumer-oriented promotions.

The 1962 amendments outlined basic requirements for acceptable prescription drug marketing: Prescription drug promotional materials cannot be false or misleading; they must provide a “fair balance” coverage of risks and benefits of using the drug; they must provide a “brief summary” of contraindications, side effects, and effectiveness; and they must meet specific guidelines for readability and size of print. After some controversy involving the DTCA of an anti-arthritic drug in 1982, the FDA asked industry to comply with a “voluntary” moratorium during which time the FDA would assess the impact of DTCA on public health. In 1985 the FDA announced that the combination of current regulations and the Kefauver-Harris Amendments was sufficient to enable it to adequately regulate DTCA so as to protect public health, and that hereafter DTCA would be required to meet the same standards and criteria as promotional material aimed at health care professionals.

For a number of years, the FDA interpreted the “brief summary” provision as requiring the advertiser to provide the detailed information contained in the drug’s FDA-approved product labeling, thereby confining it to print form, typically in small print. However, under FDA regulatory precedents, there were two conditions under which firms could avoid the “brief summary” in TV advertising: first, if the advertisement were “help-seeking” in that only disease symptoms were mentioned, but no name of any drug was given, and the other was when only the name of the drug was mentioned without specifying its indicated use.

As DTCA began to grow in the mid-1990s, the FDA’s regulatory discretion was tested, and thus in 1997 the FDA felt obliged to clarify its regulation of prescription drug advertising, particularly for television ads. According to the FDA’s 1997 guideline clarifications, instead of requiring the lengthy “brief summary” taken from the product label insert, advertisements now needed only to include “major statements” of the risks and benefits of the drug, along with directions to information sources in addition to a physician, such as a toll-free phone number or a Web site.

The level of DTCA has increased considerably since 1994 (Tab. 1). The growth trend has been quite steady, and in particular there appears to be no material change in the slope of the trend line following FDA publication of the 1997 clarifying guidelines. After leveling off in 2002, by 2003 total DTCA spending increased to about $3.2 billion and to $4.1 billion by 2004, with most of the growth consisting of television advertising.

Table 1. Prescription drug promotion expenditures

	1996	2001	2002	2003
Physician office detailing	26.8%	25.2%	25.1%	17.2%
Hospital detailing	6.0	3.7	4.1	3.2
Retail value of free samples	53.5	54.9	56.2	63.4
Medical magazine advertising	5.0	2.2	2.1	1.7
Direct-to-consumer advertising (*DTCA*)	8.6	14.1	12.5	14.5
Total	99.9	100.1	100.0	100.0
Total promotion expenditures (in millions, mid-2000)	$9,764	$18,617	$20,379	$24,460

The Future of Customer Service

Editor-in-Chief — Tue, 04 Mar 2008 19:35:00 +0000

I believe that we are on the precipice of a new age that I like to think of as the Customer Service Revolution (CSR). Technology is influencing our live more than at any other time in history. But the technological advances we have experienced in the last twenty years are almost nothing compared to those that will occur in the next decades.

Customers literally have a world of choices. I purchase pharmaceuticals from the other side of the world on a regular basis. I do work for clients thousands of miles away simply with the click of a button. Things happen quickly and people expect fast service.
Small businesses can look like large corporations with some smart promo packages and a good website.
As business owners and operators we all have access to new and developing markets and new sources of customers. It doesn’t take a lot to start and run your own business. Pay a few fees and register a name, and bingo — you are a business owner and operator. This means that we are all facing increased competition, and I believe that the competition we face today is nothing compared to the competition we will face tomorrow.
As competition for market share becomes tougher, manufacturers and suppliers have to be highly competitive in their pricing if they want to stay in business.

But the main thing that gives one business an advantage over others is customer service.

Those businesses that are smart enough to realise that their future success lies with increasing levels of customer service will prosper in the coming decades.
The consumer backlash against having to stand in long queues in banks, dentistries, pharmacies and other institutions, or against being put on hold for long periods of time, is allowing room for smarter operators to come in and develop their own market share simply by offering better levels of service at the same price.

Customers today are time short and demanding.

They know that they have choices, and they are prepared to take their business elsewhere if the service is poor or prices aren’t competitive.
I believe that more customers are lost through lousy service than through poor pricing. If people don’t return your phone calls, don’t deliver on time and don’t thank you for your business, you will take your business elsewhere. And once a customer is lost, it’s very hard to get them back.
So, while this is a testing time for many businesses, there are also enormous upsides.

Customer service is one of the easiest and cheapest ways to improve in any business.

Normally it involves just changing the way things are done. As the Customer Service Revolution goes on, your business can either grow stronger and be a leader in your field, or it can be left behind to wallow with the majority of others.

But finally it’s up to you, dear readers, remember you and only you are the final decision makers. That’s why I would like to wish you to succeed in your business, choose the right way, just go ahead of the future and simply stay the leader in your area.

Sincerely yours,

Vladislav Gurin,
Editor-in-Chief

General concepts of Drug manufacturing

Editor-in-Chief — Mon, 25 Feb 2008 15:05:12 +0000

The manufacture of pharmaceuticals is a complicated process, comprising numerous steps leading from raw materials to finished formulated product. That finished product is the API (active pharmaceutical ingredients), and it is this product, along with the necessary inert ingredients, packaging, and labeling, which the FDA licenses.
A drug manufacturer’s plan for producing a given medicine, which must pass muster with the FDA before the agency permits its distribution, contains a number of steps:

Planning — A strategy for ordering the raw materials.
Sourcing — Choosing the suppliers that will deliver the goods and services. Suppliers could be domestic or international.
Making — This is the manufacturing step. Manufacturers schedule activities necessary for production, testing, packaging, and delivery. Manufacturing is also the most timeintensive portion of the supply chain. Manufacturing involves making the API and its conversion to the final dosage form, as mentioned above. More than one manufacturer may be involved, and manufacturing can take place in the United States or abroad. A pharmaceutical company may contract several chemical steps to foreign firms and then import the resulting intermediate compounds needed to complete the manufacture of the API domestically. The manufacturer can also outsource the manufacture of the API abroad; when it does so, the FDA closely monitors those plants. Conversion of API to the final dosage form may occur domestically or be “outsourced’’ to a foreign plant.
Delivering — This is the “logistics’’ portion of the manufacturing and supply plan. Companies coordinate the orders from customers and choose transporters who carry the product to customers, such as wholesale distributors and pharmacies. Finally, the pharmacy dispenses the finished medicines to patients.
Returning — This is the system for receiving defective and excess products back from customers and supporting customers who have problems with delivered products (including reimbursement).

Did you meet Customer Service Passion?

Editor-in-Chief — Mon, 25 Feb 2008 11:57:06 +0000

Some businesses hold it and some don’t — a passion for customer service is one of the foundations of a really wealthy business. It’s hard to say where it originates from, or how you maintain and develop your Customer Service Passion (or simply CSP), but without passion and commitment to customer service it just doesn’t appear to work.
It’s like standing in a queue at the drugstore for 30 minutes and reading over and over the sign on the wall that says ‘We value your business and save you time’ or ‘Our customers are the heart of our business’; it just doesn’t feel true.

Customer Service Passion is about doing the little things that show that your business is entrusted.

Customer Service Passion is a commitment.

It has to begin at the top of an company and work its way through the whole team. Everyone in the customer service loop needs to be made aware of what the business wants to achieve and of the level of customer service that is expected. A company might have great products at great prices, a simple and effective ordering system, friendly staff and so on, but it can be let down by one person from staff on the warehouse floor who packs the goods poorly, or by a delivery truck driver who dresses like a slob, constantly has a cigarette hanging out of his mouth and has an attitude about where he will and won’t make deliveries.

Customer Service Passion can be developed.

If you can make your team see the benefits of offering excellent customer service, you will win them over. Of course, leading by example is the best way to illustrate this point. Show your staff your customer service passion and they will pick up on it. Soon it will spread through the entire company’s business, becoming second nature to everyone. Your customers will definitely notice this positive change.

The top ten reasons for losing balance

Editor-in-Chief — Mon, 25 Feb 2008 11:27:39 +0000

This is a great question and one that we would all answer a little differently. Balance means something different for each and every one of us, and to find out what it means for us is the first step to achieving it.

For some people it means no stress at all, having everything in perfect order, living a perfectly healthy life, feeling energised, calm and under control.
For others - it is cutting back the workday from 18 hours to 14 hours, the number of coffees from 10am to 5 pm. . . You get the picture.
This is not an article with scientific approach about spiritual enlightenment, but a practical advice (step-by-step tips) to help you find your own balance between your business and other aspects of your life. As you work through it you will form your own mental picture of how you would ideally love your life to look and feel.

The following list identifies the ten reasons for getting out of Work & Life balance. Of course, there are many more, but these are the biggest most common culprits:

Overwork — simply putting in too many hours and being a slave to your business.
Financial problems — struggling to make ends meet in the business and worrying about how you will pay your bills.
Overcommitment — agreeing to do giant work for too many people and not leaving enough time or energy for yourself.
Poor stress management — not knowing how to manage your own stress or not being able to admit that it is a problem.
Relationship — with partners, family and friends, co-workers and customers.
Poor lifestyle — eating badly, lack of physical exercises, and alcohol and drug abuse.
Lack of direction — feeling trapped and isolated in the business and uncertain about your future direction or goals.
Lack of bounds — being too accessible to too many human-beings.
No space and time to rejuvenate — no holidays, time outs, hobbies or amusements to remind you why you do what you do.
Negative environment or negative people around you every day.